What causes heart disease part 54

31st August 2018

One of the greatest problems in researching possible causal factors for any disease in humans, is that if you want to do clinical studies, you run straight into a major ethical issue ‘first do no harm’.

For example, if you believe that vaping causes heart disease, it would be extremely difficult to get the go-ahead to find ten thousand people, ask them to start vaping, and see what happens. To confirm your hypothesis, you need a significant number of people to drop dead.

Which is why almost all clinical trials, at least on humans, are designed to study interventions that are supposed to make people better. Of course, ethically this is a good thing, but it does make it extremely difficult to prove causality – for sure. Which is probably why Bradford Hill, in one of his famous nine criteria for causation stated the following ‘Experiment’. Occasionally it is possible to appeal to experimental evidence. (More on Bradford Hill later)

In effect, when we try to study causal ‘risk factors’ for disease, we are normally forced to rely on epidemiological, or observational evidence. We can look at risk factors in populations, but we can’t touch. At least we can’t touch, if we are trying to create the disease we are studying. This is why you get so much conflicting advice on, just to pluck a topic from thin air, diet.

However, there are times when you get a chance to look at a causal agent in action, as with smoking. On other occasions, the window opens by accident. A drug is being used to treat condition X, and you find it triggers disease Y. This recently happened with Proton Pump Inhibitors (PPIs) such as omeprazole.

PPIs were recently found to interfere with NO synthesis1. As readers of this blog know, NO is vitally important for endothelial cell health, preventing blood clots, and endothelial progenitor cell (EPC) production in the bone marrow. Knowing this, you would expect that PPIs would increase the risk of CVD. At least you would expect that, if you believe that lowering NO is likely to cause CVD.

As some of you know, I wrote a blog on this very issue and, yes, people prescribed PPIs have a significantly increased risk of CVD – almost a doubling of risk. Not that this has had the slightest impact on long-term omeprazole prescribing, anywhere.

Of course, you can argue that the data on PPIs did not come from an interventional clinical study, specifically designed to prove that PPIs cause CVD. You are never going to get one of those. However, in a world of imperfect evidence, this is the next best thing to experimental evidence. A drug that should, theoretically, cause CVD, causes CVD.

Moving beyond PPIS, there is another class of drug which could have a far greater impact on CVD. Before I get to it, I should remind everyone that the hypothesis I am outlining in this blog is that CVD is caused by three interlinked processes:

  • Endothelial damage
  • Clot formation at the site of damage
  • Repair of the clot/damage.

These things are going on, all the time, in everybody. Atherosclerotic plaque growth – and potentially fatal blood clots – occur when damage > repair. Greater damage is caused by such things as: PPIs, or smoking, or air pollution, or raised blood glucose levels, or lead poisoning, or high blood pressure, or vitamin C deficiency, or sickle cell disease – and suchlike. However, you can also tip the balance towards plaque formation in the opposite way, by impairing the repair systems. Ensuring that: repair < damage.

One of the most important repair systems in the body consists of white blood cells, primarily monocytes and macrophages. These latch onto, engulf, and clear up the debris left by any assault of the body, including blood clots.

It is mainly the macrophages that do the heavy lifting. They destroy and digest any ‘alien’ material in the body. They start by firing a super-oxide burst at any junk in the body, which could be bacteria, or broken-down cells remnants, or what is left of blood clots. They engulf the ‘oxidised’ material, then they transport themselves to the nearest lymph nodes, where everything in them (and the macrophage itself) is broken down and, eventually excreted by the kidneys. [Or they get stuck, turn into foam cells, and die].

The other critical part of the repair system, following endothelial damage, are the Endothelial Progenitor Cells (EPCs) themselves. I have mentioned them many times in this blog. They are synthesized in the bone marrow. They cover areas of damage in blood vessels, and then mature and re-grow into a new layer of endothelial cells.

However, EPCs have another repair ‘trick’ up their sleeves. Because they are not mature cells, they can travel down other developmental pathways. Which means that they do not necessarily become mature endothelial cells, they can also transform into monocytes which, in turn, can further mature into macrophages.

Bringing all this together, if you find a drug that throws a spanner into EPC production – and thus macrophage development – whilst damaging NO synthesis and interfering with the growth of new endothelium, you will have found a drug that is almost perfectly designed to increase CVD risk.

And, yes, there is a class of drug that does exactly that and they are also, believe it or not, prescribed to humans. They are called vascular endothelial growth factor inhibitors. (VEGF-inhibitors). At one time is was thought that vascular endothelial growth factor (VEGF) was only active in the developing foetus, helping to stimulate EPCs, new endothelium growth, and driving the development of the entire vascular (blood vessel) system.

But it is now clear that VEGF still has a role in adults. It has a critical role in maintaining and helping to repair and re-grow the endothelium. Knowing this, you would expect that a drug specifically designed to inhibit VEGF could do some pretty serious damage to the cardiovascular system.

I have mentioned this class of drugs before, a few times, but I think it is worth highlighting them once more, as they provide almost perfect proof of the ‘three interlinked process’ hypothesis.

The most widely used VEGF-inhibitor is Avastin, the generic name is Bevacizumab. The mab at the end means it is a monoclonal antibody. It is an anti-cancer drug. Avastin works by inhibiting angiogenesis (‘angio’ = blood vessels, ‘genesis’ = new). Many cancers, as they grow, stimulate new blood vessel growth, which provides the tumour with the nutrients it needs. Cut the blood vessel production and the tumour shrivels and dies. This works. Avastin is an effective anti-cancer drug, and it is widely used.

Avastin is also used in macular degeneration where, in many cases, the growth of excess new blood vessels at the back of the eye (under the macula) is the problem, causing inexorably progressive blindness. With macular degeneration, Avastin is injected directly into the eyeball. (Yes, I know…ouch).

Avastin does not, as far as I can establish, seriously damage already existing endothelium – although I would imagine you would find that it does, if you looked hard enough. However, it seriously damages repair systems once the endothelium has been damaged. Therefore, it tips the scales heavily towards repair < damage. This effect has been directly studied in animals.

‘Systemic VEGF inhibition disrupts endothelial homeostasis and accelerates atherogenesis, suggesting that these events contribute to the clinical cardiovascular adverse events of VEGF-inhibiting therapies.2

That animal study was followed four years later, by a detailed review of all the clinical trials on Avastin, and the impact on ‘cardiovascular events.’. Some trials only went on for a few weeks, some were longer, lasting more than two years.

In this paper, the cardiovascular events themselves were listed in the strangest way I have ever come across. For example, we have, ‘arterial adverse events’ including arterial hypertension… is there any other sort?

Arterial adverse events’ were then further subdivided into one of the following: myocardial ischemia or infarction, cerebral infarction, cerebrovascular accident, cerebral ischemia, ischemic stroke, and peripheral or visceral arterial thrombotic events. Basically, it boils down to heart attacks and/or strokes – with a couple of other things thrown in.

Because I did not want to edit the results, I have listed them below, exactly as described in the paper. A risk of 2.40 means a two-point four times increase in the risk of something happening. This number could also be expressed as a 140% increase in risk.

The number 12.39 represents a twelve point three nine times increase in risk. Which can also be expressed as a one thousand, one hundred, and thirty-nine per cent (1,139%) increase in risk [These are relative risks].


Arterial adverse events                                  2.40 (1.64–3.52), P<0.001

Cardiac ischemia (heart attack)                      5.16 (0.91–29.33), P=0.06

Cerebral ischemia (stroke)                              12.39 (1.62–94.49), P=0.02

Venous adverse events                                 1.37 (1.11–1.68), P=0.03

Bleeding                                                          2.96 (2.46–3.56), P<0.001

Arterial hypertension                                      4.81 (3.10–7.46), P=0.001

If you read the paper in more detail you will note that the longer the trials went on for, the greater the increased risk of an arterial adverse event.

At this point I think it is time to introduce you to the full set of Bradford Hills cannons/criteria for causation. Bradford Hill was a famous epidemiologist who worked with Richard Doll to ‘prove’ that smoking causes lung cancer. Within a certain arcane world, Bradford Hill’s cannons for causation are revered. I have listed them out below, having copied this version from Wikipedia.

What you may notice is that nothing in Hill’s list is black and white. He was wise enough to know that absolute proof in something as complex as disease causation, is very tricky. Very tricky indeed. There are often contradictions, and gaps, in the knowledge. However, with Avastin, every single one of his criteria are fulfilled.

Strength (effect size): A small association does not mean that there is not a causal effect, though the larger the association, the more likely it is causal. [Avastin can cause a 1,139% increase in stroke risk in less than two years]

Consistency (reproducibility): Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect. [Every study on Avastin has shown the same thing, to a greater or lesser extent]

Specificity: Causation is likely if there is a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship. [We have a very specific connection here, with no other obvious explanation]

Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay). [There is a clear delay with Avastin, the problems only occur after the drug is given]

Biological gradient: Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence. [With Avastin we have a clear biological gradient]

Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge). [The mechanism of endothelial damage is well identified, and plausible, with Avastin]

Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that “… lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations”. [Almost perfect coherence with Avastin]

Experiment: “Occasionally it is possible to appeal to experimental evidence”. [The experiment, albeit inadvertently, has been done]

Analogy: The effect of similar factors may be considered. [Other agents that interfere with NO, e.g. omeprazole, steroids, have the same effect]

Now, whilst I am reluctant to keep harping back to the LDL hypothesis, I think it is worth asking the question. Can the LDL hypothesis explain the increase in CVD with Avastin? Answer, no it cannot. Because Avastin has no impact on LDL.

Of course, as you might expect, Avastin does increase the blood pressure (BP). If you significantly lower NO synthesis, then the blood pressure will inevitably rise. So, the classical risk factors do have something to say about Avastin – if not a great deal.

ACE-Inhibitors, such as enalapril, or perindopril, are used to keep the BP down when people are prescribed Avastin. This works, primarily because ACE-inhibitors raise NO synthesis. [Although, to be frank, I do not know if anyone involved in treating the raised BP caused by Avastin has the faintest idea that is how they work, in this case].

Anyway, if you have a hypothesis that CVD is caused by three interlinked processes:

  • Endothelial damage
  • Clot formation at the site of damage
  • Repair of the clot/damage.

Or, to be more accurate CVD is caused by any factor, or factors, that can

  • Increase endothelial damage
  • Create bigger and more difficult to shift blood clots
  • Interfere with the repair systems.

Then, your attention is bound to turn to drugs that can do one of these three things. PPIs are one, VEGF-inhibitors are another. Whilst few things are absolute in human research, the evidence linking VEGF-inhibitors to a ‘three process’ hypothesis is, I believe, compelling.

It is certainly true to say the VEGF-inhibitors are sufficient, to cause CVD, by themselves. No need for any other risk factor to be present. Does this mean that they are THE cause of CVD? Of course not, but they are A cause of CVD, and their impact cannot be explained by any of the other traditional risk factors for CVD.

What does this mean? It means we have a black swan on our hands. The blackest of black swans. An agent, that is perfectly designed to create endothelial mayhem, causes CVD, with no explanation available within the LDL/cholesterol hypothesis.

Not only that, the data on VEGR-inhibitors fits every single one of Bradford Hills cannons for causation, and that is a rare thing indeed. You might even argue that VEGF-Inhibitors have allowed us a direct and uninterrupted view of the true ‘cause’ of CVD.

1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864131 /

2: https://www.sciencedirect.com/science/article/pii/S0167527313004282

3: http://jaha.ahajournals.org/content/6/8/e006278

430 thoughts on “What causes heart disease part 54

    1. Göran Sjöberg

      Very interesting reading indeed! I agree that Gary Taubes participation may here seem disputable since the role of carbs is greatly downplayed in this article. Still the controversial stands on the “science” of nutrition and health are well pointed out when it comes to the fats of our diet.

      And, in my eyes, the absence of the logic of our physiology is just striking and the logic of which I find to be the strong point in all posts made by Kendrick.

  1. JDPatten

    To clarify the effect of Avastin in the eye:
    I believe it’s been noted in a previous blog entry that injections of the stuff locally in the eye for treating macular degeneration will not effect what happens in coronary arteries.


    1. LA_Bob


      It appears you refer to a comment from Dr K in part 48:

      “Avastin injected into the eye will not increase CVD as far as I know.”

      Disturbingly, however, there is this:

      “The decreased levels of blood VEGF after an intravitreal injection of bevacizumab indicate that bevacizumab enters the general circulation and may also affect the PEDF levels.”


      1. John

        JDPatten says, “The trick is not to get it in the first place..”. Nice thought, but how do you not get it (age related macular degeneration, AMD)?

        My wife, at the age of 71, has had significant wet AMD for a couple years, to the point of destroying part of her left retina (called Geographic Atrophy). The medical establishment offers no preventative advice whatsoever that we’ve found (for dry or wet AMD). The discovery that Avastin and similar drugs, in just the last 15 years or so, offers at least some hope of slowing or stopping the progression of wet AMD, has been a ray of hope where there was none.

        If, as the referenced abstract implies, that Avastin does enter the blood stream from intravitreal injections, well, it adds another layer of balancing risks onto a life-changing health issue already heavily laden with difficult emotions.

        Bluntly – go blind sooner, or die of heart disease younger? Not a pretty choice for anyone.

        1. Andy S

          Hi John, re “age related” diseases such as macular degeneration. I have some visual field loss in one eye. Eye doctors solution is to maintain low IOP via eye drops. My approach is to also keep an eye on mTOR via nutrition. Apparently rapamycin is used for some eye disorders. Some experts believe that chronic high mTOR activity is the cause of age related diseases.

      2. JDPatten

        I don’t know.
        Several sites I’ve investigated strongly suggest the sort of dietary tactics cited in my link above. RTCs for prevention? Couldn’t find any.
        We do the best we can do. One anecdote: My mother-in-law has lost most of the vision in one eye. Getting the injections now. Thank goodness she’s got the other. At 98, that’s about all she has going for her. Incidentally, she’s always had total cholesterol of 475 mg/dl. How that figures into the eye-thing vs the otherwise-healthy-lifespan is a guess. Everyone is different.
        Good luck to you

    2. John

      @ Leon, thank you for the link. My wife does take AREDS2 regularly. No way to know (since n=1) if it is helping slow progression or not, but there seems to be little downside.

      1. chris c

        There used to be a site which recommended various vitamins and bioflavinoids but it seems to have gone now. My mother had wet AMD in one eye and dry AMD in the other, and because they were “two different diseases” the opthalmologist said he could treat neither eye – if she had the same disease in both he could only treat the better one. What an arrogant waste of space. I found a private clinician who used Avastin but she decided to believe the doctor over her little boy. Oh well she was over ninety at the time and ended up essentially blind in one eye and half blind in the other, but think of all the money she saved the NHS . . .

  2. Göran Sjöberg

    Great logic as always!

    I am aware of the use of Avastin for cancer treatment (terminal treatments?). But what does it mean practically, e.g. in terms of survival?

    And if you are on this drug does it also mean that other endothelial damages, as from a cut, does not heal properly?

    Drugs do have side effects and that is why I myself by caution stay away from all of them if you don’t consider vitamins as harmful drugs as Big Pharma tends to do..

  3. Frederica Huxley

    Brilliant, yet again! I don’t suppose that patients prescribed PPIs and/or Avastin are ever warned of the dangers to their heart health.

    1. James DownUnder

      Yet another comfort for my minimum intake of of 6mg of Vitamin C & lysine per day.
      My guestimation using Guinea Pigs (30mg/kg) and the great apes in the wild ingesting 5 to 8 grams of C (in their food) is this 100kg human actually needs 3g per day.
      Regardless of what Big Pharma and their Fellow-Travelers say about the co$t of my urine, I feel my endothelium is well-nourished & protected.

  4. Jean Humphreys

    More to think about here, and, just for once, you speak of drug that they are not asking me to taake (yet) !

  5. Loretta Farr

    Justin, This is why your Dad will not take a PPI no matter how enthusiastically it might be prescribed.  It’s boring, but you need to read to the end.  Christian might do well to read it, too, if he has been prescribed a PPI for his LPR.  Many initials. Mom —- On Fri, 31 Aug 2018 13:12:48 -0500 Dr. Malcolm Kendrick wrote —- Dr. Malcolm Kendrick posted: “31st August 2018 One of the greatest problems in researching possible causal factors for any disease in humans, is that if you want to do clinical studies, you run straight into a major ethical issue ‘first do no harm’. For example, if you believe t”

  6. Sue Richardson

    Part 54? If this series doesn’t end up being published in book form, I’ll go to the bottom of our stairs, as we say in the North. It deserves to be.

  7. Lee Swenson Valentine

    Excellent, Malcolm. You’ve hit another one over the fence. Comments from your followers eagerly awaited.

  8. Gary Ogden

    Dr. Kendrick: Thank you for the clear explication of the Bradford hill criteria. You are, bit by bit, building a powerful case, and rapt is the attention of the jury. Another drug on the long list to avoid, Avastin. NO is surely our best friend.

    1. Leon Roijen

      ” Another drug on the long list to avoid, Avastin”

      Please read before you make such a comment. Avastin is an anti-cancer drug. If you die because you refuse Avastin, NO doesn’t matter anymore…

      1. JDPatten

        Cancer subsists on sugar. I’d like to see another RCT (which will never be done) pitting Avastin against a truly rigorous zero carbohydrate diet. An interesting third arm might involve both approaches simultaneously.

      2. Craig E

        Hi JDPattern

        The trouble is that cancer cells also use glutamine in addition to glucose. I do think there would be merit in eliminating dietary glucose sources but wonder whether the body up regulates gluconeogenesis which might override any dietary interventions.

      3. Leon Roijen


        “Cancer subsists on sugar. I’d like to see another RCT (which will never be done) pitting Avastin against a truly rigorous zero carbohydrate diet. An interesting third arm might involve both approaches simultaneously.”

        Please stop that nonsense. It’s truly ridiculous.
        While I am sure a low carbohydrate diet will prove to be of some value in the treatment of certain cancers, it certainly won’t be a cure all and can be dentrimental to many other cancer patients.

        Especially note this sentence in the text below: “Even without any carbohydrate in the diet, your body will make sugar from other sources, including protein and fat.”

        “Does sugar feed cancer?
        While researchers continue to investigate the connection between sugar and cancer, it remains a source of anxiety-inducing speculation and misinformation in the media and on the internet. Of course, the undeniable answer is that glucose (the form of sugar used most in the body) feeds every cell in the body, and is so important to the function of your brain that the body has several back up strategies to keep blood sugar levels normal. Even without any carbohydrate in the diet, your body will make sugar from other sources, including protein and fat.
        The idea that sugar could directly fuel the growth of cancer cells can lead some people to avoid all carbohydrate-containing foods. This is counter-productive for anyone struggling to maintain their weight while dealing with side effects of cancer and treatments. More importantly, the inevitable anxiety of trying to completely avoid “all sugar” creates stress. Stress turns on the fight or flight mechanisms, increasing the production of hormones that can raise blood sugar levels and suppress immune function. Both of these things may reduce any possible benefit of eliminating sugar in the first place.”


      4. JDPatten

        Thanks for your response.
        Of course, the mechanisms of the human body are more complex than we can imagine – at this point in time.
        Actually, my tongue-in-cheek RCT “idea” was bait for Leon. Would he be helpful and informative, providing citations, or would he be rude, abusive and off-putting?
        Well, both, it seems.

  9. Errett

    I’m sitting here smiling—-Black Swan—-your attacks are lethal!—so much fun sharing in your assault on the dogma—

  10. Errett


    Every cell in mammals’ bodies operates on a 24-hour cycle known as the circadian rhythm — cellular cycles that govern when various genes are active. For example, in humans, genes for digestion are more active earlier in the day while genes for cellular repair are more active at night. Previously, the Panda lab discovered that mice allowed 24-hour access to a high-fat diet became obese and developed a slew of metabolic diseases including high cholesterol, fatty liver and diabetes. But these same mice, when restricted to the high-fat diet for a daily 8- to 10-hour window became lean, fit and healthy. The lab attributed the health benefits to keeping the mice in better sync with their cellular clocks — for example, by eating most of the calories when genes for digestion were more active.

    1. Kerry Lawson

      I’m going to sign up for the clinical trial by The Salk Institute mentioned in your post at http://mycircadianclock.org/

      This is a clinical trial that uses a smartphone ap to track one’s eating, exercise and sleeping cycles.

      They did this with rats and discovered a leaner more healthy rat if he confined his eating to a 10 hour period during a 24 hour cycle.

      I already do this anyway, I fast every day, as I am working on my weight as I train for my next marathon and their free ap should help with my training documentation. I already know that I improved my half-marathon time by 55 minutes when I lost 25 pounds last year.

      I’m 69 years old and have finished 3 marathons so far and numerous half-marathons all since I started this new lifestyle in 2015. I had just retired and discovered that I had gotten overweight with high blood sugar, high blood pressure, high cholesterol and had a 60” waist.

      Dr. Kendrick’s books helped me dodge the medical pressure to “take-a-pill” to solve all my bad medical numbers. I wondered if they were all weight and life style related and started to walk on Clearwater Beach here in Florida. 4 years later and I am down 50 pounds and am drug free.

      Thanks again Dr. Kendrick and all the other posters on his newsletter who informed me of Dr. Robert Lustig, Gary Taubes, and all the other skeptical geniuses whose words changed my life.

      Kerry Lawson

      1. Mcjocko

        Hi Kerry
        I agree 100%. My life changing moment came about when reading doctoring data.(I had pre-ordered it) it was a horror story which was infact real. It forced me to be responsible for mine and my families health, I wanted to believe that doctors were God and they knew everything.
        As some people point out, we have been infantilized and programmed to trust authority. But now I had to take responsibility for my health but how? What did I know? Who could I trust? Scary! The reason it chimed with me is that I had already realised in my profession that, who outside my discipline would know which of my colleagues were competent? Nobody. Out of 10 people I worked with there were only two I would trust the rest were poor at their jobs and infact even dangerous. But at least I was competent to know this, how is it possible to know how competent others are in their professions? And especially medical professionals. After reading the book I was like a small child lost and wanted Malcolm to tell me what to do but then my natural instinct kicked in, I always want to know why things are as they are and I dig until I find the reasons and this had already made me question anything I heard or read. So why would I not do the same for my health. And so my book buying increased ten fold, most of the books I bought were due to the fantastic people on this blog and their amazing knowledge and then I discovered Twitter! Now that is like the wild west……..to sum it all up, I was ill (had glandular fever which floored me) and overweight before I started my journey all those years ago and now most people think I am twenty years younger than I am and in fact I feel healthier than twenty years ago.
        Thanks again to Malcolm and all those on this blog, today and over the last few years and not forgetting the ones who have sadly passed away.

        Salt to taste 🙂
        If only it was all about the diet!

  11. Leon Roijen

    A quick pubmed search tells me:

    “PPIs have been associated with an increased risk of vitamin and mineral deficiencies impacting vitamin B12, vitamin C, calcium, iron and magnesium metabolism.”

    NO is a problem with PPI’s, but all the nutrients named here play a role in CV-D/health, too.
    Makes it difficult to tell what contributes the most to a higher CVD risk in PPI users.

  12. lidov

    A question that connects with your ongoing series in which you explain so well why blood pressure is a major risk factor in CVD. Have you by chance been able to pull together a coherent picture of niacin hepatoxicity? If so might you share it? Niacin, especially in the possibly villainous slow release format, seems to be, otherwise, a great weapon against hypertension. Yet, I only find snatches of info, some of it obscured by what seems to be faulty indexing where I have looked so far.

    It is really heartening that you have not let your medical knowledge paralyze your gift for prose style!

  13. Leon Roijen

    This is getting VERY boring, Dr. Kendrick, and you know why? Because your case is so tight that for reasonable people it is very hard if not impossible to shoot holes in your hypothesis.
    All the evidence is there. If your case would go to court and it would be your hypothesis against the cholesterol hypothesis, a glorious victory would be yours.
    Yet in the medical world there is no justice…

    It’s always a great pleasure reading your logical, eloquent and well thought out exposés!

  14. LA_Bob

    Grand Slam August 2018! Four fascinating posts in one month, from “athero-thrombosis” through impermeability, diabetes and the glycocalyx, to Avastin and the VEGF inhibitors. Whew!

    I truly hope Dr K has the attention of one or more influential professionals in this field, because he’s publishing like he wants to draw them in before they get away!

  15. Göran Sjöberg

    I guess it is well recognized that mental “abnormal” behavior/”disorders”/diseases are linked to vascular damage – aggressive behavior being one manifestation.

    Could this be associated with acute damage to the glycocalyx in the capillaries through oscillating high/low blood sugar or insulin values?

    This issue was brought up to me this morning by all the mallards who are abundantly fed by the oat grains I put on the shore of my pond. Several of them show aggressive behavior although we are now far from the mating season. There is actually no “need” for their an aggressive behavior in my eyes.

  16. Bill In Oz

    Thank you again Malcolm for an interesting elaboration of the complexities of CVD.. I hope all cancer sufferers are warned of the side effects of Avastin..

    By the way, I was hoping to see more about Macrophages, when I read this paragraph above :

    “It is mainly the macrophages that do the heavy lifting. They destroy and digest any ‘alien’ material in the body. They start by firing a super-oxide burst at any junk in the body, which could be bacteria, or broken-down cells remnants, or what is left of blood clots. They engulf the ‘oxidised’ material, then they transport themselves to the nearest lymph nodes, where everything in them (and the macrophage itself) is broken down and, eventually excreted by the kidneys. Or they get stuck, turn into foam cells, and die.”

    The macrophages getting stuck, becoming foam cells & dying, seems to be a crucial part of the body’s inability to reduce the bulge in the artery.

    1. Bill In Oz

      No comments on this query o I will ask again : any thoughts on what to do when the repair process becomes part of the damaging process ?

      Stuck & dying macrophages in the coronary artery walls ?

  17. Göran Sjöberg


    My wife can’t stand aggressive behavior of the mallards and tells me that “The next year we should not feed them any more!” Is it that aggression is generally contagious but that the underlying “cause” is purely somatic through our physiology?

    A complex world indeed!

    Today I am going to buy a large “Falukorv” (Swedish weird speciality/staple food though) to grill at a social gathering tomorrow with our local Nature Conservation group where I am very active today in order to “Save the world” – a huge task for me now at 72. I don’t know if I will make it – though I am not alone on this task 🙂

  18. Sylvia

    We go into a lions den when visiting hospitals and GP surgeries. But, there are many who don’t question, my family members amongst them, always relinquishing freedom of thought because doctor knows best. Often the doctor does know best and wonderful treatments happen to demonstrate this. But powerful pharmaceutical products don’t fix the whole body.
    My lovely sister in law is having devastating results from RA drugs, several different ones, it is heartbreaking. Thank you Dr Kendrick for another terrific post.

