Physical Health, Mental Health

There is a growing field focused on the relationship between diet, nutrition, neurocognition, and psychiatry. I’ve written about this previously (The Agricultural Mind; Ketogenic Diet and Neurocognitive Health; & Fasting, Calorie Restriction, and Ketosis). But there aren’t many well known experts in this area.

One of the better known figures in this convergence of fields is Dr. Georgia Ede, a psychiatrist with a medical degree and a B.A. in Biology. She has completed a graduate course in nutrition at Harvard where she also completed her residency. Besides psychiatry, her employment includes as laboratory research assistant, psychopharmacologist, and nutrition consultant. Her writings regularly appear in Psychology Today.

There is another authority in this area, Dr. Natasha Campbell-McBride. She holds a degree in Medicine and Postgraduate degrees in both Neurology and Human Nutrition. After years working as a neurologist and neurosurgeon, she now practices as a nutritionist and used to run the Cambridge Nutrition Clinic. She is the founder of the widely used Gut and Psychology (GAPS) Diet.

Highly Profitable Conflicts of Interest

“Putting together my next talk on undisclosed conflicts of interest. Authors of ‘my’ go to textbook of medicine ‘funded’ in excess of $11 million without declaration. Makes practicing tricky when you lose trust in your education foundations. #TipOfIceberg”
~ Gary Fettke

We wonder why doctors coming out of medical school lack basic knowledge of treatments that don’t depend upon profitable drugs and invasive procedures. The majority of medical interns fresh out of school get about half the questions wrong on nutrition. Would you turn to someone for authoritative expertise who is as likely to be wrong as to be right in the advice they give you?

That is exactly what is happening when you ask most doctors about diet or about many issues related to diet. For example, look at the sorry state of affairs in the knowledge about cholesterol and statins. It’s standard practice for doctors to recommend statins to patients who, according to research, would not benefit from them. And so there is overprescription of statins, a class of drugs that has worrisome side effects such as neurocognitive decline (your brain needs cholesterol). This is also found with other medical practices that are continued even when doctors know they are ineffective in most cases.

The shocking part is that they’re being well funded to be this ignorant. Drug companies spend more money on advertising than on research and spend more money on influencing doctors than on advertising (they also spend money on influencing nurses, as with pharmacists, who will influence both patients and doctors; and there is the funding that goes to patient organizations).

Such ignorance among doctors doesn’t come naturally or cheaply. It requires systematic planning of a propaganda campaign that goes straight to the most ‘respectable’ gatekeepers of knowledge, such as writers in the textbook industry. This crisis extends into medical research itself, as many researchers follow this same pattern of undeclared conflicts of interest (many of those researchers, by the way, work in universities where they also teach the each new generation of doctors). This could explain at least some of why we are also experiencing a replication crisis in medical research with nutritional studies being one of the worst areas.

So, what exactly is all that money buying? And what is so dark and disturbing that these medical authorities, in not declaring it, are afraid others will find out?

* * *

Undisclosed conflicts of interest among biomedical textbook authors
by Brian J. Piper et al

ABSTRACT
Background: Textbooks are a formative resource for health care providers during their education and are also an enduring reference for pathophysiology and treatment. Unlike the primary literature and clinical guidelines, biomedical textbook authors do not typically disclose potential financial conflicts of interest (pCoIs). The objective of this study was to evaluate whether the authors of textbooks used in the training of physicians, pharmacists, and dentists had appreciable undisclosed pCoIs in the form of patents or compensation received from pharmaceutical or biotechnology companies.

Methods: The most recent editions of six medical textbooks, Harrison’s Principles of Internal Medicine (HarPIM), Katzung and Trevor’s Basic and Clinical Pharmacology (KatBCP), the American Osteopathic Association’s Foundations of Osteopathic Medicine (AOAFOM), Remington: The Science and Practice of Pharmacy (RemSPP), Koda-Kimble and Young’s Applied Therapeutics (KKYAT), and Yagiela’s Pharmacology and Therapeutics for Dentistry (YagPTD), were selected after consulting biomedical educators for evaluation. Author names (N = 1,152, 29.2% female) were submitted to databases to examine patents (Google Scholar) and compensation (ProPublica’s Dollars for Docs [PDD]).

Results: Authors were listed as inventors on 677 patents (maximum/author = 23), with three-quarters (74.9%) to HarPIM authors. Females were significantly underrepresented among patent holders. The PDD 2009–2013 database revealed receipt of US$13.2 million, the majority to (83.9%) to HarPIM. The maximum compensation per author was $869,413. The PDD 2014 database identified receipt of $6.8 million, with 50.4% of eligible authors receiving compensation. The maximum compensation received by a single author was $560,021. Cardiovascular authors were most likely to have a PDD entry and neurologic disorders authors were least likely.

Conclusion: An appreciable subset of biomedical authors have patents and have received remuneration from medical product companies and this information is not disclosed to readers. These findings indicate that full transparency of financial pCoI should become a standard practice among the authors of biomedical educational materials.

* * *

Failure of Nutritional Knowledge in Science and Practice
Flawed Scientific Research
Clearing Away the Rubbish
Cold War Silencing of Science
Eliminating Dietary Dissent
Dietary Dictocrats of EAT-Lancet
Monsanto is Safe and Good, Says Monsanto

Failure of Nutritional Knowledge in Science and Practice

“The idea that the same experiment will always produce the same result, no matter who performs it, is one of the cornerstones of science’s claim to truth. However, more than 70% of the researchers (pdf), who took part in a recent study published in Nature have tried and failed to replicate another scientist’s experiment. Another study found that at least 50% of life science research cannot be replicated. The same holds for 51% of economics papers”
~Julian Kirchherr, Why we can’t trust academic journals to tell the scientific truth

“The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue”
~Richard Horton, editor in chief of The Lancet, one of the leading medical journals where nutritional studies are published

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor”
~Dr. Marcia Angell, former editor in chief of The New England Journal of Medicine

“Simulations show that for most study designs and settings, it is more likely for a research claim to be false than true. Moreover, for many current scientific fields, claimed research findings may often be simply accurate measures of the prevailing bias.”
~John Ioannidis, Why Most Published Research Findings Are False

“Possibly, the large majority of produced systematic reviews and meta‐analyses are unnecessary, misleading, and/or conflicted.”
~John Ioannidis, The Mass Production of Redundant, Misleading, and Conflicted Systematic Reviews and Meta‐analyses

“Nutritional epidemiologists valiantly work in an important, challenging frontier of science and health. However, methods used to-date (even by the best scientists with best intentions) have yielded little reliable, useful information.”
~John Ioannidis, Unreformed nutritional epidemiology: a lamp post in the dark forest

“Associations with cancer risk or benefits have been claimed for most food ingredients. Many single studies highlight implausibly large effects, even though evidence is weak. Effect sizes shrink in meta-analyses.”
~Jonathan Schoenfeld & John Ioannidis, Is everything we eat associated with cancer? A systematic cookbook review

“Some nutrition scientists and much of the public often consider epidemiologic associations of nutritional factors to represent causal effects that can inform public health policy and guidelines. However, the emerging picture of nutritional epidemiology is difficult to reconcile with good scientific principles. The field needs radical reform.”
~John Ioannidis, The Challenge of Reforming Nutritional Epidemiologic Research

“Incoming residents to a pediatric residency program appear to be deficient in basic nutritional knowledge. With the ever increasing burden of obesity and its associated co-morbidities on society, it is imperative that medical education focuses on preparing physicians to appropriately counsel all populations on proper nutrition.”
~M. Castillo, R. Feinstein, J Tsang & M. Fisher, Basic nutrition knowledge of recent medical graduates entering a pediatric residency program.

