Success of Big Drug is Failure of Public Health

Pfizer has owns the rights to the drug Enbrel outside North America. Internal analysis at the company showed that there was a strong correlation to lower incidence of Alzheimer’s. It was an amazing 64% reduction. This is almost unheard of in Alzheimer’s research. At a company presentation, it was stated in no uncertain terms that, “Enbrel could potentially safely prevent, treat and slow progression of Alzheimer’s disease” (as quoted by Mark Terry).

Yet they didn’t follow up with more data analysis and clinical studies. Neither did they publicly release their findings. Pfizer can’t take all the blame, though. The company works with the Amgen in marketing Enbrel. This other drug company holds the patent and rights to market Enbrel in the United States and Canada. Both drug companies knew about the results and both remained silent. A company spokesman for Pfizer told the Washington Post that, “Science was the sole determining factor against moving forward.” I don’t doubt that is true for corporate science. But there sometimes is a vast difference between corporate science and non-profit science. This is indicated by another explanation that came out of Pfizer.

The WaPo reported that, the company “decided during its three years of internal reviews that Enbrel did not show promise for Alzheimer’s prevention because the drug does not directly reach brain tissue.” That is odd because, based on much research, we know there is more involved in Alzheimer’s than just the brain. The only proven clinical trial that has reversed Alheimer’s symptoms used a protocol that included many methods, including the ketogenic diet (see the clinical study and writings of Dr. Dale Bredesen).

The US FDA approved use of Enbrel is for the treatment of autoimmune diseases: rheumatoid arthritis, juvenile idiopathic arthritis and psoriatic arthritis, plaque psoriasis and ankylosing spondylitis. The effect it would have on Alzheimer’s is as an anti-inflammatory. This could be achieved in many ways, such as broadly reducing an overactive immunological response in the body, not only in the brain. The neurocognitive effect might be indirect and secondary to the process without the drug needing to cross the blood-brain barrier. It isn’t necessarily significant by which path, neurological or not, that it accomplishes this feat of inflammatory reduction. As reported in the WaPo:

Yet Alzheimer’s researchers believe inflammation outside the brain — called peripheral inflammation — influences inflammation within the brain.

“There is a lot of evidence suggesting that peripheral or systemic inflammation may be a driver of Alzheimer’s disease,’’ said Walker, the Johns Hopkins researcher. It is a fair hypothesis that fighting inflammation outside the brain with Enbrel will have a similar effect inside the brain, he said.

“I don’t believe Enbrel would need to cross the blood brain barrier to modulate the inflammatory/immune response within the brain,’’ Walker said.

“There is increasing evidence that peripheral inflammation can influence brain function,’’ said rheumatologist Christopher Edwards, of the University of Southampton in Britain.

I refuse to believe that the researchers at Enbrel didn’t know this basic scientific understanding and didn’t explain it to those making the decisions. Maybe that is why the scientists employed by Pfizer, in opposition to the management, were pushing for more research to be done.

Basically, it was a business decision and so it was irrelevant even if it was guaranteed to cure Alzheimer’s. In capitalism, there is no financial incentive in humanitarianism, at least not when its costly. As Enbrel was already patented for another medical use and its patent life was coming to an end, getting it patented for an entirely different health condition would have been difficult because of patent laws. It would have been a high-risk business investment with low probability of success and profit.

Since it wasn’t profitable for the company to pursue further research, it also wouldn’t have been profitable for the company to release the info so that others might pursue further research or else simply gain better understanding about the possibilities of different avenues of research. Promoting scientific debate and scientific knowledge is not part of capitalism (ditto for public health), other than as an unintentional side effect. No company will freely choose to disclose any information beyond what is necessary or else when deemed unrelated to any financial gain… that is unless required by law, in which case it wouldn’t be freely chosen.

If you want to hear defenses of the actions or rather inaction of Pfizer, some pieces have been written taking the other side of the debate: A Missed Alzheimer’s Opportunity? Not So Much by Derek Lowe, and 5 Reasons Pfizer Sat on a Potential New Alzheimer’s Drug by Cory Renauer. Pfizer also went to its own defense on social media: Pfizer takes to Twitter to refute ‘Washington Post’ story by Alison Kanski. I find the excuses unconvincing. It comes across more as apologia for capitalist realism.

Still, to be fair, there has been immense failure in Alzheimer’s research. A new drug treatment hasn’t been approved by the FDA in the past decade. But that is part of the problem with the corporate model of big drug. The only promising research in recent years is from methods other than pharmaceuticals. As far as capitalism goes, it doesn’t matter if Alzheimer’s can be treated and reversed with a multifactorial approach, by a combination of diet, nutrition, supplementation, exercise, detoxification, etc. There is no profit in this, since no company can patent it and so monopolize the market for decades. In that sense, it is pointless in blaming a corporation for acting like a corporation. This is the inevitable result of capitalism.

Following the obvious financial incentive, Pfizer has stopped Alzheimer’s research. This is problematic for public health, of course. Big biz, however, doesn’t give a flying fuck about public health. If we are seeking public health, then governments will have to massively invest in public funding of research and development as the United States did in the past. Instead, public funding has been drastically cut. This is expected in corporatocratic government where corporate interests determine public policy. It’s the nature of the beast. If we think it is morally wrong to let millions of people to suffer and die when there is no profit in helping them, then we will be forced by our collective conscience to demolish our present economic and political system and then replace it with something better.

But it goes beyond even this. The causes of inflammation are diverse. With industrialized capitalism, we are drowning in physiological and social stressors, from toxins to inequality, that constantly antagonize the body while disallowing the natural processes of healing. We need an entirely different model and paradigm to confront what is causing the worsening of health across the board: metabolic syndrome (obesity, diabetes, & heart disease), autoimmune disorders (Alzheimer’s, multiple sclerosis, etc), mood disorders (depression, anxiety, etc), and personality disorders (BPD, NPD, etc); psychosis, ADHD, autism spectrum disorders, drug addiction, and on and on. A common feature found in numerous health conditions is inflammation.

When the entire social order, from economic system to food system, is inflammatory and generally harmful to public health, what is the treatment? And even if we could find effective treatments, why would we settle for that rather than seeking cures and prevention? Why are we obsessed with symptoms, instead of going directly to the root cause of so many diseases?

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Pfizer had clues its blockbuster drug could prevent Alzheimer’s. Why didn’t it tell the world?
by Christopher Rowland

A team of researchers inside Pfizer made a startling find in 2015: The company’s blockbuster rheumatoid arthritis therapy Enbrel, a powerful anti-inflammatory drug, appeared to reduce the risk of Alzheimer’s disease by 64 percent.

The results were from an analysis of hundreds of thousands of insurance claims. Verifying that the drug would actually have that effect in people would require a costly clinical trial — and after several years of internal discussion, Pfizer opted against further investigation and chose not to make the data public, the company confirmed.

Researchers in the company’s division of inflammation and immunology urged Pfizer to conduct a clinical trial on thousands of patients, which they estimated would cost $80 million, to see if the signal contained in the data was real, according to an internal company document obtained by The Washington Post.

“Enbrel could potentially safely prevent, treat and slow progression of Alzheimer’s disease,’’ said the document, a PowerPoint slide show that was prepared for review by an internal Pfizer committee in February 2018.

The company told The Post that it decided during its three years of internal reviews that Enbrel did not show promise for Alzheimer’s prevention because the drug does not directly reach brain tissue. It deemed the likelihood of a successful clinical trial to be low. A synopsis of its statistical findings prepared for outside publication, it says, did not meet its “rigorous scientific standards.’’

Science was the sole determining factor against moving forward, company spokesman Ed Harnaga said.

Pfizer Did Not Pursue Possible Evidence of Enbrel Helping with Alzheimer’s Due to Low Chance of Clinical Success
by Mark Terry

Recently released documents indicate that Pfizer spent three years reviewing whether the science supported running a trial on Enbrel in Alzheimer’s. A PowerPoint slide from a February 2018 presentation stated, “Enbrel could potentially safely prevent, treat and slow progression of Alzheimer’s disease.”

But the company told The Washington Post that during those three years, they felt that the drug didn’t show promise for Alzheimer’s because it doesn’t directly reach brain tissue. So, they believed that the clinical trial’s chances of success would be low. Pfizer spokesman Ed Harnaga told The Post that the only reason the company didn’t go forward was the science.

That may or may not be reasonable, but the company’s decision not to release or publish the data is taking more criticism, with many researchers arguing they should have made that data available to researchers.

“Of course they should. Why not?” Rudolph E. Tanzi, a top Alzheimer’s researcher with Harvard Medical School and Massachusetts General Hospital.

In fact, in an interview with Tanzi earlier this year, he noted that more and more research is focused on the role of inflammation in Alzheimer’s, particularly as the amyloid-beta theory comes under fire. In Tanzi’s opinion, and there’s quite a bit of scientific research supporting it, amyloid and tangles trigger Alzheimer’s, but they’re not enough to cause dementia. But the amyloid and tangle-driven neuronal cell death eventually hits a point where the brain’s innate immune system reacts with significant levels of neuroinflammation. Tanzi told BioSpace, “Then, exponentially more cell death occurs, which leads to symptoms of dementia and Alzheimer’s disease.”

So it seems possible that a powerful anti-inflammatory like Enbrel could have a dampening effect on the entire immune system, which might decrease Alzheimer’s risk. […]

It also seems contradictory that when so many biopharma companies are investing in artificial intelligence and data mining of real-world evidence (RWE) such as the Pfizer scientists utilized in 2015, that they would then ignore what they found.

Pfizer recognizes that it hid a drug that prevents Alzheimer’s
from The Mazatlan Post

This American media also explains in its exclusive that the role of brain inflammation in Alzheimer’s disease has been attracting the attention of academics after the failure of multiple experimental drugs that pointed to the accumulation of plaques in brain tissue.

“People who have chronic inflammation have a higher risk of developing Alzheimer’s”

Thus, they recall that in 2016 researchers from the universities of Dartmouth and Harvard published an insurance claims data study , similar to the internal findings of Pfizer (for those who refused to continue investigating the possible new use of their drug) that showed a potential benefit of Enbrel.

Enbrel “shows promise as a potential treatment” For Alzheimer’s, he pointed out.” In this study, it is said that Alzheimer’s is significantly more prevalent in patients with rheumatoid arthritis, a fact that was already known: people who have chronic inflammation have a higher risk of developing Alzheimer’s. Also, those who were taking the Pfizer drug had a decreased risk, “explains the SEN member, who points out that there is evidence in basic research.

However, Pascual Sanchez says that […] “Of course it is a piece of interesting information [published by the Washington Post], and of course it is a line that, taking into account that others have not worked, such as amyloid, we are very interested in it.” There is strong genetic evidence and targets are being developed based on modulation of inflammation. ”

“We urgently need the pharmaceutical laboratories to bet on Alzheimer’s disease. Unfortunately, Pfizer has strategically abandoned the line of Neurology, and has probably been one of the reasons why not bet on it, “says Sanchez.

The expert says that Alzheimer’s disease is very complex and” from pharmaceutically no Much progress has been made. The pharmaceutical companies that have bet for now have not achieved benefits because they have not taken new drugs, but increasingly we know more and we do better clinical trials. I think there are more options for us to find something that works. And the more you invest, and the more people think about this, the more likely we are to achieve it, “he says.