    1. Jennifer

      Well said, Sylvia.
      Nowt on telly tonight, so I filled in the Heart Age questionnaire….What a load of carbage being fed to the masses. No wonder your (and many of our) relatives are frightened into blindly accepting what they are told in the surgeries and hospitals up and down the country. Brainwashing on such a large scale is very difficult to ignore.
      I love this site…keeps me sane ( I do believe).
      P.s. My age is 70:my heart age is 70…..questionaire’s explanations were still garbage though.

      1. Sylvia

        Jennifer as soon as cholesterol was mentioned as a possible problem, in one of the articles about this test, I thought, you are not the enlightened ones, like what we are!
        May as well just read your horoscope. Regards

      2. Frederica Huxley

        Had to go through a slew of questions to get travel insurance, but was nonplussed to be asked whether I had ever been advised to take statins! As everyone over a certain age in the country has been given this advice, what does a ’yes’ answer mean? Obviously the insurance industry hasn’t come up to date with regards to cholesterol.

  19. Ishbel Bertram

    Riveting stuff – especially as I watch my peer group enthusiastically taking their ever-increasing prescribed medicines without thinking of any potential negative consequences and believing that medication is the answer.

  20. Sylvia Brooke

    Thank you Dr. Kendrick. Yet another drug to put on our ‘never not no time’ list if ever suggested by our GP. this latest blog will keep me occupied for some time, it is fantastic.

    Off topic I’m afraid, but during that relentlessly hot weather we had recently, I had a nasty UTI and when visiting my GP to request an antibiotic which I KNEW would clear it, I was refused with the words “guidelines suggest three days on ????? will do the job”. Five days later the UTI returned with a vengeance and I again requested my preferred antibiotic from a different Doctor and was again refused but insisted that they gave me the antibiotic which I was requesting. Outcome – ten days on antibiotics when 7 days would have put me right, and costing the NHS more than originally necessary.

    The reason I raise this is that (a) I wonder if the drug I was given in the first instance was perhaps one suggested by big Pharma as I found no mention of it on any list of antibiotics, and (b) just what were the guidelines to which she referred in the first instance?

  21. Sylvia Brooke

    Just a correction to my previous comment.

    Drs. reply should have read “guidelines dictate” and not guidelines “suggest”.

  22. JanB

    Help! Another horror story in the medicine cupboard. 😨
    Another wonderfully informative and concise post for which many thanks.

  23. Mike Smith

    Another Brilliant Read Dr K. The issue I have though is what is the patient supposed to do when facing a cancer diagnosis and is aware that the drugs to treat the cancer will almost certainly lead to a massive risk of death by something else (ie stroke). For that matter as a GP, what would you do if it was you with hypothetical illness.

  24. Ian Roselman

    Many years ago a friend of my mother died suddenly of a heart attack. My mother was mystified as he was being treated for cancer, not heart disease. I guess now we know why.

  25. David Bailey

    To me, there are two worrying features of PPI’s

    1) Unlike statins, aspirin, etc they fix an unpleasant problem immediately – acid reflux. That means people may feel very positive about taking them.

    2) As I discovered, they are addictive, in the sense that when you stop taking them, you find the body has accommodated to them to some degree, and you find yourself with acid reflux!

    I guess they may be causing serious trouble, which will in turn make campaigners agitate for less salt and less saturated fat in food!

    1. Dave Chandler

      Some of us don’t have an option.I have Barretts Oesophagus and a Hiatus Hernia.I have atypical cells that could turn to cancer,my mother died from it.If it does turn cancerous I will have to have it lasered.I’m on 40 mg Omeprazole a day to hopefully control it.What are my alternatives?

      1. SW

        If you have barrett’s, drop all grains NOW. I HAD that and I have turned it around, even thought THEY said it could not be done. I posted all my reports on twitter about 2 weeks ago. I was diagnosed in 2012 with barrets and autoimmune gastritis, you can see all the histopathology and surgeons reports on twitter under my twitter name, Ozmandia …. I post all my reports. 2012 – 2018 surgeon reports and histopathology, 2005 – 2018 all HS CRP, CHOl, etc etc etc…. I am ZERO CARB pretty much. I was Low Carb for 3 years and in the last 2 years ZC. I had biopsy and pathology on stomach and esophagus since 2012.

        HS- CRP also fell from 1.9 to 0.6 …. My gastroenterologist is just amazed! SHe just did not know what to say, she said the esophagus was clear, she could not belive her eyes, then she did 18 biopsies to convince herself she was not seeing things! You will see on my report, my stomach is now ‘normal’! So you can cure with diet what a diet has caused. Good Luck! ( It took 5 years to clear, so do not wait!) I nevr took Nexium or anything, Dr was aware of heart probs it came with ….

    2. chris c

      I was lucky (in retrospect) to be put on Famotidine – an H2 blocker – instead. Took it for years. That also causes rebound of the reflux when stopped.

      I was disappointed that the low carb diet failed to stop the acid reflux, which is commonplace – UNTIL I gave up wheat. That did the trick – also very common. Yes I know dieticians insist that you MUST eat wheat and gluten unless you are actually diagnosed with coeliac, but then nothing else they told me was true either. (Plus I no longer fart much)

      Might be worth a try?

      1. Doug from Canada

        Hi Chris, Giving up wheat to cure acid reflux is VERY common. Worked for me, also cured my wife’s IBS. Never going to touch that stuff again.

        Giving up wheat works for a lot of things. My kids are both ‘normal’ while it seems every parent these days has some horror story about anxiety, depression, ADHD etc. I try to spread the word but it seems that the only ones who will try it are the 10% who are at the end of the rope and will try anything.

        (I know, preaching to the choir but) Try it…………

      2. JanB

        Same here, chris c, regarding a cessation of wheat products. My goodness, before that happened I was jet-propelled. Such a relief all round. 😉

      3. Dave Chandler

        Thankyou SW and AnnaM,Seems I can’t to reply to your comments.

        chris c.That is interesting about Famotidine,will bring that up with the consultant.As they said I would be on PPIs for life I don’t think I need worry about rebound.I have just stopped all grains and gone LC as trying to get rid of stomache fat.It is working too.

      4. chris c

        Scary how many identical “just anecdotes” there are. I’m not sure if it’s the wheat that has changed since the days when this didn’t happen or if it is something else like being marinated in glyphosate or eating massive amounts of Omega 6 oils. Personally I suspect both or all three.

      5. Aileen

        Leon, maybe the important thing to notice in what JD said is, “*not always, but often*, (the problem with acid reflux is too little acid)”. They are not saying that the problem is *always* too little acid, and the suggestion might be helpful for some people.

    3. JDPatten

      Not always, but often, the problem with acid reflux is too little acid. It’s the acid that stimulates the hiatal sphicter to close. Too little acid means leakage. In these cases increasing acidity – counterintuitively! – is the fix.

      1. Jean Humphreys

        For sure lack of acid can be the problem. I suffered for years and did all the right things and took ranitidine when it was offered. I had a sudden craving for pickled onoins with my bread and cheese, and said to myself “Sod it, I can always take a pill” That one helping of an acidic controversial food cured all the heartburn and reflux. I now make sure to eat some kind of pickle at least once a week. So much tastier than pharmaceuticals.

          1. Jennifer

            Hello, JanB. I have just moved my bottle of RAW cider vinegar from the kitchen to the condiment tray in our dining room, to remind me to use it, as I get a bit forgetful some days. My GP must be wondering why I rarely ask for a repeat prescription for Gaviscon these days, and by the way, I saw mention of Gaviscon having different ingredients according to which country it is sold in. I am pleased to say that mine does not mention aluminium as one. I very rarely use it anyway.
            Together with my raw, home made sauerkraut ( thanks again to Goran), my home made milk and water kefirs, as well as my sourdough bread, I reckon my gut has never been healthier. Dr Michael Mosely mentioned about previous generations coping with CHO foods such as grains and seeds etc, being prepared correctly by long term steeping. Those generations appeared not to suffer CHO intolerance due to their preparation of high CHO foods, and over the last 100 or so years, we have omitted this step in food prep, generally incorporating fast techniques, .and I think there is a point here about the amazing increase in type II diabetes.
            I sound as though I am playing into the hands of the foodie fads, but correct food preparation leading to a healthy gut, has a positive impact on my body’s metabolism and homeostasis, ( including heart health and acceptable glucose levels), so I do not apologise for promoting the healthy ideas I have picked up on this blog.

          2. JanB

            Jennifer – that all sounds so good. I always take some kefir on my fast days (is that cheating?) and would like to make sourdough bread to see if I can tolerate it, blood glucose-wise, better than ordinary bread. Sometimes I just LONG for some nice buttered toast, sigh.

          3. Jennifer

            JanB. If you have difficulty making sourdough, may I suggest you use the ‘old dough’ technique ( mentioned in bread books). It then takes at least 12 hours for the dough to rise, by which time the carbs are autolysed to the point of minimising the glucose effect on the body. The retrieved knob of old dough, (thus, before adding additional ingredients to complete the bread ) is made up of only flour and water…no yeast, no salt, and it then sits safely in a small kilner in the fridge for the occasional time you fancy reconstituting it for the next batch. I regard it as the easiest sourdough technique, and without eating too much, it is acceptable on a low(ish) CHO diet.
            Any positive adjustment to food prep techniques which help in reducing glucose spikes, is a good thing, especially if it means we do not feel too deprived of the comfort foods which crave.

          4. JanB

            Jennifer, how kind of you. I shall definitely give it a go. I always make bread for my husband (and don’t eat it.)

          5. Frederica Huxley

            We have kefir on our porridge or homemade granola – on IF days it is always a measured amount of kefir on porridge. This keeps us well sustained until our light meal in the evening.

        1. Gary Ogden

          Jean Humphries: Interesting. Those rare occasions I experienced acid reflux have entirely disappeared since I have been eating fermented vegetables at breakfast (about eight years now). Acidic enough, I guess.

      2. Leon Roijen

        “Not always, but often, the problem with acid reflux is too little acid. It’s the acid that stimulates the hiatal sphicter to close. Too little acid means leakage. In these cases increasing acidity – counterintuitively! – is the fix.”

        Yes, that’s the assertion by alternative medicine.
        But that’s complete nonsense – if you think it is not, then tell me why medication against gastric acid works? If your assertion were true, this kind of medication would only worsen symptoms, which is not the case.
        In reality the causes of hearburn/GERD are manifold ( https://www.rxlist.com/heartburn/drugs-condition.htm ) – and not simply a matter of “too little acid”.

    4. JDPatten

      I wonder what specific research would tell us about Barrett’s esophagus and cancer. Since it’s virtually always treated with PPIs, and PPIs cause cancer . . . which is the true culprit?? (Another RCT that will never be done.)

      1. chris c

        I’ve read that Barrett’s Oesophagus and some stomach cancers are related to helicobacter infection. Not sure how strongly this has been confirmed, or not.

  26. Andy S

    A low carb diet can reduce VEGF by inhibiting mTOR, safer than a drug.

    The mTOR/AP-1/VEGF signaling pathway regulates vascular endothelial cell growth

    “The incidence of human coronary heart disease (CHD) has recently been increasing year by year [1]. Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are the most common treatments for coronary heart disease [2]. Restenosis of the bridging vein can be suppressed by inhibiting mammalian target of rapamycin (mTOR), an atypical serine/threonine protein kinase that plays an important role in the regulation of cell proliferation [3–5].”

  27. AnnaM

    Hello people,
    I noted that at the end of the last blog a couple of people seemed worried about the recent report that meat is bad and connected to cancer. Well.
    Just a little bit of exaggeration there…check it out; it is delightful.

    1. David Bailey

      That is a superb video, because it not only blows away the actual evidence that meat causes cancer, but it also seems to more or less rubbish the theories related to the chemicals supposed to cause cancer, can actually cause cancer at the relevant concentrations.

      Georgia Ede has also written about this, which will help people who want to follow up references etc:


    2. Leon Roijen

      She starts with saying that she was able to reverse every health problem she ever had by switching to a meat-based, ketogenic diet – like such a diet would be a cure-all.
      Well, sorry, but such a silly remark immediately disqualifies her talk.

      Now the real science:

      ” Globally, on the basis of the systematic review and the meta-analysis results, a higher intake of heme iron has shown a tendency toward a positive association with cancer risk. Evidence regarding high levels of biomarkers of iron stores (mostly with serum ferritin) suggests a negative effect toward cancer risk. More prospective studies combining research on dietary iron intake, iron biomarkers, genetic susceptibility, and other relevant factors need to be conducted to clarify these findings and better understand the role of iron in cancer development.”


      But continue to eat your meat: It’s only karmic justice if some meat-eaters die because of them eating meat. I’d call it sweet revenge.
      The saddening thing is that meat-eaters are like smokers: Even if it does kill them they are not sure it’s the smoking/meat and they come up with thousand-and-one excuses.

      Even sadder is the absolute immorality of eating meat and people not getting it.
      There is no moral difference whatsoever between people slaughtering each other or animals.

      1. AhNotepad

        ”Even sadder is the absolute immorality of eating meat and people not getting it.
        There is no moral difference whatsoever between people slaughtering each other or animals.”

        Well you have made a liar out of me as I said I would not reply to any more of your posts.

        Your post, from which I have quoted, does however, raise the question, are these posts written by someone with reasoned beliefs? or are they just intended to be inflammatory (and nothing to do with healing in this instance) outbursts, as they seem rather troll like?

        There is I presume some moral justification in cutting the heads off plants and eating them, or eating their reproductive parts. Also some justification in the way agriculture’s method of operating is to kill everything except the crop being grown. This includes the poisioning of any insect or mammal species, intentionally or unintentionally, which would otherwise eat a portion of the crop. I of course am not able to uderstand this subtlety. I assume you have no items which have been made with, or from leather, anywhere in your possession.

      2. David Bailey

        Leon wrote:
        “She starts with saying that she was able to reverse every health problem she ever had by switching to a meat-based, ketogenic diet – like such a diet would be a cure-all.
        Well, sorry, but such a silly remark immediately disqualifies her talk.”

        Surely a cure-all would realate to everyone’s medical problems – she was only referring to her own. Fortunately most of us only have a few medical problems!

      3. AnnaM

        What are your qualifications to speak in such a know-it-all manner? It is a bit annoying. Too bad that you wrote off her excellent expose on the shoddy and even dishonest reporting of those studies. But it is convenient for you.

        A lot of people do get great results with keto diets, and I have run into a couple of credible people who claim that may problems cleared up with an actual carnivore diet. Now, I don’t believe that should be the norm. Rather, I think that such people have had longstanding infections with fungus and perhaps bacteria from eating lousy food or from other insults to the body, and that they become unable to cope with all but the purest of food, which I guess is meat.

      4. AnnaM


        “Even sadder is the absolute immorality of eating meat and people not getting it.
        There is no moral difference whatsoever between people slaughtering each other or animals.”

        I didn’t see this before my last reply. I probably shouldn’t have bothered as you are an extremist.
        So you think it is the same to kill a chicken and to kill the little boy next door?
        I do feel sad that the way life works is that everything is eating everything. But no species deserves to go extinct, except perhaps poison ivy. Humans need to eat such a diet that their species can survive and thrive into the future. A diet dependent upon supplements and foodstuffs from faraway places is not a natural situation. You mention ice cream, so I suppose you eat dairy. This is a copout. In order to have dairy, you must have pregnant cows, and half their calves will be male. Ditto chickens and so on.
        So far as I know, there are no successfully reproducing vegan societies anywhere. To be sure, an animal can sometimes eat what isn’t good for it such as the current sugar addiction, but the persistence of meat eating in all human groups verifies that veganism is a fantasy.

      5. Leon Roijen

        “Well you have made a liar out of me as I said I would not reply to any more of your posts.”

        Welcome back on board 🙂

        “Your post, from which I have quoted, does however, raise the question, are these posts written by someone with reasoned beliefs? or are they just intended to be inflammatory (and nothing to do with healing in this instance) outbursts, as they seem rather troll like?”

        Reasoned yes, a belief? No. That animals eat each other I can understand, they are programmed to do so and they don’t have the brains to think about this issue, often even aren’t fit for a meatless diet, biologically.
        With humans that’s very different. We have evolved, we’ve got brains we can use. We are not carnivorous, we are omnivorous and we can thrive well on a plant based diet if we choose or food wisely.
        If despite that we chose to kill other living beings, sorry, but in my opinion that is madness.
        I don’t think that is a belief. If you don’t want suffering yourself, then don’t cause it to others, animals included.

        “Also some justification in the way agriculture’s method of operating is to kill everything except the crop being grown. This includes the poisioning of any insect or mammal species, intentionally or unintentionally, which would otherwise eat a portion of the crop.”

        Humans have to eat. With meat, all you describe above happens (crops are grown for feeding animals) and then additional suffering is caused in the animals raised for meat. While that last step is not necessary.
        We have a HUGE problem here on earth: the ecological footprint of people in industrial countries is enormous and while we feed plant food (I don’t know exactly how much, isn’t it 7 kilos of plant food for one kilo of meat?) to cattle, in other parts of the world people die from hunger. Again, I think that is madness.

        “I assume you have no items which have been made with, or from leather, anywhere in your possession.”

        Your assumption is wrong 🙂

      6. Leon Roijen


        “I probably shouldn’t have bothered as you are an extremist.”

        Not all circumcised, bearded men are extremists; AnnaM – nor muslim, let me add, before you get any extreme idea.

        Quite funny that you defend the killing of innocent beings and you call me an extremist.

        And even if your crazy labelling would be justified, then I am in very good company, starting with Mahatma Gandhi followed by many others:


        “So you think it is the same to kill a chicken and to kill the little boy next door?”

        No, the difference is that you can kill a chicken without (direct) punishment but if you kill the little boy next door you would ruin your own life to say the least.
        So that’s pure egoism, in my opinion a strange foundation to build your morals on.

        Your other remarks I am not going to react to: I already addressed them in an earlier discussion.

      7. David Bailey


        I think your argument is best approached by an analogy. Suppose a man sees a gunman about to open fire on a crowd, and he rushes him and throws him to the ground, taking a wound on the way.

        His action would be very moral, but dangerous to his health.

        His other possible action – to hide – would be less moral (but utterly understandable) but more healthful.

        I can respect vegetarians and vegans, but there are two utterly different questions here, and I see no point in arguing them simultaneously.

        Furthermore, if we did all become vegans, there would be virtually no cows, pigs, or chickens. Maybe those creatures would prefer to have some time on the earth, rather than none?

        I’d like to read your honest assessment of what she said in the video – not just use a bit of rhetoric to dismiss her whole lecture. Remember, medical studies can be (deliberately) flawed in so many ways – injecting rats with a carcinogen before testing the carcinogenic properties of meat seems pretty flawed/dishonest to me. For one thing, such studies only test a small number of animals (thank goodness) and if you give all the rats a fair chance of getting cancer, you have about a 50% chance of getting more cancers among the meat eating rats. The studies that come out the other way, probably never get published, and certainly won’t get included in the WHO report!

        1. JanB

          David Bailey – no cows, pigs or chickens. Yes, and no natural fertiliser to spread on the ground for all those virtuous lettuces either.

      8. Leon Roijen

        “I’d like to read your honest assessment of what she said in the video – not just use a bit of rhetoric to dismiss her whole lecture. Remember, medical studies can be (deliberately) flawed in so many ways – injecting rats with a carcinogen before testing the carcinogenic properties of meat seems pretty flawed/dishonest to me. For one thing, such studies only test a small number”


        I didn’t talk about these things, I am not that much interested in the WHO report either: I already gave a link to a systematic review and analysis that I will repeat here:

        “Globally, on the basis of the systematic review and the meta-analysis results, a higher intake of heme iron has shown a tendency toward a positive association with cancer risk. Evidence regarding high levels of biomarkers of iron stores (mostly with serum ferritin) suggests a negative effect toward cancer risk. More prospective studies combining research on dietary iron intake, iron biomarkers, genetic susceptibility, and other relevant factors need to be conducted to clarify these findings and better understand the role of iron in cancer development.”


        Obviously I am of the opinion that iron is the biggest problem in meat eating – not only as far as cancer is concerned, but also in cardiovascular disease.
        I am not saying all this is simple and black and wite: as the researchs say: genetic susceptibility and other factors play undoubtedly play a role, too and maybe not for everybody high iron stores are a problem. Of course here the notion of “personal medicine” gets interesting. But as long as we don’t know all the factors there can’t be personal medicine relating this topic and it would be wiser to eat less (red) meat and avoid high iron stores, I think.

      9. Leon Roijen


        “I can respect vegetarians and vegans, but there are two utterly different questions here, and I see no point in arguing them simultaneously”

        Of course in my opinion they can be treated simultaneously:

        1. Vegetarians with a varied and well composed diet can be perfectly healthy – there is little scientifical doubt about that

        2. The point above only makes a stronger case for not unnecessarily killing other living beings

  28. SW

    Dr K, any readings on RANKL … has that cropped up at all? I am thinking of another ‘mab’ drug DENOSUMAB for osteoporosis.

  29. Jane

    9 months ago, my mother passed away from a fatal subarachnoid haemorrhage. She had been on blood pressure medication and PPI’s for decades. In the12 or so months prior to her sudden death, she was on a regime of being injected with Avastin in her eyeball. Your revelations not only anger me but distress me greatly. A disastrous combination of medications more than likely contributing to the early demise of my dear mother. But what of the continual stream of older/elderly patients “blindly” awaiting such treatment in waiting rooms around the world? A simple, straight forward procedure lining the pockets of many specialists unaware and uncaring of these potential disastrous consequences?

  30. Andy S

    High glucose interferes with repair process.

    The number of EPCs in type 2 diabetes was significantly decreased compared with healthy controls and there was an inverse correlation between the EPC numbers and plasma glucose, as well as HbA1C. The number and function of EPCs in patients with good glycemic control were recovered compared with those with poor glycemic control. When glucose was supplemented in the culture in vitro, there was a negative effect on the proliferation and viability of EPCs, in a dose-dependent manner, whereas the enhancement of apoptosis was observed.

  31. Gordon Ferris

    brilliant deduction… as ever, Dr Kendrick. Will taking supplements of L Arginine improve NO and mitigate the effects of treatments like PPIs and Avastin? If so, how much would one need to take to show an improvement of material significance?

    1. Leon Roijen

      @Gordon Ferris @KidPsych

      Citrulline -that is turned into arginine by the kidneys- is more effective indeed.
      Personally I take 750 mg, 3 times a day, which seems a reasonable dose.
      It lowers my blood pressure sufficiently. At home it was about 100/150 in the evening and now is about 92/135. At the doctor’s office systolic pressure went from 180 to 150.

      I don’t think anything can be said about whether it will mitigate the effects of PPI’s and Avastin. No studies on that available.
      What you could do: I don’t know why you need a proton pump inhibitor but maybe you could talk to your doctor and switch to (a higher dose of) ranitidine or a similar medication.

  32. Dave Chandler

    People like me have no chance then.I’m on 40mg omeprazole twice a day due to untypical cells on my oesophagus plus a hiatul hernia.Have been on 20 mg twice a day for over ten years after getting a huge ulcer there but nobody told me to have a checkup every three years.Now they have found untypical cells so boosted to 40mg.I didn’t have any noticeable reflux but did sleep on stomache which I think cause the ulcer.What can I do?stop Omeprazole and rely on bicarbnate of soda,take l-citrulline and stop taking 2.5mg Ramapril.I have noticed since taking the higher dose my calf muscles feel very tight/stiff.Is there an alternative to PPI’s

    My mother died from cancer of the oesophagus and watching that was agony.

    1. David Bailey

      Unfortunately as Dr Kendrick has said several times, he isn’t allowed to give specific medical advice over the internet.

      I do know that there is another class of acid inhibitors known as H2 inhibitors, so it might be worth discussing these with your doctor, and maybe others here will comment with more knowledge.

      There is also Gaviscon, which works in a mechanical way to stop acid reflux.

      Taking PPI’s has other problems as well – in my case I ended up with very low levels of B12, because you need a reasonable level of acid in the stomach to absorb this vitamin from food!

      There is a book – written by a specialist – about the problems of being ‘overdiagnosed’ by medical tests.


      I don’t know if it is relevant to the tests you are being given, but it is worth thinking about.

      1. Dave Chandler

        Thanks for reply David,I wasn’t expecting Dr Kendrik to prescribe,just maybe point me in another direction.I do take Gaviscon last thing at night.I also take Vit B12 supplement,Magnesium transdermally and extra dietary calcium in the form of dairy products.I also sleep with a raised bed head.

        I didn’t have any sign of reflux till I had a large ulcer on my oesophagus 13 yrs ago.Nobody at the hospital gave me any advice,except to tell me I would be on Omeprazole for life, and didn’t tell me I needed to have a checkup every three years.I didn’t have any sign of reflux till after retiring and gaining fat around stomache.I think that plus sleeping on my stomache(very hard to change) caused reflux between 2 and 4 am into mouth and lungs.

        Thanks for the tip on H2s,will look into it.I’m waiting for results from a very thorough endoscopy carried out at another hospital,will bring it up with them when I get them.The consultant there seems much more on the ball.

        1. AhNotepad


          In general, side effects caused by Gaviscon can be very severe due to the ingredient of aluminum. Many individuals may accumulate high levels of aluminum, especially those who take high doses of this medication daily. Most of the aluminum is eliminated from the body by the gastrointestinal tract, yet aluminum absorption as well as increased levels in the blood have been documented. Long-term use of aluminum drugs can deposit aluminum in multiple places throughout the body.”


          Gaviscon is made by GlaxoSmithKline, the same company whose director, James Murdoch, owner of The Times, published Brian Deer’s untruthful and misleading article which resulted in Andrew Wakefield being struck off. I wonder why.

          I think there might be other less problematic ways of dealing with acid reflux.

      2. David Bailey

        David Chandler wrote:
        “Thanks for reply David,I wasn’t expecting Dr Kendrick to prescribe,just maybe point me in another direction.”

        It is important to get away from the idea that ‘they’ are trying to be fair or reasonable – ‘they’ would just like to stop Dr K giving everyone his thoughts, but they know he is right (or at least a lot more right than ‘they’ are), so they need a bogus reason to stop him, however weak. Look up how they treated Professor Noakes Though he seems to have prevailed!)

      3. Leon Roijen

        “In general, side effects caused by Gaviscon can be very severe due to the ingredient of aluminum.”

        It depends on the country; not all Gaviscon formulations contain aluminium.