“Many US medical schools still fail to prepare future physicians for everyday nutrition challenges in clinical practice. Nutrition is a dominant contributor to most chronic diseases and a key determinant of poor treatment outcomes. It cannot be a realistic expectation for physicians to effectively address obesity, diabetes, metabolic syndrome, hospital malnutrition, and many other conditions as long as they are not taught during medical school how to recognize and treat the nutritional root causes.”
~Kelly Adams, W. Scott Butsch & Martin Kohlmeier, The State of Nutrition Education at US Medical Schools

* * *

I’ve written about this topic before. In some of those earlier posts, I used a few of the above quotes. But I also came across some new quotes that emphasize the point. I decided to gather them all together in one place without analysis commentary, as they speak for themselves. I’ll allow myself to make a single note of significance.

A lot of medical research is done by doctors. In Rigor Mortis, Richard Harris points out that doctors aren’t generally well educated and trained in research methodology or statistical analysis. My cousin who does medical research confirmed this observation. On top of that, doctors when they were back in medical school also weren’t taught much about diet and nutrition — interns right out of medical school get about half the nutritional questions wrong, which would be a failing grade.

So, combine doctors not trained in research doing research on diet and nutrition which they never learned much about. It is not surprising that nutritional studies is one of the worst areas of replication crisis. The following are the prior posts about all of this:

Flawed Scientific Research
Scientific Failure and Self Experimentation
Clearing Away the Rubbish
Most Mainstream Doctors Would Fail Nutrition

* * *

Bonus Video – Below is a speech given by Dr. Aseem Malhotra at the European Parliament last year and another speech by Dr. Michael Eades. Among other things, he covers some of the bad methodologies, deceptive or misleading practices, and conflicts of interest.

Sometimes research is intentionally bad because of the biases of funding and ideological agendas, an issue I’ve covered numerous times before. It can’t all be blamed on the insufficient education of doctors in their doing research. After the video, I’ll throw in the links to those other pieces as well.

Cold War Silencing of Science
Eliminating Dietary Dissent
Dietary Dictocrats of EAT-Lancet
Monsanto is Safe and Good, Says Monsanto

Diets and Systems

Chuck Pezeshki is a published professor of engineering in the field of design theory and high performance work teams. I can claim no specialty here, as I lack even a college degree. Still, Pezeshki and I have much in common — like  me: He prefers a systems view, as he summarizes his blog on his About page, “As we relate, so we think.” He states that, “My work exists at, and reaches far above the micro-neuroscience level, into larger systemic social organization.”

An area of focus we share is diet and health and we’ve come to similar conclusions. Like me, he sees a relationship between sugar, obesity, addiction, trauma, individuality, empathy issues, authoritarianism, etc (and inequality comes up as well; by the way, my favorite perspective on inequality in this context is Keith Payne’s The Broken Ladder). And like me, he is informed by a low-carb and ketogenic approach that was initially motivated by weight loss. Maybe these commonalities are unsurprising, as we do have some common intellectual interests.

Much of his blog is about what he calls “structural memetics” involving value memes (v-memes). Even though I haven’t focused as much on value memes recently, Ken Wilber’s version of spiral dynamics shaped my thought to some extent (that kind of thing being what brought me to Pezeshki’s blog in the first place). As important, we are both familiar with Bruce K. Alexander’s research on addiction, although my familiarity comes from Johann Hari’s writings (I learned of the rat park research in Chasing the Scream). A more basic link in our views comes from each of us having read the science journalism of Gary Taubes and Nina Teicholz, along with some influence from Dr. Jason Fung. He has also read Dr. Robert H. Lustig, a leading figure in this area who I know of through the work of others.

Related to diet, Pezeshki does bring up the issue of inflammation. As I originally came around to my present diet from a paleo viewpoint, I became familiar with the approach of functional medicine that puts inflammation as a central factor (Essentialism On the Decline). Inflammation is a bridge between the physiological and the psychological, the individual and the social. Where and how inflammation erupts within the individual determines how a disease condition or rather a confluence of symptoms gets labeled and treated, even if the fundamental cause originated elsewhere, maybe in the ‘external’ world (socioeconomic stress, transgenerational trauma, environmental toxins, parasites because of lack of public sanitation, etc. Inflammation is linked to leaky gut, leaky brain, arthritis, autoimmune disorders, mood disorders, ADHD, autism, schizophrenia, impulsivity, short-term thinking, addiction, aggression, etc — and such problems increase under high inequality.

There are specific examples to point to. Diabetes and mood disorders co-occur. There is the connection of depression and anhedonia, involving the reward circuit and pleasure, which in turn can be affected by inflammation. Also, inflammation can lead to changes in glutamate in depression, similar to the glutamate alterations in autism from diet and microbes, and that is significant considering that glutamate is not only a major neurotransmitter but also a common food additive. Dr. Roger McIntyre writes that, “MRI scans have shown that if you make someone immune activated, the hypervigilance center is activated, activity in the motoric region is reduced, and the person becomes withdrawn and hypervigilant. And that’s what depression is. What’s the classic presentation of depression? People are anxious, agitated, and experience a lack of spontaneous activity and increased emotional withdrawal” (Inflammation, Mood Disorders, and Disease Model Convergence). Inflammation is a serious condition and, in the modern world, quite pervasive. The implications of this are not to be dismissed.