“We need to do more trials and probably need more complex approaches to this disease, we are realizing that we will need several treatments or different simultaneous approaches to treat the disease, there are many factors that are involved, such as amyloid, TAU protein, inflammation or even p43, probably if we focus only on one factor we will not succeed, we must have a more global vision of the problem and also of the solutions”, concludes Pascual Sánchez.

Pfizer, pocketing a big tax cut from Trump, will end investment in Alzheimer’s and Parkinson’s research
by Michael Hiltzik

No one would say that drug companies should engage in research as a philanthropic exercise, but within the context of the U.S. pharmaceutical industry, Pfizer looks risk-averse. The second-biggest U.S. drug company by sales (after Johnson & Johnson), Pfizer in recent years seems to have devoted more effort to financial engineering than biomedical engineering. In 2015, for instance, it announced a $160-billion merger with Allergan, the maker of Botox. The deal was a so-called inversion, aimed transparently at cutting Pfizer’s tax bill in part by eliminating U.S. tax on $147 billion in profits it had stashed overseas.

Although the company denied that the deal was “simply… a tax transaction,” the truth emerged in 2016 when the deal was canceled; the only thing that had changed was that the U.S. Treasury had implemented new rules that all but eliminated the tax savings. So, bye-bye, Allergan.

Pfizer is expected to be among the prime beneficiaries of the corporate tax cut. The measure allows companies to pay a tax rate as low as 8% on foreign earnings they bring home, a big discount from the 21% top rate the law assesses on domestic earnings, itself a big cut from the previous rate of 35%. By some estimates, that could be worth more than $5 billion to Pfizer alone, not counting any gains from the lower tax rate.

As it happens, Pfizer signaled how it would apply the tax savings even before the final passage of the tax bill: The company announced a $10-billion share buyback on Dec. 18, four days before President Trump signed the tax cut into law. That buyback was on top of $6.4 billion left to be spent from a previous buyback plan, and was accompanied by a 6% increase in the company’s stock dividend, which will be worth roughly another half-billion dollars a year.

For comparison’s sake, Pfizer’s entire research and development budget averaged about $8 billion a year from 2014 through 2016.

Pfizer’s diversion of its tax break to shareholders parallels its behavior the last time American companies received a tax holiday on repatriated foreign earnings. That was in 2004, after corporations promised to apply their tax savings to hiring more workers and investing in their business. Instead, they laid off workers, bought back their shares, and pumped up their CEO compensation.

Pfizer brought home more than any other company in that amnesty, $35.5 billion, according to a 2007 investigation by Sen. Carl Levin, D-Mich. From 2004 through 2007, Levin reported, Pfizer bought back more than $27 billion in stock and reduced employment by 11,748 workers.

This time around, the company is again gifting its shareholders and laying off workers. Abandoning a challenging research field is a new wrinkle, however.

What’s most discouraging to patient advocates is the dearth of alternatives to big pharmaceutical companies in brain research. Pfizer’s withdrawal, especially if it prompts other big pharma companies to flee the field, places more of the burden on small biotech firms, academia, foundations and government. The news “reinforces the urgent need for additional federal investment in Alzheimer’s research,” a spokesman for the Alzheimer’s Foundation of America told me. But the Trump administration has placed funding for government research projects in almost all scientific fields on the chopping block.

Some experts recognize that the big drug companies may have been less than sturdy partners all along. “Many groups have been hoping for quick wins in the [central nervous system] space and we haven’t succeeded,” Beck of the Parkinson’s Foundation says, “so there’s some frustration from the viewpoint of management that we’re not getting the progress we need.”

He says his organization and others will still focus on the most promising pathway to a cure: Trying to understand the mechanisms of these diseases, which are still very murky. Only once those riddles are solved can drug research truly move ahead.

But as long as purely economic considerations drive drug R&D, the prospects for progress are dim. The Republicans who drafted the corporate tax cut promised that it would lead to more business investment and therefore economic growth. But as Pfizer demonstrates, all the incentives run in the opposite direction: More investment in shareholder welfare, less economic growth, and less attention to what corporations are supposed to exist for — improving people’s lives.

Profits before people: capitalists abandon Alzheimer’s and Parkinson’s research
by Joe Attard

Pfizer’s announcement is an especially striking testament to the horrors of capitalism when seen in context with the damage caused by Alzheimer’s and Parkinson’s. For example, the global cost of Alzheimer’s and dementia (in terms of medical care, social care and hospices) is estimated at $605 billion: equivalent to 1 percent of the entire world’s gross domestic product. Meanwhile, the financial impact incurred for a UK citizen living with Parkinson’s disease (which affects mobility, and eventually communication) are £16,000 per year on average – factoring in assistance with cleaning, loss of income and benefits and so on. For the poorest Parkinson’s’ sufferers, professional help might be unaffordable, placing the duty of care on family members.

Pfizer pulling out of Alzheimer’s and Parkinson’s research will shunt more of the burden of seeking treatments for these diseases on the public sector – via universities, for example. That is, as is becoming the norm, they leave the bill for research to be paid for by taxpayers, only to take over the patents for small change at a later stage. […]

The main driving force for Pfizer is cold, hard profit. Its R&D chief, Mikael Dolsten, recently told a J.P. Morgan healthcare conference that the company bases its R&D strategy on drugs with “multi-billion-dollar blockbuster potential.” These drug giants focus their attention on whatever nets the biggest windfalls with the least amount of effort, which can lead to an emphasis on manufacturing financial loopholes rather than medicines. In 2015, Pfizer acquired Allergan (the company that makes Botox) in a $160-billion merger: a move that eliminated U.S. tax on $147 billion in profits it had stashed overseas. In Britain, despite making sales of between £1.3bn and £1.8bn annually between 2001 and 2014, Pfizer paid almost no tax over the period because it announced major operating losses each year, except for a tiny profit of £9m in 2013. The company is also expected to benefit substantially from Donald Trump’s new corporate tax cut, to the tune of $5bn: 10 times more than the US government’s 2017 pledge to Alzheimer’s research, and more than half of Pfizer’s entire research and development budget from 2014 through 2016. Donald Trump has generously rewarded Pfizer’s shareholders, who have responded by slashing early development research on neurological diseases, firing hundreds of employees and continuing to inflate the cost of its products.

This should all come as no surprise. The whole medical industry has become thoroughly parasitical, making billions from ripping off state healthcare services, withholding essential medicines from Third World countries and lobbying governments to deregulate the healthcare market. Pfizer was itself hit with a record fine in 2016 after it charged the NHS £50m for an anti-epilepsy drug: up from £2m in 2013. For years Pfizer withheld fluconzale (a powerful anti-fungal agent that can be used to treat AIDS-related diseases like oral thrush and cryptococcal meningitis) from the developing world, while continuing to sell it to wealthy American and European patients. Only after provoking international outrage did it make the drug available to NGOs operating in developing countries with a greater than 1 percent prevalence of HIV/AIDS in 2001. The firm has also never been shy about using its financial clout to get its way in the political sphere, spending $25 million in 2010 alone on lobbying for healthcare deregulation in the USA. Big business and the state are connected to each other by a thousand threads. Despite Donald Trump’s promises during the primaries that he would reign in Big Pharma, his appointment of former pharmaceutical executive Alex Azar to replace Tom Price as Health and Human Services Secretary suggests otherwise.

In stark contrast to claims that free market competition fosters innovation, the private pharmaceutical industry reveals the stagnation, irrationality and base cruelty of capitalism in its state of senile decay. From Martin Shkreli’s jacking up the cost of Daraprim (a drug used in the treatment of AIDS-related conditions) from US$13.50 to US$750 per pill; to drug giants profiteering off AIDS epidemics in Africa and Asia; to Big Pharma taking public money (in the form of tendered contracts) from the NHS and stashing it in tax havens, the logic of capitalism ensures that healthy profits always take precedence over public health. Moreover, Pfizer’s actions demonstrate the sheer barbarism of allowing vast reserves of money, expertise and talent to be wasted or misdirected by private medical firms. Permitting research priorities to be dictated by market forces has resulted in pharmaceutical giants directing more attention towards lifestyle drugs targeted at the wealthy – designed to treat such tragic conditions as obesity, baldness, wrinkles and impotence. There is a multi-billion-dollar market for such products. Meanwhile, the difficult, expensive work of producing treatments for illnesses like Alzheimer’s and Parkinson’s disease is sacrificed to the bottom line.

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Essentialism On the Decline

Before getting to the topic of essentialism, let me take an indirect approach. In reading about paleolithic diets and traditional foods, a recurring theme is inflammation, specifically as it relates to the health of the gut-brain network and immune system.

The paradigm change this signifies is that seemingly separate diseases with different diagnostic labels often have underlying commonalities. They share overlapping sets of causal and contributing factors, biological processes and symptoms. This is why simple dietary changes can have a profound effect on numerous health conditions. For some, the diseased state expresses as mood disorders and for others as autoimmune disorders and for still others something entirely else, but there are immense commonalities between them all. The differences have more to do with how dysbiosis and dysfunction happens to develop, where it takes hold in the body, and so what symptoms are experienced.

From a paleo diet perspective in treating both patients and her own multiple sclerosis, Terry Wahls gets at this point in a straightforward manner (p. 47): “In a very real sense, we all have the same disease because all disease begins with broken, incorrect biochemistry and disordered communication within and between our cells. […] Inside, the distinction between these autoimmune diseases is, frankly, fairly arbitrary”. In How Emotions Are Made, Lisa Feldman Barrett wrote (Kindle Locations 3834-3850):

“Inflammation has been a game-changer for our understanding of mental illness. For many years, scientists and clinicians held a classical view of mental illnesses like chronic stress, chronic pain, anxiety, and depression. Each ailment was believed to have a biological fingerprint that distinguished it from all others. Researchers would ask essentialist questions that assume each disorder is distinct: “How does depression impact your body? How does emotion influence pain? Why do anxiety and depression frequently co-occur?” 9

“More recently, the dividing lines between these illnesses have been evaporating. People who are diagnosed with the same-named disorder may have greatly diverse symptoms— variation is the norm. At the same time, different disorders overlap: they share symptoms, they cause atrophy in the same brain regions, their sufferers exhibit low emotional granularity, and some of the same medications are prescribed as effective.

“As a result of these findings, researchers are moving away from a classical view of different illnesses with distinct essences. They instead focus on a set of common ingredients that leave people vulnerable to these various disorders, such as genetic factors, insomnia, and damage to the interoceptive network or key hubs in the brain (chapter 6). If these areas become damaged, the brain is in big trouble: depression, panic disorder, schizophrenia, autism, dyslexia, chronic pain, dementia, Parkinson’s disease, and attention deficit hyperactivity disorder are all associated with hub damage. 10

“My view is that some major illnesses considered distinct and “mental” are all rooted in a chronically unbalanced body budget and unbridled inflammation. We categorize and name them as different disorders, based on context, much like we categorize and name the same bodily changes as different emotions. If I’m correct, then questions like, “Why do anxiety and depression frequently co-occur?” are no longer mysteries because, like emotions, these illnesses do not have firm boundaries in nature.”

What jumped out at me was the conventional view of disease as essentialist, and hence the related essentialism in biology and psychology.