    2. AnnaM

      I would look for alternative cancer treatments and start taking them now, when it is easier to turn it around. But that’s me. I’m talking about simple stuff, oregano oil, eating fresh garlic cloves, olive leaf extract, black seed oil with honey. I’d try giving up carbs and wheat. Maybe not all carbs. I mean, I don’t seem to have that much will power.
      I don’t think antacids are the answer either. I used to get a bit of heartburn, not a lot. I have hydrochloric acid capsules for that. The alternative theory is – and this is just my understanding – that we don’t need less acid but more. It seems paradoxical, but most people don’t get heartburn when they are young and the stomach has more acid. They get heartburn later, when the acid has begun to drop off.
      But now, for cancer, I’m taking digestive enzymes. And they are great for helping out with digestion, but I mostly take them on an empty stomach to give them a different path – that of cleaning up any nasty protein coats on irregular cells. I now have very little gas and very little heartburn. I chalk it up to the enzymes, cuz I hardly take the hydrochloric acid pills.

      In the end if I was seriously worried about cancer I would start to read and educate myself. I find that very few people are minded to say no to chemo and try to heal themselves. But I have so little confidence in the medical model in which conditions so often just get inexorably worse.

    3. Leon Roijen

      @Dave Chandler

      I second David Bailey:

      There is indeed another class of medications, called H2 receptor antagonists. An example is Ranitidine.
      Maybe these (higher/highest dose) may work for you.
      Ask your doctor and tell him why you would like to switch, if possible. Tell him you are concerned about the effects of PPI’s.

      As for hypertension medication: It depends on your condition and certain other characteristics but in general diuretics should be the first choice for most people. For most people they have been proven to confer better protection than other, newer anti-hypertension medication.
      As said, there are exceptions.

      I think citrulline is certainly worth trying but depending on your other conditions and how high your blood pressure is without medication, it may not be wise to suddenly stop the Ramapril.
      Talk about this, too, with your doctor. Maybe after consulatation with your doctor you could switch to a lower dose of Ramapril and try citrulline (dose: 750 mg 3 times a day).
      And if that works and if your doctor allows it, then you could try and switch to a diuretic, if that can be done, depending on your condition and characteristics.

      Gaviscon is not a good thing to take all day but if you can take Ranitidine, you could take Gaviscon suspension before going to sleep to extra protect your oesophagus.

      Note that I am not a doctor and I cannot emphasize enough that you should talk to a doctor first.
      It might well be possible that your doctor doesn’t want to think along – in that case you could see another doctor who could be more inclined to try other solutions.

  33. mmec7

    Dr Kendrick – came across this paper posted up on a different site : https://www.sciencedirect.com/science/article/pii/S0735109712047730
    Most concerning as seems to be pushing the cholesterol envelope way further out – now claiming to lead to Alzheimer’s / Dementia / Glaucoma … Apart from stating that ‘proven’ to lead to heart disease ! Sad. One could heave it over the side of the boat, however, would not help in refuting the string of claims against cholesterol – though, boiling the comment down to basics, it does give a nod in the direction of the necessity of cholesterol for brain health, though ‘too much of a good thing is’ etc etc However, your own comments and ‘team’ comments would be of interest.

    1. Bill In Oz

      This is what they did :
      “We conducted a series of meta-analyses to estimate the effect of long-term exposure to lower LDL-C on the risk of CHD mediated by 9 polymorphisms in 6 different genes. We then combined these Mendelian randomization studies in a meta-analysis to obtain a more precise estimate of the effect of long-term exposure to lower LDL-C and compared it with the clinical benefit associated with the same magnitude of LDL-C reduction during treatment with a statin.”

      Now…. can any one of us say what the fuck this really means ? I doubt it but it does tell us that there is NOT a single ‘experiment ‘tested’ in it.

      Frankly I do not want to waste my time with junk science.

      It’s Spring here. I have a garden to dig. 🙂

      1. Andy S

        Bill in Oz
        These studies are important to understand the deception used in medical studies.

        Result of study:
        “We found that prolonged exposure to lower LDL-C beginning early in life is associated with a 3-fold greater reduction in the risk of CHD for each unit lower LDL-C than treatment with a statin started later in life”
        So if statin treatment reduced CHD by 0% later in life then lowering LDL-C over a longer period of time will reduce risk by 0%.

      2. Bill In Oz

        Andy, I agree there is a need to understand the fake science…In order to be able to refute it..But I grow tired of the endless discussions about diet and CVD..When if we actually read and understood what Malcolm is writing for us in his posts,we would have clear in our minds, that LDL-C and saturated fats have no causal relationship to CVD…

        Let repeat that is Caps lock : LDL-C & SATURATED FATS HAVE NO CAUSAL RELATIONSHIP TO CVD.

        However the news that the lead author is a militant veganist is useful as it tells me that we can safely ignore this zealous outpouring…

        1. Andy S

          Bill, no need to shout. Nobody is disputing that cholesterol and saturated fat is not cause of CVD.
          Maybe we need a better term than “diet” . How about “nutrients” for good stuff and “anti-nutrients” for bad stuff that we consume on a daily basis. Excess “nutrients” can also be a problem. Endothelial damage and blood composition?

      3. Bill In Oz

        Andy, Ummm yes I was using caps lock for emphasis…And partly that is because I have gown tired of the constant drift by many commentators here to revert back to focusing on diet as the ’cause’ of CVD….Such stuff drowns out attempts to examine the real science that is being researched & published. And that has lead to me spending less time on this blog & commenting less…

        I now really think that Malcolm should moderate out all such comments and ask these people to buy the new book he has just published…

    2. chris c

      It’s the Empire Striking Back. Joel Kahn is a noted Militant Vegan so I suspect the others are too. They still believe Ancel Keys was God.

  34. AhNotepad

    Just for amusement I tried out the NHS Heart Age test. What a load of rubbish. I am 65. This morning I did some tree cutting for a couple of hours and for about an hour and a half I was digging out stumps on a railway embankment. This afternoon I did a couple of hours digging out old sleepers (on a full size railway) ready for replacement.

    According to the NHS test which wanted to know how old I was, my height, weight, if I smoked, had diabetes, anyone in the family diagnosed with CVD, kidney disease, if I had a cholesterol test, if I knew what my blood pressure was, all of which was “no”, oh, and postcode, I have a heart age of 67. This could be lowered by 3 years if I reduced my cholesterol, and a year if I lowered my blood pressure.

    What a load of unscientific twaddle. They are still chanting the same misleading and ill informed mantras. But I expect it will please one or two round here as they would be able to provide references if asked, where I just make assertions. Most of the rest of you here will be able to find references easily enough, as I have seen you do it. I just take plenty of holy water, oops sorry, I meant vitamin C.

    1. Jennifer.

      AhNotepad. I agree completely. The poor, unsuspecting public. We are being lied to left right and centre these days. My most recent concern is what I am learning about ‘organic foods’. I was aware that even organic foods are permitted to be treated with about 3 chemicals, but never imagined they would include potential carcinogenic agents, as quoted on BBC The Food Programme, re unwaxed lemons.
      What are we to do about such problems?

      1. AnnaM

        I despair. The populace must be so vigilant, and they never stop sneaking in the back door. Our ancestors were right, this world IS the devil’s playground.

        1. AhNotepad

          On BBC Radio4 More or Less on 7/9/18 they discussed the PHE Heart Trivia Quiz, and it would be worth listening to Dr. Margaret McCarthy (Scottish you see, so must be ok (as long as they are not politicians of course)). She explained the test, and how it was poorly constructed and run.

          The test assumes poor figures for blood pressure and cholesterol if you don’t know them, so makes the assumption you are a near basket case. Never mind that neither of these two measurements cannot be used to predict mortality. :roll_eyes: To date the tet has been done nearly 2,000,000 times.

    1. AhNotepad

      Charles, I looked at the link you posted, and I looked at Barry’s link. The tests are as much twaddle as the NHS tests. They want to know about cholesterol levels, which as far as we know have no significant effect on mortality, unless thay are very low.

  35. Göran Sjöberg

    New try.

    I never miss an opportunity to discuss CVD matters and with my own successful experience with refusing CABG and all medication as a base. So also at our nature conservation meeting (it was the ‘Mushroom day”) this weekend among the fifty participants.

    Today one of the participants who listened carefully came to see me since he had received a weird note from the health care service regarding his CVD problems and went confused since the messages he had received so far were contradictory. He had fibrillation problems which were treated with ablation a year ago. But today they didn’t have much more to offer him.

    I understand that the ablation procedure may work but am still very skeptical since it seems to be more like a remedy procedure than a cure. Just the idea of interfering, destroying, more or less at random with the internal nerve system of the heart doesn’t make very much sense to me – there is no obvious logic.

    What could I say to him?

    I suggested him to try the same regime that helped me and my wife to reverse the metabolic syndrom by turning to ketogenic diet – strict LCHF.
    “Give a try – it may help!”
    I said.

    You have nothing to loose!

    1. Leon Roijen

      “I suggested him to try the same regime that helped me and my wife to reverse the metabolic syndrom by turning to ketogenic diet – strict LCHF.
      “Give a try – it may help!”
      I said.”

      Absurd advice. “The Low carb high fat diet your cure-all: Come and see!!
      Sprinkle a little holy water over it, and its 100 % effectiveness will raise to 200 % effectivieness!!

      No, you didn’t do your friend a good service, on the contrary.

      What your friend could try, also depending on his blood results, is taking additional magnesium and potassium. This can (certainly not in everyone) help alleviate rhythm problems.

      Your advice on the contrary could make matters worse: LCHF can cause magnesium and potassium deficiencies, leading to worsening of your friend’s problems.

      1. Clathrate

        Hello Leon – what an appalling and pathetic response to Goran. I do not think an apology to Goran would be out of order (and no need to tell me that you don’t care what I think as I’m not bad at second guessing).
        Hello Goran – yours are comments that I enjoy reading and your advice to your friend is sound by me. In addition, I appreciate that you will have added context to the advice.

        (Leon of course LCHF ‘could’ / ‘can’ be bad but I am familiar with what Goran / his wife eats as LCHF, and it would certainly not lead to magnesium and potassium deficiencies – you are welcome to re-read comments of Dr Sjöberg from previous blog responses over the last few years.)

        1. JanB

          Clathrate – I agree with you 100%. I flared when I read Leon’s response. Goran is a highly respected contributor to this blog and I was upset at Leon’s lack of respect. Please be nice, Leon.

          1. AhNotepad

            JabnB, since Leon appears to be a religeon founded zealot, then whatever he says must by definition be “the truth”, therefore “nice” is not a relevant concept. Some of what he says is worth hearing, the rest is merely supported by misguided dogma.

            Me? I just fall into the bigot category, as I have no religeon. I shall eat dead animal flesh tonight, since The Bible says only an animal sacrifice is acceptable to God. Moses would have had to sacrifice his son had it not been fortunate that a (somewhat unfortunate) goat been stuck in a thicket, so that got the chop instead. (I can believe it if it suits).

      2. Andy S

        Hi Leon,
        Adding magnesium/potassium to a crappy diet might not be effective. Goran gets my vote for recommending LCHF to his friend.

      3. Göran Sjöberg


        Why don’t you relax?

        I don’t have any problems with any your constructive comments, which adds to the knowledge process on this blog, but I certainly have a problem with your categorical ones and especially with your efforts to ridicule what I suggest from my own practical experience and they are certainly proposed in a “non-categorical” way.

        But I guess you are the one “who know” what is right – right?


        I just came back from our visit at the Ridgedale farm in Värmland. A visit rendering great experience and which told me that there must not be a stiff contradiction between vegetarians and “meat-eaters” – the moral of both sides meet here in an effort to “save the world” although it is an uphill battle. Animals are here an integrated part of their saving operation to restore the soil. And with pleasure I watched my wife save two hens which had escaped from their “egg-mobiles”

      4. Göran Sjöberg

        For those who may be interested in a holistic view of how we can restore the soil to produce food with the “intended” full nutritional values (in the Weston Price context and including magnesium and potassium) it could be worthwhile to see the holistic efforts at the Ridgedale farm explained in the attached short video.

      5. Leon Roijen


        “I don’t have any problems with any your constructive comments, which adds to the knowledge process on this blog, but I certainly have a problem with your categorical ones and especially with your efforts to ridicule what I suggest from my own practical experience”

        I don’t have any problems with any of your constructive comments either, but if you recommend someone with heart rhythm problems a low carb high fat diet without good base in science, I am seriously vexed, especially now that such a diet – often deficient in magnesium and potassium – could make matters only more serious for this person.
        I haven’t paid much attention to your background but I believe I read you were a scientist in your professional life.
        I think I also read you and your wife “solved” metabolic problems with a low carb high fat diet.
        I think especially you as a scientist should know that merely personal experience is not science and that “solving” one problem with a diet and then recommending it for a quite different problem is even less scientific.
        I am sorry if I am harsh but – and I must be honest about this – I am allergic to people handing out advice without any base in science. Because “if it doesn’t work it doesn’t hurt” often is not true at all.
        If you can produce research that clearly shows the low carb high fat diet might heal or reduce heart rhythm disorders, I will offer my apologies immediately, but until then, I hope you will think twice before giving people advice that might be counter-productive.

        “But I guess you are the one “who know” what is right – right?”

        Haha, I wish I were – unfortunately that’s not the case at all.
        I don’t take everything for granted but I am also not one to follow the latest hypes or believe everything that is alternative. And that places me in a kind of “no-man’s land” I guess. A persona non grata for some in conventional medicine but also for some in “alternative” medicine. Well, so be it.

        “A visit rendering great experience and which told me that there must not be a stiff contradiction between vegetarians and “meat-eaters” – the moral of both sides meet here”.

        If, like me you consider killing animals unnecessarily and immoral, there cannot be a meeting of different morals.
        It reminds me of the verdict the Indian Supreme Court just issued striking a law that punishes gay sex by 10 years in prison. One sentence from that verdict:

        ““Constitutional morality cannot be martyred at the altar of social morality,””

        And, I have had discussions with Dr Kendrick about this on this blog: I truly believe there is a higher, universal morality (the court here calls it “constitutional morality”) if we want to see it.
        Part of that morality is already laid down in the Universal Declaration of Human Rights. But of course that one is for humans.

        1. Dr. Malcolm Kendrick Post author

          Leon. Your problem is that you have declared that eating animals is immoral, or unethical. Therefore, those that do so are either immoral, or unethical, depending on whether you use morality, or ethics, as your preferred term. My view is that ‘ethos’ is ones personal view of how life should be lived. ‘Ethics’ are decisions on how groups/population/nations decide how life should be lived – often incorporated into law. Morality requires an extra-corporeal being – often known as a God. God’s law supersedes any human ethos, or ethics. Which is why it is difficult to have medical ethics in a Muslim country, in that Sharia law – morality/laws/behaviour laid down by Allah – cannot be altered by any human.

          However you wish to label decisions to live life in one way, or another, these are primarily emotionally based decisions. ‘I really hate people doing this – we should pass a law – it is unethical – it is immoral.’

          Equally, it is impossible to argue the case using science, or logic. There is no science or logic behind ‘ethics’. One thing is for certain, you are very unlikely to change anyone’s mind by telling them they are, effectively, unethical murderers.

        2. AhNotepad

          ”I don’t have any problems with any of your constructive comments either, but if you recommend someone with heart rhythm problems a low carb high fat diet without good base in science,”

          Well it worked for me and made the scientifically prescribed (by a medically qualified Doctor) beta-blockers un necessary. Haven’t taken them for years, and my resting heart rate is 60 to 70 bpm instead of the previous 120+.

      6. Leon Roijen

        Dr Kendrick:

        I know your stance and I understand what you mean. Probably I did not explain my stance enough in our previous discussion on the same topic.
        So I Googled a bit, and I found this:


        “Natural Law is a moral theory of jurisprudence, which maintains that law should be based on morality and ethics. Natural Law holds that the law is based on what’s “correct.” Natural Law is “discovered” by humans through the use of reason and choosing between good and evil. Therefore, Natural Law finds its power in discovering certain universal standards in morality and ethics.”

        “Natural Law – The Conclusion
        In the end, where does law come from? The Theory of Natural Law maintains that certain moral laws transcend time, culture, and government. There are universal standards that apply to all mankind throughout all time. These universal moral standards are inherent in and discoverable by all of us, and form the basis of a just society. ”

        And as you can understand from the definition given above, such a natural law doesn’t need to come from a divine being; on the contrary: It can come from our own “ratio”, a latin word we use in Dutch and which could be translated into English as “the capability to think our reason”.

        You can dispute that such a Law exists or can be discovered by our “ratio” , but that’s my conviction.

        “However you wish to label decisions to live life in one way, or another, these are primarily emotionally based decisions.”

        On the contrary: as described above, those decisions should be judged using our intelligence, what we call in Dutch our “ratio”, our intelligence.
        And I think sometimes we need our heart to let our brains function rationally.

        Take the beautiful first article of the Universal Declaration of Human Rights

        “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”

        For me, that’s a magnificent example of reason and emotion (the heart…) combining and leading to a codification of natural law.

        ‘I really hate people doing this – we should pass a law – it is unethical – it is immoral.’

        Yes, that’s what happens a lot – I hope you understand by now that is not what I am advocating.

        “Equally, it is impossible to argue the case using science, or logic. There is no science or logic behind ‘ethics’.”

        That comes close to justifying religious people stating we need laws from a divine being to base (good) morals on.
        Of course I refuse such an assumption and though I have to admit good (as opposed to evil) morals cannot be determined by science or logic (alone), I have the conviction that using our intelligence and hearts can lead to sound, universal (in time and place) morals.

        Please note “natural law”/”universal morals” doesn’t mean something all or most people will always, everywhere agree on. Here the “ego” is the disturbing factor.

        “One thing is for certain, you are very unlikely to change anyone’s mind by telling them they are, effectively, unethical murderers.”

        Grin. Of course much more is needed than just calling things what they are, but that’s where it starts.

        I don’t think we are going to agree and I guess there are good arguments on both (your and mine) sides but I hope you know understand a little bit better how I see morals.

      7. Leon Roijen


        “since Leon appears to be a religeon founded zealot,”

        It is you who is a rabid follower of vitamin C quacks who sprinkle holy water and give out prayer cards ( see a previous post of mine on this blog), not me.
        May I also remind you that I never said I base my conviction on religion?

        I usually dislike people calling each other trolls lightly but here I cannot escape the impression that you are trolling, certainly when considering that your message adds nothing at all to the discussion.

        We can have arguments, strong discussions, as long as they are based on something – and I don’t mind a bit of strong language -, but this is nothing more than a cheap personal attack. I don’t mind, it doesn’t bother me but I think you are degrading this blog by doing so.

      8. Leon Roijen

        Andy S:

        “Hi Leon,
        Adding magnesium/potassium to a crappy diet might not be effective.”

        Hi Andy,

        I’d state the opposite: even a healthy diet providing normal amounts of magnesium and potassium may not be effective.
        There is plenty research showing that additional magnesium and potassium can reduce both
        supraventricular and ventricular arrhythmias.

        I am not saying ALL people on a low carb diet will develop magnesium and potassium deficiencies, but the risk of developping them is bigger with low carb diets.
        So low carb would not be the first advice I would give to someone with arrhythmia.

        1. Andy S

          Hi Leon, agree with magnesium importance. My LCHF meals include leafy greens, a source of magnesium. In addition I SUPPLEMENT many other vitamins and minerals, so actually it is a LCHF+AP+S diet (Low Carb, High Fat, Adequate Protein, Supplements).

          The low carb is to avoid postprandial glucose spikes. The fat is for energy. Adequate protein for tissue maintenance. Supplements added for essential ingredients that are not always available from foods.

          The low carb part is also to avoid anti-nutrients in plants. They have too many defence mechanisms to avoid being eaten by animals. I restrict my pant consumption to mostly home grown onions, garlic, leafy greens, beets, and berries. By restricting plant proteins I probably eat more plants.

          The contentious part seems to be protein source, plant or animal?

      9. Leon Roijen

        Hi Andy,

        “Supplements added for essential ingredients that are not always available from foods.”

        Makes me curious what you add, how much and whether it is lacking in your diet.

        “The low carb part is also to avoid anti-nutrients in plants.”

        If “anti-nutrients” would be a big problem of a plant-based diet, then all the herbivores would be in big trouble.
        I’d say the biggest “problem” of a plant-based diet is iron. But when there is enough vitamin C in the diet, even that should not be a problem.
        And the problem of sometimes too little iron absorption is at the same time one of the big health advantages of a plants-based diet: Of course nothing is black and white in food science but I think there is overwhelming evidence showing that high iron stores are not good for health.

        “The contentious part seems to be protein source, plant or animal?”

        Nutrition-wise it is not contentious I think: what is important is that you get all the essential amino-acids, the building blocks of protein.

        I am convinced a plant-based diet has more protecting substances to offer (against cancer and CVD) than a meat-based diet.
        Its no wonder that many medications come from plants and that herbs have been used through the ages to heal people. I don’t know many medications of animal origin.

        The moral question about eating meat – you can read my opinion elsewhere on this page.

        1. ellifeld

          Herbivores eat all day long, 7 days a week, plus they have 2,3,4 stomachs just to extract nutrition from their food, which is mostly water (almost 95%), cellulose, no protein or fat and little amounts of vitamins, minerals and some antioxidants. So no, herbivores aren’t in trouble because they eat ALL day long, everyday.

        2. Andy S

          Hi Leon
          Fortunately I have never followed official dietary guidelines (low saturated fat, low cholesterol, more PUFA). Functioning well at 78 with no medications.
          Re Suppplements: Added iodine and selenium to prevent thyroid nodules getting larger, an insurance policy.

          Re Ati-nutrients: plant protein sources ie soybeans, wheat, beans could be problematic
          Wheat is one of the most consumed cereal grains worldwide and makes up a substantial part of the human diet. Although government-supported dietary guidelines in Europe and the U.S.A advise individuals to eat adequate amounts of (whole) grain products per day, cereal grains contain “anti-nutrients,” such as wheat gluten and wheat lectin, that in humans can elicit dysfunction and disease. In this review we discuss evidence from in vitro, in vivo and human intervention studies that describe how the consumption of wheat, but also other cereal grains, can contribute to the manifestation of chronic inflammation and autoimmune diseases by increasing intestinal permeability and initiating a pro-inflammatory immune response.

          Re Animals thriving on plants: evolutionary adaptation. Feeding grains to herbivores or carnivores not a good idea.

          Re Plant medicines: Green leafy things like herbs and weeds are part of my diet. Cannabis is a wonderful medicinal plant, have 2 plants growing in my garden.

      10. Leon Roijen

        Andy S:

        About grains: the study you cite doesn’t say grains are generally bad. It says more studies are warranted. If people because of that leave out grains from their diet, they better stop eating altogether. There aren’t many foods that are not suspect these days…

        “Re Animals thriving on plants: evolutionary adaptation. Feeding grains to herbivores or carnivores not a good idea.”

        We are omnivores 🙂

        1. Andy S

          Generally safer to eat herbivores than plants. Conclusion from searching info on poisonous plants. There are exceptions:
          “An innocuous plant, white snakeroot was responsible for the death of Abraham Lincoln’s mother, Nancy Hanks. White snakeroot is a North American herb with flat-topped clusters of small white flowers and contains a toxic alcohol known as trematol. Unlike those who have died from directly ingesting deadly plants, poor Nancy Hanks was poisoned by simply drinking the milk of a cow who had grazed on the plant. Indeed, both the meat and milk from poisoned livestock can pass the toxin to human consumers. Symptoms of “milk poisoning” include loss of appetite, nausea, weakness, abdominal discomfort, reddened tongue, abnormal acidity of the blood, and death. Luckily farmers are now aware of this life-threatening hazard and make efforts remove the plant from animal pastures.”

    2. JDPatten

      I had three ablations starting in 2012 for atrial fibrillation. Is your friend’s the atrial kind? It makes quite a difference if it’s ventricular, as you can imagine.

      My symptoms were pronounced and frightening, though tolerable – as long as I didn’t do anything vigorous. But “vigorous” has been my way of life.
      In 2012 I had a choice of medication which usually failed after a brief time (and it failed me) or a promise of a “cure” with ablation. So I went for it. And again. And again.

      Now there are people such as John Mandrola and Prash Sanders making themselves and their work heard. They are electrophysiologists, a sub specialty of cardiology. (Thankfully, electrophysiology does not concern itself with things like cholesterol and statins!)
      They are looking upstream to address causes. Risk factors include the results of modern life-style and, of course, aging.
      Reduce overweight/obesity.
      Address high blood pressure
      Test for and treat obstructive sleep apnea
      Test for and treat diabetes (You know all about that one!)
      Above all, exercise – resistance training and aerobic training – not too much!

      This is not to say that everything is known. Electrophysiologists are the first to admit that. Just that this reduction of risks generally works to reduce (Sometimes cure??) AF episodes. This seems to be true as long as your AF has been with you fewer than six years or so.
      Would that I had known this before I subjected myself to extensive atrial scarring six years ago!

      1. Göran Sjöberg

        New try

        Well, my friend is certainly overweight (mostly in the visceral sense) and was concerned about this as most tend to be. Here LCHF seems to be a very good way of attacking this “abnormality” and the success of which “treatment” I have noticed among other friends who have rapidly lost 10 – 20 kg in the course of a year or actually faster. For me and my wife it was though our poor metabolic health that made us turn into LCHF and without any intentions we also lost 20 and 15 kg respectively in a couple of years. The immediate and dramatic health benefits were though our first “harvest”.

        BTW My “ill advised” friend was advised by his GP and cardiologist to refrain from exercise which I told him in my eyes was just an absurd advice based on my own experience after my serious MI 20 years ago when I actually just did the opposite – pressing my cardiac system through different physical exercises to the limit apart from my skipping all sweets in my diet but adding a glass of wine daily. I think it is a very good scientific way of building the collaterals.

      2. Leon Roijen


        “BTW My “ill advised” friend was advised by his GP and cardiologist to refrain from exercise which I told him in my eyes was just an absurd advice based on my own experience after my serious MI 20 years ago when I actually just did the opposite ”

        What I think is absurd, is that you call this absurd advise without being a cardiologist and without knowing all the details of your friend’s medical case.
        Nowadays cardiologists stimulate heart patients to exercise. They might have good reasons to advise your friend to refrain from exercise. Moreover: You cannot be certain what exactly they advised your friend – he might have misunderstood his doctor: Maybe he was only to refrain from (very) vigorous activity.

        1. AhNotepad

          What I think is absurd, is that you call this absurd advise without being a cardiologist and without knowing all the details of your friend’s medical case.