I’ve been thinking about this kind of thing for years now. But this is the first time I’ve come across someone else making these same connections, at least to this extent and with such a large context. The only thing I would add or further emphasize is that, from a functional medicine perspective (common among paleo, low-carb, and keto advocates), the body itself is a system as part of the larger systems of society and the environment — it is a web of connections not only in which we are enmeshed but of which forms everything we are, that is to say we aren’t separate from it. Personal health is public health is environmental health, and think of that in relation to the world of hyperobjects overlapping with hypersubjectivity (as opposed to the isolating psychosis of hyper-individualism):

“We shouldn’t personally identify with our health problems and struggles. We aren’t alone nor isolated. The world is continuously affecting us, as we affect others. The world is built on relationships, not just between humans and other species but involving everything around us — what some describe as embodied, embedded, enacted, and extended (we are hypersubjects among hyperobjects). The world that we inhabit, that world inhabits us, our bodies and minds. There is no world “out there” for there is no possible way for us to be outside the world. Everything going on around us shapes who we are, how we think and feel, and what we do — most importantly, shapes us as members of a society and as parts of a living biosphere, a system of systems all the way down. The personal is always the public, the individual always the collective, the human always the more than human” (The World Around Us).

In its earliest meaning, diet meant a way of life, not merely an eating regimen. And for most of history, diet was rooted in cultural identity and communal experience. It reinforced a worldview and social order. This allows diet to be a perfect lens through which to study societal patterns and changes over time.

* * *

Relevant posts by Chuck Pezeshki:

Weight Loss — it’s in the V-Memes
Weight Loss — It’s in the v-Memes (II)
Weight Loss by the V-Memes — (III) What’s the v-Meme stack look like?
Weight Loss by the V-Memes (IV) or Channeling your Inner Australopithecine
Weight Loss by the v-Memes (V) – Cutting out Sugar — The Big Psycho-Social-Environmental Picture
The Case Against Sugar — a True Psychodynamic Meta-Review
Quickie Post — the Trans-Cultural Diabolical Power of Sugar
How Health Care Deprivation and the Consequences of Poor Diet is Feeding Contemporary Authoritarianism – The Trump ACA Debacle
Quickie Post — Understanding the Dynamics of Cancer Requires a Social Structure that can Create Cellular Dynamics
Finding a Cure for Cancer — or Why Physicists May Have the Upper Hand
Quickie Post –A Sober Utopia
Rat Park — Implications for High-Productivity Environments — Part I
Rat Park — Implications for High-Productivity Environments — Part II
Leadership for Creativity Isn’t all Child’s Play
Relational Disruption in Organizations
The Neurobiology of Education and Critical Thinking — How Do We Get There?
What Caused the Enlightenment? And What Threatens to Unravel It?

* * *

Relevant posts from my own blog:

It’s All Your Fault, You Fat Loser!
The World Around Us
The Literal Metaphor of Sickness
Health From Generation To Generation
The Agricultural Mind
Spartan Diet
Ketogenic Diet and Neurocognitive Health
Fasting, Calorie Restriction, and Ketosis
Like water fasts, meat fasts are good for health.
The Creed of Ancel Keys
Dietary Dictocrats of EAT-Lancet
Eliminating Dietary Dissent
Cold War Silencing of Science
Essentialism On the Decline

There is also some discussion of diet in this post and the comments section:

Western Individuality Before the Enlightenment Age

And related to that:

Low-Carb Diets On The Rise

“It has become an overtly ideological fight, but maybe it always was. The politicization of diet goes back to the early formalized food laws that became widespread in the Axial Age and regained centrality in the Middle Ages, which for Europeans meant a revival of ancient Greek thought, specifically that of Galen. And it is utterly fascinating that pre-scientific Galenic dietary philosophy has since taken on scientific garb and gets peddled to this day, as a main current in conventional dietary thought (see Food and Faith in Christian Culture ed. by Ken Albala and Trudy Eden […]; I made this connection in realizing that Stephen Le, a biological anthropologist, was without awareness parroting Galenic thought in his book 100 Million Years of Food).”

* * *

Mental health, Psychopathy, Addiction, Inflammation, Diet, Nutrition, etc:

Dark triad traits and health outcomes: An exploratory study
by Jasna Hudek-Knezevic et al

Brain chemical is reward for psychopathic traits
by Ewen Callaway

Psychopaths’ brains wired to seek rewards, no matter the consequences
from Science Daily

Psychopathic traits modulate brain responses to drug cues in incarcerated offenders
by Lora M. Cope et al

Links Between Substance Abuse and Antisocial Personality Disorder (ASPD)
from Promises Behavioral Health

Antisocial Personality Disorder and depression in relation to alcoholism: A community-based sample
by Laura C. Holdcraft et al

More inflammation but less brain-derived neurotrophic factor in antisocial personality disorder
by Tzu-Yun Wang et al

High Neuroticism and Low Conscientiousness Are Associated with Interleukin-6
by Sutin, Angelina

Aggressive and impulsive personality traits and inflammatory markers in cerebrospinal fluid and serum: Are they interconnected?
by S. Bromander et al

Inflammation Predicts Decision-Making Characterized by Impulsivity, Present Focus, and an Inability to Delay Gratification
by Jeffrey Gassen et al

Could Your Immune System Be Making You Impulsive?
by Emma Young

Impulsivity-related traits are associated with higher white blood cell counts
by Angelina R. Sutin et al

Dietary long-chain omega-3 fatty acids are related to impulse control and anterior cingulate function in adolescents
by Valerie L. Darcey

Diabetes Risk and Impulsivity
by David Perlmutter

Experimentally-Induced Inflammation Predicts Present Focus
by Jeffrey Gassen et al

Penn Vet researchers link inflammation and mania
by Katherine Unger Baillie

Anger Disorders May Be Linked to Inflammation
by Bahar Gholipour

Markers of Inflammation in the Blood Linked to Aggressive Behaviors
from University of Chicago Medical Center

Anhedonia as a clinical correlate of inflammation in adolescents across psychiatric conditions
by R. D. Freed et al

From Stress to Anhedonia: Molecular Processes through Functional Circuits
by Colin H. Stanton et al

Mapping inflammation onto mood: Inflammatory mediators of anhedonia
by Walter Swardfager et al

Understanding anhedonia: What happens in the brain?
by Tim Newman

Depression, Anhedonia, Glutamate, and Inflammation
by Peter Forster et al

Depression and anhedonia caused by inflammation affecting the brain
from Bel Marra Health

Inflammation linked to weakened reward circuits in depression
from Emory Health Sciences

Depression in people with type 2 diabetes: current perspectives
by L. Darwish et al

The Link Between Chronic Inflammation and Mental Health
by Kayt Sukel

Emory team links inflammation to a third of all cases of depression
by Oliver Worsley

Brain Inflammation Linked to Depression
by Emily Downwar

The Brain on Fire: Depression and Inflammation
by Marwa Azab

Inflammation, Mood Disorders, and Disease Model Convergence
by Lauren LeBano

High-inflammation depression linked to reduced functional connectivity
by Alice Weatherston

Does Inflammation Cause More Depression or Aggression?
by Charles Raison

A probe in the connection between inflammation, cognition and suicide
by Ricardo Cáceda et al