[…]

Researchers have found that there are prospective causes to be studied. Consider proprionate, a substance discussed by Alanna Collen (10% Human, p. 83): “although propionate was an important compound in the body, it was also used as a preservative in bread products – the very foods many autistic children crave. To top it all off, clostridia species are known to produce propionate. In itself, propionate is not ‘bad’, but MacFabe began to wonder whether autistic children were getting an overdose.” This might explain why antibiotics helped many with autism, as it would have been knocking off the clostridia population that was boosting propionate. To emphasize this point, when rodents were injected with propionate, they exhibited the precise behaviors of autism and they too showed inflammation in the brain. The fact that autistics often have brain inflammation, an unhealthy condition, is strong evidence that autism shouldn’t be taken as mere neurodiversity (and, among autistics, the commonality of inflammation-related gut issues emphasizes this point).

There is no doubt that genetic determinism, like the belief in an eternal soul, can be comforting. We identify with our genes, as we inherit them and are born with them. But to speak of inflammation or propionate or whatever makes it seem like we are victims of externalities. And it means we aren’t isolated individuals to be blamed or to take credit for who we are. To return to Collen (pp. 88-89):

“In health, we like to think we are the products of our genes and experiences. Most of us credit our virtues to the hurdles we have jumped, the pits we have climbed out of, and the triumphs we have fought for. We see our underlying personalities as fixed entities – ‘I am just not a risk-taker’, or ‘I like things to be organised’ – as if these are a result of something intrinsic to us. Our achievements are down to determination, and our relationships reflect the strength of our characters. Or so we like to think.

“But what does it mean for free will and accomplishment, if we are not our own masters? What does it mean for human nature, and for our sense of self? The idea that Toxoplasma, or any other microbe inhabiting your body, might contribute to your feelings, decisions and actions, is quite bewildering. But if that’s not mind-bending enough for you, consider this: microbes are transmissible. Just as a cold virus or a bacterial throat infection can be passed from one person to another, so can the microbiota. The idea that the make-up of your microbial community might be influenced by the people you meet and the places you go lends new meaning to the idea of cultural mind-expansion. At its simplest, sharing food and toilets with other people could provide opportunity for microbial exchange, for better or worse. Whether it might be possible to pick up microbes that encourage entrepreneurship at a business school, or a thrill-seeking love of motorbiking at a race track, is anyone’s guess for now, but the idea of personality traits being passed from person to person truly is mind-expanding.”

This goes beyond the personal level, which lends a greater threat to the proposal. Our respective societies, communities, etc might be heavily influenced by environmental factors that we can’t see. A ton of research shows the tremendous impact of parasites, heavy metal toxins, food additives, farm chemicals, hormones, hormone mimics, hormone disruptors, etc. Entire regions might be shaped by even a single species of parasite, such as how higher rates of toxoplasmosis gondii in New England is directly correlated to higher rates of neuroticism (see What do we inherit? And from whom? & Uncomfortable Questions About Ideology).

Health From Generation To Generation

To emphasize this point, the testing of newborn babies in the United States shows that they’ve already accumulated on average more than 200 synthetic chemicals from within the womb; and then imagine all the further chemicals they get from the breast milk of their unhealthy mothers along with all kinds of crap in formulas and in their environments (e.g., carcinogenic fire retardants that they breathe 24/7). Lead toxicity has decreased since my own childhood and that is a good thing, but thousands of new toxins and other chemicals have replaced it. On top of that, the hormones, hormone mimics, and hormone disruptors add to dysbiosis and disease — some suggesting this is a cause of puberty’s greater variance than in past generations, either coming earlier or later depending on gender and other factors (maybe partly explaining the reversal and divergence of educational attainment for girls and boys). Added to this mix, this is the first generation of human guinea pigs to be heavily medicated from childhood, much of it medications that have been shown to permanently alter neurocognitive development.

A major factor in many modern diseases is inflammation. This has many causes from leaky gut to toxicity, the former related to diet and often contributing to the latter (in how the leaky gut allows molecules to more easily cross the gut lining and get into the bloodstream where they can freely travel throughout the body — causing autoimmune disorders, allergies, asthma, rheumatoid arthritis, depression, etc). But obesity is another main cause of inflammation. And one might note that, when the body is overloaded and not functioning optimally, excess toxins are stored in fat cells — which makes losing weight even more difficult as toxins are released back into the body, and if not flushed out causing one to feel sick and tired.

It’s not simply bad lifestyle choices. We are living in unnatural and often outright toxic conditions. Many of the symptoms that we categorize as diseases are the bodies attempt to make the best of a bad situation. All of this adds up to a dysfunctional level across society. Our healthcare system is already too expensive for most people to afford. And the largest part of public funding for healthcare is going to diabetes alone. But the saddest part is the severe decrease in quality of life, as the rate of mood and personality disorders skyrockets. It’s not just diet. For whatever reason (toxins? stress?), with greater urbanization has come greater levels of schizophrenia and psychosis. And autism, a rare condition in the past, has become highly prevalent (by the way, one of the proven effective treatments for autism is a paleo/keto diet; also effective for autoimmune conditions among much else).

It’s getting worse and worse, generation after generation. Imagine what this means in terms of epigenetics and transgenerational trauma, as nutritional deficits and microbiotic decimation accumulates, exacerbated by a society driven mad through inequality and instability, stress and anxiety. If not for nutrients added to our nutrient poor food and supplements added to our unhealthy diet, we’d already be dying out as a society and our civilization would’ve collapsed along with it (maybe similar to how some conjecture the Roman Empire weakened as lead toxicity increased in the population). Under these conditions, that children are our future may not be an affirmation of hope. Nor may these children be filled with gratitude once they’ve reached adulthood and come to realize what we did to them and the world we left them. On the other hand, we aren’t forced to embrace fatalism and cynicism. We already know what to do to turn around all of these problems. And we don’t lack the money or other resources to do what needs to be done. All that we are waiting for is public demand and political will, although that might first require our society reaching a point of existential crisis… we are getting close.

The stumbling block is that there is no profit in the ‘healthcare’ industry for advocating, promoting, incentivizing, and ensuring healthy diet and healthy conditions for a healthy population. Quite the opposite. If disease profiteering was made illegal, there would be trillions of dollars of lost profit every year. Disease is the reality of capitalist realism, a diseased economic system and social order. This collective state of sickliness has become the norm and vested interests will go to great lengths to defend the status quo. But for most who benefit from the dysfunctional and destructive system, they never have to give it much thought. When my mother brought my nephew to the doctor, she pointed out how he is constantly sick and constantly eating a poor diet. The doctor’s response was that this was ‘normal’ for kids (these days), which might be true but the doctor should be shocked and shamed by his own admission. As apathy takes hold and we lose a sense of hope, low standards fall ever lower.

Fasting, Calorie Restriction, and Ketosis

Fasting, for example, increases the level of neurotransmitters such as serotonin, dopamine, and norepinephrine while temporarily reducing the brains release and use of them; plus, serotonin and its precursor tryptophan are made more available to the brain. So, it allows your reserves of neurotransmitters to rebuild to higher levels. That is partly why a ketogenic diet, along with the brains efficient use of ketones, shows improvements in behavior, learning, memory, acuity, focus, vigilance, and mood (such as sense of well-being and sometimes euphoria); with specific benefits, to take a couple of examples, in cerebral blood flow and prefrontal-cortex-related cognitive functions (mental flexibility and set shifting); while also promoting stress resistance, inflammation reduction, weight loss, and metabolism, and while decreasing free radical damage, blood pressure, heart rate, and glucose levels. Many of these are similar benefits as seen with strenuous exercise.

We know so much about this because the ketogenic diet is the only diet that has been specifically and primarily studied in terms of neurological diseases, going back to early 20th century research on epileptic seizures and autism, was shown effective for other conditions later in the century (e.g., V. A. Angelillo et al, Effects of low and high carbohydrate feedings in ambulatory patients with chronic obstructive pulmonary disease and chronic hypercapnia), and more recently with positive results seen in numerous other conditions (Dr. Terry Wahl’s work on multiple sclerosis, Dr. Dale Bredesen’s work on Alzheimer’s, etc). By the way, the direction of causality can also go the other way around, from brain to gut: “Studies also suggest that overwhelming systemic stress and inflammation—such as that induced via severe burn injury—can also produce characteristic acute changes in the gut microbiota within just one day of the sustained insult [15].” (Rasnik K. Singh et al, Influence of diet on the gut microbiome and implications for human health). And see:

“Various afferent or efferent pathways are involved in the MGB axis. Antibiotics, environmental and infectious agents, intestinal neurotransmitters/neuromodulators, sensory vagal fibers, cytokines, essential metabolites, all convey information about the intestinal state to the CNS. Conversely, the HPA axis, the CNS regulatory areas of satiety and neuropeptides released from sensory nerve fibers affect the gut microbiota composition directly or through nutrient availability. Such interactions appear to influence the pathogenesis of a number of disorders in which inflammation is implicated such as mood disorder, autism-spectrum disorders (ASDs), attention-deficit hypersensitivity disorder (ADHD), multiple sclerosis (MS) and obesity.” (Anastasia I. Petra et al, Gut-Microbiota-Brain Axis and Its Effect on Neuropsychiatric Disorders With Suspected Immune Dysregulation) […]

For example, a ketogenic diet modulates the levels of the microbes Akkermansia muciniphila, Lactobacillus, and Desulfovibrio (Lucille M. Yanckello, Diet Alters Gut Microbiome and Improves Brain Functions). It is the microbes that mediate the influence on both epileptic seizures and autism, such that Akkermansia is decreased in the former and increased in the latter, that is to say the ketogenic diet helps the gut regain balance no matter which direction the imabalance is. In the case of epileptic seizures, Akkermansia spurs the growth of Parabacteroides which alters neurotransmission by elevating the GABA/glutamate ratio (there is glutamate again): “the hippocampus of the microbe-protected mice had increased levels of the neurotransmitter GABA, which silences neurons, relative to glutamate, which activates them” (Carolyn Beans, Mouse microbiome findings offer insights into why a high-fat, low-carb diet helps epileptic children), but no such effect was found in germ-free mice, that is to say with no microbiome (similar results were found in human studies: Y. Zhang, Altered gut microbiome composition in children with refractory epilepsy after ketogenic diet). Besides reducing seizures, “GABA is a neurotransmitter that calms the body. Higher GABA to glutamate ratios has been shown to alleviate depression, reduce anxiety levels, lessen insomnia, reduce the severity of PMS symptoms, increase growth hormone, improve focus, and reduce systemic inflammation” (MTHFR Support, Can Eating A Ketogenic Diet Change Our Microbiome?). To throw out the other interesting mechanism, consider Desulfovibrio. Ketosis reduces its numbers and that is a good thing since it causes leakiness of the gut barrier, and what causes leakiness in one part of the body can cause it elsewhere as well such as the brain barrier. Autoimmune responses and inflammation can follow. This is why ketosis has been found beneficial for preventing and treating neurodegenerative conditions like Alzheimer’s (plus, ketones are a useful alternative fuel for Alzheimer’s since their brain cells begin starving to death for loss of the capacity to use glucose as a fuel).

All of this involves the factors that increase and reduce inflammation: “KD also increased the relative abundance of putatively beneficial gut microbiota (Akkermansia muciniphila and Lactobacillus), and reduced that of putatively pro-inflammatory taxa (Desulfovibrio and Turicibacter).” (David Ma et al, Ketogenic diet enhances neurovascular function with altered gut microbiome in young healthy mice). Besides the microbiome itself, this has immense impact on leakiness and autoimmune conditions, with this allowing inflammation to show up in numerous areas of the body, including the brain of course. Inflammation is found in conditions such as depression and schizophrenia. Even without knowing this mechanism, much earlier research has long established that ketosis reduces inflammation.