          What I think is absurd is that you make these pronouncments without being a doctor and pronouncements about what treatments that people have found effective being nothing more that “holy water”. Regrettably Dr Kendrick welcomed your input, which may have been good to stimulate thinking, but it has become more a case of your beliefs being the driver, however flawed they may be. There are many religeons with differing beliefs, some opposite to others. Who is right? what is right? They are only beliefs. Please try to seperate your “beliefs” from facts, and discuss matters without resorting to riciculing any view that you disagree with.

        2. Sasha

          Leon, that’s appeal to authority, a common logical fallacy. Gorman may be right in his advice or he may be wrong but it has nothing to do with him being a cardiologist.

      3. LA_Bob

        JD Pattern,

        You included “Test for and treat obstructive sleep apnea” in your list.

        Anecdotal, of course, but I know someone who had “extreme, severe sleep apnea”, and the CPAP machine resolved his atrial fibrillation as well as improving his blood pressure.

        So, this one is potentially very important.

      4. Göran Sjöberg

        Well Leon – it is interesting to find a person with your views on Malcolm’s blog – it is stimulating to say the least.

        You are quite right that I have spent most of my life in the research of the natural sciences and for some years I was a professor of “Aerospace Materials” at the Chalmers University of Technology in Gothenburg, so I believe that I understand the “basics” of the standard research methodology. My understanding is though that most of the professors I have encountered around the world with few exceptions don’t understand what “science” is. They are doing research and don’t think very much outside their own consensus “box”.

        When I, twenty years ago, was “hit” by my MI I approached with ardour, to me, the new discipline of medicine and it didn’t take long for me to realize that there was very little “science” of the fundamental kind (physics and chemistry) I myself had been involved in my metallurgy. Very soon my “research” into this new medical field led me to the conclusion that what the cardiologists suggested was plain nonsense from a “scientific” point of view. E.g. the comprehensive CABG offered didn’t bring any benefits but for the Big Pharma so I abstained. The same thing I found for each one of the pharmaceuticals prescribed. It took me half a year of “research” from the “outside” to realise this and I didn’t take any of them any more. The last one was the aspirin, which I dropped after one year – there are less dangerous alternatives.

        So I turned my back to the NHS as an unscientific enterprise in my eyes, which doesn’t mean that they don’t know how to trade pharmaceuticals. Basically the cardiologists are in the hands of Big Pharma and they don’t overly “think”, otherwise they get punished. They are naturally not interested in my “successful” experience. “I am not the least interested in what you have been doing for 15 years!” as the last one I met stated at the beginning of our encounter. Not a very scientific attitude in my eyes in which they are just an ignorant bunch of “self confident” “experts”. And I am for sure one who is not interested in the nonsense they continually express. You may call me a sceptic if you like but I am pretty sure that I am better read on CVD issues than you may be – but I may of course be wrong.

        With my “scientific” research background I found it necessary to properly do my “home work” and to start with study the basic textbooks involved and not least the “Molecular Biology of the CELL”, Alberts et al. (a recommended reading, especially the sixth edition) but also textbooks about our Physiology and other serious textbooks.

        All this led me to the point when I wondered how “medicine” could have got it so “wrong”. As a consequence the subject of the fundamental philosophy of science “popped up” and I spent considerable time on this subject. (Do you, e.g., know anyone who has read the complete works of Plato – tell me!) Anyway it was basically the philosopher of science Thomas Kuhn who opened my eyes. Even Schopenhauer and Karl Popper, to name just two more philosophers, added to my understanding of the complexity involved in “science”. Wittgenstein, of course, added to realize the “nonsense” involved in any positivistic attitude, which tends though to permeate also present day medical “science”. This is really disgusting to me! It is a question of an attitude towards science.

        And when it comes to the question of moral versus ethics, which Malcolm brought up, philosophy, from Plato, Aristotle and onwards, is full of it. When it comes to veganism which has evidently, in my eyes, very little to do with science, the reading of Lierre Keith’s, “The Vegetarian Myth” taught me a lot about the moral issues, the religion, involved in veganism. As she stated when she had converted to “Permaculture”: “To live you have to kill one way or another – that’s life!”

      5. Göran Sjöberg

        BTW Leon,

        When you cook a carrot you actually “Kill it”” – that’s life!

        When you farm in the modern sense you have to kill all living creatures in the fields before you are able to start seeding your crop and the killing proceeds.

        The idea of permaculture is in contrast to preserve life as far as possible and in an “ethical” way.

      6. JDPatten

        There you have it – who Goran is. Of course, we who have been around here for a while knew that about him. We also have known how gracious and giving he is, understanding that we are in here not as combatants in an argument contest, but as seekers of better understanding in this forum of ideas pursuant to all things heart disease related.

        So, now, who are you, when you’re at home?

      7. JDPatten

        Sleep apnea! Yes. I had it. Mild to moderate. Did that lead to my AF? It was a likely contributor, at least.

        My father (1898 – 1973) always snored like the the thunderstorm in the next room. A trial for everyone else, but he was oblivious.
        He died at age 75.
        Did he have apnea?
        Did he have atrial fibrillation?
        Did he die of a stroke because of the AF, because of the apnea?
        No one knew enough at the time to ask the questions, much less address them.

        Current questions that are not yet answerable include:
        Exactly what are the genetics involved?
        Did I inherit an AF predisposition?
        Did I pass that along to my son? Daughter? Granddaughter?
        If so, what preventive measures can be taken to specifically address the problems those genetics engender?

        It’s acutely exciting, and it’s monstrously frustrating, to be at . . . any sort of cutting edge.

      8. Leon Roijen


        This is what I said:

        “What I think is absurd, is that you call this absurd advise without being a cardiologist and without knowing all the details of your friend’s medical case.”

        That’s absolutely not “an appeal to authority”.
        If you want to use these “classy” terms, then first learn to read please.

        1. I said (I assume) that Göran did not see all the medical recors of his friend, maybe doesn’t even know the exact heart rhythm disturbance his friend is suffering from.

        2. It’s an absolute fact that Göran is not a cardiologist and (again I assume) is not schooled in reading ECG’s.

        An “appeal to authority” is described in Wikipedia as follows:

        “An argument from authority, also called an appeal to authority, or argumentum ad verecundiam is a form of defeasible[1] argument in which a claimed authority’s support is used as evidence for an argument’s conclusion.”

        Well, nowhere I said that the cardiologist of Göran’s friend was absolutely right – I just showed that Göran doesn’t have the specialised knowledge to judge his friend’s case, nor does he have his friend’s medical details.

        If you call that “an appeal to authority” you absolutely need to go back to school.

      9. Aileen

        Sleep apnoea: William Dement (one of the founding fathers of sleep medicine) spoke about it a lot in his book The Promise of Sleep” and was certain that it was implicated in cardiac problems.

        1. Andy S

          Hi Aileen,
          Sleep apnea and CVD share common features, such as being overweight.

          “Obstructive sleep apnea is most common in overweight and obese people. The sleep disorder causes loud snoring and sleep disruptions as a result of the airway becoming temporarily blocked during sleep. If untreated, obstructive sleep apnea can also increase the risk of high blood pressure, stroke, and heart disease.”

          1. JDPatten

            What you say is generally true. However, you can’t count yourself as safe if you’re skinny. Obstructive sleep apnea is mainly a matter of your mouth, tongue and palate/soft palate architecture. Skinny little children get apnea. Add to that what happens to the tissues of that architecture when aging, and, yes, add to that overweight, and you get a higher risk and worsened symptoms.
            Humans’ throats are different from other mammals. A wolf gorging on a fresh kill can bite, chew and swallow – all while breathing. (Don’t try this at home – even if your party is rife with Heimlich experts!)
            We, however, can speak because of our difference. That difference puts us at apnea risk. Wolves, etc, not so much.
            Evolution of Homo sapiens: Mixed bag.

          2. Andy S

            Worked for me. Losing 10% weight stopped complaints from my wife about snoring.
            Losing and gaining weight involves macrophages. My interest is what affects their function. Apparently glucose and alcohol shift macrophages from type M1 (inflammation fighting) to type M2 (tissue repair}. Too much tissue repair could be detrimental. A bit of alcohol is beneficial, too much is bad. Question is how does glucose and alcohol affect CVD? Maybe affects AFIB?

            Macrophages Facilitate Electrical Conduction in the Heart

          3. JDPatten

            Thanks. A very interesting article. I’ll have to study it in detail. From what I see in the abstract and in the conclusion, it seems that the little buggers in question have their effect at or just after the atrio-ventricular node. That is where the electrical impulse is passed off from atria to ventricles. The pulse signal has done what it was going to do with the atria by that time, so I don’t see how the macrophages could have a back-effect on atrial fibrillation. ??

            Black swan. That’s me. Skinny to the point you can see the muscle fibers through my skin. Always have been. Turns out we skinnies can get type II diabetes as well as obstructive sleep apnea.
            I’m doing OK now on LCHF for diabetes.
            I’m doing very well with apnea by using “Breathe Right Strips” EVERY night and sleeping on my side. MUCH more comfortable than CPAP! (Works for me; not everybody.)

      10. Aileen

        Andy and JD, thanks for your thoughts. My father in law has had AF (possibly brought on by hypothyroidism?), treated twice with DC cardioversion (both times successfully, though it returned a couple of years after the first one). After the second cardioversion he was put on the list for an ablation, which hasn’t happened yet. He is in his late 70s and doesn’t become generally very symptomatic when he is in AF but it does very much affect his ability to walk on hills, and he loves walking.

        He lives alone, and it has crossed my mind that sleep apnoea might be a problem and none of us would know about it. He isn’t overweight, I don’t think, though quite heavily built.

        The other thing that bothers me somewhat is that he is now on warfarin for life. Clearly warfarin is beneficial for stroke protection if you are in persistent AF. But I do wonder, what about after cardioversion/ablation, when you might (or might not) be experiencing paroxysmal AF? Neither of them offer any guarantees.

        I’m going to Google John Mandola and Prash Sanders!

      11. JDPatten

        It’s a great idea to do everything you can for your father to avoid ablation and still get back a normal rhythm. Those two guys are great for that. If you must, and if you can, Andrea Natale in the U S is tops for ablation.

        Warfarin is cheap. It’s also evil. It messes with your vitamin K, thereby reducing coagulation – as long as your dosing is precise and you don’t vary the greens in your diet. The balance is notoriously difficult to keep, requiring perpetual finger sticks for testing. Of course, with lowered vitamin K and K2, you’re subject to arterial calcification and bone loss. You’re also subject to extra bleeding, including brain bleeds. A friend of mine was on warfarin for a decade before he had a hemorrhagic stroke.
        The new oral anti-coagulants are all quite expensive, but they don’t require constant testing and they’ve a much reduced risk of bleeding and hemorrhagic stroke without reducing effectiveness against ischemic stroke. Apixaban (Eliquis) seems the best of them so far. No, I get no kick-back. It’s my choice for myself. It’s not too much of a burden with the insurance I have.
        There are formulas (chads-vasc; has-bled) that the docs plug your personal info into to determine “necessity” for anticoagulation. That includes age, rhythm status, kidney function, diabetes, etc, etc. There’s the question as to how reliable the formulae are. Some believe that you can go off anti-coagulation if your rhythm’s shown to be OK. Some not.
        Be sure that your dad is consulting an experienced electrophysiologist, and that he/she has the same life goals and values as your dad.
        Doctor and patient. It’s a cooperative venture, with the patient having the determining say.

      12. Aileen

        Thank you so much JD. There is a lot of food for thought there and I’m feeling more justified in my unease about the warfarin. I’d forgotten about the chads-vasc. We are in the UK and FiL is being treated on the NHS. His care has been very good (cardioversion changed his life for the better, twice) but Mandrola and Sanders’ ideas don’t seem to have reached this part of the world – yet!

        1. mmec7

          Aileen – Eliquis – there is, as yet, no antidote. There is to Warfarin, Vit-K2. Simple. There is, just recently, to Rivaboxavan. Though the side effects of the NOACs and the one antidote to the R’boxavan, Ho-Hum.

          Eliquis – Dosing, Uses, Interactions, and Warnings – Drugwatch
          Apr 18, 2018 … Also unlike Coumadin, there is no antidote for internal bleeding or hemorrhage caused by Eliquis. While the drug has a relatively short half-life, …

          Following a serious thrombosis and then by a PE, I am on Warfarin. Then, following a very recent acute ischaemic event, landing me emergency hospitalised, and a DEB intervention (drug-eluting balloon) I continue on the warfarin – my choice. As for the INR – no, not a finger stick, here in France it is a blood draw. A few seconds. Simple. Following the recent intervention, when I had to stop the warfarin, I have a weekly INR check. As soon as I am back in balance, later this week ? Then it will be back to once a month.

          NOACs, the new oral anticoagulants, are being pushed (expensive), warfarin (cheap, with a long track record) being sidelined. The FDA passed them with ‘no’ antidote in sight – the Rivaroxaban antidote is only a couple of months on the market and the possible side effects are…! Please do check out all the aspects of the NOACs.

          1. JDPatten

            Pulmonary emboli are a rather different ballgame than stroke by atrial fibrillation.
            If there’s a rhythm problem, talk to an experienced electrophysiologist . . . or two – having learned all you can about the condition first, so that you can have intelligent conversations.

            The antidote exists. It just needs further testing and approval, but it seems that it will work with the Xa inhibitors such as rivaroxaban (Xarelto) and apixaban (Eliquis). (I like to use the generic terms because that’s what’s used in the research.) There are very many coagulation pathways. K and Xa are just two.

            Yes, short of having the yet-to-be-approved antidote we must rely on the short half life. I take an apixaban pill every 12 hours. The half life is such as to not be a problem but for the most dire circumstances. I still climb ladders. I use a chainsaw. Sharp kitchen knives. Circular saws. You can’t let fear of negative possibilities rule your life.

            To be clear, anti-coagulation won’t have you bleed out if you badly cut your finger. I testify to that!
            Look up “tissue factor”. Look up intrinsic and extrinsic factors.

            And then, concerning warfarin, you might consider this:

          2. mmec7

            JDPatten : thank you for that, which information I already had. Had discussed with my medical team, with the end agreement that I was a suitable candidate to continue staying with the warfarin – which I have been on for over a year – though my cardiologist prefers Eliquis (Apixaban) possibly because I do have mild Afib, and he dislikes warfarin. My levels are well controlled, I can check the INR at any time with a standing prescription to the walk in lab. If and when necessary I titrate (myself) to keep within the 2 – 3 boundary, which in turn has only been necessary following the 4 day wash-out period for the DEB intervention. Another INR and a check on platelets tomorrow morning. Again, I am in control of my levels and am good to stay with the warfarin / coumadin. Thank you for your input.

      13. Martin Back

        To check on your FIL’s possible sleep apnea, get an app for his cell phone to monitor snoring. I use SnoreLab to check on myself occasionally.

      14. JDPatten

        It is certainly true that most obstructive sleep apnea occurs in those who snore.
        But not necessarily. Snoring doesn’t mean you have clinical apnea. It’s a good indication of risk, but it takes a sleep study to know the severity level.
        Scarier is the prospect of being one of the few silent apnea victims. Snoring apps can’t find those.

  36. SW

    How olive oil and sleep could stave off heart attacks and strokes: New study examines plasma protein’s role
    Apolipoprotein A-IV linked with thrombosis in new study
    September 6, 2018
    St. Michael’s Hospital
    Foods high in unsaturated fats may protect against cardiovascular disease, and new research has uncovered why.

    Foods high in unsaturated fats may protect against cardiovascular disease, and new research published today in Nature Communications has uncovered why.

    Apolipoprotein A-IV, known as ApoA-IV, is a plasma protein. Levels of ApoA-IV increase after the digestion of foods, particularly foods high in unsaturated fats, such as olive oil. Higher levels of ApoA-IV in the blood have been reported to be associated with lower rates of cardiovascular disease.

    New research from the Keenan Research Centre for Biomedical Science (KRCBS) of St. Michael’s Hospital demonstrates that ApoA-IV is an inhibitory factor for platelets, which are small blood cells that play a key role in multiple diseases, particularly in bleeding and cardiovascular diseases.

    These new findings suggest that ApoA-IV is a blocker of platelet surface glycoproteins GPIIbIIIa (also named integrin αIIβ3). Integrin αIIβ3 is a platelet receptor that is necessary for platelets to clump together in the blood (called platelet aggregation). Platelet aggregation can cause vessel occlusion that blocks blood flow, leading to thrombosis, which is the most common cause of mortality and morbidity worldwide.

    “Platelet aggregation can save lives, because it can stop bleeding in damaged vessels,” said Dr. Heyu Ni, Platform Director for Hematology, Cancer and Immunological Diseases at the KRCBS, who is the principal investigator of this study. “But we usually don’t want platelets to block blood flow in the vessels. This is thrombosis, and if vessel occlusion occurs in the heart or brain, it can cause heart attack, stroke or death.”

    Platelets bind together with a series of connectors. For one platelet to bond to another, the platelet receptor integrin αIIβ3 first binds to fibrinogen — an abundant protein that bridges platelets in blood — and fibrinogen molecules then bind another integrin αIIβ3 on a second platelet. Then fibrinogen and likely also other proteins allow many platelets to bind one another, leading to platelet aggregation.

    Examining both lab models and humans, Dr. Ni, who is also a scientist at Canadian Blood Services Centre for Innovation, and his team have shown that ApoA-IV can link to the integrin αIIβ3 and block fibrinogen binding, decreasing platelet aggregation in a vessel. The ApoA-IV protein can also change its shape to accommodate increased blood flow, and become more effective to protect vessels from complete blockage.

    “This is the first study to link ApoA-IV with platelets and thrombosis,” Dr. Ni said. “With this work, we have also explained why higher levels of ApoA-IV can slow down plaque build-up in blood vessels, known as atherosclerosis, because this process is also related to platelet function.”

    The researchers also examined ApoA-IV’s interaction with food. After every meal, platelets are stimulated, which makes it easier for them to bond together or bond to white blood cells. ApoA-IV increases in circulating blood almost immediately after meals containing unsaturated fats and decreases platelet hyperactivity and bonding, thus reducing the inflammation after meals and the risk of heart attack and stroke.

    The study also found that ApoA-IV has its own circadian rhythm. It is most active overnight and least active in the morning.

    “Mother Nature wants us to sleep well,” Dr. Ni said. “So we are protected by this protein while we sleep, and most likely to experience a cardiovascular event after waking up in the morning.”

    Dr. Ni and his team are excited about these findings because they show that foods with high unsaturated fats, along with appropriate sleep patterns, create the perfect combination for the protein ApoA-IV to play a positive role in reducing the chances of cardiovascular disease in the form of atherosclerosis, heart attack, or stroke.

    This new knowledge has many potential applications, Dr. Ni explained. Future studies will focus on better understanding this protein and how to harness its protective potential to build therapies targeted at cardiovascular disease and other diseases that arise from platelet activation and aggregation….

    1. Andy S

      SW, re study showing “Foods high in unsaturated fats may protect against cardiovascular disease”
      Not convincing enough to give up butter, lard and coconut oil. ApoA-IV is on every chylomicron as a result of fat metabolism. Unsaturated fats (PUFA’s) are inflammatory and perhaps need more ApoA-IV.

      1. SW

        Andy, It did not say give up butter, It was looking at therapeutic targets BUT it may explain success off Med Diet in the REAL Med Regions…I line in HOng KOng half of the year where life and healthspan are very long. THey are big meat eaters and the meat they eat is PORK is which is super high in MONOunsaturated fat as well…they also eat a LOT of seafood… so do MEd Regions. Both places are hilly, sunny and super community driven…May I add salt in take in MEd and HK are also v high

  37. Bill In Oz

    I posted a couple of queries about Macrophages earlier in this discussion. So far no on ehas taken me on with this. So I wnet looking for what I could find about the subject. And I found this :
    “Cardiac macrophages and their role in ischaemic heart disease” by Stefan Frantz Matthias Nahrendorf in the Cardiovascular Research, Volume 102, Issue 2, 1 May 2014, Pages 240–248,
    published: 05 February 2014

    Here is the Abstract
    “Cardiac macrophages are abundant in the healthy heart and after myocardial infarction (MI). Different macrophage phenotypes likely promote myocardial health vs. disease. Infarct macrophages are inflammatory and derive from circulating monocytes produced by the haematopoietic system. These cells are centrally involved in inflammatory tissue remodelling, resolution of inflammation during post-MI healing, and left ventricular remodelling. Presumably, macrophages interact with myocytes, endothelial cells, and fibroblasts. Although macrophages are primarily recruited to the ischaemic myocardium, the remote non-ischaemic myocardium macrophage population changes dynamically after MI. Macrophages’ known roles in defending the steady state and their pathological actions in other disease contexts provide a road map for exploring cardiac macrophages and their phenotypes, functions, and therapeutic potential. In our review, we summarize recent insights into the role of cardiac macrophages, focus on their actions after ischaemia, and highlight emerging research topics.”

    This to my own thinking is good basic science…It asks more questions that it gives answers and does not make wild assertions.

    1. Bill In Oz

      OK folks, after trying to generate a worthwhile discussion on the issue of macrophages and CVD, I give up. By all means go on with the diet focused crap. I will just ignore or delete…

      1. Jennifer.

        OK Bill, I assume you are referring to the likes of me, blogging on about food. You pop out into your garden in the nice Spring weather, most probably to cultivate good food, so you must believe food and excercise have a part to play towards a healthy heart. I have said before on this blog that there is certainly a place for the well researched info we get given. But, us lesser academics can contribute stuff that some may find helpful, albeit anecdotal. Just because you seem to want well researched scientific explanations, does not negate the more simple observations some of us have made regarding better health based on what we eat, and how we prepare food. This is the sort of stuff which is not scientifically researched, except by us lot experimenting in our homes and kitchens.
        While you are tending your plants ( I am not fortunate to have a garden these days), I am off to tend to my sauerkraut ,( I live just near Captain Cook’s birthplace …..yes him of the life-saving sauerkraut, as well as his connection to Australia) yogurt, kefir, sourdough, plus knitting , sewing and painting…..all valid and positive contributions to a healthy lifestyle. Folks like practical info too.
        Of course you are unlikely to read my reply. Enjoy your healthy produce.

    1. Bill In Oz

      Yes Randal.I have been taking Vitamin K2 capsules for about 5 years…Currently Life Extension Super K. Also excellent at helping to prevent osteopena…A elderly female friend had this issue as showed by bone density tests..But after a year on K2 her bone density improved. Her quack was surprised.But then he knew nothing about K2.

  38. AndrewPLarwood@dsl.pipex.com

    Hi Malcolm,

    Will there come a time when all of your blogs on “What causes heart disease?” can be published in a book format?

    I hope it does……..as it’ll be a best seller!


    Andrew Larwood

  39. AnnaM


    You shirked my question. You stated that killing a person or an animal is equal. So I ask you again, not about whether getting arrested is inconvenient, but whether you find killing a chicken equal to killing the little boy next door?

    1. Dr. Malcolm Kendrick Post author

      OK. I think I am now drawing a line under discussion on moral/ethical elements of meat eating vs. vegetarianism/vegan. These are interesting discussions, but they do not advance our scientific understanding of heart disease and diabetes and obesity and suchlike. AnnaM, this is not a comment, on your comment specifically. It is just that I fear we are generating more heat than light.

      1. Leon Roijen

        Of course I respect that decision.

        Instead of eternally reacting to the (negative) myths about vegetarianism propagated here, I’d like to move away from the discussion on the immorality of eating of meat, I would like to debunk a claim I heard here often: Namely that vegetarians can’t “thrive” or some similar nonsense – of course a very unscientific wording by people who have no idea what they are talking about.

        Below you find a text that shows that a big part of the Indian population is vegetarian. They have been vegetarian for milleniums because of Hinduism.

        In 2007, UN FAO statistics indicated that Indians had the lowest rate of meat consumption in the world.[68] India has more vegetarians than the rest of the world put together.[69] In India, vegetarianism is usually synonymous with lacto vegetarianism. Most restaurants in India clearly distinguish and market themselves as being either “non-vegetarian”, “vegetarian”, or “pure vegetarian”. Vegetarian restaurants abound, and many vegetarian options are usually available. Animal-based ingredients (other than milk and honey) such as lard, gelatin, and meat stock are not used in the traditional cuisine. India has devised a system of marking edible products made from only vegetarian ingredients, with a green dot in a green square. A mark of a brown dot in a brown square conveys that some animal-based ingredients (meat, egg, etc.) were used. Products like honey, milk, or its direct derivatives are categorized under the green mark.[70]

        According to the 2006 Hindu-CNN-IBN State of the Nation Survey, 31% of Indians are vegetarian, while another 9% also consume eggs (ovo-vegetarian).[27] Among the various communities, vegetarianism was most common among the Brahmins, Lingayat, Vaishnav Community, Jain community, and, less frequent among Muslims (3%) and residents of coastal states. Other surveys cited by FAO[71] and USDA[72][73] estimate 40% of the Indian population as being vegetarian. These surveys indicate that even Indians who do eat meat, do so infrequently, with less than 30% consuming it regularly, although the reasons are mainly cultural.[73] In states where vegetarianism is more common, milk consumption is higher and is associated with lactase persistence. This allows people to continue consuming milk into adulthood and obtain proteins that are substituted for meat, fish and eggs in other areas.[74][75] An official survey conducted by the Government of India, with a sample size of 8858 and the census frame as 2011, indicated India’s vegetarian population to be 28-29% of the total population.[76] Compared to a similar survey done almost a decade earlier, India’s vegetarian population has increased.[77]

        According to a 2014 survey released by the registrar general of India, Rajasthan has the highest fraction of vegetarians: 74.9%. Other states with vegetarians include Haryana (69.25%), Punjab (66.75%), Gujarat (60.95%), Madhya Pradesh (50.6%), Uttar Pradesh (47.1%), Maharashtra (40.2%), Delhi (39.5%), Jammu & Kashmir (31.45%), Uttarakhand (27.35%), Karnataka (21.1%), Assam (20.6%), Chhattisgarh (17.95%), Bihar (7.55%), Jharkhand (3.25%), Kerala (3.0%), Orissa (2.65%), Tamil Nadu (2.35%), Andhra Pradesh (1.75%), West Bengal (1.4%), and Telangana (1.3%).[78]


      2. Leon Roijen

        “To be sure, but I did find it a provocative statement!”

        It surely is – surely for slaveholders in Southern US states the abolishment for slavery was provocative, too – as undoubtedly was the end of racial segregation for many, or “gay” marriage in more modern times, and so on and so on… without people being provoked, without calling things what they are – nothing ever changes.