What If We’re Wrong About Depression?
by Anna North

People with ‘rage’ disorder twice as likely to have parasitic infection
by Kevin Jiang

Rage Disorder Linked with Parasite Found in Cat Feces
by Christopher Wanjek

Maternal Inflammation Can Affect Fetal Brain Development
by Janice Wood

The effects of increased inflammatory markers during pregnancy
from Charité – Universitätsmedizin Berlin

Inflammation in Pregnancy Tied to Greater Risk for Mental Illness in Child
by Traci Pedersen

Inflammation may wield sex-specific effects on developing brain
by Nicholette Zeliadt

Childhood obesity is linked to poverty and parenting style
from Concordia University

The Obesity–Impulsivity Axis: Potential Metabolic Interventions in Chronic Psychiatric Patients
by Adonis Sfera et al

The pernicious satisfaction of eating carbohydrates
by Philip Marais

Your Brain On Paleo
from Paleo Leap

The Role of Nutrition and the Gut-Brain Axis in Psychiatry: A Review of the Literature
by S. Mörkl et al

Emerging evidence linking the gut microbiome to neurologic disorders
by Jessica A. Griffiths and Sarkis K. Mazmanian

New Study Shows How Gut Bacteria Affect How You See the World
by David Perlmutter

The Surprising Link Between Gut Health and Mental Health
from LoveBug Probiotics

Nutritional Psychiatry: Is Food The Next Big Frontier In Mental Health Treatment?
by Stephanie Eckelkamp

Ketogenic Diets for Psychiatric Disorders: A New 2017 Review
by Georgia Ede

Low-Carbohydrate Diet Superior to Antipsychotic Medications
by Georgia Ede

Gut microbiome, SCFAs, mood disorders, ketogenic diet and seizures
by Jonathan Miller

Can the Ketogenic Diet Treat Depression and Anxiety, Even Schizophrenia?
by Rebekah Edwards

Diabetic Confusion

There is been a lot of data coming out about diabetes. Obviously, it gets heavy focus from researchers. Rates have been worsening for the entire 20th century and into the 21st with the majority of the American population now being diabetic, prediabetic, or insulin resistant. But recently, there is some evidence that the rise is finally leveling out, maybe even dipping down a bit.

One could argue that the emerging public debate about and popularity of low-carb diets might finally be having an impact. On the other hand, the data is mixed. Diabetes is getting worse for the young. And it is happening earlier in life. That is the strange part. Type 2 diabetes used to be called adult onset diabetes. Yet this condition, once rare among children and young adults, has become increasingly common. And type 1 diabetes used to be called juvenile diabetes, whereas it is presently found in 42% over the age of 30.

A distinction between these two types is that type 1 diabetes was assumed to be primarily genetic. If that were true, we wouldn’t be seeing the pattern of diabetes increasing the most in type 1. It turns out that we’ve found that both types respond to dietary changes and lifestyle interventions (incidences of type 1 diabetes fell by 60% during WWII because of food scarcity). Many with the genetic predisposition of type 1 diabetes aren’t getting it until late in life, which indicates that what triggers the predisposition might be dependent on other factors.

This confusion can cause further problems. The two types can be mistaken for the other. Children with type 2 diabetes sometimes get misdiagnosed with type 1 and vice versa for adults with type 1. That can harm the patient, since how they are treated is different. Further complicating the situation is the realization that insulin resistance also plays a role in Alzheimher’s, what some are now calling type 3 diabetes.

As with the other two, diet and lifestyle have been proven to improve or even reverse Alzheimer’s symptoms. The same changes that are useful for treating all types of diabetes are also useful for nearly every health condition imaginable. So, despite all the uncertainty and disagreement, we do know this much. A low-carb diet will probably be healthier for anyone. And if you don’t have diabetes, a low-carb diet might help prevent it.

On Health or Lack Thereof

Millennials’ health plummets after the age of 27: Study finds the generation has unprecedented rates of diabetes, depression, and digestive disorders
by Natalie Rahhal

  • After age 27, all major measures of health start to decline sharply for millennials, according to a new Blue Cross Blue Shield Report
  • Millennials have higher rates of eight of the top 10 most common health conditions by their mid-30s than generation X-ers did at the same age
  • As their health continues to decline, millennials stand to cost the American health care industry and economy steep sums

It's all downhill from here: A depressing graph shows steep health decline that begins after age 27 and continues until death for millennials
It’s all downhill from here: A depressing graph shows steep health decline that begins after age 27 and continues until death for millennials

Effect of Dietary Lipid on UV Light Carcinogenesis in the Hairless Mouse
by Vivienne E. Reeve, Melissa Matheson, Gavin E. Greenoak, Paul J. Canfield, Christa Boehm‐Wilcox, and Clifford H. Gallagher

Isocaloric feeding of diets varying in lipid content to albino hairless mice has shown that their susceptibility to skin tumorigenesis induced by simulated solar UV light was not affected by the level of polyunsaturated fat, 5% or 20%. However a qualitative effect of dietary lipid was demonstrated. Mice fed 20% saturated fat were almost completely protected from UV tumorigenesis when compared with mice fed 20% polyunsaturated fat. Multiple latent tumours were detected in the saturated fat‐fed mice by subsequent dietary replenishment, suggesting that a requirement for dietary unsaturated fat exists for the promotion stage of UV‐induced skin carcinogenesis.

Therapeutic benefit of combining calorie-restricted ketogenic diet and glutamine targeting in late-stage experimental glioblastoma
by Purna Mukherjee, Zachary M. Augur, Mingyi Li, Collin Hill, Bennett Greenwood, Marek A. Domin, Gramoz Kondakci, Niven R. Narain, Michael A. Kiebish, Roderick T. Bronson, Gabriel Arismendi-Morillo, Christos Chinopoulos, and Thomas N. Seyfried

Glioblastoma (GBM) is an aggressive primary human brain tumour that has resisted effective therapy for decades. Although glucose and glutamine are the major fuels that drive GBM growth and invasion, few studies have targeted these fuels for therapeutic management. The glutamine antagonist, 6-diazo-5-oxo-L-norleucine (DON), was administered together with a calorically restricted ketogenic diet (KD-R) to treat late-stage orthotopic growth in two syngeneic GBM mouse models: VM-M3 and CT-2A. DON targets glutaminolysis, while the KD-R reduces glucose and, simultaneously, elevates neuroprotective and non-fermentable ketone bodies. The diet/drug therapeutic strategy killed tumour cells while reversing disease symptoms, and improving overall mouse survival. The therapeutic strategy also reduces edema, hemorrhage, and inflammation. Moreover, the KD-R diet facilitated DON delivery to the brain and allowed a lower dosage to achieve therapeutic effect. The findings support the importance of glucose and glutamine in driving GBM growth and provide a therapeutic strategy for non-toxic metabolic management.