Trends in Depression and Suicide Rates

Stephen Ilardi made two very important points.

First, depression is a disease of civilization. He spoke of research done on a hunter-gatherer tribal people. What the researcher found was that depression was almost non-existent among them. They lived a hard life and often hard deaths, but they weren’t clinically depressed. Nor did they have many of the other diseases of civilization, all of which are related to inflammation in the body.

He points out that studies have shown that depression is related to inflammation in the brain, at least partly caused by an unhealthy ratio between Omega 6 fats and Omega 3 fats. Combined with the stresses and social isolation of modern society, clinical depression has become a massive problem.

Second, clinical depression is a growing problem. Each generation has higher rates of depression than the generation before. It correctly can be called an epidemic at this point and it increases as people age. The younger generations will as they age, if the pattern holds, have 50% or more experiencing clinical depression.

This gets at an issue I continually return to. Everything is getting worse for the young generation such as poverty, economic inequality, unemployment and homelessness. My generation is the first generation do worse than their parents in the 20th century. My generation as children had poverty rates not seen since the Great Depression and had the worst child suicide rates since such things were recorded. How bad does society have to get before even children become so desperate and hopeless that they kill themselves?

Most people in the older generations never personally experienced these kinds of conditions. Because of this, they have no tangible understanding, no sympathy. They can’t see how this is a systemic problem throughout society, a problem transcending individuals and even generations.

I’ve previously discussed this a bit in terms of capitalist realism (see here and here), but I’ve never gone into much detail about this before. The analysis behind the concept of capitalist realism is based on the collective inability to imagine alternatives and hence collective inability to perceive the problems of the present system. The individual is the product and the scapegoat of capitalist realism.

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

American Diabetes Association Changes Its Tune

Over the past decade, ever more mainstream health organizations and government agencies have been slowly reversing their official positions on the dietary intake of carbohydrates, sugar, fat, cholesterol, and salt. This was seen in how the American Heart Association, without acknowledgment, backed off its once strong position about fats that it defended since I think 1961, with the federal government adopting the same position as official policy in 1980. Here we are in 2019, more than a half century later.

Now we see the American Diabetes Association finally coming around as well. And its been a long time coming. When my grandmother was in an assisted living home, the doctors and nurses at the time were following the official ADA position of what were called “consistent carbs”. Basically, this meant diabetics were given a high-carb diet and that was considered perfectly fine, as long as it was consistent so as to manage diabetes with consistent high levels of insulin use. It was freaking insanity in defying common sense.

While my grandmother was still living with my parents, my mother kept her blood sugar under control through diet, until she went to this healthcare facility. After that, her blood sugar was all over the place. The nurses had no comprehension that not all carbohydrates are equal since the glycemic index might be equivalent between a cookie and a carrot, irrespective of glycemic load and ignoring that maybe diabetics should simply be cutting out carbs in general. Instead, they argued that old people should be allowed to enjoy carbs, even if it meant that these nurses were slowly killing their patients and profiting the insulin companies at the same time. My mother was not happy about this callous attitude by these medical ‘professionals’.

Yet here we are. The ADA now says low-carb, high-fat (LCHF) diets aren’t a fad and aren’t dangerous. They go so far as to say they are beneficial for type 2 diabetes. Those not completely ignorant have been saying this for generations. And the research has been accumulating for just as long. The shift in official recommendations that happened in the decades following the 1960s never made sense even according to the research at the time. Many academics and researchers pointed out the lack of evidence in blaming saturated fat and cholesterol. But they were ignored and dismissed, then later attacked, discredited, and silenced by influential and, in some cases, downright charismatic figures (e.g., Ancel Keys) in powerful organizations that became aligned with leading politicians and bureaucrats in key positions. Many careers were destroyed and debate was shut down.

Now those victims of dietary authoritarianism are vindicated, not that this helps all the average folk harmed. There was many decades of bad dietary advice was force onto the American public. This determined official policies and practices of government healthcare programs, school lunch programs, and healthcare providers. Because of the central position of the United States as a geopolitical power during the Cold War, countries all over the world adopted this unhealthy dietary ideology as part of their own official policies.

This also influenced the food system with the government subsidizing high yields of corn and grains to meet the recommendations of these nutritional guidelines. Big ag and big food changed their business models accordingly and put out products that were high in carbs and sugar while low in saturated fat, replacing the latter with unhealthy hydrogenated oils. At least hundreds of millions, if not billions of people, worldwide over multiple generations have suffered a horrible diet, increased sickness, bad medical care, and premature mortality as a result.

Without admitting they were wrong all this time, without apologizing for all the harm they caused, these leading experts and officials are changing their opinion. Better late than never. Mark this date for it is a historic moment.

* * *

Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report
by Alison B. Evert et al, American Diabetes Association
(also see here)

EATING PATTERNS: Consensus recommendations

  • A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes.
  • Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key
    factors that are common among the patterns:
    ○ Emphasize nonstarchy vegetables.
    ○ Minimize added sugars and refined grains.
    ○ Choose whole foods over highly processed foods to the extent possible.
  • Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.
  • For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very lowcarbohydrate eating plans is a viable approach

New Consensus Report Recommends Individualized Eating Plan to Meet Each Person’s Goals, Life Circumstances and Health Status
news release from American Diabetes Association

“‘What can I eat?’ is the number one question asked by people with diabetes and prediabetes when diagnosed. This new Consensus Report reflects the ADA’s continued commitment to evidence-based guidelines that are achievable and meet people where they are and recommends an individualized nutrition plan for every person with diabetes or prediabetes,” said the ADA’s Chief Scientific, Medical and Mission Officer William T. Cefalu, MD. “The importance of this consensus also lies in the fact it was authored by a group of experts who are extremely knowledgeable about numerous eating patterns, including vegan, vegetarian and low carb.”

Nina Teicholz:

Just out: @AmDiabetesAssn guidelines–most comprehensive review to date of Dietary Patterns + diabetes prevention/treatment. What’s new: low-carb recommendations are prominent. (Says low-carb “are among the most studied eating patterns for T2 diabetes.”) […]

This is the key advancement of new @AmDiabetesAssn guidelines. Low carb is no longer “dangerous”‘or “fad”‘but a “viable”‘diet supported by “substantial”‘research and considered best for a number of T2 diabetes outcomes.

Dr. John Owens:

This is an historic day! My case managers and dietitian have been supporting my low-carb recommendations for years, going against ADA guidelines. Now they don’t have to!

Dr. Eric Sodicoff:

Still….They seem a little backward here. Bust out the low carb diet when meds not working?? Really? IMHO-Carb restriction is JOB #1 in diabetes management for use early and always. It is NOT second to medication my treatment protocol.

Starofthesea:

If you go back to the beginning, like back in the 1930’s, the doctors were telling diabetics to stop eating carbohydrates. Then somebody fabricated the cholesterol theory of heart disease and invented a drug called statins. Then suddenly carbs were okay for diabetics.

Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report — American Diabetes Association
from r/ketoscience

lutzlover:

“Eating patterns that replace certain carbohydrate foods with those higher in total fat, however, have demonstrated greater improvements in glycemia and certain CVD risk factors (serum HDL cholesterol [HDL-C] and triglycerides) compared with lower fat diets.”

Yay! Ack that higher fat isn’t deadly.

“The body makes enough cholesterol for physiological and structural functions such that people do not need to obtain cholesterol through foods. Although the DGA concluded that available evidence does not support the recommendation to limit dietary cholesterol for the general population, exact recommendations for dietary cholesterol for other populations, such as people with diabetes, are not as clear (8). Whereas cholesterol intake has correlated with serum cholesterol levels, it has not correlated well with CVD events (65,66). More research is needed regarding the relationship among dietary cholesterol, blood cholesterol, and CVD events in people with diabetes.

Or, in layman’s language: While the data doesn’t support vilifying cholesterol as causing heart attacks, we’re going to keep on searching in hopes we find the answer we want.

dem0n0cracy:

Are protein needs different for people with diabetes and kidney disease?

“Historically, low-protein eating plans were advised to reduce albuminuria and progression of chronic kidney disease in people with DKD, typically with improvements in albuminuria but no clear effect on estimated glomerular filtration rate. In addition, there is some indication that a low-protein eating plan may lead to malnutrition in individuals with DKD (317–321). The average daily level of protein intake for people with diabetes without kidney disease is typically 1–1.5 g/kg body weight/day or 15–20% of total calories (45,146). Evidence does not suggest that people with DKD need to restrict protein intake to less than the average protein intake.

dem0n0cracy:

“The amount of carbohydrate intake required for optimal health in humans is unknown. Although the recommended dietary allowance for carbohydrate for adults without diabetes (19 years and older) is 130 g/day and is determined in part by the brain’s requirement for glucose, this energy requirement can be fulfilled by the body’s metabolic processes, which include glycogenolysis, gluconeogenesis (via metabolism of the glycerol component of fat or gluconeogenic amino acids in protein), and/or ketogenesis in the setting of very low dietary carbohydrate intake (49).”

dem0n0cracy:

Low-carbohydrate (110–112) Emphasizes vegetables low in carbohydrate (such as salad greens, broccoli, cauliflower, cucumber, cabbage, and others); fat from animal foods, oils, butter, and avocado; and protein in the form of meat, poultry, fish, shellfish, eggs, cheese, nuts, and seeds. Some plans include fruit (e.g., berries) and a greater array of nonstarchy vegetables. Avoids starchy and sugary foods such as pasta, rice, potatoes, bread, and sweets. There is no consistent definition of “low” carbohydrate. In this review, a low-carbohydrate eating pattern is defined as reducing carbohydrates to 26–45% of total calories. c A1C reduction c Weight loss c Lowered blood pressure c Increased HDL-C and lowered triglycerides

Very low-carbohydrate (VLC) (110–112) Similar to low-carbohydrate pattern but further limits carbohydrate-containing foods, and meals typically derive more than half of calories from fat. Often has a goal of 20–50 g of nonfiber carbohydrate per day to induce nutritional ketosis. In this review a VLC eating pattern is defined as reducing carbohydrate to ,26% of total calories. c A1C reduction c Weight loss c Lowered blood pressure c Increased HDL-C and lowered triglycerides”

dem0n0cracy:

Low-Carbohydrate or Very Low Carbohydrate Eating Patterns

“Low-carbohydrate eating patterns, especially very low-carbohydrate (VLC) eating patterns, have been shown to reduce A1C and the need for antihyperglycemic medications. These eating patterns are among the most studied eating patterns for type 2 diabetes. One metaanalysis of RCTs that compared lowcarbohydrate eating patterns (defined as #45% of calories from carbohydrate) to high-carbohydrate eating patterns (defined as .45% of calories from carbohydrate) found that A1C benefits were more pronounced in the VLC interventions (where ,26% of calories came from carbohydrate) at 3 and 6 months but not at 12 and 24 months (110).

“Another meta-analysis of RCTs compared a low-carbohydrate eating pattern (defined as ,40% of calories from carbohydrate) to a low-fat eating pattern (defined as ,30% of calories from fat). In trials up to 6 months long, the low-carbohydrate eating pattern improved A1C more, and in trials of varying lengths, lowered triglycerides, raised HDL-C, lowered blood pressure, and resulted in greater reductions in diabetes medication (111). Finally, in another meta-analysis comparing lowcarbohydrate to high-carbohydrate eating patterns, the larger the carbohydrate restriction, the greater the reduction in A1C, though A1C was similar at durations of 1 year and longer for both eating patterns (112). Table 4 provides a quick reference conversion of percentage of calories from carbohydrate to grams of carbohydrate based on number of calories consumed per day.