  40. Göran Sjöberg

    I often find the newsletters from Dr. Mercola interesting. The one I received this very morning is very revealing to what is going on in the industrial enterprise of meat production and it is for sure disgusting from most points of view and not least it relates to the present discussion going on here on this blog.


    So, I fully understand the moral/religious attitudes of the “vegan” people, like Leon here, although I think they are missing the “target”. There is nothing wrong with meat as a nutrient – on the contrary it is as close as you can get to what we are built from. Though, you can survive as a vegetarian but it is an uphill battle basically against nature. (The vegan ape state we actually left behind several million years ago when our large intestine, where the veggies are digested, also turned very short compared with e.g. the vegan gorillas.)

    My own standpoint here is that we, from a moral point of view (?) but more from a self perseverance one, should fight the present poisonous industrial practices of Big Pharma as well as those of Big Agro. These are the “huge elephants in the room” which the vegan community tends to downplay in their moral attacks on “meat eaters”. There is a saying that vegans are “good idiots” in the hands of the corporate business.

    Presently I again noting the aggressiveness of my mallards feeding on the carbs I am supplying in abundance in the pond outside my window, I can not refrain from connecting to this aggressiveness I note (but certainly Lierre Keith after her heresy) among vegans towards “meat eaters”. Is that physiologically also driven by an excessive carb intake where the aggressiveness typically tends to appear with the rapid fall of the blood sugar after a typical “western diet” meal?

    So, my advice here is for the vegans to relax by abstaining from the carbs which may be a good start.

    Religion is though a really interesting subject which brings people closer together in different contexts/communities where dogma of course rule as Émile Dürkheim so well put it more than a hundred years ago.

    1. Leon Roijen

      Göran, I don’t want to go into all the nonsense about vegetarians you bring up here.

      I wish to pick out one silly claim:

      “Though, you can survive as a vegetarian but it is an uphill battle basically against nature. (The vegan ape state we actually left behind several million years ago when our large intestine, where the veggies are digested, also turned very short compared with e.g. the vegan gorillas.)”

      People are omnivores and there is no unequivocal, sound research whatsoever that people cannot be vegetarian and enjoy good health.

      The one who propagates a myth here (that we need meat), who has a religious attitude towards diet is you, not me.

      1. AhNotepad

        The one who propagates a myth here (that we need meat), who has a religious attitude towards diet is you, not me.

        Apart from being another example where you have brought nothing to the discussion though you are happy to level that accusation at others, it is another logical fallacy so beloved of barristers. You could have missed your calling.

    2. Leon Roijen

      And, Göran, I see you often talking about Big Pharma as do so many people here, but in my opinion, the real problem here is the doctors:
      They let themselves be influenced by pharmaceuticals – it starts already the first day in university I read. We most do away with the thought that Big Pharma is the problem. It brings us nowhere.
      It’s doctors who should get more critical. With them lies the real problem. Without doctors prescribing unnecessary (expensive) or even dangerous medication Big Pharma is powerless.

      1. ellifeld

        Sure let’s focus on doctors. So who goes to medical school? Usually very bright students who want to help others. Quite a different mentality than those who go the business school. It’s an extremely long and expensive grind. Long hours and years. Debt can run in the US to avg almost $300K. And many would be starting families at this point also. But in your mind you’d like the focus for change to be on them. Of course to make it thru school and residency, the entire focus has been medications to treat disease. And how many hours do they study nutrition? Roughly 4-6 total. Guess what? There’s no money in suggesting dietary changes. That’s a problem. In fact doctors are rarely concerned about their diets, unless they are overweight. Sorry, doctors are part of a system, which is run by the pharmaceutical and insurance industries.

      2. Jean Humphreys

        To Leon Riojen
        If you believe that the problem is that the doctors prescribe the products of “big pharma” then it seems to me that you are looking at the situation from the wrong angle. I would prescribe some open-minded reading of writings by Peter C Gotzsche, followed by a nice dish of properly cooked well seasoned belly pork, from a local herd of rare breed pigs.

        1. Gary Ogden

          Jean Humphreys: Like the Mangalista, whose sliced belly we relish at our breakfast table, or a rib chop for supper-heavenly!

      3. Leon Roijen


        “Sorry, doctors are part of a system, which is run by the pharmaceutical and insurance industries.”

        They allow themselves to be part of that system. If they stood up against certain practices they could make big changes and change how Big Pharma is influencing the system.

        But what is the case? Medical students are already influenced by Big Pharma, doctors accept gifts from Big Pharma, doctors bought by Big Pharma influence guidelines pushing for medication.

        Doctors are not just passively “part of the system” . They are co-actors and therefore to be held responsible.

        Of course there are exceptions.

      4. ellifeld

        It’s so easy to get on a computer and make judgemental statements like yours, isn’t it Leon? I think you lack common sense and also a factual understanding of how the medical system works. Btw, is it your position that only if physicians would recommend a vegetarian diet that everything would be cured? Is that what you believe physicians should do?
        As far as how the system works, doctors follow what is called standard of care, they must make certain recommendations otherwise they can be liable for anything that happens. Those rules are established by the drug industry and insurance. In your mind, someone who has taken considerable time and money to become a doctor should just risk everything, losing their position, and get more “critical” as you say. Really? Easy for Leon to say. Like I said, you don’t understand the system, but you think you do. The system you are talking about is profit motivated. Like I previously said, there’s little money in recommending dietary changes.

        Maybe I missed your response regarding herbivores. I commented that herbivores have to eat continually 7 days a week, and have 2, 3, 4 stomachs, so they can extract the nutrients they need, which is scarce from plant life. Plant life is mostly water, some fiber, small amounts of vitamins, minerals and antioxidants. No fat or protein. Maybe if we ate continually we could also extract what we need even without those extra stomachs although I doubt it. Wouldn’t give us much time to do much else either, would it?

      5. Aileen

        Leon, “they let themselves be influenced by the pharmaceuticals”. But the influence can be subtle and apparently innocuous. The NHS itself pays for very little in the way of training beyond the absolute basics. This leaves a gigantic opening for pharmaceutical companies.

        As an example, you might have an NHS employee (H) who specialises in managing a devastating neurological condition. Very bright, hardworking, good at teaching. Anxious to educate as many health professionals as possible so that people can receive the best care possible. Her post is woefully under-supported by her NHS employers. A pharmaceutical company (X) offers to fund a few hours of admin support a week. This post will be funded for a year, after which responsibility for supporting it will be up to the NHS Trust concerned (if it chooses to). K is engaged. To all intents and purposes it is as if K is being employed by the NHS, but the post is entirely funded by X.

        H doesn’t yet have a lot of patients, as many GPs tend not to refer these patients to secondary care. This is not good: people may be misdiagnosed with a terrible illness they don’t have, or alternatively left undiagnosed altogether until it’s too late to help them. Those who *are* correctly diagnosed are likely to be left without properly adjusted medication or support, both of which can make a massive difference to their lives.

        A series of county-wide education sessions for GPs is proposed. But it is a rural area – how do you persuade people to turn out of an evening for an education session? X helps by paying for refreshments. K arranges the meetings and prepares some professional-looking PowerPoint slides. H conducts the meetings.

        H goes on to deliver presentations at many more medical meetings and conferences across the country (fares, accommodation and meals paid for by X) and builds up a well-earned reputation for knowledge, experience and competence. In time she gains a place on the NICE guidelines committee and is thus in the enviable position of being able to exert real influence. She is a person of real integrity who wants to do the best for her patients.

        There is one first-line drug for this condition, of which two versions are available. They are produced by two different pharmaceuticals, one of which is X.

        Years later, long after they have been superseded, the guidelines will still be available on the internet. They will contain no mention of X’s financial support of H.

  41. Jean Humphreys

    I have been hanging around here for some time now, and although I get a bit fed up with the talk of supplements of this and that, and how much, I think “If if works for them, fine” I do get a bit fed up with various posters who KNOW that they are right. They are the names that prompt me to delete unread.
    Through my life, I have learned to be wary of the people who KNOW that they are right, particularly in religion, but in health and medicine as well. Nothing puts my back up like a blast of righteous pontificating – especially as I am of the female persuasion, and know quite a lot more that many gve me credit for!

      1. Jean Humphreys

        Am I saying that I know that I am right? Absolutely right, I know that I am right when I say I don’t know it all. But I do know some things better than some other people do. I have in mind the cardiologists who didn’t listen, and thank goodness for the ones that did, and trusted what I told them. The useful ones.

  42. Sylvia

    Jean, lets indeed here it for females, females are fabulous. As Ginger Rogers said, ” I did everything Fred Astaire did but backwards” Sorry Dr Kendrick, couldn’t resist.

    1. Bill In Oz

      Close Sylvia but not quite accurate : The real quote goes like this :” I did everything Fred Astaire did but backwards & in high heels ! ”

  43. AnnaM

    Some people think that the powers that be are very clever at getting all the good people to fight one another. Divide and conquer. Vegans battle the ketos, but shouldn’t we all be battling the corporate food chain and their government subsidies and protections?

    Leon, I think it is not entirely incorrect to use the term religion when someone has a belief system they hold fast to, even though it isn’t a named religion.

    The problem with the natural law argument is that from my own reading, I see lots of evidence that humans simply cannot get adequate nutrients from a plant diet and I see a lot of pretending on that score. It may even be the case that if humans were to adopt such a thing and more or less stick to it, that our brains would devolve. The human brain is in a unique position for far as the percentage of energy it requires. True plant eaters always have large guts, and humans have very flat guts. Nor do we eat all day.
    Our similarities with other primates are, in my opinion, greatly exaggerated. There are many profound differences. We don’t even have the same mode of locomotion! Their guts are big, ours are small. They have a big cecum, our is tiny. Our brains use primarily omega 3, theirs uses omega 6. And of course our brain size. Different rib cage, hair pattern, larynx and pharynx, length of arms and legs. Not even the same number of chromosomes.

    1. Leon Roijen

      My natural law argument has nothing to do with nutrition, Anna. “Natural law” is just a term to describe the idea (suggesting) there is a universal law (or morals) applicable to all times and places and that we can “discover” that law by using our reason.
      Also, it has nothing to do with “the law of nature”.

      I think this article migh be interesting for you, I found it quite interesting:


      We are not herbivores, we are not carnivores, but omnivores and therefore we can easily thrive on a vegetarian diet. See a few comments above showing that a large part of the Indian population is vegetarian and has been so for a very long time.

      1. JDPatten

        Friendly reminder:
        “OK. I think I am now drawing a line under discussion on moral/ethical elements of meat eating vs. vegetarianism/vegan.”

        1. Dr. Malcolm Kendrick Post author

          I am a free speech kind of guy. I think Leon has probably achieved nothing, but to harden the stance of many here against him – and thus against vegetarianism. Unfortunately, debate is sometimes uncomfortable, but I always fear what Cass Sunstein has written. ‘To become an extremist, hang around with people you agree with.’ Getting the opposite point of view is something we humans deal very badly with, generally. But I think it is important to try and see how other people see the world. You never know, some people may even change their minds – although, to be frank that seems highly unlikely in this case.

          1. Gary Ogden

            Dr. Kendrick: Three cheers for your sentiments on this issue. It is good for us to get out of our comfort zone from time to time. As for me, I usually don’t read much of what Leon writes, but then, I fought those battles long ago, and frankly, the debate bores me to tears. Who am I to be so presumptuous to tell others how to live?

      2. Leon Roijen

        “I think Leon has probably achieved nothing, but to harden the stance of many here against him – and thus against vegetarianism. ”

        I’m not a missionary and I didn’t comment here on meat eating versus vegetarianism to gain souls. That would be religious indeed. I don’t believe that’s the way to change things. If you look at many big changes in history, they occur because people are forced to give up bad habits (I already mentioned slavery and racial seggregation, but you can find many more examples).

        I think much tougher measures are needed to stop people from eating meat.
        I’m a liberal when it comes to free choice. Do you want to smoke? Don’t you mind the cancer risk? Your choice.
        But in eating meat other sentient living beings are involved and there I draw the line.

        1. AhNotepad

          I think much tougher measures are needed to stop people from eating meat.
          I’m a liberal when it comes to free choice.

          Of course you are Leon, very liberal indeed in your condemnation of those whose views you disagree with. We are free to choose we have no choice, or we are free to choose we do not have a choice.

      3. AnnaM


        I am glancingly familiar with the concept of natural law. I would say that I accept it. Nonetheless I just think you’re wrong in your application of it to human diet. And, as I said elsewhere, because we are omnivores does not mean we can ‘decide’ to live as herbivores!

  44. Göran Sjöberg

    I guess that this input may seem a little too technical for some for which I apologize. (I though “love” chemistry.)

    It is a striking fact that fats are essential when it comes to our physiology/metabolism and our “health” mostly since the membranes of all our cells are built by a combination of different fat molecules, saturated and unsaturated, of different kinds adding to their flexibility or stiffness. (All natural fats are a combination of these in various compositions and proportions but it is striking that olive oil and animal fats are very similar in composition.)

    It is also a well established fact that the long chain polyunsaturated ones, DHA and EPA, are extremely important since they are so reactive due to the presence of their high number of double bonds between the carbon atoms which makes these molecules very “kinky”. For this very reason they add to the flexibility of the cell membrans to say the least.

    The basic subject of fat chemistry excites me a lot where the number and the locations of these double bond between the carbon atoms are crucial. Here we are interested in the natural rotation (impressively high) of these kinked molecules which is the basic reason for their “softening” influence (lowering the melting point; good for fish in cold water) on the cell membranes. (Being the first one to explain the nature of these chemical bonds Linus Pauling received his first Nobel prize BTW.)

    Humans are very poor at synthesizing the DHA and EPA from shorter chain precursors which is why flax seed oil omega-3’s with a conversion rate of 0.1 % (?) doesn’t help very much.(Previously I was taking some flax oil since I thought it was “good” for me but not any longer since I know better!)

    Then we are back to the benefits of fish ore rather krill oil which are “full” of DHA and EPA coming from the algae in their food chain.

    This also brings me back to Dr. Mercola whose newsletter this very morning is dissecting this omega-3/omega-6 issue. Again Mercola triggered an input to this eminent blog.


    1. Gary Ogden

      Göran: Thanks. I had not thought about the idea of membrane flexibility in regard to the kinkiness of MUFA and PUFA. Interesting to ponder. I, too, once consumed flax seed oil, but didn’t much like it, and now realize not much is converted to EPA and DHA. Now I just eat fatty fish. But they don’t seem to make me a fatty person!

      1. Göran Sjöberg


        Interesting is that the admitted industrial “poisonous” transfats (read margarine; “heart healthy” fats) have been twisted 180 degrees around unsaturated carbo-carbon double bonds in which the adjacent hydrogen atoms naturally repell one another in their cis (same side) form and thus producing the kink in the molecule but in the transform they don’t do that any more making the kinked molecule straight and mimicking the straight saturated molecules.

        That is in my eyes fooling the nature to increase the melting point of cheap vegetable oils to produce fats that can be can be put in all the junk food for long shelf life – they don’t go rancid.

    2. Leon Roijen

      You better start reading serious sources instead of Mercola. He mixes facts with fiction and makes omissions.
      Moreover, he sells the stuff he talks about.

      “Then we are back to the benefits of fish ore rather krill oil which are “full” of DHA and EPA coming from the algae in their food chain.”

      We need not fish or krill – we can get EPA + DHA directly from algae:


      Saves a lot of fish and is a much cleaner product.
      Saves us also from buying the ridiculously expensive krill oil from Dr Mercola which has less EPA and DHA in a daily dose compared to the cheaper algae oil.

      1. Dr. Malcolm Kendrick Post author

        I tend to find Mercola pretty reliable. At times a bit over the top. Yes, he sells things. But we all have to make a living somehow. I am lucky enough to earn my money in other ways, so I can blog without charging any money. However, in future I may well look to try and make some money from all of this work that I currently do for free.

      2. Leon Roijen

        Dr Kendrick,

        “I tend to find Mercola pretty reliable. At times a bit over the top. Yes, he sells things. But we all have to make a living somehow. I am lucky enough to earn my money in other ways, so I can blog without charging any money. However, in future I may well look to try and make some money from all of this work that I currently do for free.”

        There is a thin line between “over the top” and “reliable”.
        I looked at his homepage, chose an article on milk and got this:

        “Raw Milk Vending Machines Flourish in Europe”

        “Raw milk vending machines provide a convenient outlet for residents in many countries to stock up on what is considered a healthy and wholesome food
        Self-service machines may be found at farmers markets and small farms as well as in shopping centers and near schools and playgrounds”


        Suggesting that Europe is full of raw milk vending machines, and as examples he names the UK and the Netherlands.
        Now I don’t know about the UK but as for the Netherlands, this is the first time that I heard about these raw milk vending machines and if there are 10 on a population of, say 18 millions, you can’t really say that these machines are “flourishing”. You might call it over the top, I call it completely unreliable.

        Worse, he does not warn against the risks of raw milk: Salmonella, Campylobacter, E. coli, Listeria (and possibly more). Serious infections as you undoubtedly know as a doctor.
        Those risks are now downplayed and (as I read) there are only a few deaths in Europe due to raw milk nowadays but that could quickly change if more people start consuming raw milk.

        It’s completely irresponsible encouraging people to drink raw milk without telling them about the dangers involved.
        He also fails to notice that in the Netherlands, on farms where raw milk is sold, farmers by law must mention that the milk should be heated before consumption.

        And so one can find many very disputable articles on Mercola’s website.

        What about his vaccination fearmongering?


        I am well aware that vaccines also have drawbacks, but do you as a medical doctor find this information “pretty reliable”? Do you think we should stop DTP vacinations?

        Lastly, I’m not saying there is anything wrong with making money. But if you advocate the very products you sell (as often happens on his site), sorry, but that doesn’t make you a very reliable source.

        1. Dr. Malcolm Kendrick Post author

          Well, I visit a farmers shop and buy raw milk from time to time. Not a vending machine, but in the UK raw milk sales are flourishing. I wouldn’t say they are taking over the country, but then again you may wish to argue the nature of the world flourishing. If we are talking about unreliable information, I suggest you have a look at this youtube video by Richard Smith – who edited the BMJ for over twenty years. His view is that 85% of what is published is just, plain, wrong. Usually biased by financial support from the pharmaceutical industry. https://www.youtube.com/watch?v=7oR5PCC6dng&feature=youtu.be&t=5s

          1. washjohngalt

            This was a great video! I was looking for it for a friend but it is now marked as private on youtube (I guess do to the Covidian purge). Anyone know how to gain access?

        2. AhNotepad

          Worse, he does not warn against the risks of raw milk: Salmonella, Campylobacter, E. coli, Listeria (and possibly more). Serious infections as you undoubtedly know as a doctor.

          All of those are available without having “raw” milk. Unpasteurised, more correctly, has a range of organisms which are able to ensure the milk is likely to be in general, wholesome. You cannot make things safe by killing bad organisms, only by overwhelming them with good ones.

          I would be surprised if most of us weren’t carrying the “infections” you mention, it’s just we have protectors which deal with them as long as we stay healthy.

      3. mmec7

        Leon Roijen – Raw Milk – Vending Machines –
        Leon – Here in the small town in France where I live, we have a raw milk vending machine, 1 euro a litre. At the weekly farmer’s market, a stall sells raw milk produce : raw milk; raw milk cream (delicious); various cheeses, excellent. All produce good and well supported by the local populace. We are all well.
        When I lived in India, the doodh wallah would drive his buffalo to my door, where the buffalo would stand to be milked. Raw milk, fresh from the source. The only illness I had in India during my seven year stay there, was food poisoning from a Chinese meal ! I was never so well as when I lived in India – and was basically a vegetarian : so much simpler, as most of my friends and colleagues were vegetarians.

      4. Leon Roijen

        Dr Kendrick,

        “I suggest you have a look at this youtube video by Richard Smith – who edited the BMJ for over twenty years. His view is that 85% of what is published is just, plain, wrong. Usually biased by financial support from the pharmaceutical industry. ”

        I am well aware of it, but does it justify Mercola? I think not.
        You conveniently didn’t address the vaccination scare mongering by Mercola and you didn’t answer my question whether you think we should stop DTP vacinations 🙂

        Below you find illegal and totally absurd health claims he made for the products he sells:

        FDA Warnings
        In 2005, the FDA ordered Mercola and his Optimal Wellness Center to stop making illegal claims for products sold through his Web site [20]. The claims to which the FDA objected involved three products:

        Living Fuel Rx, claimed to offer an “exceptional countermeasure” against cancer, cardiovascular disease, diabetes, autoimmune diseases, etc.
        Tropical Traditions Virgin Coconut Oil, claimed to reduce the risk of heart disease and has beneficial effects against Crohn’s disease, irritable bowel syndrome, and many infectious agents
        Chlorella, claimed to fight cancer and normalize blood pressure.
        In 2006, the FDA sent Mercola and his center a second warning that was based on product labels collected during an inspection at his facility and on claims made on the Optimum Wellness Center Web site [21]. This time the claims to which the FDA objected involve four products:

        Vibrant Health Research Chlorella XP, claimed to “help to virtually eliminate your risk of developing cancer in the future.”
        Fresh Shores Extra Virgin Coconut Oil, claimed to reduce the risk of heart disease, cancer, and degenerative diseases.
        Momentum Health Products Vitamin K2, possibly useful in treating certain kinds of cancer and Alzheimer’s disease.
        Momentum Health Products Cardio Essentials Nattokinase NSK-SD, claimed to be “a much safer and effective option than aspirin and other pharmaceutical agents to treating heart disease.”

        ( https://www.quackwatch.org/11Ind/mercola.html )

        Oh, and what about Mercola and Aids denialism (didn’t I cover that earlier?):

        “Questioning whether HIV is the cause of AIDS, claiming manifestations of AIDS (including opportunistic infections and death) may be the result of “psychological stress” brought on by the belief that HIV is harmful.[31] The scientific community considers the evidence that HIV causes AIDS conclusive.[32][33][34][35] Mercola.com has also featured positive presentations of the claims of AIDS denialists, a fringe group which denies the role of HIV in causing AIDS.[1]”

        ( https://en.wikipedia.org/wiki/Joseph_Mercola#Other_views )

        You are still convinced Mercola is “reliable”? I rest my case.

        1. Dr. Malcolm Kendrick Post author

          Leon, you use so many techniques that were outlined by Schopenhauer in his essay 38 ways to win an argument. Your favoured techniques are:

          Carry your opponent’s proposition beyond its natural limits; exaggerate it. The more general your opponent’s statement becomes, the more objections you can find against it. The more restricted and narrow his or her propositions remain, the easier they are to defend by him or her.

          State your proposition and show the truth of it by asking the opponent many questions. By asking many wide-reaching questions at once, you may hide what you want to get admitted. Then you quickly propound the argument resulting from the opponent’s admissions.

          Use your opponent’s answers to your questions to reach different or even opposite conclusions.

          If your opponent has taken up a line of argument that will end in your defeat, you must not allow him or her to carry it to its conclusion. Interrupt the dispute, break it off altogether, or lead the opponent to a different subject.


          These were all, according to Schopenhauer, tricks in arguing that should not be used, as they are simply strategies used by lawyers and politicians, ans suchlike, to try and ‘win’ an argument. They are not an attempt to get at the truth of anything. More like a sporting contest, at the end of which you get to shout. ‘I win, you lose.’

          I see no value whatsoever in attempting to to ‘win’ a scientific argument. End of. I believe Mercola is, generally, a reasonable source of information. I would never take what he writes as absolutely true – I would never do that of anything, especially not medical journals. He has some ideas that I do not agree with – so does everybody. He is ruthlessly attacked by those who, in many cases, are closely allied with the pharmaceutical industry. I admire his bravery. I speak as someone who is also regularly attacked for being a quack.

        2. AhNotepad

          Sounds like a case of pot calling the kettle black. Why do you not address the totally absurd health claims of vaccine manufacturers whose products caused so much damage they had to pass the liability to the US government in 1986, as they couldn’t stand the cases brought against their products. Perhaps, Leon, you would care to look at Suzanne Humphries work especially as you mention DTP into the cases distribution of pretussis in the US, where 86% of the cases are in vaccinated people, you know, those who are supposed to be protected by, er, the vaccine.

      5. Göran Sjöberg


        That was a really great talk by Richard Smith – thank you for this link! It just confirms my prejudices about a corrupt medical world.

        The talk could perhaps even impress on medically ignorant people – who knows?

        BTW i wonder about the “new” practice om BMJ to invite patients like me to participate in the review process if it is just basically a “useless” process.

        1. Gary Ogden

          It would also eliminate those of us who cannot do financial transactions on line, and can’t figure out how to fix the problem. The one on-line resource I support I send my support by check, as I do the non-commercial radio station I listen to.

      6. Leon Roijen

        Dr Kendrick,

        May I remind you of Schopenhauer’s stratagem 34:

        “When you state a question or an argument, and your opponent gives you no direct answer, or evades it with a counter question, or tries to change the subject, it is a sure sign you have touched a weak spot, sometimes without knowing it. You have as it were, reduced the opponent to silence. You must, therefore, urge the point all the more, and not let your opponent evade it, even when you do not know where the weakness that you have hit upon really lies.”

        However, I won’t urge this point anymore – as promised, I rest my case 😉

  45. Martin Back

    Re the discussion on wheat elsewhere: The wheaten goods we eat these days are made from flour that the wheat germ has been milled out of, in the interests of commerce. This substantially reduces the food value of these products.

    “Tocopherols are a group of monophenolic antioxidants found in many plant materials. Antioxidants eliminate free radicals, providing in this way primary defense to our body. They accomplish the same task in vegetable oils, preventing the formation of hydroperoxides.

    “Wheat germ oil has the highest tocopherol content of all vegetable oils, up to about 2500 mg/kg (Shuler, 1990), and also the highest content of a-tocopherol, which represents around 60% of the total content. Also, wheat germ oil is highly valued due to its high content of unsaturated fatty acids: it has about 80%, mostly linoleic (18:2) and linolenic (18:3) (Wang and Johnson, 2001). These two fatty acids are of great importance in human metabolism and cannot be synthesized by the organism. They are precursors of a group of hormones called prostaglandins, which play an important role in muscle contractions and in the proper healing of inflammatory processes (Coultate, 1989). Furthermore, linoleic acid helps to eliminate cholesterol and is a precursor of cell membrane phospholipids (Salinas, 1993).”http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-66322006000100011

    Mostert’s Mill is a heritage mill here in Cape Town where they produce stone-ground flour from whole wheat. It is pale yellow because the wheat germ is still in it, and makes a fabulous bread. You can understand why bread in the old days didn’t cause the problems it does today — it was a much healthier product.