Writer’s block
by Dr. Malcolm Kendrick

Anyway, to return to the main issue here, which is that medical science may now be incapable of self-correction. Erroneous ideas will be compounded, built on, and can never be overturned. Because of a thing called non-reproducibility.

In most areas of science, there is nothing to stop a researcher going back over old research and trying to replicate it. The correct term is reproducibility. In every branch of science there is currently an acknowledged crisis with reproducibility.

‘Reproducibility is a hot topic in science at the moment, but is there a crisis? Nature asked 1,576 scientists this question as part of an online survey. Most agree that there is a crisis and over 70% said they’d tried and failed to reproduce another group’s experiments.’ 2

This is not good, but in medical research this issue is magnified many times. Because there is another in-built problem. You cannot reproduce research that has been positive. Take clinical trials into statins. You start with middle aged men, split them into two groups, give one a statin and one a placebo. At the end of your five-year trial, you claim that statins had a benefit – stopped heart attacks and strokes and suchlike.

Once this claim has been made, in this group, it becomes unethical/impossible to replicate this study, in this group – ever again. The ethics committee would tell you that statins have been proven to have a benefit, you cannot withhold a drug with a ‘proven’ benefit from patients. Therefore, you cannot have a placebo arm in your trial. Therefore, you cannot attempt to replicate the findings. Ever.

Thus, if a trial was flawed/biased/corrupt or simply done badly. That’s it. You are going to have to believe the results, and you can never, ever, have another go. Ergo, medicine cannot self-correct through non-reproducibility. Stupidity can now last for ever. In fact, it is built in.

When Evidence Says No, but Doctors Say Yes
by David Epstein

Even if a drug you take was studied in thousands of people and shown truly to save lives, chances are it won’t do that for you. The good news is, it probably won’t harm you, either. Some of the most widely prescribed medications do little of anything meaningful, good or bad, for most people who take them.

In a 2013 study, a dozen doctors from around the country examined all 363 articles published in The New England Journal of Medicine over a decade—2001 through 2010—that tested a current clinical practice, from the use of antibiotics to treat people with persistent Lyme disease symptoms (didn’t help) to the use of specialized sponges for preventing infections in patients having colorectal surgery (caused more infections). Their results, published in the Mayo Clinic Proceedings, found 146 studies that proved or strongly suggested that a current standard practice either had no benefit at all or was inferior to the practice it replaced; 138 articles supported the efficacy of an existing practice, and the remaining 79 were deemed inconclusive. (There was, naturally, plenty of disagreement with the authors’ conclusions.) Some of the contradicted practices possibly affect millions of people daily: Intensive medication to keep blood pressure very low in diabetic patients caused more side effects and was no better at preventing heart attacks or death than more mild treatments that allowed for a somewhat higher blood pressure. Other practices challenged by the study are less common—like the use of a genetic test to determine if a popular blood thinner is right for a particular patient—but gaining in popularity despite mounting contrary evidence. Some examples defy intuition: CPR is no more effective with rescue breathing than if chest compressions are used alone; and breast-cancer survivors who are told not to lift weights with swollen limbs actually should lift weights, because it improves their symptoms.

A separate but similarly themed study in 2012 funded by the Australian Department of Health and Ageing, which sought to reduce spending on needless procedures, looked across the same decade and identified 156 active medical practices that are probably unsafe or ineffective. The list goes on: A brand new review of 48 separate studies—comprising more than 13,000 clinicians—looked at how doctors perceive disease-screening tests and found that they tend to underestimate the potential harms of screening and overestimate the potential benefits; an editorial in American Family Physician, co-written by one of the journal’s editors, noted that a “striking feature” of recent research is how much of it contradicts traditional medical opinion.

That isn’t likely to change any time soon. The 21st Century Cures Act—a rare bipartisan bill, pushed by more than 1,400 lobbyists and signed into law in December—lowers evidentiary standards for new uses of drugs and for marketing and approval of some medical devices. Furthermore, last month President Donald Trump scolded the FDA for what he characterized as withholding drugs from dying patients. He promised to slash regulations “big league. … It could even be up to 80 percent” of current FDA regulations, he said. To that end, one of the president’s top candidates to head the FDA, tech investor Jim O’Neill, has openly advocated for drugs to be approved before they’re shown to work. “Let people start using them at their own risk,” O’Neill has argued.

So, while Americans can expect to see more drugs and devices sped to those who need them, they should also expect the problem of therapies based on flimsy evidence to accelerate. In a recent Stat op-ed, two Johns Hopkins University physician-researchers wrote that the new 21st Century Cures Act will turn the label “FDA approved” into “a shadow of its former self.” In 1962, Congress famously raised the evidentiary bar for drug approvals after thousands of babies were born with malformed limbs to mothers who had taken the sleep aid thalidomide. Steven Galson, a retired rear admiral and former acting surgeon general under both President George W. Bush and President Barack Obama, has called the strengthened approval process created in 1962 the FDA’s “biggest contribution to health.” Before that, he said, “many marketed drugs were ineffective for their labeled uses.”

Striking the right balance between innovation and regulation is incredibly difficult, but once remedies are in use—even in the face of contrary evidence—they tend to persist. A 2007 Journal of the American Medical Association papercoauthored by John Ioannidis—a Stanford University medical researcher and statistician who rose to prominence exposing poor-quality medical science—found that it took 10 years for large swaths of the medical community to stop referencing popular practices after their efficacy was unequivocally vanquished by science.

Science institute that advised EU and UN ‘actually industry lobby group’
by Arthur Nelson

An institute whose experts have occupied key positions on EU and UN regulatory panels is, in reality, an industry lobby group that masquerades as a scientific health charity, according to a peer-reviewed study.

The Washington-based International Life Sciences Institute (ILSI) describes its mission as “pursuing objectivity, clarity and reproducibility” to “benefit the public good”.

But researchers from the University of Cambridge, Bocconi University in Milan, and the US Right to Know campaign assessed over 17,000 pages of documents under US freedom of information laws to present evidence of influence-peddling.

The paper’s lead author, Dr Sarah Steele, a Cambridge university senior research associate, said: “Our findings add to the evidence that this nonprofit organisation has been used by its corporate backers for years to counter public health policies. ILSI should be regarded as an industry group – a private body – and regulated as such, not as a body acting for the greater good.”

The New Faces of Coke
by Kyle Pfister

Of the 115 individuals Coca-Cola admitted to funding, here’s a breakdown:

By sector, 57% (65) are dietitians, 20% (23) are academics, 7% (8) are medical professionals (mostly Doctors), 6% (7) are fitness experts, 5% (6) are authors, 3% (3) are chefs, and 1% (1) are food representatives. I was not able to identify sectors for two of the funded experts.