“Because of theoretical concerns regarding use of VLC eating plans in people with chronic kidney disease, disordered eating patterns, and women who are pregnant, further research is needed before recommendations can be made for these subgroups. Adopting a VLC eating plan can cause diuresis and swiftly reduce blood glucose; therefore, consultation with a knowledgeable practitioner at the onset is necessary to prevent dehydration and reduce insulin and hypoglycemic medications to prevent hypoglycemia.

“No randomized trials were found in people with type 2 diabetes that varied the saturated fat content of the low- or very low-carbohydrate eating patterns to examine effects on glycemia, CVD risk factors, or clinical events. Most of the trials using a carbohydrate-restricted eating pattern did not restrict saturated fat; from the current evidence, this eating pattern does not appear to increase overall cardiovascular risk, but longterm studies with clinical event outcomes are needed (113–117).”

dem0n0cracy:

What is the evidence to support specific eating patterns in the management of type 1 diabetes?

“For adults with type 1 diabetes, no trials met the inclusion criteria for this Consensus Report related to Mediterraneanstyle, vegetarian or vegan, low-fat, low-carbohydrate, DASH, paleo, Ornish, or Pritikin eating patterns. We found limited evidence about the safety and/or effects of fasting on type 1 diabetes (129). A few studies have examined the impact of a VLC eating pattern for adults with type 1 diabetes. One randomized crossover trial with 10 participants examined a VLC eating pattern aiming for 47 g carbohydrate per day without a focus on calorie restriction compared with a higher carbohydrate eating pattern aiming for 225 g carbohydrate per day for 1 week each. Participants following the VLC eating pattern had less glycemic variability, spent more time in euglycemia and less time in hypoglycemia, and required less insulin (130). A single-arm 48-person trial of a VLC eating pattern aimed at a goal of 75 g of carbohydrate or less per day found that weight, A1C, and triglycerides were reduced and HDL-C increased after 3 months, and after 4 years A1C was still lower and HDL-C was still higher than at baseline (131). This evidence suggests that a VLC eating pattern may have potential benefits for adults with type 1 diabetes, but clinical trials of sufficient size and duration are needed to confirm prior findings.”

Eliminating Dietary Dissent

There was a hit piece in the Daily Mail that targeted three experts in the field, all doctors who are involved in research. It’s not exactly a respectable publication, but it does have a large mainstream readership and so its influence is immense, at least within the UK (even as an American, I occasionally come across Daily Mail articles). Here is the response by Dr. Malcolm Kendrick’s (Scottish). And by Dr. Zoe Harcombe’s (Welsh). Both responses were sent to the Daily Mail. The hit piece was published in timing with her planned speech before the UK Parliament, an attempt to discredit her and to distract from debate of the evidence. The third target of attack, Dr Aseem Malhotra (British) who also spoke to the UK Parliament (and the European Parliament as well), chose not to respond as he concluded it would be futile and it appears he was correct, in that the Daily Mail chose not to alter its message in the least because of what Kendrick and Harcombe wrote.

This is the same basic battle that I’ve mentioned previously, the conflict between two prestigious British medical journals, the BMJ and the Lancet. It has developed into full ideological warfare. But those defending the status quo are being forced to acknowledge their detractors, which is an improvement over silencing.

In the failed attacks on Robert Atkins (American), Annika Dahlqvist (Swedish), Gary Taubes (American), Tim Noakes (South African), Gary Fettke (Australian), Peter C.Gøtzsche (Danish), Maryanne Demasi (Australia), and Shawn Baker (American) over similar disputes, and among others who have felt the politically correct wrath of conventional and corporatist authority (I could mention Uffe Ravnskov, Nina Teicholz, etc; there is Malcolm Kendrick, Zoe Harcombe, and Aseem Malhotra as well; and, as I’ve discussed before, Adelle Davis, Carlton Fredericks, Gayelord Hauser, and Herman Taller), we see how the powers that be use mainstream institutions (private and public) as weapons. But that isn’t to ignore that there are also some successful examples of silencing such as John Yudkins (British), Jen Elliott (Australian), Maryanne Demasi (Australian), etc. In The Big Fat Lie that is soon to be a documentary, Nina Teicholz discusses other major figures in the healthcare field and research community that were effectively silenced in being discredited and excluded, in that they couldn’t get funding and were no longer invited to speak at scientific conferences; and Gary Taubes earlier discussed the same territory in Good Calories, Bad Calories; but if you prefer a detailed personal account of how a systematic attack is done, read Tim Noakes’ Lore of Nutrition. Anyways, failed or successful, these attacks are cautionary tales in setting examples of what the authorities can and will do to you if you step out of line. It creates a stultifying atmosphere and a sense of wariness among researchers, healthcare professionals, science writers, journalists, and public intellectuals — hence encouraging people to censor themselves.

In a similar area of dispute, there is another ongoing fight where an individual, Diana Rodgers (American), like the others has been targeted. Attacking individuals in trying to destroy their careers or authority seems to be the standard tactic. Fortunately, social media sheds light on this dark practice and brings out the support for these doctors, dieticians, researchers, etc who in the past would’ve felt isolated. It’s one of the positives of the internet.

Yet again, here is an example of conventional idiocy in its attempt to use a mainstream platform to spread disinfo and enforce conformity. Consider Newsweek that, like the Daily Mail, is a low quality but widely read mainstream publication. They decided to do a piece critical of the carnivore diet. And the writer they assigned to do it normally writes about video games and pop culture. Unsurprisingly, written by someone with no knowledge or expertise, the article was predictably misinformed. Every single comment in the comments section was critical (nearly the same in the comments of Nina Teicholz’s tweet), including comments by doctors and other experts. It’s less to do with a specific diet. This same kind of backlash is seen toward every variety of low-carb diet, whether plant-based paleo or plant-free carnivore, whether high-(healthy)fat or moderate, whether ketogenic or not. The reason is that there is no way to have a low-carb diet while maintaining large profits for the present model of the big biz food system of heavily-subsidized, chemical-drenched, and genetically-modified surplus grains as used to produce shelf-stable processed foods.

And it is far from limited to trashy popular media, as the same kinds of dismissive articles are found in higher quality publications like the Guardian, along with major medical organizations such as Harvard and the Mayo Clinic (although there is increasing positive press as the scientific research and popular support becomes overwhelming). Harvard, for example, is closely tied to the EAT-Lancet agenda (by way of Walter Willett, the ideological heir of Ancel Keys and, as I recall, involved in the leak of Robert Atkins’ medical records in a failed attempt to smear his reputation after his death) and the corporations behind it (Harvard, like other universities, have become heavily funded by corporations, as government funding has dried up; the Koch brothers have been key figures in the corporate takeover of universities with influence over hiring and firing of faculty and, by the way, the Koch brothers are heavily invested in big ag which is to say they are financially connected to the government-subsidized “green revolution” and the processed food industry).

Yet a growing movement is emerging from below, not only seen in comments sections and social media, but also in forming new organizations to demand accountability; for example, Gary Taubes’ Nutrition Science Initiative (NuSI) that is promoting much needed research. In reaction, the self-proclaimed authority figures in the mainstream are trying to enforce dietary conformity. I suspect the fact that so many people are questioning, doubting, and experimenting is precisely the reason elites all of a sudden are pushing even harder for basically the old views they’ve been pushing for decades. They sense the respect for their position is slipping and are in damage control mode. This isn’t only about statins, LCHF diet, or whatever else. It indicates a deeper shift going on (with low-carb diets on the rise) and those who are resisting it because of vested interests. What’s at stake is a paradigm change and the consequences of the status quo remaining in place are dire for public health.

* * *

On a related note, there is also a dark side to how the internet has been wielded as propaganda network. We know how effectively social media can be used to spread disinfo — yes, by whackos and controlled opposition like Alex Jones but even more powerfully by governments and corporations, think tanks and lobbyist groups, astroturf operations and paid trolls.

Wikipedia and Rational Wikipedia seem to have been taken over by defenders of the establishment, a sad fate for both of them. Many Wikipedia pages related to low-carb diets and alternative health (including tame criticism of statins by world reknown scientists) have been heavily slanted or deleted on Wikipedia. This agenda of censorship goes straight to the top — Jimmy Wales, the founder of Wikipedia, has called all critics of conventional medicine “lunatic charlatans” and demands that they be eliminated from Wikipedia, as if they never existed. This is a major change from earlier Wikipedia policy that promoted articles showing multiple viewpoints, but the reason for the change is that Wikipedia is being pressured to be an authoritative source as with traditional encyclopedias since Wikipedia is now used by services like Apple’s Siri.

Rational Wikipedia labels as “statin denier” anyone who is skeptical of highly profitable and corporate-promoted overprescription of statins, including critics who are practicing doctors and peer-reviewed researchers (the same false accusation is made by other pseudo-skeptical organizations such as CSICOP) — according to this logic, one of the most well-respected medical journals in the world, the BMJ, are “statin denialists” for being skeptical of the overuse of statins that the scientific research shows can cause much harm. Meanwhile, Rational Wikipedia rationalizes away this concerted effort of propaganda, probably because it’s the same people behind both operations, by way of hard-to-track sock puppets (I know from personal experience and research how deep the hole can go in trying to track down the identity of a disinfo agent, be they paid troll or merely the mentally disturbed). Pseudo-skepticism has come to rule the internet —- some of it as mentally disturbed true-believers but it also includes organizations that are astroturf. And so be skeptical most of all of anyone who poses as a skeptic.

Fortunately, alternatives are emerging such as Infogalactic as a non-censored, balanced, and independent version of Wikipedia. Unlike Wikipedia, an editor or group of editors can’t monopolize or delete a page simply because they ideologically disagree with it. And unlike Rational Wikpedia, there is no narrow institutional ideology informing what is allowable.

This is partly why it is so hard for the average person to find good info. Not only are we being lied to by big gov and big biz by way of big media for the same powerful interests are co-opting the new media as well. The purge and demonetizing of alternative voices, left and right, on YouTube was a great example of this. A similar purge has happened on Pinterest, generally censoring alternative health views and specifically targeting low-carb diets using centralized propaganda as the justification: “Keto doesn’t conform to CDC dietary guidelines” — despite the fact that ketogenic diets are among the most widely and longest researched with massive amount of data supporting numerous areas of benefit: longevity, cancer, epilepsy, autism, insulin resistance, autoimmune conditions, Alzheimer’s, etc. If the CDC is anti-science when particular science opposes highly profitable corporate interests, that is a major problem — but it shouldn’t be surprising that Pinterest, a highly profitable corporation (likely owned by a parent company that also owns other companies involved in agriculture, food production, pharmaceuticals, etc), defends the interests of big biz in collusion with big gov.

There is a struggle by the powerful to regain control of all potential avenues of propaganda and perception management. In terms of public debate, it’s always a matter of the perception of who wins. This is why propagandists, as with advertisers, have long understood that repetition of claims or ideas will make them so familiar as to feel true — what is called cognitive ease. That is why it is so important to silence opponents and make them invisible. Repetition requires total control, as the other side will also attempt to repeat their views. But it doesn’t matter how often alternative views are repeated if they are effectively erased from public view and from public forums. Look widely for info and scrutinize everything carefully. Find the few experts that are genuine honest actors and follow what they put out.