    Thank heavens they haven’t yet figured out how to remove the goodness from meat! ;o)

      1. Martin Back

        For a complete discussion one would need to add the leavening process — slow fermentation by wild yeast versus the speeded-up Chorleywood process with selected yeast strains, versus no yeast only baking powder or the like. But I won’t go that far. Suffice it to say that I trust the wild yeast to gobble up any harmful stuff, as it has been doing for humans for thousands of years.

    1. Jennifer.

      Martin. I purchase the best quality organic stoneground flour in the hope that I am doing the correct thing. I also purchase organic wheatgerm to use with porridge etc, but I wonder why it has a short shelf life ( so I keep it in the fridge). I understand it goes rancid rather quickly due to the oil in it, but my query is whether rancidity is purely about ‘off-taste’ or is it unwholesome?
      Do you or any other bloggers know the answer please?

      1. Andy S

        Wheat germ agglutinin adverse effects.


        Wheat germ agglutinin (WGA) is a plant protein that binds specifically to sugars expressed, among many others, by human gastrointestinal epithelial and immune cells. WGA is a toxic compound and an anti-nutritional factor, but recent works have shown that it may have potential as an anti-tumor drug and as a carrier for oral drugs. To quantitate the toxicity threshold for WGA on normal epithelial cells we previously investigated the effects of the lectin on differentiated Caco2 cells, and showed that in the micromolar range of concentrations WGA could alter the integrity of the epithelium layer and increase its permeability to both mannitol and dextran. WGA was shown to be uptaken by Caco2 cells and only approximately 0.1% molecules were observed to cross the epithelium layer by transcytosis. Here we show that at nanomolar concentrations WGA is unexpectedly bioactive on immune cells. The supernatants of WGA-stimulated peripheral blood mononuclear cells (PBMC) can alter the integrity of the epithelium layer when administered to the basolateral side of differentiated Caco2 cells and the effects can be partially inhibited by monoclonal antibodies against IL1, IL6 and IL8. At nanomolar concentrations WGA stimulates the synthesis of pro-inflammatory cytokines and thus the biological activity of WGA should be reconsidered by taking into account the effects of WGA on the immune system at the gastrointestinal interface. These results shed new light onto the molecular mechanisms underlying the onset of gastrointestinal disorders observed in vivo upon dietary intake of wheat-based foods.

      2. Gary Ogden

        Jennifer: Rancidity in oils is unwholesome. The 2015-16 schism in WAPF was caused by the president’s promotion of rancid cod liver oil.

  46. Sasha

    Regarding India, it’s important to keep in mind that historically, and even now, a significant portion of India’s population could not and cannot afford animal products. There are millions of Indians today who subsist primarily on white rice and lentils because that’s all they have money for. And these people are far from healthy. The situation is reversed among the affluent and the middle class; India is one of those countries where the poor are skinny and the rich are fat. India also has pretty high rates of CVD and diabetes. Many (possibly most) religious traditions within Hinduism prohibit or advise against the use of meat and other animal products, likely because they interfere with the meditative practices. However, a large number, maybe a majority of the followers of these traditions do not meditate or do not meditate seriously enough for animal products to cause problems. I wouldn’t be surprised if these prohibitions could have initially evolved as more like religious edicts to keep the peace amongst the population who couldn’t afford meat products anyway. As Napoleon reportedly said: “Religion is what keeps the poor from murdering the rich”.

    1. Leon Roijen


      You talk about two extremes.
      On one side poor people who are mostly vegetarian and have poor diets, and on the other side the rich who have poor meat and sugar loaded diets.

      Not all Indian vegetarians are poor and unhealthy and not all rich people have an unhealthy diet.

      Many studies show vegetarians live longer. Some researchers say it’s not because of the vegetarian diet but because vegetarians live healthier in other ways, too.
      Maybe these researchers are right, who knows, but even so, if a vegetarian would be a disaster for health, vegetarians would certainly not live as long or longer than meat-eaters.

      The myth that people need meat of course is propagated by the meat industry in which more people worldwide have an interest than Big Pharma.

      1. Sylvia

        I rather like prof Tim Noakes talks about diet. He speaks from experience and obviously his medical knowledge. Though the wonderful farmer who founded Compassion in world Farming, Peter Roberts was a vegetarian, he strongly believed animals should be killed at or near the farm of rearing and of course no transportation long distances of live animals.

      2. Sasha

        I am not sure which studies you refer to. I think many of them suffer from selection biases. It’s true that evolutionary many of our ancestors didn’t have the same 24/7 access to high caloric foods as we do today but that includes all foods, not just animal proteins. It is also true that we evolved to be omnivores and virtually every population in history ate animal proteins whenever they had access to it. That includes the so called Blue Zones where people live longer than average and most, if not all, hunter gatherers who generally are free from diseases of civilization. Many of them didn’t eat as much animal proteins as we do today but they ate them, nevertheless. So, your claim that vegetarians live longer than non-vegetarians has no basis, I think.

        1. Gary Ogden

          Sasha: Also, there is evidence emerging now that it was the climate changing in east Africa from forested to open savanna, with its large herds of herbivores, which played a key role in the evolution of our species. That is, that the change in diet from primarily fruits and other vegetable foods, to the inclusion of meat from mammals (some evidence for the inclusion of shellfish, too) coincided with the enlargement of the brain, and the increase in its complexity, which, over time, led to us. Natural History magazine for September has a series of articles about such matters.

          1. Sasha

            Gary, very interesting. “Nothing in biology makes sense except through the lens of evolution”, as they say…

    2. Gary Ogden

      Sasha: In the current (September) issue of Harper’s is an article by Rohini Mohan, “A Template for Hate,” which is primarily about violence against Muslims in some parts of India by extremist Hindus, but it touches on the issue of eating beef. Apparently the prohibition against the slaughter and eating of cattle indeed originated for political reasons, and relatively recently-the late 19th Century. and only in parts of India.

      1. Sasha

        Gary, that’s interesting. I always thought that cows were sacred in Hinduism and that the prohibition goes back centuries if not thousands of years. I also thought that it could have been to prevent the people from killing “the golden goose”. I would need to check on this as I have difficulty believing the Harper’s version…

        1. Gary Ogden

          Sasha: I suspect it is more complex than we have always assumed. Throughout our history, humans, like all other creatures, have exploited whatever food sources are available. Thus the cow, while of great value in many cultures for the nourishing milk it provides, and fuel as well, only gives this in about half of the offspring. It would be interesting to know the history of how male cattle were used in India, region by region. A large nation of many cultures.

        2. mmec7

          Vegetarianism in India goes back centuries, 600 BCE. This is Wiki, with a useful snapshot and good
          “Killing the golden goose” is also correct. The animal gives more for far longer than killing the animal for food would give. Cow = milk and milk products for several years. Chickens give eggs for a few years (yes, I have kept chickens, some can live for 7 – 8 years, most, to 5 years. Production wise, 3 years before less production. Have read of 5 year olds producing 2 – 3 times per week).
          As for other ‘food’ animals, suspect. That is, cleanliness.
          Here’s an extract from Wiki :-
          “Contrary to popular Hindu belief, the Aryans did eat meat. They did not have any qualms about beef and other meats. Soon, the types of meat allowed for consumption reduced due to the Aryan concept of “unclean meat”. Sacrificing meat was also a practice done to appease the Gods and improve agriculture. Meat sacrifices began to be frowned upon when war, drought and famine arose (around 600 BCE). As the population grew, more land was needed for agriculture and soon communities with administration and trade popped up. This was a time of questioning, as mystic teachers called Samanas went around initiating debates on the relevance of the cow. The cow was a major economic and agricultural advantage so killing it for food was impractical. People connected the large number of Gods and Goddesses as depicted in a cow with the animals practical advantages. Killing a cow was considered a sin in the newly forming Hindu theology.[13]”
          See also the extensive notes, research and references.

          I would suggest that the Harper’s article is poor.

        3. mmec7

          A note to Gary Ogden – re the male calves, and for that matter cockerels :-
          Quote : “It would be interesting to know the history of how male cattle were used in India, region by region. A large nation of many cultures.”

          As far as bullocks – usually let loose to go fend for themselves. Turned away at birth. Unpleasant.
          Buffalo, can be put to the plough, and also used as general draft animals.
          Cockerels, turned loose to go fend for themselves.

          This is what I know and have observed directly, first hand. As for the ‘history’ – do not know.

          Otherwise : Lamb, goat and pig freely available.

          Jains are the vegans of India. Non meat eaters, Gujaratis and Brahmans, especially South Indian Brahmans, and Buddhists. There are many sects and many vegetarians. Biggests meat eaters in India will be Northern Indians and the Sikhs. But nothing is set in concrete…I know vegan Sikhs and vegan North Indians. All healthy. Would suggest diabetes is a big issue in India, much sugar and very sweet dishes plus carbs with the rice dishes and the various breads – chapati to naans to the Peshawari Naans, phulka, dosha, iddli, etc etc. Many different breads – all carbs. (I miss my dosha, onion samba and curds from raw buffalo milk ! You can keep *all the sweets )

          1. Sasha

            Yes, from my observation as well, DM and various metabolic disturbances are quite prevalent in India. People often overindulge when they can afford it and food is calorie dense. Also, exercise isn’t emphasized in the Indian culture, despite centuries old traditions of yoga, Indian wrestling, etc

  47. Göran Sjöberg

    I actually wonder why Leon is spending so much of his time here at this blog and to gain very little sympathy for his vegetarianism, which though today is certainly a completely politically correct standpoint.

    As I understand most of us here are, based on our personal experiences, more or less skeptical towards the official agenda of Big Pharma but perhaps to a lesser degree towards Big Agro. And as Malcolm suggests Leon’s “provokations” seems to backlash since while we see a bad system at work Leon, with his moral approach, seems more prone to see us individuals as not “taking our responsibility” for our own health. “It is your own fault if you get “trapped” in the metabolic syndrom and turn e.g. diabetic or with CVD.” (As my wife and myself:)

    To me Leon can not provoke more than what already comes out from the main stream media on this moral issue since it is the same message we hear from him. Thus he is in essence defending a corrupt system in my eyes. To be nice towards Leon I don’t think he is the least aware of this fact so I can not possibly accuse him of breaking any moral “rules”. To be able to do such a thing we had had to be members of the same “religious community” which Leon evidently and categorically denies.”Vegetarians save the world while especially the meat eaters destroy it!”

    I wonder if he at any point deviates from what is officially proclaimed about nutrition – that would be very interesting to find out.

    But I agree with Malcolm that Leon’s presence here makes us aware of what we are up against. So, I am not sure he is a very good advocate for the “Big” ones.

  48. Göran Sjöberg

    “You better start reading serious sources instead of Mercola”

    Those of you who have followed me and my reading suggestions over the years on different issues relating to our corrupt medical world now fully understand that Leon is just kidding with us.

    If he doesn’t understand that e.g. Alberts et al. is a serious textbook, “Molecular Biology of he CELL”, is a serious textbook I wonder what he consider to be serious reading. But perhaps he hasn’t even read Alberts, irrespective of his own proclaimed “seriousness”. I, myself, doubt that he has put his nose into that book.

    I have found that it to be a very popular rhetoric trick among our opponents to “Google” for a while to find some “corrupt” papers and then throw links out to these in their comments. “Read that and that!” which usually is just a waste of time as is well pointed out by Richard Smith in his talk linked to above.

    (When Malcolm is suggesting a reading I find them clearly “serious”.)

    1. Mr chris

      The only point where I disagree with you about Leon, is your use of the term troll. For me trolls disrupt for the sake of disrupting, whereas Leon seems driven. I think he used to post occasionally and then suddenly he is like a virus, posting multiple times a day, and then with the usual mark of a man with a message, putting obscure papers on a level with more serious stuff.

  49. Bill In Oz

    A meta comment : I decline to read or repy to any of Leon Roijen’s comments. But from the length & quantity of them, s/he must have a very sedentary life with all the high risks that leads to as regards heart disease !

    Back to the garden for me ! Guaranteed to minimise CVD ! 🙂

    1. Gary Ogden

      Bill in Oz: Me, too! Fall planting is even more important for me than Spring. Bunching onions are up, and yesterday I planted cabbages. The amazing thing is that in one spot in the garden, where I’ve had carrots, celery, and beets, all three have made babies, and I needn’t replant them, except the beets, of which I eat a lot. Agree about Leon’s comments, but as they say, it’s a free country.

      1. Bill In Oz

        Indeed Gary..I am still enjoying the ‘fruits’ of the Winter plantings I did last Summer..Lots of leeks, red giant mustard, Russian reed Kale, celery, chard, and the 5-6 garlic varieties are now growing well with the warmth of Spring..
        Parts of Oz are in a long drought.But here in my part of SA we have had good Winter rains and all is green. The weather gods have blessed us this year.

  50. Göran Sjöberg

    If it was not obvious to me that Leon is a “true believer” in vegetarianism, from what we read, I would myseld have suspected that he was hired by Big Pharma/Agro one way or another as a troll. I have come across this phenomena as facts on on our LCHF blogs here in our small country of Sweden. Usually the trolls are then disclosed when you ask them to openly tell us who they are and more often than not they then go very silent on this subject and Leon has certainly not responded to this request yet. (He can perhaps do a similar personal declaration to the one I did myself here so we know.)

    Let’s face it.

    Malcolms blog is a real threat to the huge corporates (they are for sure keeping ‘an keen eye’ on whatever appears on his blog and Leon is, as far as I can judge, obviously on their side with his advocacy) and the resources these corporates dispose over are almost unimaginable for normal people. (Think just about the profits they are doing on their statins.)

  51. Göran Sjöberg

    Well, I searched facebook on Leon Roijen and found just an “empty hole”.

    I don’t know if this tells something but it is obvious to me that he doesn’t want to appear openly with his persona (for whatever reason). With his attitudes he should though have nothing to “fear” from our authorities. So why is he not “open” if he wants, as an underdog (?), to “convert the world” to vegetarianism, as he claims, in the same way as I am trying to do with LCHF “for health”.

    To me as a researcher, trust is built by full “openness” which is at the core of all serious science. (As was also the key point in Richard Smith’s talk.)

    1. Bill In Oz

      Goran you are right..I did a simple google search earlier this year..I found that this person is a female vegetarian Buddhist in Belgium..I just repeated that search & got the same hits… So we are dealing with a sedentary female, vegetarian, Buddhist Belgian troll…
      The easiest way of dealing with such an individual is to completely ignore her…Or for Malcolm to edit her comments which is time consuming for him.

      1. Leon Roijen

        “Goran you are right..I did a simple google search earlier this year..I found that this person is a female vegetarian Buddhist in Belgium..I just repeated that search & got the same hits… So we are dealing with a sedentary female, vegetarian, Buddhist Belgian troll…”

        Oh dear…

        That reminds me of a story my father-in-law used to tell and really happened:

        He worked for a concrete factory and one of the drivers of a concrete mixer truck got lost – back then there was no GPS.
        So he stopped along a road and asked a farmer for directions.
        The farmer asked him what he transported in his truck. “Mandarins” answered the driver.
        “But then, why is it rotating?” – the farmer asked.
        “To make them round” – the driver answered.

        Saying good-bye, the driver asked: Farmer, when will you become human?
        Of course, for the driver now it was time to leave – the farmer, having realised his stupidity, came running with his pitchfork 🙂

        Now Bill, with your simple Google search, you got it completely wrong and show as much stupidity as that farmer.

        1. Dr. Malcolm Kendrick Post author

          I knew he was wrong, but I was interested to see your reply. However, on a more general point, I find it strange for a Buddhist to create so much anger in other people. Isn’t that, kind of, what you are not supposed to do?

          Buddhism teaches that anger is never justified, however. Our practice is to cultivate Metta, a loving-kindness toward all beings that is free of selfish attachment. “All beings” includes the guy who just cut you off at the exit ramp, the co-worker who takes credit for your ideas, and even someone close and trusted who betrays you.

          For this reason, when we become angry we must take great care not to act on our anger to hurt others. We must also take care not to hang on to our anger and give it a place to live and grow. In the final measure, anger is unpleasant to ourselves, and our best solution is to surrender it.

      2. Leon Roijen

        “I knew he was wrong, but I was interested to see your reply. However, on a more general point, . Isn’t that, kind of, what you are not supposed to do?”

        Then why did you let it through, if you knew he was wrong?
        Or rather – as I don’t think someone who is wrong needs to be censored – why did you allow him to insult me? He called me a troll. And this is not the first time someone throws this at me for having a radically different opinion. I thought you earlier said you draw the line at personal insult?

        Please don’t get me wrong, I was not angered by Bill’s nonsense, but making false accusations or insinuations about my person, as Göran is doing, too, is not something I would expect at a serious blog.
        Yes, I am the first to admit I haven’t been a diplomat, but I don’t think I engaged in making false accusations or insinuations about other participants in this blog.

        It’s not the outside world that “creates” anger, it’s one’s own mind in which arises anger, Dr Kendrick.

        To answer your question “I find it strange for a Buddhist to create so much anger in other people”:

        As already said, anger in the first place belongs to the person who is angry:


        “One day Buddha was walking through a village. A very angry and rude young man came up and began insulting him. “You have no right teaching others,” he shouted. “You are as stupid as everyone else. You are nothing but a fake.”

        Buddha was not upset by these insults. Instead he asked the young man “Tell me, if you buy a gift for someone, and that person does not take it, to whom does the gift belong?”

        The man was surprised to be asked such a strange question and answered, “It would belong to me, because I bought the gift.”

        The Buddha smiled and said, “That is correct. And it is exactly the same with your anger.

        If you become angry with me and I do not get insulted, then the anger falls back on you.”


        I never said I was a good Buddhist – on the contrary, I even never took Buddhist vows ( https://www.accesstoinsight.org/lib/authors/bodhi/wheel282.html ) as I feel I am not ready for it.
        I even abandoned Buddhism for more than a year following depression and I am still not sure if Buddhism was part of the cause of my depression or if it was me seeing Buddhism through depression coloured glasses.

        I can’t apologise for the anger that others allow to arise in themselves, but I want to sincerely apologise for my lack of compassion with them that I have undoubtedly demonstrated here.

        Finally, I believe we all simply speak too much: “idle chatter” in Buddhist terms, a disease of all times but especially of modern times, especially in internet.

        Am I allowed to finish with the Buddha’s criteria on right speech?

        (“Tathagata” is another name for the Buddha: https://en.wikipedia.org/wiki/Tath%C4%81gata

        The criteria for deciding what is worth saying

        [1] “In the case of words that the Tathagata knows to be unfactual, untrue, unbeneficial (or: not connected with the goal), unendearing & disagreeable to others, he does not say them.

        [2] “In the case of words that the Tathagata knows to be factual, true, unbeneficial, unendearing & disagreeable to others, he does not say them.

        [3] “In the case of words that the Tathagata knows to be factual, true, beneficial, but unendearing & disagreeable to others, he has a sense of the proper time for saying them.

        [4] “In the case of words that the Tathagata knows to be unfactual, untrue, unbeneficial, but endearing & agreeable to others, he does not say them.

        [5] “In the case of words that the Tathagata knows to be factual, true, unbeneficial, but endearing & agreeable to others, he does not say them.

        [6] “In the case of words that the Tathagata knows to be factual, true, beneficial, and endearing & agreeable to others, he has a sense of the proper time for saying them. Why is that? Because the Tathagata has sympathy for living beings.”

        — MN 58


          1. Mr chris

            I put this point earlier, but you didn’t let it through, I think I Speak for many in hoping this could go back to being a blog about endolethial damage, it’s repair and clots. This has become a Leon blog.

          2. Dr. Malcolm Kendrick Post author

            Yes, of course, that it what this blog is about, and I shall be returning to it shortly. I allow my interest in trying to work out why people think what they think to take over at times. As my son would say. My bad.

      3. JDPatten

        You’re outraged that the good doc allowed someone to insult you??
        You do know the common aphorism about the pot and the kettle, don’t you?

        Further, as I’ve written elsewhere where I thought it was needed, as here:

        “The loudest and quickest to object are usually the most deeply entrenched in long-term self-serving beliefs and least willing to make an effort at deep consideration of differing thought.
        Give it an actual try. It’s refreshing.
        . . . My suggestion ought to apply to anyone who finds him/herself opposed to anyone else.”

      4. Leon Roijen

        “Leon. Thank you for your reply. I am no Buddhist, but I like the general approach to life. None of us can live up to those standards, however.”

        Malcolm, whether we can live up to these standards or not – if people still attain enlightenment these days – has been a matter of debate in Buddhist forums, too.
        I think it is possible, after all, the Buddha himself, too, was a human of flesh and blood, not a divine being. And after him others followed and attained enlightenment.
        But we don’t see people attaining enlightenment, because, as a famous Buddhist nun (Ayya Khema (1): of Jewish origin, survived WW2 thanks to child transport to Scotland: https://en.wikipedia.org/wiki/Ayya_Khema )put it:

        “When we love unconditionally, the ego gets smaller – and the teachings of the Buddha revolve around nothing else – until one day it gets so small that we recognise it as a phantasm, an illusion, as something that really doesn’t exist. And when the ego gets a little smaller, also the point (or place) where it stands moves: Not any longer in the spotlight, in the centre, but a little to the side; and other people march into the spotlight”

        (1) She wrote a great autobiography, worth reading and interesting whether you are Buddist or not: https://www.amazon.com/I-Give-You-My-Life/dp/1570625719

        So, I believe these people who become enlightened, who can live up to these standards are people not like Mother Theresa or Nelson Mandela for example (who are certainly not without merits), but simple people who live a simple and quiet life.

        After all, the Metta Sutta starts thus:

        This is what should be done
        By one who is skilled in goodness,
        And who knows the path of peace:
        Let them be able and upright,
        Straightforward and gentle in speech,
        Humble and not conceited,
        Contented and easily satisfied,
        Unburdened with duties and frugal in their ways.
        Peaceful and calm and wise and skillful,
        Not proud or demanding in nature.
        Let them not do the slightest thing
        That the wise would later reprove.
        Wishing: In gladness and in safety,
        May all beings be at ease.
        Whatever living beings there may be;
        Whether they are weak or strong, omitting none,
        The great or the mighty, medium, short or small,
        The seen and the unseen,
        Those living near and far away,
        Those born and to-be-born —
        May all beings be at ease!


        For us more “ordinary” people it is difficult to live up to these standards indeed, we can and we should try, but as for myself, I fear there are still many rebirts to go through 🙂
        Thank you for reminding me I should work harder.

      5. Göran Sjöberg

        I wonder if I have a “Buddist” inclination (“turn the other cheek” attitude) myself which my wife sometimes adhere to me. On the other hand she, and perhaps also now Leon, notice that I can turn rather vicious if provoked sufficiently which as Malcolm so clearly sees is not a Buddist treat.

        I am BTW a profound materialist/atheist – I believe in the priority of the real world as THE driver over any Platonic or post modern idealism.

      6. Leon Roijen


        You’re outraged that the good doc allowed someone to insult you??
        You do know the common aphorism about the pot and the kettle, don’t you?”

        I can’t stress this enough and I am not saying this to insult you, (you are also absolutely not the only one) but please learn to read. I never said that I was outraged, nor did I come close to saying such a thing.

        As for your aphorism about the pot and the kettle:
        For me personally, there is a big difference between provocations and insults.
        Provocations can serve a goal, insults not.

        Now, I don’t know whether I provoked or insulted you, but it seems you feel sore about something I said to you, otherwise I can’t explain your behaviour sticking your nose multiple times in discussions in which I’m involved without contributing substantive arguments. Unless you are a real troll of course, but as you might have understood, I am not one to quickly call someone a troll.

        So, If I insulted you, please accept my heartfelt apologies, and even better: show me where I went wrong so I can learn from it.

        If your way of interacting with me has nothing to do with something personal you hold against me, may I then kindly ask you to refrain from such behaviour? We are all adults here and old and developped enough to stand up for ourselves, I think.
        By making unsubstantive comments in “threads” that don’t concern you, you only add to the drama and it doesn’t contribute to Dr Kendrick’s blog.

      7. Göran Sjöberg

        BTW, I share my contemplations with you in the early rainy morning and not “with a dollar in my hand” but with the computer in my lap in my cozy bed at home noticing with comfort the rain outside hitting the window and thus myself not being “a long way from home and with the pockets full of sand” as in the melancholic tune.

        Talking about Buddist attitudes at the road, as mentioned by Malcolm, I and especially my wife have for many years now tried to practice a forgiving/defensive (Buddist?) attitude towards aggressive fellow drivers. E.g. when someone is pushing us by getting very close in on our back (happens to often in our opinion) we usually pull to the side at the first convenient opportunity just to let the driver easily pass in order to get rid of his aggression. (We always suspect it is all about a “carb eater addict” who is in an evident blood suger fall and who needs a fresh injection of carbs!)

        We often discuss if this act from our side is a “kind” thing to do or if if it is a ‘reversed’ kind of an aggressive act in order to make the guy feel ashamed of his asocial behavior since he, or sometimes a she, must clearly notice that they have actively “pushed us out of the way”. Or are they leaving us behind with the feeling “We won” or even indifferent?

        Another “philosophy” I personally have practiced towards aggressive drivers in my back, who evidently want me to drive faster although I am already driving well over the speed limit, and a philosophy which I have found always “successful”, is to reduce my speed to the actual speed limit to start with in order to alleviate the passing if I can’t pull to the side. If the driver then comes even closer and closer just “to show me” I reduce my speed even more until he “dares” to pass – since I can not do his passing work for him. This is usually a fail proof procedure but sometimes the driver realize that the “pushing technique” to make me drive faster evidently was not successful and, being a supposedly intelligent being, he relaxes and pulls back as I now also notice with Leon. Then I increase my speed to my previous level and very seldom the driver repeats his aggression. Is my behavior Buddism in practice?

        Anyway it is very relaxing to get rid of aggression or rather an apparent “reduction” of the aggression as we see now on this blog, which I with Malcolm, have noticed.

      8. Göran Sjöberg


        Since you seem to be deep into “religion” and also suggest “serious readings” to me I think you surely also can benefit from reading a serious book about the fundamentals of religion (as also e.g. Albert’s book on the Molecular Biology) and then I would recommend you (again) Emil Dürkheims excellent book on this subject, ” The Elementary Forms of the Religious Life” written now more than a hundred years ago. To my opinion this book, having already read it twice myself together with my wife but now also contemplating a third reading, is worth all the time you can offer on this challenging reading.