Kellogg Paid ‘Independent Experts’ to Promote Its Cereal
by Michael Addady

Kellogg paid council experts an average of $13,000 per year, according to emails and contracts obtained by the Associated Press. The payment was for expert to engage in “nutrition influencer outreach” and refrain from offering their services to products that were “competitive or negative to cereal.”

Outreach usually meant one of two things: Experts would claim Kellogg was their favorite brand on social media, or they would tout the cereal during public appearances. Kellogg’s spokesperson Kris Charles told Fortune in a statement that the experts’ association with the company was disclosed at public appearances.

Additionally, the experts’ connection to the company may have affected some of their published work. For example, an independent expert was involved in publishing an academic paper in the Journal of the Academy of Nutrition and Dietetics that defined a “quality breakfast.” Kellogg had the opportunity to edit the paper and even asked that the author remove a suggestion about limiting added sugar (something the sugar industry has also been accused of doing with heart disease research).

FDA: Sampling finds toxic nonstick compounds in some food
by Ellen Knickmeyer, John Flesher, and Michael Casey

A federal toxicology report last year cited links between high levels of the compounds in people’s blood and health problems, but said it was not certain the nonstick compounds were the cause.

The levels in nearly half of the meat and fish tested were two or more times over the only currently existing federal advisory level for any kind of the widely used manmade compounds, which are called per- and polyfluoroalykyl substances, or PFAS.

The level in the chocolate cake was higher: more than 250 times the only federal guidelines, which are for some PFAS in drinking water.

Food and Drug Administration spokeswoman Tara Rabin said Monday that the agency thought the contamination was “not likely to be a human health concern,” even though the tests exceeded the sole existing federal PFAS recommendations for drinking water.

Why smelling good could come with a cost to health
by Lauren Zanolli

About 4,000 chemicals are currently used to scent products, but you won’t find any of them listed on a label. Fragrance formulations are considered a “trade secret” and therefore protected from disclosure – even to regulators or manufacturers. Instead, one word, fragrance, appears on ingredients lists for countless cosmetics, personal care and cleaning products. A single scent may contain anywhere from 50 to 300 distinct chemicals.

“No state, federal or global authority is regulating the safety of fragrance chemicals,” says Janet Nudelman, policy director for Breast Cancer Prevention Partners (BCPP) and co-founder of the Campaign for Safe Cosmetics. “No state, federal or global authority even knows which fragrance chemicals appear in which products.”

Three-quarters of the toxic chemicals detected in a test of 140 products came from fragrance, reported a 2018 BCPP study of personal care and cleaning brands. The chemicals identified were linked to chronic health issues, including cancer.

Inherited Learned Behavior

There is what we inherit from our parents and there is what we learn from our own experience. The two are distinct, right? Well, actually no they are not separate. This was further demonstrated by a Princeton study (Danger avoidance can be genetically encoded for four generations, biologists say):

“Moore and her colleagues investigated whether C. elegans can convey this learned avoidance behavior to their progeny. They found that when mother worms learned to avoid pathogenic P. aeruginosa, their progeny also knew to avoid the bacteria. The natural attraction of offspring to Pseudomonas was overridden even though they had never previously encountered the pathogen. Remarkably, this inherited aversive behavior lasted for four generations, but in the fifth generation the worms were once again attracted to Pseudomonas.”

This is not an entirely new understanding. Earlier research has found similar results in other species. The study that always fascinates me had to do with rodents. The scent of cherry blossoms was emitted in their cage and immediately following that the bottom of the cage was electrified. Unsurprisingly, the rodents jumped around trying to avoid the pain. The rodents learned to begin jumping merely at the presence of the scent, whether or not any electric shock followed. The interesting part is that their rodent descendants, even though never shocked, would also jump when they smelled cherry blossoms. And this lasted for multiple generations. A very specific learned behavior was passed on.

Of course, this isn’t limited to worms and rodents. Humans are harder to study, partly because of our longer lives. But researchers have been able to observe multiple living generations to discover patterns. I’m not sure if this exactly fits into learned behavior, except in how the body learns to respond to the environment. It’s similar enough. This other research found that the children and grandchildren of famine survivors had higher rates of obesity that had nothing to do wasn’t caused by genetics or diet. It is what is called epigenetics, how the genes get set for expression. The same genes can be switched on or off in numerous ways in relation to other genes.

I find that fascinating. It also makes for much complication. Almost no research ever controls for multigenerational confounding factors. Epigenetics has been largely a black box, until quite recently. To be certain that a particular behavior was directly related to specific genetics in a population, you would have to be able to follow that population for many generations. To fully control for confounders, that would require a study that lasted more than a century. It might turn out that much of what we call ‘culture’ might more correctly be explained as population-wide epigenetics.

* * *

As a side note, this would have immense significance to dietary and nutritional research. Many of the dietary changes that have happened in modern society are well within the range of epigenetic involvement. And the epigenetic effects likely would be cumulative.

We have an ongoing and uncontrolled experiment going on. No one knows the long-term consequences of the modern industrial diet of refined carbohydrates, added sugars, highly processed vegetable oils, food additives, farm chemicals, microplastic, etc. It’s a mass experiment and the subjects never chose to participate.

Definitely, we have reasons to be concerned. Francis M. Pottenger Jr. studied the dietary impact on feline health. He fed some cats a raw food diet, others a cooked food diet, and a third group with a diet mixed of raw and cooked. The cats on the cooked food diet became sickly in the first generation and were entirely infertile after a number of generations.

This is not exactly similar to the human diet of industrial foods. But it points to how results play out across generations. The worst effects aren’t necessarily seen in the immediate generation(s). It’s future generations that have to deal with what those before them caused, as true for epigenetics as it is for national debt and environmental destruction.

Official Guidelines For Low-Carb Diet

A while back, the Swedish government came around to advising a low-carb (and high-fat or at least not low-fat) diet for treating obesity, diabetes, and heart disease. They were the first Western country to do so. The government committee didn’t come to this official position casually, as they first reviewed 16,000 studies (Brian Shilhavy, Sweden Becomes First Western Nation to Reject Low-fat Diet Dogma in Favor of Low-carb High-fat Nutrition). The committee consisted of ten physicians, several of which were skeptics of the low-carb diet — far from being a foregone conclusion (Dr. Andreas Eenfeldt, “Fat Trims Your Waistline”).

The committee’s assessment of the low-carb diet was glowing: “…a greater increase in HDL cholesterol (“the good cholesterol”) without having any adverse affects on LDL cholesterol (“the bad cholesterol”). This applies to both the moderate low-carbohydrate intake of less than 40 percent of the total energy intake, as well as to the stricter low-carbohydrate diet, where carbohydrate intake is less than 20 percent of the total energy intake. In addition, the stricter low-carbohydrate diet will lead to improved glucose levels for individuals with obesity and diabetes, and to marginally decreased levels of triglycerides” (as quoted by Dr. Andreas Eenfeldt in Swedish expert committee: A low-carb diet most effective for weight loss).