* * *

The Dark Side of Wikipedia
from Full Measure

Astroturfing Revealed–the Ruining of Wikipedia
by Angela A. Stanton

Wikipedia Declares War on Low Carb Diet Experts
by Aarn

Jimmy Wales Admits Free Access To Health Knowledge Has Strict Limits On Wikipedia
by Paul Anthony Taylor

Wikipedia: Cementing The Power Of The Status Quo
from Dr. Rath Health Foundation

Let me tell you a little bit about how the @Wikipedia farce works from someone who spent a lot of time battling there as an editor.
by Mike Carrato

Wikipedia Captured by Skeptics
from Skeptics about Skeptics

The Philip Cross Affair
by Craig Murray

Wikipedia censorship of natural, non-drug therapies
from Alliance for Natural Health

Kendrick, Wikipedia and ‘Dark Forces’ Waging War on Science
by Marika Sboros

Dr Malcolm Kendrick – deletion from Wikipedia
by Malcolm Kendrick

Wikipedia a parable for our times
by Malcolm Kendrick

Who Deserves to be a Wikipedia Article?: The Deletion of Dr. Malcolm Kendrick
by Anthony Pearson

‘Fat Head’ Targeted For Deletion By The Weenie At Wikipedia
by Tom Naughton

Follow-Up On The Weenie Wiki Editor
by Tom Naughton

BEWARE: New Plan to Censor Health Websites
by Joseph Mercola

Reddit discussions:
Doctors who are against statin are being removed from Wikipedia
Fat Head movie Wikipedia article up for deletion next !
Malcolm Kendrick and other low-carb and keto advocates are being attacked at Rationalwiki as pseudoscientists

Iowa Senator Zach Wahls

“I’m a registered Democrat, but am not opposed to voting for intellectually honest Republicans. My biggest frustration with politicians is not about specific policies, usually, but about whether or not the politicians are being honest about what those policies will do, why they are presenting those policies, etc. Way too much of our policy making is about emotionally-charged and intellectually dishonest claims instead of real world problem solving. Any politician with the courage to put forward solutions–that actually solve problems, even if they’re unpopular–is worth consideration in my book.”
~Zach Wahls (from an interview by Michael Hulshof-Schmidt)

My fellow Iowa Citian Zach Wahls was elected to the Iowa Senate. I don’t know him personally, but I know of his family. The church he grew up in and remains a member of, the local Unitarian Universalist, I attended for a period of time back in the early Aughts. He was was a young kid at the time, having been born in 1991. I’m sure I saw him and his family around the place and around the community, as it is a fairly small town. He still is young for a politician, at 27 years old.

This particular upbringing surely shaped his worldview. He was raised by two mothers, that likely being a major reason his family went to the UU church, as it is well known as a bastion of liberalism. Unitarian Universalism, along with closely related deism, has its roots in Enlightenment thought and was originally popularized in the United States by a number of revolutionaries and founders. In 1822, Thomas Jefferson predicted that “there is not a young man now living in the US who will not die an Unitarian.” He was a bit off in his prediction. But as Zach Wahls election demonstrates, this religious tradition remains a force within American society.

Senator Wahls first became politically involved by writing for his high school newspaper and continued his journalistic interests later on through a local newspaper. On a large stage, he first came to political and public attention in 2011 through a speech he gave on the Iowa House Judiciary Committee. It was in defense of same sex marriage, and interestingly was an expression of a uniquely Iowan attitude that emphasizes community and citizenship, hard work and family values but not in the sense of the fundamentalist culture wars. That speech went viral and was widely reported in the mainstream media. He was interviewed on some popular shows. That opened doors for him. He gave another speech at the 2012 Democrat National Convention and he was a delegate for Hillary Clinton in 2016.

So, his being in the limelight began not that many years ago. His mother, Dr. Terry Wahls, initially was more well known than him. She wrote some books over the past decade about how she reversed the symptoms of multiple sclerosis in herself, in her patients and in the subjects of clinical studies; with her initial book having been published in 2010, a short while before her son’s first major speech. Although a mainstream medical doctor, she is popular in the field of alternative diet and health. She is among a growing number of doctors, researchers, and experts who have challenged the problems and failures of our present healthcare system. It is unsurprising that her son while campaigning for the Iowa Senate seat promised, among other things, to reform healthcare.

It remains to be seen what kind of politician he will be. As with Alexandria Oscasio-Cortez, he is fresh blood from a generation just now entering the political arena. But he grew up ensconced in a liberal class bubble and appears to fall prey to some of its biases. It doesn’t go without notice that he was such a major supporter of Hillary Clinton, rather than Bernie Sanders, not that I know he ever attacked or spoke badly of Sanders. Still, he comes across as a fairly mainstream Democrat with some mild progressive leanings. He might be ahead of the game, though.

Clinton and Obama didn’t support same sex marriage until recent years, long after they had built their political careers, and long after the majority of Americans were already in favor of same sex marriage. Those old Democrats are used to playing it safe by making sure to remain to the right of public opinion and inching left only when public demand forces them to. Zach Wahls, on the other hand, grew up with same sex marriage as the norm of his entire reality. He began defending it in articles published in his high school newspaper. The old school Blue Dog Democrats have roots in Southern conservatism, established by the Southern Evangelical Jimmy Carter and more fully entrenched by Bill Clinton who also was a born-and-bred Southerner. Senator Wahls, however, formed his worldview in the heart of liberal progressivism, situated in a Northern town alien to Southern culture and politics. He takes the political left for granted as the starting point and so, even as part of mainstream politics, he is pushing the Overton window further back to the left again.

Young and idealistic, Senator Wahls enters the political fray right at the moment when the American public is being radicalized and reform is in the air. This might elicit the better angels of his nature. It might be easier for reform to take hold now when the majority of Americans are behind it. More importantly, he is bringing with him genuine knowledge of the issues, knowledge built on personal experience and so with personal stakes. The civil rights angle is important, whether in terms of same sex marriage or other things. But to my mind, more important is healthcare reform, as it touches on the nerve of populism. His mother, if she hadn’t turned to alternative health to treat her multiple sclerosis, would now at best be wheelchair-bound and at worst already dead. She did this after conventional medicine was unable to help her. So, Senator Wahls understands the failure of the system in an intimate way and he understands the kinds of concrete changes that need to happen.

As an Iowan, I’ll be watching him closely. The more infamous Iowa politician, Steve King, appears to be on the decline in his position within the Washington establishment. The older generation is losing its grip on power and the younger generation is clamoring to replace them. Senator Wahls, in particular, seems like a new breed of Democrat. I wish him well.

Most Mainstream Doctors Would Fail Nutrition

“A study in the International Journal of Adolescent Medicine and Health assessed the basic nutrition and health knowledge of medical school graduates entering a pediatric residency program and found that, on average, they answered only 52 percent of eighteen questions correctly. In short, most mainstream doctors would fail nutrition.”
~Dr. Will Cole

That is amazing. The point is emphasized by the fact that these are doctors fresh out of medical school. If they were never taught this info in the immediate preceding years of intensive education and training, they are unlikely to pick up more knowledge later in their careers. These young doctors are among the most well educated people in the world, as few fields are as hard to enter and the drop-out rate of medical students is phenomena. These graduates entering residency programs are among the smartest of Americans, the cream of the crop, having been taught at some of the best schools in the world. They are highly trained experts in their field, but obviously this doesn’t include nutrition.

Think about this. Doctors are where most people turn to for serious health advice. They are the ultimate authority figures that the average person directly meets and talks to. If a cardiologist only got 52 percent right to answers on heart health, would you follow her advice and let her do heart surgery on you? I’d hope not. In that case, why would you listen to the dietary opinion of the typical doctor who is ill-informed? Nutrition isn’t a minor part of health, that is for sure. It is the one area where an individual has some control over their life and so isn’t a mere victim of circumstance. Research shows that simple changes in diet and nutrition, not to mention lifestyle, can have dramatic results. Yet few people have that knowledge because most doctors and other officials, to put it bluntly, are ignorant. Anyone who points out this state of affairs in mainstream thought generally isn’t received with welcoming gratitude, much less friendly dialogue and rational debate.

In reading about the paleo diet, a pattern I’ve noticed is that few critics of it know what the diet is and what is advocated by those who adhere to it. It’s not unusual to see, following a criticism of the paleo diet, a description of dietary recommendations that are basically in line with the paleo diet. Their own caricature blinds them to the reality, obfuscating the common ground of agreement or shared concern. I’ve seen the same kind of pattern in the critics of many alternative views: genetic determinists against epigenetic researchers and social scientists, climate change denialists against climatologists, Biblical apologists against Jesus mythicists, Chomskyan linguists against linguistic relativists, etc. In such cases, there is always plenty of fear toward those posing a challenge and so they are treated as the enemy to be attacked. And it is intended as a battle to which the spoils go to the victor, those in dominance assuming they will be the victor.

After debating some people on a blog post by a mainstream doctor (Paleo-suckered), it became clear to me how attractive genetic determinism and biological essentialism is to many defenders of conventional medicine, that there isn’t much you can do about your health other than to do what the doctor tells you and take your meds (these kinds of views may be on the decline, but they are far from down for the count). What bothers them isn’t limited to the paleo diet but extends seemingly to almost any diet as such, excluding official dietary recommendations. They see diet advocates as quacks, faddists, and cultists who are pushing an ideological agenda, and they feel like they are being blamed for their own ill health; from their perspective, it is unfair to tell someone they are capable of improving their diet, at least beyond the standard advice of eat your veggies and whole grains while gulping down your statins and shooting up your insulin.

As a side note, I’m reminded of how what often gets portrayed as alternative wasn’t always seen that way. Linguistic relativism was a fairly common view prior to the Chomskyan counter-revolution. Likewise, much of what gets promoted by the paleo diet was considered common sense in mainstream medical thought earlier last century and in the centuries prior (e.g., carbs are fattening, easily observed back in the day when most people lived on farms, as carbs were and still are how animals get fattened for the slaughter). In many cases, there are old debates that go in cycles. But the cycles are so long, often extending over centuries, that old views appear as if radically new and so easily dismissed as such.

Early Christians heresiologists admitted to the fact of Jesus mythicism, but their only defense was that the devil did it in planting parallels in prior religions. During the Enlightenment Age, many people kept bringing up these religious parallels and this was part of mainstream debate. Yet it was suppressed with the rise of literal-minded fundamentalism during the modern era. Then there is the battle between the Chomskyites, genetic determinists, etc and their opponents is part of a cultural conflict that goes back at least to the ancient Greeks, between the approaches of Plato and Aristotle (Daniel Everett discusses this in the Dark Matter of the Mind; see this post).

To return to the topic at hand, the notion of food as medicine, a premise of the paleo diet, also goes back to the ancient Greeks — in fact, originates with the founder of modern medicine, Hippocrates (he also is ascribed as saying that, “All disease begins in the gut,”  a slight exaggeration of a common view about the importance of gut health, a key area of connection between the paleo diet and alternative medicine). What we now call functional medicine, treating people holistically, used to be standard practice of family doctors for centuries and probably millennia, going back to medicine men and women. But this caring attitude and practice went by the wayside because it took time to spend with patients and insurance companies wouldn’t pay for it. Traditional healthcare that we now think of as alternative is maybe not possible with a for-profit model, but I’d say that is more of a criticism of the for-profit model than a criticism of traditional healthcare.