    2. TS

      My work looking into the personality traits and problems of young children led me to the conclusion that they can make themselves, and become permanently, so switched off that they can be devoid of any conscience. Con men thrive because the rest of us have difficulty believing that the person who is being so nice, kind and understanding, is capable of such ruthless manipulation and heartlessness.

  52. Martin Back

    This may be of interest to some. The Ramos paper is available in full.

    Statins in the old and very old—a nonagenarian negative
    Here is some evidence to inform practice for octa and nonagenarians, a rare form of evidence indeed. Ramos et al’s large retrospective cohort study looked at the impact of statin use on atherosclerotic cardiovascular disease and all-cause mortality in people over 75 without pre-existing atherosclerotic cardiovascular disease. They divided people into those with type 2 diabetes and those without. They found no benefit of statins in those without diabetes. There was benefit in those with diabetes, but this benefit was less over age 85 and disappeared in those over 90. A randomised controlled trial of statins in over 70s (STAREE) is underway so we should soon have a definitive answer which takes adverse events into account. This will be a great step in efforts to tackle polypharmacy in the elderly.https://blogs.bmj.com/bmj/2018/09/10/alex-nowbars-research-reviews-10-september-2018/

    1. Göran Sjöberg


      Funny that I read your comment now!

      Me and my wife just returned from a visit to my 82 year old friend to give him a bottle of LAGAVULIN 16 years single malt whisky for a great favor he made to us last year.

      It was a very pleasant visit where we met not only him but also one of his daughters though they have been rather hostile towards any discussion about statins for som years and the daughters had actually forbidden him to discuss his medication with me.

      And I had with great sorrow noticed my friends decline, mentally but not least physically, when he returned to his statins which I earlier had made him “throw away”. I had actually ten years ago “stolen” one of his bottles with pills at one time to make my point clear. There were though many turns around this issue.

      Lately, I myself but also my wife though noticed that he all of a sudden seemed to improve on both health fronts and finally he revealed that he had met a GP who with sympathy had told him that people over 70 shouldn’t take statins.

      So at our visit this time it was now a very very friendly atmosphere and his daughter was also very keen to know “all the details of how to improve health” and they wouldn’t even let us leave.. We were rather overwhelmed by this change of attitude.

      Perhaps it was just the obvious “clinical” facts around the statin issue which was the turning point here.

      With Sir Francis Bacon we believe in a materialistic approach to reality 🙂

    1. Göran Sjöberg


      Couldn’t resist to follow your link and the first comment that popped up was the following.

      Dear all,

      Just a little note: when I discussed with Ajahn Brahm about permaculture practices of killing animals that we raise in a humane way versus being a vegetarian versus buying meat from supermarkets, one sentence from him that impressed me the most is: a great number of lives have to die for us to live, so live yourself in a skilful and wholesome way to make those lives worthwhile.

      Warmest metta,


      I like that one since it coincides with my own holistic views on “life” but BTW also with what Lierre Keith states in her excellent book her own “vegan life delusion”. (It is a little “Silent Spring” around that book.)

      Yesterday we went to a nearby farm to buy some “Green grass pastured” meat. On this farm they bring in a mobile slaughter house to minimize the suffering for the animals at their one and only “bad day” – I like that too.

  53. TS

    My comment was a general one – not aimed at any one in particular but an attempt to explain some of the outrageous behaviour and corruption we come across in the world. Some people who lead others and influence them do not exhibit normal behaviour, as well we know. There are of course various degrees, or a continuum, for the lack of conscience. Some people will just be self-interested but others are more complicated, in my opinion.

  54. TS

    Why not have a ‘Malcolm Kendrick Anti-corruption Award’? E.g., “And this year’s Malcolm Kendrick Anti-corruption Award goes to………
    All it would need is a bit of publicity – media engagement?
    And it’s time some poor whistle-blowers were rewarded and encouraged.
    Anyone out there with some energy?

  55. Bill In Oz

    Ohhhh dear,.I made a mistake.I said Leon is a sedentary, female, vegetarian Buddhist. I was wrong; I apologise. He is a male, sedentary, vegetarian Buddhist.

    It’s curious. At times I have explored Buddhism. I love the biography of the Buddha by Thich Nhat Hanh..and others.But eventually came to the conclusion that it was not for me.

  56. Göran Sjöberg

    Funny that we have now entered into proper “religion” and especially into the very “tempting” and “forgiving” Buddhism. (I think though we find the same ideas in Christianity – e.g. “Sermon on the Mount” ?) Great turns indeed here at Malcolm’s blog and Leon is for sure a great catalyst.

    And with that I am very convinced that Leon will finally turn very happy when he is “dead” and I think that was also the conviction of Schopenhauer but we really don’t know if the conviction really materialized and Leon is evidently still very alive and “kicking”.

  57. AnnaM

    About Mercola.

    I believe he walks his talk. He is one of those people who is bound and determined to live as long and healthy a life as possible. He is constantly searching, upgrading and adding to his knowledge, he does the diets and the exercises that he speaks of, and he wants good quality products to be available, and that is what he sells. One can of course be wary when someone promotes what they sell, but that hardly makes them illegitimate. If the car dealer drives the cars he sells, he at least probably thinks it is a good car.
    Some of the claims he makes on the products could be too strong, but in general I found the examples given to be likely reasonable. Some of the claims pasted up above were definitely reasonable, such as about coconut oil.
    That the FDA does not allow herbalists and others to make any health claims for supplements is well known.
    AIDS denialism-I went down that rabbit hole some years ago and spent a long time there. I came away not able to decide. It seems the AIDS virus has not passed Koch’s postulates. And there are some other issues, such as AIDS deaths in very poor areas of Africa that are of persons who were never tested for AIDS and where the tests are rarely performed as they don’t have the money – but they do have a financial aid incentive to report the deaths as such.
    Meanwhile, of course an AIDS diagnosis is harmful! Perhaps you have never had a really scary diagnosis, but it is extremely stressful and this depresses the immune system and can lead to feelings of depression and giving up.

    1. Leon Roijen


      “AIDS denialism-I went down that rabbit hole some years ago and spent a long time there. I came away not able to decide. It seems the AIDS virus has not passed Koch’s postulates.”


      You’re not a (professional) scientist I suppose, not a doctor, I don’t even know how much biology you had in school, so I can’t blame you, but a doctor who is an Aids-denialist at a time when there can’t be any reasonable doubt anymore and who sells a product claiming it can “help to virtually eliminate your risk of developing cancer in the future”…

      Sorry, but in my eyes such a behaviour is criminal, such a person is a charlatan, a crook.

      And I truly have compassion for the people who fall victim to it. It is easy to exploit the sick or those fearing sickness. Not only Big Pharma knows this.

      But as in the discussion with Dr Kendrick on the same topic, I rest my case here.
      You’re free to believe what and who you want.

      1. Dr. Malcolm Kendrick Post author

        It is true that you cannot deny that a broad spectrum, poorly defined syndrome, that we loosely call AIDS exists. The issue is more whether or not HIV is the primary cause of some, all of those lazily diagnosed with AIDS. The complete inability to create an HIV vaccine suggests the entire issue is more complex that we think. It is of interest that, in memory serves, you need to dilute the test sample for HIV by a factor of 4,000, otherwise everyone tests positive. Can HIV be like the herpes zoster virus that infects us all, then sits in the body doing nothing until activated – in some way. The problem with AIDS, like vaccination, is that you cannot even start to discuss any ideas without instantly being dismissed as an AIDS ‘denialist’ or a vaccine ‘denialist’. This is not an environment that supports scientific debate. It is an environment where everyone is commanded to support the party line. This is one of the key definitions of living in a Tyranny. I know, because I just read ‘On Tyranny’ by Timothy Snyder.

      2. Leon Roijen

        “It is of interest that, in memory serves, you need to dilute the test sample for HIV by a factor of 4,000, otherwise everyone tests positive.”

        Seems to be utter nonsense from Aids denialists:

        See: http://www.thebody.com/Forums/AIDS/SafeSex/Q195655.html

        “The problem with AIDS, like vaccination, is that you cannot even start to discuss any ideas without instantly being dismissed as an AIDS ‘denialist’ or a vaccine ‘denialist’.”

        May I remind you of Schopenhauer’s stratagems again? 🙂
        Maybe number one:

        “Carry your opponent’s proposition beyond its natural limits; exaggerate it. The more general your opponent’s statement becomes, the more objections you can find against it. The more restricted and narrow his or her propositions remain, the easier they are to defend by him or her.”

        I talked about people who fully deny HIV as the cause of Aids. I did not oppose discussing ideas.

        Before effective drugs against HIV became available, hospitals were full of HIV patients:

        “Around 1996, the wards started to empty. People I’d known who looked as if they had days to live suddenly got better. Steven and the other patients were the unlucky ones who got sick just before treatment became available. Only last month, the Centre for Disease Control declared that people who are HIV positive and taking medication cannot pass the virus on through sex. We live in such different times.”


        I suggest those denying HIV as the cause for HIV inject themselves with the virus. Let’s see what happens.

        We might have differing opinions here, but in my opinion there should be at least some degree of morals in science. Wikipedia states:

        “Two independent studies have concluded that the public health policies of Thabo Mbeki’s government, shaped in part by Duesberg’s writings and advice, were responsible for over 330,000 excess AIDS deaths and many preventable infections, including those of infants”

        A scientist should be aware that he is not disconnected from the real world and that his deeds have real world consequences.
        At the beginning of the HIV epidemic Duesberg’s stance might have been perceived as plausible but later on not so anymore.

        Now, in this context, you might ask about yourself and your hypothesis about CVD and statins.
        I would say that is a different case altogether. Although you reduce them to one mechanism, CVD clearly has many “causes”. Or let’s say many factors are involved. There is a lot of research that proves it. So your hypothesis is far from being unreasonable.
        However in the case of HIV-AIDS it has been proven beyond reasonable doubt that HIV is the cause of AIDS (at least in the majority of cases).

        I am well aware that now I open a route of attack using the expression “beyond reasonable doubt”. Well, so be it. Not only in law it’s the best we can work with, in science it’s the same and in medicine the standard is often much lower, unfortunately.

        1. AhNotepad

          So HIV needs pharmaceutical drugs, is what I see in your post. You will no doubt dismiss https://youtu.be/W5Bgdqsorg0 as a quack (no, not Dr Kendrick in this case) sprinkling holy water. It is a pity you are not more respectful and less dismissive of people who do not share your inflexible doctrine, though as Shopenhauer says the ways of winning an argument he lists are methods not to use in discussion, you will no doubt use several of them in reply.

        2. Sasha

          Leon, how can you on one hand “not oppose discussing ideas” and on the other dismiss Duesberg and his ideas based on what you read in Wikipedia? You seem to know so much about so much, no wonder people think you’re trolling…

      3. Martin Back

        Duesberg proposed his hypothesis that AIDS is caused by long-term consumption of recreational drugs or antiretroviral drugs, and that HIV is a harmless passenger virus. In contrast, the scientific consensus is that HIV infection causes AIDShttps://en.wikipedia.org/wiki/Peter_Duesberg

        Anyone who believes Duesberg’s theory is ignoring a whole flock of black swans. As Dr Kendrick has pointed out, you can’t prove a theory, but you can disprove it. And IMO Duesberg’s theory has been disproven thousands of times over.

        – How do you explain that healthy non-drug users like children got AIDS from infected blood transfusions before HIV tests for donated blood were available?

        – How do you explain how AIDS arose in the first place in the 1980s when people were using recreational drugs long before then. If it is a recreational drug which is responsible, which one is it? I note that opium, alcohol, and marijuana have been used for centuries with no mention of AIDS.

        – How do you explain that before antiretrovirals, people would live for maybe ten years after infection by HIV, but now with ARVs they can live a normal lifespan?

        – How do you explain that cases of AIDS-like symptoms without detectable HIV infection are “extremely rare”? They should be common if Duesberg is correct.– https://www.newscientist.com/article/mg13718610-700-cause-unknown-for-aids-without-hiv/

        – How do you explain that in a community that cannot afford any sort of drug, it is the women who are having sex with HIV-infected individuals who go on to get AIDS while the others don’t? (So much for the theory that HIV lurks in all of us)*

        * Mbali is HIV negative. But 36 percent of the adults in Vulindlela are positive, as are about 60 percent of the women aged 25 to 40. Although HIV infection rates have stabilized globally, hundreds of thousands of South Africans are infected every year; more than 7 million live with the virus in their bodies. And in the midst of this, the largest HIV epidemic in the world, the HIV prevalence among adolescent girls is roughly five times greater than that of boys. By performing genetic analyses on samples of HIV virus in Vulindlela, researchers have concluded that the high rate of infections here—among both sexes—is driven in part by relationships like the one Mbali had when she was 17. [Mbali, like many poor young women in the area, was having sex with a wealthy older man.] — https://www.theatlantic.com/health/archive/2018/03/the-blessers-curse/555950/

        See also how vaginal conditions affect transmission of HIV, a factor that should not be significant if Duesberg’s theory is correct.

        Conclusion: AIDS is caused by HIV infection transmitted by body fluids. If you choose not to treat it with ARVs, it’s your funeral, literally.

      4. Joe

        To: Martin Black

        – How do you explain that healthy non-drug users like children got AIDS from infected blood transfusions before HIV tests for donated blood were available?

        First, healthy children don’t require transfusions, do they? And since AIDS is a complex of over 30 conditions, all contactable by people who are not HIV positive, I’m going to need more information. Also, since AIDS drugs are DNA chain terminators and kill cells indiscriminately, essentially causing AIDS, if the children died, they were likely killed by the very drugs that were designed to help them. I.e., AIDS by prescription.

        – How do you explain how AIDS arose in the first place in the 1980s when people were using recreational drugs long before then. If it is a recreational drug which is responsible, which one is it? I note that opium, alcohol, and marijuana have been used for centuries with no mention of AIDS.

        Have you ever heard of the Stonewall riots? It was essentially the “coming out” of gays in the U.S. That incident was what kicked off the rampant drug use and promiscuity among gay males. If you’d like to know more about the gay lifestyle in those days, I suggest reading Larry Kramer’s book “Faggots.” It will give you a new perspective regarding gay sex and drug use (including the kinds of drugs they used). Not to mention the promiscuous part, which almost always requireed muscle relaxers to facilitate that many sexual encounters in one outing. And most of it would qualify as “rough sex,” entailing the actual exchange of blood and fluids between partners. And due to all these foreign proteins being exchanged, almost on a daily basis, you can imagine, can’t you, the effect of that on their immune systems, which are designed to combat such foreign proteins (essentially the same thing that killed hemophiliacs before the development of pure factor VIII)).

        – How do you explain that before antiretrovirals, people would live for maybe ten years after infection by HIV, but now with ARVs they can live a normal lifespan?

        Lifespans were determined by the amount of destruction that occurred to one’s immune stem. And lifestyles vary. Plus how soon they began to take AIDS drugs, essentially the “coup de grace,” if you will. The original cocktails were far stronger than those in use today, which is why they didn’t live very long in the beginning. But the drugs given today still contain DNA chain terminators (albeit at a much lower dose), so they’re just being killed more slowly. And suffering sometimes horrible side effects in the process.

        – How do you explain that cases of AIDS-like symptoms without detectable HIV infection are “extremely rare”? They should be common if Duesberg is correct.– https://www.newscientist.com/article/mg13718610-700-cause-unknown-for-aids-without-hiv/

        Each of the 30 or so “AIDS defining diseases” can be acquired by people who are HIV-negative. That is, they are common. Extremely common.

        If someone who tests positive for HIV gets pneumonia and dies, he dies from AIDS.

        If someone who tests negative for HIV gets pneumonia and dies, he dies from pneumonia.

        – How do you explain that in a community that cannot afford any sort of drug, it is the women who are having sex with HIV-infected individuals who go on to get AIDS while the others don’t? (So much for the theory that HIV lurks in all of us)*

        Did you know that pregnancy can cause a false-positive result for HIV antibodies? That’s among a whole host of other ways to test positive:


        Martin, I urge you to read Duesberg’s book, or even to visit his web site, if you have more questions. It’s a very complicated subject, and it’s difficult to discuss on a blog.

        And since a lot of people think things have changed since the early 80s:

      5. Martin Back

        I live in a country (South Africa) where Duesberg’s views on AIDS were taken seriously and incorporated into government health guidelines. As a result, people were dying literally faster than they could be buried. Not just gays; everybody across the board. Bodies were stacked two to a drawer in mortuaries and the overflow put into butchers’ cold rooms. There were traffic jams at the cemeteries due to the demand for burials.

        Fortunately, and as a result of massive pressure from courageous individuals (google Treatment Action Campaign), the government reversed its stance and brought in comprehensive HIV testing and ARVs available from government clinics, and the death rate is now back to normal. But millions are now living with HIV.

        The rich, who could afford medical aid and good medical advice, got ARVs and survived, once ARVs became available. (In the early days they died. I knew a few personally.) The poor, who could afford nothing except perhaps herbal concoctions from sangomas, were told to boost their immune systems with garlic, lemon juice, beetroot, and african potato, and died in their thousands until the government saw the light.

        Essentially, South Africa was a huge trial of Duesberg’s theories. And if you can’t accept that the theory is a proven failure, then clearly nothing will persuade you.

        One group of people I feel really sorry for is the new young doctors. They have to serve a compulsory two years’ internship at government hospitals where a high proportion of the sick people will be HIV positive. Three of them were interviewed on TV. They got needlestick injuries or patients’ body fluids sprayed in their eyes and immediately went onto HIV prophylaxis, which involves massive and nauseating doses of drugs. One of them said she couldn’t take the nausea any more and stopped treatment. She is hoping for the best. It is a trial all our new doctors will go through, and of course our nurses. Thanks, Duesberg.

      6. Joe

        To: Martin Black

        Here’s a graph of SA’s population going back to 1960 Please note, the population has steadily increased throughout that period.


        I don’t doubt what you saw, just the reason for it. “Mortuaries overflowing” appears to be a common occurrence in SA from time to time. From local epidemics, to strikes, to labor shortages.

        But what *I* think you saw were bodies piling up from *traditional* African diseases and disorders. TB, malaria, malnutrition, wasting, diarrhoeal diseases, pneumonia, hepatitis, typhoid, cholera, etc.

        Here’s some reading for you. By Charles Geshekter, an African studies professor who spends a good part of each year in Africa.


        I think you’ll have a different view of “AIDS” in Africa after reading through those papers.

        “They got needlestick injuries or patients’ body fluids sprayed in their eyes and immediately went onto HIV prophylaxis, which involves massive and nauseating doses of drugs. One of them said she couldn’t take the nausea any more and stopped treatment. She is hoping for the best.”

        Now, IMO, if she stays away from AIDS drugs in the future, she should live a normal life, whether she ever tests positive for HIV antibodies or not.

        Martin, we can go back and forth here indefinitely, but I don’t think that’s what the people came here for. They want to talk about the cause of heart disease, and so do I. We’ve each had two exchanges on AIDS and HIV now, so let’s go back to doing that, okay?

        Again, I urge you to read Duesberg’s book and visit his web site. So should others here who are interested in this topic.

      1. Joe

        To: Sasha

        That scientist is Peter Duesberg, and a great scientist he is, IMO.

        Your friends with HIV are doing the right thing, IMO, but they have to stay away from recreational and certain prescription drugs, not abuse alcohol, and refrain from promiscuous gay sex (because of exposure to so many foreign proteins via the exchange of blood and fluids). All of those things work to weaken the immune system, eventually destroying it. And that includes not taking any AIDS drugs, because they’re mostly DNA chain terminators, like AZT, which kill all cells indiscriminately (it was originally developed as a cancer drug, but was shelved because it was too toxic), including the cells that comprise the immune system. The reason AIDS patients live longer today is because of prescribing much lower doses (especially of AZT) and and giving them to mostly healthy people.

        Measuring “viral load” with PCR is a fool’s errand, because it can’t do that, says the inventor of the technology himself, Kary Mullis. I.e., it can amplify, but not quantify.

        If you’d like to read more about Duesberg and his debunking of the HIV=AIDS hypothesis, you should read his book (and/or have your friends do so):

        Inventing the AIDS Virus

        To: Dr. Kendrick

        Duesberg didn’t discover retroviruses (that would be Howard Temins), but he was first to map the genetic structure of retroviruses and he isolated the first oncogene. He’s a truly remarkable scientist, who’s now working on the aneuploidy (abnormal number of chromosomes) theory of cancer.

        NB: I promise to ignore any replies from you-know-who.

          1. Gary Ogden

            Sasha: My thanks as well. It shows the depths of depravity in the pharmaceutical industry the way they have gone after those who threaten their profit stream, and the degree of ownership they have of at least the U.S. and U.K. governments is frightening to say the least. Other good reads: HIV/AIDS: Celia Farber’s March, 2006 Harper’s article, “Out of control, AIDS and the corruption of medical science,” and Janine Roberts’ “Fear of the Invisible.” Vaccines/autism: J.B. Handley’s new book, “How to End the Autism Epidemic,” which features depositions from two of the leading experts in the U.S. in mitochondrial disorders stating unequivocally that at least 30% of cases of regressive autism are in children with mitochondrial disorders and result from vaccination.

          2. Sasha

            Gary: thank you for the reading suggestions. I will definitely look it up.

            I was walking through Moscow subway yesterday. It has computer displays with public service announcements. The one yesterday said: “Low fat products don’t promote satiety and cause you to consume more calories. Do not eat low fat products.”

            Refreshing to see after all the saturated fat scares and pushing of statins…

          3. Gary Ogden

            Frederica Huxley: Thank you for posting the link. J.B. Handley is one of the good guys. His book is one everyone should read.

          4. Sasha

            Gary, thanks for the Harper’s article. Fascinating. Also very interesting what Duesberg says about cancer.
            Amazing how many parallels there are between HIV debate and cholesterol hypothesis and vaccines. And how corrupt to the core the whole system is…

          5. Gary Ogden

            Sasha: I’m rereading “Fear the Invisible.” Shocking. The U.K. government injured many children in 1994 with a completely unnecessary measles/rubella mass vaccination campaign, the purpose of which was to use up the leftover stocks of these two components of the withdrawn MMR vaccine before their shelf life expired (withdrawn because of a spike in meningitis from the Urabe strain of the mumps component, which had already happened in Canada, and they knew it). She also wrote a followup book in 2010, “The Vaccine Papers”. Just a few short years ago it was possible to question vaccine safety in public. This is no longer the case. Such is the iron grip the pharma cartel has on governments, and their propagandists, the media.

          6. AhNotepad

            Re: the MMR in ‘94, there may be a change of government attitude, though I doubt it. In the news today the UK system is dithering and not permitting the use of low THC cannabis for mental treatments “because it may cause harm”. Wonder how they justify using the unbelieveably toxic chemo-therapy drugs, or even something in common use like warfarin. They may cause harm. Perhaps big(and corrupt) pharma does not stand to make much money out of cannabis. Still, no matter, we are all permitted to injest aspartame despite the known harm it may cause.

    2. Sasha

      Also, in reference to what AnnaM and Dr Kendrick wrote in regards to AIDS. There is a scientist in California who used to be pretty big (won a science prize close to Nobel, I think). His last name starts with a D, maybe someone on here would know. Once he began doubting publicly the whole AIDS hypothesis, he became a pariah and now sits somewhere in a dungeon even though he was internationally known before. Leon, maybe you could look him up if Mercola isn’t good enough for you…

      I personally know two men who are HIV positive and who keep their viral loads WNL (or nearly so) by super healthy living and without retrovirals, thus, confirming (to me at least) what that scientist has been saying for years. And they told me they have friends doing similar things as them and doing it successfully.

      1. Leon Roijen

        “Duesberg. The man who discovered retroviruses.”

        That’s not correct, retroviruses were discovered even before Duesberg was born:

        “Retroviruses were discovered at the turn of the century in two investigations devoted to neoplastic diseases in chickens. In 1908, the Danish physician-veterinarian team of Vilhelm Ellermann and Oluf Bang showed that chicken leukosis, a form of leukemia and of lymphoma, was caused by a virus. In 1911, Peyton Rous at the Rockefeller Institute in New York reported the cell-free transmission of a sarcoma in chickens (Ellermann and Bang 1908; Rous 1911)”



        “The second stage of HIV infection is chronic HIV infection (also called asymptomatic HIV infection or clinical latency). During this stage of the disease, HIV continues to multiply in the body but at very low levels. People with chronic HIV infection may not have any HIV-related symptoms, but they can still spread HIV to others. Without treatment with HIV medicines, chronic HIV infection usually advances to AIDS in 10 years or longer, though in some people it may advance faster.”


        And of course what you tell about your friends is anecdotal at best. And in very rare cases the immune system can deal with HIV. That’s known: https://en.wikipedia.org/wiki/Innate_resistance_to_HIV

        However, most people infected with HIV and left untreated unfortunately go on to develop full-blown Aids.

        1. Dr. Malcolm Kendrick Post author

          Leon. I am now going to restrict you to one comment per day. You have much to say, perhaps you would like to start your own blog, and attract your own audience. However, currently, things are getting dragged too far off track.

          1. Mr chris

            This is great news. In the end, as it was, Leon would destroy this blog, with multiple off-topic posts, that no one would read.
            Thank you

        2. Sasha

          Yes, what I learned from those two men is anecdotal but, IMO, it’s not a good enough reason to dismiss their experiences. One of them told me it was very hard for him to deal with side effects of retrovirals so he chose to do something else. He said it’s been years, he feels excellent, and has blood work to prove it.

          I don’t think there will ever be a trial comparing what they do to standard therapy so “it’s just anecdotal” criticism will always be there.

      2. Leon Roijen

        “Leon. I am now going to restrict you to one comment per day.”

        You just did me a good service there, Dr. Kendrick.
        Reading and reacting to your charlatanry embracing entourage (leaving out some exceptions) and now you yourself coming up with gratuitous and dangerous nonsense (the dilution of the HIV test, “maybe we all have the virus”) is not good for my health.

        I feel liberated.


      3. Göran Sjöberg

        I also feel “liberated” by the bye bye to Leon.

        He has certainly made his point clear in his defense of the “existent medical order” and about his vegetarian nonsense.

        I just read in Weston Price great book that he during his world wide search for connections health and food among indigenous peoples had not encountered any people who fared well on a purely vegetarian diet. And for sure Weston Price was in my eyes a very serious researcher.

      4. Bill In Oz

        I am glad that you have decided to leave Leon. Your future vegetarian Buddhist conversion efforts do not belong in a blog about heart disease.

    3. Göran Sjöberg


      Thank you for the link to the Duesberg talk. It taught me a lot about a disease about which I previously knew basically nothing but not least it taught me about the obvious vicious agenda of people defending Big Pharma like Leon.