As you can see, they went so far as to speak well of a stricter version of the low-carb diet. That is the way mainstream experts refer to what cannot be named. The ketogenic diet retains a stigma that isn’t easily shaken, despite a century of powerful medical research behind it. The ketogenic diet sneaks in, nonetheless — just low-carb with a bit more restriction, which sounds less threatening. But the saturated fat issue is still a sore spot, despite the lack of research ever causally linking it to any disease condition. It’s one step at a time. Openly and loudly declaring low-carb diets as an unequivocal good is a massive step forward. It swings the door wide open for the rest to follow.

The Swedish committee came out with their report in 2017. Now the Australian government has also taken the official position that low-carb diet should be the default diet for diabetes, although I’m not quite sure when this happened (here is a 2018 position statement: Low carbohydrate eating for people with diabetes). “A landmark Australian report has highlighted that remission, not just management, should be the target for type 2 diabetes interventions, and that low carb provides a valuable way to achieve this” (Jack Woodfield, Landmark Australian report promotes low carb approach for treating type 2 diabetes). The committee report even included mention of the benefits from “very low-carbohydrate” dieting, that is to say ketogenic (Ryan Mernin, Australian Lawmakers Propose Low-Carb as Official Diabetes Treatment). This is an amazing about-face from the position taken only a few years ago.

“Fettke, an orthopedic surgeon,” Jennifer Calihan wrote, “was sanctioned in 2016 by regulators (the Australian Health Practitioners Regulation Agency or AHPRA) for recommending a low-carb lifestyle to patients he felt could improve their health by changing their diets. As we wrote in November 2016, Dr. Fettke was officially ‘silenced’ by the AHPRA; this means he was forbidden to give diet-related advice to his patients” (Dr. Gary Fettke exonerated! Receives apology from regulators).

How did that end? Two years later, those attacking him were forced to admit that they had wronged Dr. Fettke. “We are pleased to report that after careful review, the AHPRA has repealed its decision in its entirety, and cleared Dr. Fettke of all charges. He also received a written apology…” As when Tim Noakes won his case in South Africa, this was one more victory for the validity of low-carb diets. Other incidents where doctors have been attacked for advocating for their patients’ health have ended similarly. The tide has turned. It didn’t come out of nowhere, though. In 2017, an Australian government research agency put out a low-carb diet book (Dr. Andreas Eenfeldt, Australian Government Research Agency Releases Low-Carb Diet Book). It’s sad that they were doing this at the same time that regulators were attacking Dr. Fettke.

Such shifts don’t happen easily or evenly. Governments lurch back and forth before finally taking a new direction. It’s been building up for a while. This has been true for many governments and health institutions, as they slowly and quietly shift away from the old high-carb dogma without ever admitting they were wrong, instead often hiding the changes of position on a back page of their official website without any public announcement reported by every major news outlet. This is how, without most people realizing it, new viewpoints take hold. Only future historians will look back and realize the dramatic paradigm shift that occurred.

Yet sometimes the shift is quite dramatic. Belgium’s Royal Academy of Medicine recently stated in no uncertain terms that children, teens, pregnant women, and nursing mothers should not follow a vegan diet. A precedent was set with a 2017 case of a child’s death from a vegan diet where the parents were given suspended jail time (Mitchell Sunderland, Judge Convicts Parents After Baby Dies from Vegan Diet). The Belgian government has decided that from now on they will legally prosecute other parents in cases such as these (Susan Scutti, Is vegan diet healthy for kids? Belgian doctors say no). In other countries, there have been similar prosecutions against vegan parents when children have died. And before this decision in Belgium, there was a 2016 proposal for prosecution in Italy (BBC, Italy proposal to jail vegans who impose diet on children).

This fits into the larger shift I’m talking about. Veganism is typically high-carb and low-fat, not to mention low-protein (e.g., fruit smoothies loaded with sugar) — the complete opposite of the typical LCHF diet that emphasizes moderate-to-high protein intake, such as fatty animal foods. It’s true a vegan could go on a LCHF diet and some do and yet few choose to do so since, without animal fat, it seems glucose becomes the preferred fuel for the body.

The prosecution of vegan-related childhood death is a real shocker, considering veganism has been held up as the ultimately healthy plant-based diet for decades. Veganism had become quite trendy among celebrities, but that is likely reversing as well. This past year or so, a large number of well known vegans, many of them vegan advocates with sizable followings, have given up the vegan diet and gone back to eating animal foods. Other than some Hollywood stars, the most famous example is that of Tim Shieff, a professional athlete who had become a leader in the vegan movement but began eating meat again because of serious health concerns. So, along with an emerging shift in public policy, there has also been a shift in public perception about diets.

This new dietary attitude is not limited to more progressive countries elsewhere. We are seeing these same trends even in the corporatist United States, the epicenter of high-carb advocacy by government authorities and institutional experts and big food lobbyists. There has been a slow revolution. Some years back, the American Heart Association snuck in some changes to sugar intake and it barely received any media attention — no public announcement, no apologies, as if that was always their position. That was amazing. All the way back to the 1950s, the AHA had led the charge in blaming fats and exonerating sugar. Almost three quarters of a century of being wrong and now they’re backtracking. The U.S. government followed suit in 2015 (Jen Christensen, 2015 Dietary Guidelines). Neither of these was a defense of low-carb diets, but it was a reversal of course without explanation. Even Walter Willett who followed in Ancel Keys footsteps admitted that they had been wrong in having put all blame on saturated fat and that was a mind-blowing admission, considering how hard those like him had defended the status quo and attacked all alternative views with many careers destroyed in the process.

Just this year, the American Diabetes Association also changed its tune. Once again, there was little fanfare. It’s as if a volcano erupted in the middle of New York City and no media outlet thought to send a reporter to the scene to see what happened. Suddenly, a volcano in New York City is the new norm. The ADA went even further than did the AHA, in that they specifically and clearly declared that LCHF diets are not a fad and are not dangerous. This thawing of dietary ideology has been slowly cracking the edifice of the glacier that had enclosed public debate since the mid-20th century. The growing evidence simply can’t be denied, as the research on low-carb including keto has shown positive results, the shift having taken hold in the 1990s with the Charlie Foundation. The new direction was initially imperceptible to anyone not paying attention. I barely noticed this myself until quite recently, even though I’ve long thought of sugar as an addictive drug and even though I did experiment with the low-carb diet earlier last decade, but I didn’t realize how much the science itself was going down a different path.