The dietary denialists love to dismiss the paleo lifestyle as a ‘fad diet’. But as Timothy Noakes argues, it is the least fad diet around. It is based on the research of what humans have been eating since the Paleoithic era and what hominids have been eating for millions of years. Even as a specific diet, it is the earliest official dietary recommendations given by medical experts. Back when it was popularized, it was called the Banting diet and the only complaint the medical authorities had was not that it was wrong but that it was right and they disliked it being promoted in the popular literature, as they considered dietary advice to be their turf to be defended. Timothy Noakes wrote that,

“Their first error is to label LCHF/Banting ‘the latest fashionable diet’; in other words, a fad. This is wrong. The Banting diet takes its name from an obese 19th-century undertaker, William Banting. First described in 1863, Banting is the oldest diet included in medical texts. Perhaps the most iconic medical text of all time, Sir William Osler’s The Principles and Practice of Medicine , published in 1892, includes the Banting/Ebstein diet as the diet for the treatment of obesity (on page 1020 of that edition). 13 The reality is that the only non-fad diet is the Banting diet; all subsequent diets, and most especially the low-fat diet that the UCT academics promote, are ‘the latest fashionable diets’.”
(Lore of Nutrition, p. 131)

The dominant paradigm maintains its dominance by convincing most people that what is perceived as ‘alternative’ was always that way or was a recent invention of radical thought. The risk the dominant paradigm takes is that, in attacking other views, it unintentionally acknowledges and legitimizes them. That happened in South Africa when the government spent hundreds of thousands of dollars attempting to destroy the career of Dr. Timothy Noakes, but because he was such a knowledgeable expert he was able to defend his medical views with scientific evidence. A similar thing happened when the Chomskyites viciously attacked the linguist Daniel Everett who worked in the field with native tribes, but it turned out he was a better writer with more compelling ideas and also had the evidence on his side. What the dogmatic assailants ended up doing, in both cases, was bringing academic and public attention to these challengers to the status quo.

Even though these attacks don’t always succeed, they are successful in setting examples. Even a pyrrhic victory is highly effective in demonstrating raw power in the short term. Not many doctors would be willing to risk their career as did Timothy Noakes and even fewer would have the capacity to defend themselves to such an extent. It’s not only the government that might go after a doctor but also private litigators. And if a doctor doesn’t toe the line, that doctor can lose their job in a hospital or clinic, be denied the ability to get Medicaire reimbursement, be blacklisted from speaking at medical conferences, and many other forms of punishment. That is what many challengers found in too loudly disagreeing with Ancel Keys and gang — they were effectively silenced and were no longer able to get funding to do research, even though the strongest evidence was on their side of the argument. Being shut out and becoming pariah is not a happy place to be.

The establishment can be fearsome when they flex their muscles. And watch out when they come after you. The defenders of the status quo become even more dangerous precisely when they are the weakest, like an injured and cornered animal who growls all the louder, and most people wisely keep their distance. But without fools to risk it all in testing whether the bark really is worse than the bite, nothing would change and the world would grind to a halt, as inertia settled into full authoritarian control. We are in such a time. I remember back in the era of Bush jr and as we headed into the following time of rope-a-dope hope-and-change. There was a palpable feeling of change in the air and I could viscerally sense the gears clicking into place. Something had irrevocably changed and it wasn’t fundamentally about anything going on in the halls of power but something within society and the culture. It made me feel gleeful at the time, like scratching the exact right spot where it itches — ah, there it is! Outwardly, the world more or less appeared the same, but the public mood had clearly shifted.

The bluntness of reactionary right-wingers is caused by the very fact that the winds of change are turning against them. That is why they praise the crude ridicule of wannabe emperor Donald Trump. What in the past could have been ignored by those in the mainstream no longer can be ignored. And after being ignored, the next step toward potential victory is being attacked, which can be mistaken for loss even as it offers the hope for reversal of fortune. Attacks come in many forms, with a few examples already mentioned. Along with ridicule, there is defamation, character assassination, scapegoating, and straw man arguments; allegations of fraud, quackery, malpractice, or deviancy. These are attacks as preemptive defense, in the hope of enforcing submission and silence. This only works for so long, though. The tide can’t be held back forever.

The establishment is under siege and they know it. Their only hope is to be able hold out long enough until the worst happens and they can drop the pretense in going full authoritarian. That is a risky gamble on their part and likely not to pay off, but it is the only hope they have in maintaining power. Desperation of mind breeds desperation of action. But it’s not as if a choice is being made. The inevitable result of a dominant paradigm is that it closes itself not only to all other possibilities but, more importantly, to even the imagination that something else is possible. Ideological realism becomes a reality tunnel. And insularity leads to intellectual laziness, as those who rule and those who support them have come to depend on a presumed authority as gatekeepers of legitimacy. What they don’t notice or don’t understand is the slow erosion of authority and hence loss of what Julian Jaynes called authorization. Their need to be absolutely right is no longer matched with their capacity to enforce their increasingly rigid worldview, their fragile and fraying ideological dogmatism.

This is why challengers to the status quo are in a different position, thus making the altercation of contestants rather lopsided. There is a freedom to being outside the constraints of mainstream thought. An imbalance of power, in some ways, works in favor of those excluded from power since they have all the world to gain and little to lose, meaning less to defend; this being shown in how outsiders, more easily than insiders, often can acknowledge where the other side is right and accept where points of commonality are to be found, that is to say the challengers to power don’t have to be on the constant attack in the way that is required for defenders of the status quo (similar to how guerrilla fighters don’t have to defeat an empire, but simply not lose and wait it out). Trying to defeat ideological underdogs that have growing popular support is like the U.S. military trying to win a war in Vietnam or Afghanistan — they are on the wrong side of history. But systems of power don’t give up without a fight, and they are willing to sacrifice loads of money and many lives in fighting losing battles, if only to keep the enemies at bay for yet another day. And the zombie ideas these systems are built on are not easily eliminated. That is because they are highly infectious mind viruses that can continue to spread long after the original vector of disease disappeared.

As such, the behemoth medical-industrial complex won’t be making any quick turns toward internal reform. Changes happen over generations. And for the moment, this generation of doctors and other healthcare workers were primarily educated and trained under the old paradigm. It’s the entire world most of them know. The system is a victim of its own success and so those working within the system are victimized again and again in their own indoctrination. It’s not some evil sociopathic self-interest that keeps the whole mess slogging along; after all, even doctors are suffering the same failed healthcare system as the rest of us and are dying of the same preventable diseases. All are sacrificed equally, all are food for the system’s hunger. When my mother brought my nephew for an appointment, the doctor was not trying to be a bad person when she made the bizarre and disheartening claim that all kids eat unhealthy and are sickly; i.e., there is nothing to do about it, just the way kids are. Working within the failed system, that is all she knows. The idea that sickness isn’t or shouldn’t be the norm was beyond her imagination.

It is up to the rest of us to imagine new possibilities and, in some cases, to resurrect old possibilities long forgotten. We can’t wait for a system to change when that system is indifferent to our struggles and suffering. We can’t wait for a future time when most doctors are well-educated on treating the whole patient, when officials are well-prepared for understanding and tackling systemic problems. Change will happen, as so many have come to realize, from the bottom up. There is no other way. Until that change happens, the best we can do is to take care of ourselves and take care of our loved ones. That isn’t about blame. It’s about responsibility, that is to say the ability to respond; and more importantly, the willingness to do so.

* * *

Ketotarian
by Dr. Will Cole
pp. 15-16

With the Hippocratic advice to “let food be thy medicine, and medicine thy food,” how far have we strayed that the words of the founder of modern medicine can actually be threatening to conventional medicine?

Today medical schools in the United States offer, on average, only about nineteen hours of nutrition education over four years of medical school.10 Only 29 percent of U.S. medical schools offer the recommended twenty-five hours of nutrition education.11 A study in the International Journal of Adolescent Medicine and Health assessed the basic nutrition and health knowledge of medical school graduates entering a pediatric residency program and found that, on average, they answered only 52 percent of eighteen questions correctly.12 In short, most mainstream doctors would fail nutrition. So if you were wondering why someone in functional medicine, outside conventional medicine, is writing a book on how to use food for optimal health, this is why.

Expecting health guidance from mainstream medicine is akin to getting gardening advice from a mechanic. You can’t expect someone who wasn’t properly trained in a field to give sound advice. Brilliant physicians in the mainstream model of care are trained to diagnose a disease and match it with a corresponding pharmaceutical drug. This medicinal matching game works sometimes, but it often leaves the patient with nothing but a growing prescription list and growing health problems.

With the strong influence that the pharmaceutical industry has on government and conventional medical policy, it’s no secret that using foods to heal the body is not a priority of mainstream medicine. You only need to eat hospital food once to know this truth. Even more, under current laws it is illegal to say that foods can heal. That’ right. The words treat, cure, and prevent are in effect owned by the Food and Drug Administration (FDA) and the pharmaceutical industry and can be used in the health care setting only when talking about medications. This is the Orwellian world we live in today; health problems are on the rise even though we spend more on health care than ever, and getting healthy is considered radical and often labeled as quackery.

10. K. Adams et al., “Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey,” Academic Medicine 85, no. 9 (September 2010): 1537-1542, https://www.ncbi.nlm.nih.gov/pubmed/9555760.
11. K. Adams et al., “The State of Nutrition Education at US Medical Schools,” Journal of Biomedical Education 2015 (2015), Article ID 357627, 7 pages, http://dx.doi.org/10.1155/2015/357627.
12. M. Castillo et al., “Basic Nutrition Knowledge of Recent Medical Graduates Entering a Pediatric Reside): 357-361, doi: 10.1515/ijamh-2015-0019, https://www.ncbi.nlm.nih.gov/pubmed/26234947.

Despite Growing Burden of Diet-related Disease, Medical Education Does Not Equip Students to Provide High Quality Nutritional Care to Patients
by Millie Barnes

The reviewed studies consistently found that medical students wanted to receive nutrition education to develop their skills in nutrition care but perceived that their education did not equip them to do so. Students cited both quantity and quality of their education as reasons for this — poor quality and under prioritization of nutrition in the curriculum, lack of interest and expertise in nutrition among faculty members, and few examples of nutritional counseling during clinical years to serve as models for emerging doctors.

Furthermore, students uniformly reported having a lack of required nutrition knowledge, which was also found through testing. For instance, one study found that when nutrition knowledge was assessed in a test, half of medical students scored below the pass rate.

Five studies assessing curriculum initiatives found that they had a modest positive effect. However, most nutrition initiatives were employed opportunistically as a once-off activity, rather than being integrated in a sustained way into the medical curricula. Innovative initiatives — such as online curriculum, hands on cooking experiences, and learning from other health professionals such as dietitians — showed short-term and long-term benefits for patients and health systems. Therefore, the authors call for more funding for innovative curriculum initiatives to be developed and implemented.

Scientific Failure and Self Experimentation

In 2005, John P. A. Ioannidis wrote “Why Most Published Research Findings Are False” that was published in PloS journal. It is the most cited paper in that journal’s history and it has led to much discussion in the media. That paper was a theoretical model but has since been well supported — as Ioannidis explained in an interview with Julia Belluz:

“There are now tons of empirical studies on this. One field that probably attracted a lot of attention is preclinical research on drug targets, for example, research done in academic labs on cell cultures, trying to propose a mechanism of action for drugs that can be developed. There are papers showing that, if you look at a large number of these studies, only about 10 to 25 percent of them could be reproduced by other investigators. Animal research has also attracted a lot of attention and has had a number of empirical evaluations, many of them showing that almost everything that gets published is claimed to be “significant”. Nevertheless, there are big problems in the designs of these studies, and there’s very little reproducibility of results. Most of these studies don’t pan out when you try to move forward to human experimentation.