      To me, today, the corruption of the medical discipline seems to be everywhere and not only relating to the CVD issue of my prime concern.

      What a cynic world!

      Just now an old friend of mine visits me and he has been asking “inappropriate” questions to the doctors about the benefits of vaccination they are trying to bring on his child. He has been chocked by their evident total ignorance. He is actually getting depressed by realizing the corruption he now, as me, notice almost everywhere in our society; not only in the medicine.

      1. Göran Sjöberg

        And this very morning I find again an interesting reading from another “person non grata” in the official medical circles and as often he now ventures into the vaccine issue and autism.


        In Sweden we had a hot debate when our LCHF-pioneer Dr. Annika Dahlqvist 2009 stood up against, and herself officially refused to take, the recommended swine flue vaccin. She was then a second time close to lose her license but she certainly proved to be right (as she had been cleared 2008 after threes years of investigation having been accused of medical “misconduct” when recommending LCHF for overweight patients; a parallell to Prof. Noakes case on the same subject) when hundreds of children had their lives destroyed by Narcolepsy after having been forced to take the flue vaccine 2009.

        1. Gary Ogden

          Göran: “Influenza” and the flu shot is surely one of the longest-running scams in medical history.
          Here is a fascinating read about the 1918-19 “Spanish flu pandemic.”

          About the role Bayer’s new drug aspirin played in many of the deaths (this was before the Pure Food and Drug Act, which came in 1926):
          The U.S. Public Health Service, in conjunction with the U.S. Navy made a valiant attempt in 1918, on two separate military bases, to show the means of transmission of influenza. They utterly failed. Not a single case. It is not transmissible. Bechamp was correct; it is the terrain, not the germ, responsible for the pathology of infectious agents.

  58. Bill In Oz

    It is a great shame we get side tracked down nutrionist dry gullies. Back to the subject of this blog and post !!

    I have been reading again what Malcolm wrote on the 31st of August in this post. The repair process in the arteries is crucial in that repair process …Malcolm wrote :
    “It is mainly the macrophages that do the heavy lifting. They destroy and digest any ‘alien’ material in the body. They start by firing a super-oxide burst at any junk in the body, which could be bacteria, or broken-down cells remnants, or what is left of blood clots. They engulf the ‘oxidised’ material, then they transport themselves to the nearest lymph nodes, where everything in them (and the macrophage itself) is broken down and, eventually excreted by the kidneys. Or they get stuck, turn into foam cells, and die.”

    Arteries with dead foam cells stuck within them, are inflamed, They are swollen etc. And that is a cause of concern.

    Now by pure coincidence a few weeks ago I hurt my achilles tendon.( The tendon that joins the back of the ankle to the calf muscles) It got swollen and and tender. I put up with it for a while but eventually went to see a physiotherapist. He showed me a number of specific exercises to do; suggested I not do some other types of exercises and demonstrated a specific type of daily massage to do on my achilles tendon. The massage involved putting quite firm pressure running along the tendon. This had the effect of reducing the swelling and easing the tenderness almost instantly.

    What was happening ? The massage process was breaking down the debris of dead cells & fluid from the injury. And I suspect this included dead macrophage cells ( foam cells ?) which has moved in to help heal the tendon….The massage process broke down all the debris and then the body’s lymph glands could cart it away…

    Sooooooooo : Is there a way of massaging these inflamed arteries to get a similar result ? Yes I am aware that the arteries are far more essential and have a task to perform all the time – delivering oxygenated blood to the heart & the rest of the body.
    We have all heard about CPR. and how it helps people in heart attacks..Could the process of CPR be massaging the inflamed arteries so that more normal function is restored.

    All this is my own thought experiment. Any thoughts or comments on this thinking among this blog community ?

    1. Sasha

      IMO, there’s very little chance that CPR massages anything. I would think it happens more during exercise and things like yoga.

      1. Bill In Oz

        Sasha, thanks for the reply. Why do you have that opinion about CPR ? Do you have any information supporting your view ? This is not a criticism or even a diagreement .It’s a genuine question seeking information.

        My own thinking is by “analogy” 1 : My achilles tendon was inflamed. It had dead cells and fluid around it and so was swollen. Being swollen it was painful and that made walking difficult. 2: The specific massage process relieved the swellling which means I think that the dead cells and fluids were ‘assisted’ away from the tendon. 3: The coronary arteries are injured in the course of daily life due to a range of damaging causes ( BUT not LDL-C ) 4: There is often a build up of dead cells ( foam cells, former macrophages ) and fluid in the wall of the arteries associated with the plaque which is the first stage of repair..5: And this stuff is trapped in the artery wall leading to swelling of the artery and thus blocking of blood flow….

        So 6 : Could a massage like process help to disapate this stuff within the artery wall ? And does CPR which does provide a type of significant manual pressure be such a massage process ? I do not know. I am speculating..Based on what has happened to me..
        And yes my achilles is almost good again !

        1. Sasha

          In CPR you’re just compressing the chest wall. I guess, you could say that for a short time you’re massaging what is contained within the chest cavity.

        1. Sasha

          I would say specific sequence rather than asanas. IMO, look into Iyengar or Sivananda styles. And be careful with Ashtanga, the injuries you get there can be insane…

      2. Bill In Oz

        JD I do not as a rule take any anti-biotics and have never taken Cipro to my knowledge..But thanks for the tip and link !

    2. Gary Ogden

      Bill in Oz: Interesting conjecture, that the massaging action of CPR may have an additional salutary effect. I have used both heat and self-massage, with wonderful effect, to heal the injuries active people get.

      1. Bill In Oz

        Gary I recognise there are significant problems with this CPR ‘massage’ perspective. Unlike the achilles tendon, the coronary arteries are very well protected behind the ribs of the chest. And I have read that CPR can actually break rib bones !
        But I still think that this thought offers some way forward in the future. An example could an inflamed coronary artery with lots of foam cells and fluid. be relieved by actual direct massage ? Blocked arteries are currently dealt with by stents or Coronary Bypass operation. The evidence seems to be that stents frequently don’t help in the longer term while the newly inserted vein used often also get inflammed & block blood flow quickly. I don’t know the answer. I’m just exploring this thought

    3. Andy S

      Hi Bill,
      A bit of searching turned up some interesting facts about, tendons and macrophages.

      “New insights are provided on macrophages involvement during oAECs tendon regeneration.”

      Human monocytes and macrophages undergo M1-type inflammatory polarization in response to high levels of glucose

      “The aim of this review is to discuss the importance of the vasculature in tendon damage and repair, and what is known about factors that regulate changes in the vasculature of what is normally a sparsely vascularised tissue.”
      “Vascular endothelial growth factor (VEGF), the prototypic angiogenic growth factor, has also been localised to cells in the early stage of tendon wound healing.”

      Take home message from the references:
      – tendon repair involves increased blood circulation, benefit of massage
      – macrophages do the inflammation followed by repair
      – hyperglycaemia promotes inflammation by increasing M1 type macrophages, most likely a systemic effect. Perhaps resident heart macrophages as well as other tissues also become inflammatory type 1
      – does not look like tendon rupture involves foam cells, more likely reduced blood flow or old age

      1. Bill In Oz

        Andy I think you missed my point. I don’t need to be informed with multiple links from researchers about tendons etc. Let’s keep it simple. The human body has repair & healing processes which are deployed whenever needed all over the body. Simple idea !

        When I saw the physiotherapist we talked about what had happened. The tendon was damaged.The body responded with it’s standard repair & healing process. The Injured bits of my tendon were broken down and new cells moved to grow and be integrated into the tendon. But tendons have limited blood supply so the dead cells & the fluid were stuck there leading to the infalmation not going away. Masage ( Specifically a stripping action down the length of the tendon on each side and the back as well ) got the de-inflammation process moving…In fact my tendon swelling reduced by about 50% immediately.

        Now please just think about that process : It happens elsewhere in the body. is this thinking applicable to damaged arteries ? I think so.

        1. Andy S

          Hi Bill,
          Maybe other people might find the info on tendons and macrophages interesting. Problem with tendons might apply to cartilage (like back pain) where nutrient supply is assisted by movement. Blood and lymph flow at the capillary level appears to be the problem and the solution is to move more. EECP would also stimulate capillary function but jumping around could be just as effective.

          Your point about massaging arteries to aid foam cell removal cannot be dismissed off-hand. How about an ultrasound device to induce vibration, say an hour a day. If it works there would not be any need to pay attention to diet. A whole body massage /reclining chair is another possibility, a bit expensive perhaps. Even if foam cells are not removed the circulation will be improved.

          A mouse study could be set up to see if any of these ideas work.

          1. Andy S

            Hi Sasha,
            I agree with you that there is very little that can be done to dislodge a cell from tissue. On the other hand smooth muscle cells apparently migrate, stuff moves in and out of cells. Why does infra red therapy work? Energy is being transmitted to cells. Could sound waves have an effect on cells? it is energy after all.
            Then there is man made electromagnetic radiation that could upset quantum processing.

          2. Sasha

            Andy, no doubt all or some of those therapies work and possibly do a lot. But, IMO, proper diet is so fundamental to our well being that if it’s not there, high tech therapies become marginal.

          3. Andy S

            Agree wth you that diet is #!, but some people are offended by that term. The present topic was how to reverse plaque without resorting to diet. Have to understand how arteries clog in the first place, still a ways to go.

          4. Gary Ogden

            Andy S: Yes, EMF radiation is worrisome, as 5G, with orders of magnitude greater radiation, is being shoved down our throats. The solution to internet speed and download capacity is fiber optic cable.

    4. Martin Back

      The arteries should be getting a gentle internal massage from the blood pressure pulse with every beat of the heart. I would imagine that CPR — which can be vigorous enough to break one’s ribs — is far more likely to break up any large plaques and give the patient a second MI than clear away accumulated foam cells.

        1. Gary Ogden

          Good to revisit this. From the Cleveland Clinic, “. . . EECP may stimulate the openings or formation of collaterals to create a natural bypass around narrowed or blocked arteries.” Sounds like a winner.

          1. Andy S

            Hi Gary,
            From my limited understanding hypoxia initiates angiogenesis. Demand for oxygen exceeds supply. Tissue residing macrophages coordinate the process. Cellular communication between cell needing oxygen and macrophages.
            Not sure how the reverse process works ie blood vessel pruning and bone/muscle tissue loss from inactivity. No need to keep surplus tissue if not used. Looks like apoptosis, but what is signal pathway?

      1. Bill In Oz

        No, Martin ! I am not arguing for CPR as a ‘compulsory’ artery massage program. I have had a rib cracked on one occasion when training in Aikido.It was not pleasant. And no treatment either ! Bugger !

        No, I am suggesting that CPR may have the incidental side effect of massaging & breaking down dead cells etc in the artery intima..and this helping as a side effect…

        But maybe yoga sequences do this even better.. as Sasha suggests or EECP – which I know zip about and is completely absent here in Oz…

        Can we have some more info about EECP Malcolm ?

      2. Göran Sjöberg

        For sure great readings about EECP on the “net” – a very convincing treatment indeed!

        In my own case I, for sure, wouldn’t be offered such a treatment, lasting a couple of months at a cost of 8000 EURO by our NHS, since I haven’t first accepted their “offers” of being CABG’ed and/or taking any of their prescribed pharmaceuticals. As my last cardiologist stated: “What you are up to I consider almost criminal!.” (Sometimes I though can understand how my sceptic Popperian refusal attitude can provoke “hatred” among main stream Big Pharma advocates “who know” as we have lately noticed here on Malcolm’s blog but perhaps now finally have got rid of.)

        As far as i understand the main benefit of the EECP process is to stress the heart to produce collaterals. I realize that my own and Dr. Mercola’s suggestion of tough physical exercises are doing about the same thing but at no cost. At the same time there is here another benefit when the aspect of my garden improves with each physical “burst” from my side 🙂

  59. Gary Ogden

    A week or so ago someone posted a link to a paper which said that EPCs exist in key places in the vasculature and elsewhere, and that these do most of the heavy lifting in the repair process. It piqued my interest, and I’ve been pondering it ever since. Does this align with your knowledge and understanding of the repair process, Dr. Kendrick?

    1. Dr. Malcolm Kendrick Post author

      It is what repairs damaged endothelial cells. Quite where all the EPCs lurk – I am not certain. They are manufactured in the bone marrow, but what they do after that – for sure – I don’t think anyone is quite sure

      1. Andy S

        Dr. K,
        Re. tissue=resident macrophages

        Tissue-Resident Macrophages Self-Maintain Locally throughout Adult Life with Minimal Contribution from Circulating Monocytes

        “Despite accumulating evidence suggesting local self-maintenance of tissue macrophages in the steady state, the dogma remains that tissue macrophages derive from monocytes. “

        Appears that these TRM’s maintain homeostasis by an orderly recycling of apoptotic cells. Problems could arise when apoptosis or necrosis exceeds capacity of TRM’s to clear up the debris. In this case circulating monocytes are recruited and an inflammatory condition results.
        Even macrophages have a limited lifespan.
        If there are 50 trillion cells and they are replaced over a period of 5 to 7 years how many cell per minute would that be?

  60. Leon Roijen

    Dr. Kendrick,

    Could people with diabetes be raising their CVD risk by pricking themselves in order to measure their blood glucose and thus possibly activating the blood clotting system?

  61. Martin Back

    Not all proteins are created the same. Men grow taller on animal protein, particularly from dairy, compared to those who consume plant protein.

    Major correlates of male height: A study of 105 countries
    This comparison identified three fundamental types of diets based on rice, wheat and milk, respectively. The consumption of rice dominates in tropical Asia, where it is accompanied by very low total protein and energy intake, and one of the shortest statures in the world (∼162–168 cm). Wheat prevails in Muslim countries in North Africa and the Near East, which is where we also observe the highest plant protein consumption in the world and moderately tall statures that do not exceed 174 cm. In taller nations, the intake of protein and energy no longer fundamentally rises, but the consumption of plant proteins markedly decreases at the expense of animal proteins, especially those from dairy. Their highest consumption rates can be found in Northern and Central Europe, with the global peak of male height in the Netherlands (184 cm).

  62. AnnaM


    Regarding Mercola saying about a product that it virtually eliminates your chance of developing cancer. Could you please point me to that article because that doesn’t sound like something he would say about just one supplement.

    I have noticed that it is often scientists who have really shone out and made a name for themselves, i.e., top notch scientists with very promising futures, who then get persecuted for standing for what they see as the truth. Duesberg had nothing to gain and everything to lose (and he did lose) by doing that. Now you say he is immoral. I say he is sincere, and it isn’t immoral to have a theory or for a theory to be wrong. Once those who stand out from the crowd are called immoral, it justifies persecution.

    I haven’t looked into the question for about 15 years. Has anything changed?

  63. Charles Gale

    What was the subject of part 54? 320 comments later, the bulk of which was hijacked and off topic but sometimes informative, I’ve forgotten. The news has reminded me of some recent topics…

    Today’s (Sat 15 Sept) news in UK’s i newspaper:

    1. Heart disease cured in a few years: essentially, it says, an injection of antibodies


    2. low carb diet treatment for type 2 diabetes. It quotes good guy cardiologist Dr Aseem Malhotra: “…it is now clear that a low carb approach is the most effective way to manage type 2 diabetes not only in terms of glucose control and improving cardiovascular risk factors…”.

    Nice to see the low carb/diabetes headline. I can never understand how we are bombarded by stories, adverts and so on bashing e.g. cholesterol but you won’t hear adverts on radio advocating anything other than the official party line e.g. grass fed butter or meats.

    Bill in Oz – I saw your attempts to get a discussion going on macrophages and wish I could have contributed but didn’t know much about them, or the glycocalyx from a recent blog, but do appreciate what you have put together including your 6 pointed summary.

  64. Charles Gale

    Bill in Oz

    cpr and your point 6 “could a massage like process help dissipate this stuff…”

    Like Sasha’s comment, I’m not sure that cpr massages anything.

    We all know what cpr is but here’s what the British Heart Foundation has to say:


    I went crashing down 2 plus years ago and my colleagues did cpr, then I was defibrillated by the ambulance crew. Having been taken to intensive care, survived and staggered off the cardio slab I discovered I also had damaged ribs to deal with – the joke was the damaged/cracked/painful ribs showed they did the cpr properly!

    Massaging the arteries. I find your thoughts interesting and might add that perhaps (pure speculation):

    – good blood flow might do that
    – keeping your arteries flexible and elastic might do that
    – I’ve seen the word “fibrous” applied to advanced plaque growth and would imagine it would be hard to shift in that state…especially if there is hard, chronic calcification.

    1. Bill In Oz

      Thanks Charles for your reply.. There are comments up above on this….Your last remark about fibrous plaques needs a reply though..

      The plaque is in my terms a “Scab’ that forms on the inside of the artery wall as part of the healing process..And new arterial tissue forms over the plaque.. And the body’s repair process them goes ahead and breaks down the plaque /scab as is it no longer needed. That’s the Ideal scenario !

      But this may not or cannot happen sometimes.

      The scab/plaque in the intima cannot be completely broken down & removed by the macrophages in the body. So the artery thickens…setting up future blockages of blood flow…

      Which brings us back to what helps the artery repair process ? CPR maybe by accident ? Yoga ? EECP ?

      God now that we are not all distracted by ‘diet dictates’ point scoring, maybe we can think this through ?

      1. Andy S

        Hi Bill,
        re your question
        “Which brings us back to what helps the artery repair process ? CPR maybe by accident ? Yoga ? EECP ?”

        Can’t see how any of them would help to repair a clogged artery.

      2. AnnaM

        I am doubting that cpr could dislodge plaque, and if it did, the result would generally be disaster. The ankle tendon stripping may have dealt with a very different type of tissue and the inflammatory debris was smaller, not to mention new. I would imagine arterial plaques to be rather oldish and sticky. Also, inside a tube.

  65. Randall

    THIS IS IT. There is no evidence that high levels of total cholesterol or of “bad” cholesterol cause heart disease, according to a new paper by 17 international physicians based on a review of patient data of almost 1.3 million people. The authors also say their review shows the use of statins – cholesterol lowering drugs – is “of doubtful benefit” when used as primary prevention of cardiovascular disease.

    1. Gary Ogden

      Randall: Thanks! Kudos to the authors of this cold, hard look at the evidence against the lucrative quackery of statins.

  66. Charles Gale

    Bill in Oz

    Arterial repair process.

    Well, ideally, either removing or minimising the cause of the damage. Easier said than done (e.g. stress) and also problems in identifying the cause of the damage (take your pick, there are a multitude to choose from such as vit c deficiency, high homocysteine levels and many more).

    Also, ensure, as Dr Kendrick has often mentioned, that the repair process is greater than the damage being done. I won’t list the suggestions (which you know anyway) but from a nutritional point of view might include e.g. good hydration, vit C, magnesium and much more. Away from nutrition these would include e.g. sunlight, exercise.

    I note your comments on the ideal scenario and wonder why the immune/defense system (which includes macrophages, cholesterol and lp(a)) doesn’t always get the job done. Perhaps we’re back to (1) damage greater than repair or (2) a unhealthy, poorly maintained and not looked after body which hasn’t got a good immune system and thus not able to produce these defense substances in suitable amounts.

    And on the subject of external massaging of the body to aid repair, here’s an anecdote I cherry picked from the comments of another website:

    The commenter “once heard of somebody that thoughtlessly played with the artery in his neck for many years and developed arterial plaque there.”

    Who knows?

    And don’t forget that link I attached to a 2018 presentation by cardiologist Dr Peter Langsjoen in which he discussed arterial trauma. He gave 2 examples (1) set of drawers and (2) steering wheel damage damaging the arteries and triggering plaque build up. n.b. He did state these were rare examples and the trauma was quite severe.

    My thoughts, incorporating the comments your query has generated, are to proceed with caution with things like cpr or rubbing (as an aside I try never to cross my legs when sitting to maintain blood flow – old wives tale maybe?) and perhaps yoga and EECG have a lot of merit.

    I was never offered EECG (or heard of it) but Dr Kendrick has explained the preference for stenting.

      1. LA_Bob

        Somehow, I think if you wanted a proper “massage” for the coronary arteries, the ideal one would be a good, long laugh. Really gets the diaphragm moving.

        Same with a good, deep cry. I never forget the words of the great Dr Frederick Leboyer, famous author of Birth Without Violence.

        “Laughter and tears are very close to one another”.

        From my personal experience, they help to manage stress / strain.

    1. Sylvia Brooke

      re your comment re. never crossing your legs. I honestly don’t think that advice is an old wive’s tale. Many years ago, whilst in hospital following quite a big operation, if ever the Ward Sister found anyone on the Ward crossing their legs she would go wild and everyone would get another lecture about NOT crossing their legs, and she very much frowned on smoking too.

      When she was leaving for home at the end of a week’s shift she would delight in saying (with a huge smile on her face) “Goodnight ladies. I’m off home now to enjoy a fag, with my legs crossed, in front of the Telly”!! The laughs that “goodnight” raised were better than any medicine.

    2. Bill In Oz

      Charles & Martin, I do not know anything about EECP. I don’t think it is available in Australia – or at least anywhere in South Australia. It’s probably not registered as a treatment under our Medicare Program. But I suspect it is something worth checking out.
      At various times in my life I have done yoga..Mostly the Integral Yoga style.( Sort of Sivananda ) ..And in terms of physical health it was good for me…( And before you ask, despite those benefits, I abandoned it & all contact due to the main teacher & group because of being involved in sexual abuse allegations..But that’s another story)

      I have seen people using the stomach massage belt machines..But nowadays they are rare here. None of the gyms I know use them anymore..Perhaps they became unfashionable & nobody had worked out the benefit to the arteries ?

      As for CPR.. It just came to me that it is used whenever a heart attack happens and so it may, apart from oxygenating the lungs and blood, also help resolve artery swelling inflammation.. But yes it’s a bit ‘rugged’ a modus operandi !

  67. David Bailey


    My understanding is the idea that cancer might be inhibited on a ketogenic diet is based on the fact that most cancers do not oxidise glucose to release the full energy, they split it without using oxygen (a process known as glycolysis) that releases much less energy. This is the basis for PET scanning for cancer.


    This is believed to be because cancer cells usually contain defective mitochondria.

    Since you don’t seem to reference this mechanism, I don’t think you understand why people are interested in ketogenic diets as a cure for cancer (possibly in combination with other therapies).

    1. Göran Sjöberg


      Here we have prof. Thomas Seyfried who has in detail entangled the damaged metabolic processes in the mitochondria of the cancer cells and as the driver of the cancer cells in his great book “Cancer as a Metabolic Disease”. Bottom line here is the hypothesis that the mitochondria with their wrecked metabolism do not supply enough ATP energy for the DNA repair processes in the nucleus which explains the high mutation rate of the cancer cells – an effect rather than a cause of cancer.

      I like the dedication of the book:

      “This book is dedicated to the millions of people who have suffered and died from toxic cancer therapies.”

    2. Sylvia

      Just like to say, I follow ketopetsanctuary advice re my dogs cancer, osteosarcoma, their outcomes are good following low carb diet. I do give homoeopathy to my dog also. Apologies Dr Kendrick, bringing canines into your blog, but I did have a dog with, I am sure, congestive cardiac failure, I got her from a breeder,she was so weary from too many litters. At night she had cardiac asthma, have watched this from my nursing career. Always used my lovely vet, but do my own thing also. Sorry for straying again.

  68. Charles Gale

    Hi Bill in Oz

    Some further thoughts (make of them what you will) on your line of enquiry which I think/hope I’ve understood correctly as the impact (positively or negatively) of external pressure applied to the body (e.g. cpr, massage, yoga) on the arteries/arterial plaque removal.

    I made a comment about leg crossing (thanks for your comment Sylvia) and here are a few more which have come my way over the years…old wives tales?… as follows…

    From a blood flow point of view:

    – tight neck collars. This bulked large from a male hair loss point of view (and may still do) because of restricting blood flow to the scalp. I think in James Joyce’s 1922 novel Ulysses protagonist Bloom makes a comment along these lines about a fellow Dubliner with hairloss and a tight collar. From a CVD or rather stroke perspective, the carotid arteries are in the neck carrying blood to and from the brain so perhaps something to think about.

    – wristwatches. I had a colleague who never wore a wristwatch, he carried it in his pocket. I think the reason were something like the weight, the pressure on the wrist and maybe something to do with electrical charges. Bottom line – I think he felt it was contrary to nature.

    – tight fitting clothes/slip on shoes. For example, overly tight elasticated waist bands and sock tops restricting blood flow and leaving an impression of the material on your skin when you take them off.

    Again, who knows?

    From an arterial point of view:

    I have pronounced vascularity (much coveted by body builders, especially along the biceps. There is plenty of guidance/tips on youtube on how to achieve this. I can’t work out if pronounced vascularity is good or bad though). I’m not sure if this makes you more vulnerable to external trauma but I err on the side of caution.

    Any conclusions?

    Not sure.

    Perhaps that there is more potential for damage than repair with any (sustained) pressure on the body.

    There are those who reckon you can halt and remove/reverse arterial plaque.

    And those who say you can’t.

    Did anything in particular trigger this line of enquiry?

    1. Sylvia Brooke

      Sorry Charles, me again.
      Tight socks which leave an imprint on your legs are a definite nono in my opinion, along with tight wristwatches etc. and don’t get me going about tight waistbands – after wearing one for too long I do a fair impression of Quasimodo, believe me. But all joking aside I consider anything that restricts your blood flow in ANY way is really bad. Take it from an old wife who knows from experience.

  69. Charles Gale


    Bill in Oz – ignore my question about your line of enquiry…I’ve just read your original comment on the topic!

  70. Gary Ogden

    Dr. Peter C Gøtzsche has been expelled from Cochrane. Pharma fascism is now in charge of everything good and wholesome.

    1. Göran Sjöberg

      Well this is not a unik manifestation of Big Pharma vicious actions.

      We have e.g. our Dr. Annika Dahlqvist in Sweden.

      There is Prof. Tim Noakes in South Africa

      and “Dr Gary Fettke reprimanded by medical watchdog AHPRA for suggesting patients eat low-carb diets”. He was “tired” of his amputations on his diabetic patients.

      But as I claim “science is on our side”!

  71. Göran Sjöberg


    Locking back into the actual post by Malcolm I found the third reference very interesting and double clicked on that. And when I did that my computer was overwhelmed by a number security warnings. And the closer I approached the actual web site the hotter the warning became. Finally I was requested to change my security settings on my computer. At that point I gave up.

    I have never encountered anything in the vicinity of this and wonder why.

    Am I getting over suspicious?


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