Dr. Robert Lustig points out how he was taught this information in his nutritionist education, but then had it drilled out of him in medical school. He forgot about what he had learned and followed establishment thought for the next twenty years. It’s maybe not surprising that he re-awoke to his horrible mistake around the time the Charlie Foundation was established. He was angry, presumably for having failed his patients in providing them the best care but no doubt also for allowing himself to be duped. Many other doctors and other health experts have grown angry as well and that anger has driven a sense of passionate advocacy and moral responsibility. It wasn’t merely a personal failure but that of an entire field and public health was the victim, that is to say hundreds of millions of Americans suffered the consequences.

It’s been building up for a while. And the public hasn’t been entirely kept in the dark. The internet opened up public debate like never before. At the same time research was proving that low-carb works, people were experimenting on themselves and discovering the truth of this. This initially led to a backlash by the powers that be, but the public awareness keeps gaining momentum. The ketogenic diet has become the most Googled diet. One hears about low-carb diets all the time thee days, even when it is simply another denial of the facts. Suppression of truth through silence is no longer an option. Authorities are forced to respond one way or another, and increasingly that has meant a gradual movement toward low-carb. Maybe unsurprisingly, as more Americans embrace low-carb diets following the peak of sugar intake in 1999, for the first time in decades the diabetes epidemic seems to be subsiding.

There have been widely read journalistic accounts of what has gone so wrong in the field of diet and nutrition, specifically the work of Gary Taubes and Nina Teicholz. Several popular documentaries have also had quite an impact, from Pete Evans’ The Magic Pill to Tom Naughton’s Fat Head. On social media, there has been growing influence of low-carb advocates, including many doctors and scientists. Some low-carb Facebook groups have millions of members. And a video of a biochemistry talk criticizing sugar by Dr. Robert Lustig has received millions of views.

I’ve argued that changes will come from below before we see changes in public policy, but in some countries the government is taking the lead. In the United States, it’s going to take a while for low-carb diets to make their way into the official dietary recommendations. The main problem is the U.S. was the original force behind the high-carb, low-fat fad diet and the reason other governments adopted it. There are too many American experts who built their careers on it and several highly respected institutions that fully embraced it. They can never admit they were wrong. I’m sure many of the people involved see the writing on the wall, but they are trying to figure out how to switch their position while saving face and without too many people noticing. Only after many other Western governments take up the low-carb approach will the U.S. government follow their example. Then and only then, if we are lucky, the entire food system of transnational corporations might begin to fall in line.

Consensus will eventually shift. Most of the experts that once were against low-carb will suddenly be for it or else they’ll simply become irrelevant and forgotten. A generation will grow up not knowing anything else and the former dietary ideology will quickly fade from public memory, but the consequences on public health will epigenetically linger for many generations more. Fortunately, individuals don’t have to wait for the rest of society to catch up. What you do as an individual can improve your health, along with the health of your children and grandchildren. One thing that is guaranteed is that low-carb is a vast improvement over what most Americans are eating and what the United States government is recommending. That much is clear from the science.

“Simply, we were dumb.”

Dr. Richard David Feinman*: “Whatever else we know or don’t know about Paleo, we know that our ancestors did not get three squares a day, and evolution must have invested far more in ketogenic metabolism than was reflected in our research interests.

“Simply, we were dumb. We’re trying to fix that now.”

Dr. Robert Lustig**: “The thing is I’m a practicing physician and a scientist and for every one patient I took care of and got better ten more would show up in my door. There was no way I was ever going to fix this.

“And the thing that really really bothered me was I learned virtually everything I know about nutrition in college because I majored in nutrition and food science at MIT. And then I went to medical school and they beat it out of me and told me that everything I’d learned was the irrelevant, it had no place in patient care, it wasn’t necessary, and that really all I had to do was focus on calories. I figured these are the clinicians. I’m gonna be closer. I better listen to them and so I practiced that way for like 20 years.

“And then I started doing research because my patients weren’t getting better and I started doing research to try to figure out what’s going on and it like all came rushing back to me, kind of like post-traumatic stress disorder. It’s like, oh my, I knew this stuff back in 1975. So I got pissed off. So I think part of the passion actually is sort of the the being dumbfounded and the anger of what I see going on in medicine today. So I’m glad it translates in a positive way and that people appreciate the passion but I’m just like really ticked off.”

* * *

*”[Dr.] Richard David Feinman is Professor of Cell Biology (Biochemistry) at the State University of New York (SUNY) Downstate Medical Center  in Brooklyn, New York. Dr. Feinman’s original area of research was in protein chemistry and enzyme mechanism, particularly in blood coagulation and related processes.

“Dr. Feinman has worked in several scientific areas including animal behavior and he has had a previous life in the visual arts. His friends consider him a Renaissance Man but he has made peace with the term dilettante.

“His current interest is in nutrition and metabolism, specifically in the area of diet composition and energy balance. Work in this area is stimulated by, and continues to influence, his teaching in the Medical School where he has been a pioneer in incorporating nutrition into the biochemistry curriculum. Dr. Feinman is the founder and former co-Editor-In-Chief (2004-2009) of the journal, Nutrition&Metabolism. Dr. Feinman received his BA from the University of Rochester and he holds a PhD in chemistry from the University of Oregon.” (from bio on his blog)

Dr. Feinman is quoted by Kathryn Goulding in a Paleo Magazine interview for an article on his book Nutrition in Crisis (June/July 20019).

**Dr. Robert Lustig is a Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco. He specializes in neuroendocrinology and childhood obesity. He is a leading expert on the obesity, diabetes, and metabolic syndrome epidemics.

His career has included working as a physician, involvement in research (authored 125 peer-reviewed articles and 73 reviews), public speaking (videos of his talks have received millions of views), and authoring books (Fat Chance, Hacking the American Mind, Sugar Has 56 Names, and Obesity Before Birth; also the introduction to John Yudkin’s classic Pure, White and Deadly). He has also been a co-founder, president, director, chairman, member, and consultant of numerous public and private medical, health and dietary task forces, committees, board of directors, institutes, and other organizations.

His focus has been primarily on sugar, not carbohydrates in general. Dr. Feinman has been critical of him on this account. But it appears that he is moving toward the low-carb diet, along with a convergence of his views with those of Gary Taubes. See the discussion on the Ketogenic Forums: Has Lustig moved toward us?

Dr. Lustig is quoted from the below video:

 

Is Diabetes Epidemic Reversing?

“After an almost 20-year increase in the national prevalence and incidence of diagnosed diabetes, an 8-year period of stable prevalence and a decrease in incidence has occurred. […]

“Trends in several risk factors for type 2 diabetes, including intake of added sugar, sugared beverages, total calories, and physical inactivity, peaked in the mid-2000s and either plateaued or decreased thereafter, consistent with the slowing in diabetes incidence.”

New directions in incidence and prevalence of diagnosed diabetes in the USA
by Stephen R Benoit, Israel Hora, Ann L Albright, and Edward W Gregg