“Even for randomized controlled trials [considered the gold standard of evidence in medicine and beyond] we have empirical evidence about their modest replication. We have data suggesting only about half of the trials registered [on public databases so people know they were done] are published in journals. Among those published, only about half of the outcomes the researchers set out to study are actually reported. Then half — or more — of the results that are published are interpreted inappropriately, with spin favoring preconceptions of sponsors’ agendas. If you multiply these levels of loss or distortion, even for randomized trials, it’s only a modest fraction of the evidence that is going to be credible.”

This is part of the replication crisis that has been known about for decades, although rarely acknowledged or taken seriously. And it is a crisis that isn’t limited to single studies —- Ioannidis wrote that, “Possibly, the large majority of produced systematic reviews and meta-analyses are unnecessary, misleading, and/or conflicted” (from a paper reported in the Pacific Standard). The crisis cuts across numerous fields, from economics and genetics to neuroscience and psychology. But to my mind, medical research stands out. Evidence-based medicine is only as good as the available evidence — it has been “hijacked to serve agendas different from what it originally aimed for,” as stated by Ioannidis. (A great book on this topic, by the way, is Richard Harris’ Rigor Mortis.) Studies done by or funded by drug companies, for example, are more likely to come to positive results for efficacy and negative results for side effects. And because the government has severely decreased public funding since the Reagan administration, so much of research is now linked to big pharma. From a Retraction Watch interview, Ioannidis says:

“Since clinical research that can generate useful clinical evidence has fallen off the radar screen of many/most public funders, it is largely left up to the industry to support it. The sales and marketing departments in most companies are more powerful than their R&D departments. Hence, the design, conduct, reporting, and dissemination of this clinical evidence becomes an advertisement tool. As for “basic” research, as I explain in the paper, the current system favors PIs who make a primary focus of their career how to absorb more money. Success in obtaining (more) funding in a fiercely competitive world is what counts the most. Given that much “basic” research is justifiably unpredictable in terms of its yield, we are encouraging aggressive gamblers. Unfortunately, it is not gambling for getting major, high-risk discoveries (which would have been nice), it is gambling for simply getting more money.”

I’ve become familiar with this collective failure through reading on diet and nutrition. Some of the key figures in that field, specifically Ancel Keys, were either intentionally fraudulent or really bad at science. Yet the basic paradigm of dietary recommendations that was instituted by Keys remains in place. The fact that Keys was so influential demonstrates the sad state of affairs. Ioannidis has also covered this area and come to similar dire conclusions. Along with Jonathan Schoenfeld, he considered the question “Is everything we eat associated with cancer?”

“After choosing fifty common ingredients out of a cookbook, they set out to find studies linking them to cancer rates – and found 216 studies on forty different ingredients. Of course, most of the studies disagreed with each other. Most ingredients had multiple studies claiming they increased and decreased the risk of getting cancer. Most of the statistical evidence was weak, and meta-analyses usually showed much smaller effects on cancer rates than the original studies.”
(Alex Reinhart, What have we wrought?)

That is a serious and rather personal issue, not an academic exercise. There is so much bad research out there or else confused and conflicting. It’s about impossible for the average person to wade through it all and come to a certain conclusion. Researchers and doctors are as mired in it as the rest of us. Doctors, in particular, are busy people and don’t typically read anything beyond short articles and literature reviews, and even those they likely only skim in spare moments. Besides, most doctors aren’t trained in research and statistics, anyhow. Even if they were better educated and informed, the science itself is in a far from optimal state and one can find all kinds of conclusions. Take the conflict between two prestigious British journals, the Lancet and the BMJ, the former arguing for statin use and the latter more circumspect. In the context of efficacy and side effects, the disagreement is over diverse issues and confounders of cholesterol, inflammation, artherosclerosis, heart disease, etc — all overlapping.

Recently, my dad went to his doctor who said that research in respectable journals strongly supported statin use. Sure, that is true. But the opposite is equally true, in that there are also respectable journals that don’t support wide use of statins. It depends on which journals one chooses to read. My dad’s doctor didn’t have the time to discuss the issue, as that is the nature of the US medical system. So, probably in not wanting to get caught up in fruitless debate, the doctor agreed to my dad stopping statins and seeing what happens. With failure among researchers to come to consensus, it leaves the patient to be a guinea pig in his own personal experiment. Because of the lack of good data, self-experimentation has become a central practice in diet and nutrition. There are so many opinions out there that, if one cares about one’s health, one is forced to try different approaches and find out what seems to work, even as this methodology is open to many pitfalls and hardy guarantees success. But the individual person dealing with a major health concern often has no other choice, at least not until the science improves.

This isn’t necessarily a reason for despair. At least, a public debate is now happening. Ioannidis, among others, sees the solution as not difficult (psychology, despite its own failings, might end up being key in improving research standards; and also organizations are being set up to promote better standards, including The Nutrition Science Initiative started by the science journalist Gary Taubes, someone often cited by those interested in alternative health views). We simply need to require greater transparency and accountability in the scientific process. That is to say science should be democratic. The failure of science is directly related to the failure seen in politics and economics, related to powerful forces of big money and other systemic biases. It is not so much a failure as it is a success toward ulterior motives. That needs to change.

* * *

Many scientific “truths” are, in fact, false
by Olivia Goldhill

Are most published research findings false?
by Erica Seigneur

The Decline Effect – Why Most Published Research Findings are False
by Paul Crichton

Beware those scientific studies—most are wrong, researcher warns
by Ivan Couronne

The Truthiness Of Scientific Research
by Judith Rich Harris

Is most published research really wrong?
by Geoffrey P Webb

Are Scientists Doing Too Much Research?
by Peter Bruce

Health From Generation To Generation

Traveling around the world, Weston A. Price visited numerous traditional communities. Some of them hunter-gatherers and others agricultural, including some rural communities in Europe. This was earlier last century when industrialization had yet to take hold in most places, a very different time in terms of diet, even in the Western world.

What he found was how healthy these people were, whether they consumed more or less meat, dairy or not — although none were vegetarian (the typical pre-agricultural diet was about 1/3 to 2/3 animal products, often a large part of it saturated fat). The commonality is that they ate nutrient-dense foods, much of it raw, fermented, or prepared traditionally (the singlemost nutrient-dense food is organ meats). As a dentist, the first thing Price looked for was dental health. A common feature of these traditional societies was well-developed jaws and bone structure, straight uncrowded teeth, few cavities facial symmetry, etc. These people never saw a dentist or orthodontist, didn’t brush or floss, and yet their teeth were in excellent condition into old age.

This obviously was not the case with Price’s own American patients that didn’t follow a traditional diet and lifestyle. And when he visited prisons, he found that bone development and dental health was far worse, as indicators of worse general health and by implication worse neurocognitive health (on a related note, testing has shown that prisoners have higher rates of lead toxicity, which harms health in diverse ways). Between malnutrition and toxicity, it is unsurprising that there are so many mentally ill people housed in prisons, especially after psychiatric institutions were closed down.

Another early figure in researching diet and health was Francis M. Pottenger Jr, an American doctor. While working as a full-time assistant at a sanatorium, he did a study on cats. He fed some cats a raw food diet, some a cooked food diet, and another group got some of both. He also observed that the cooked food diet caused developmental problems of bone and dental structure. The results were worse than that, though. For the cats fed cooked food, the health of the next generation declined even further. By the third generation, they didn’t reach adulthood. There was no generation after that.

I was reading about this at work. In my normal excitement about learning something new, I shared this info with a coworker, a guy who has some interest in health but is a conventional thinker. He immediately looked for reasons for why it couldn’t be true, such as claiming that the generations of cats kept as pets disproves Pottenger’s observations. Otherwise, so the argument goes, domestic cats would presumably have gone extinct by now.

That was easy to counter, considering most pets are born strays who ate raw food or born to parents who were strays. As for purebred cats, I’m sure breeders have already figured out that a certain amount of raw food (or supplementation of enzymes, microbes, etc that normally would be found in raw food) is necessary for long term feline health. Like processed human food, processed pet food is heavily fortified with added nutrients, which likely counteracts some of the negative consequences to a cooked food diet. Pottenger’s cats weren’t eating fortified cooked food, but neither were the cats fed raw food getting any extra nutrients.

The thing is that prior to industrialization food was never fortified. All the nutrients humans (and cats) needed to not only survive but thrive was available in a traditional/natural diet. The fact that we have to fortify foods and take multivitamins is evidence of something severely wrong with the modern, industrialized food system. But that only lessens the health problems slightly. As with Pottenger’s cats, even the cats on a cooked food diet who had some raw food added didn’t avoid severely decreased health. Considering the emerging health crisis, the same appears to be true of humans.

The danger we face is that the effects are cumulative across the generations, the further we get from a traditional diet. We are only now a few generations into the modern Western diet. Most humans were still consuming raw milk and other traditional foods not that long ago. Earlier last century, the majority of Americans were rural and had access to fresh organic food from gardens and farms, including raw milk from pastured cows and fertile eggs from pastured chickens (pastured meaning high in omega-3s).

Even living in a large city, one of my grandfathers kept rabbits and chickens for much of his life and kept a garden into his old age. That means my mother was raised with quite a bit of healthy food, as was my father living in a small town surrounded by farms. My brothers and I are the first generation in our family to eat a fully modern industrialized diet from childhood. And indeed, we have more mental/neurocognitive health problems than the generations before. I had a debilitating learning disorder diagnosed in elementary school and severe depression clearly showing in 7th grade, one brother had stuttering and anxiety attacks early on, and my oldest brother had severe allergies in childhood that went untreated for years and since then has had a host of ailments (also, at least one of my brothers and I have suspected undiagnosed Asperger’s or something like that, but such conditions weren’t being diagnosed when we were in school). One thing to keep in mind is that my brothers and I are members of the generation that received one of the highest dosages of lead toxicity in childhood, prior to environmental regulations limiting lead pollution; and research has directly and strongly correlated that to higher rates of criminality, suicide, homicide, aggressive behavior, impulse control problems, lowered IQ, and stunted neurocognitive development (also many physical health conditions).

The trend of decline seems to be continuing. My nieces and nephews eat almost nothing but heavily processed foods, way more than my brothers and I had in our own childhoods, and the produce they do eat is mostly from nutrient-depleted soil, along with being filled with farm chemicals and hormones — all of this having continuously worsened these past decades. They are constantly sick (often every few weeks) and, even though still in grade school, all have multiple conditions such as: Asperger’s, learning disorder, obsessive-compulsion, failure to thrive, asthma, joint pain, etc.

If sugar was heroin, my nephew could be fairly called a junky (regularly devouring bags of candy and on more than one occasion eating a plain bowl of sugar; one step short of snorting powdered sugar and mainlining high fructose corn syrup). And in making these observations, I speak from decades of experience as a junkfood junky, most of all a sugar addict, though never quite to the same extreme. My nieces too have a tremendous intake of sugar and simple carbs, as their families’ vegetarianism doesn’t emphasize vegetables (since going on the paleo diet, I’ve been eating more organic nutrient-dense vegetables and other wholesome foods than my brothers and their families combined) — yet their diet fits well into the Standard American Diet (SAD) and, as the USDA suggests, they get plenty of grains. I wouldn’t be surprised if one or all of them already has pre-diabetes and likely will get diabetes before long, as is becoming common in their generation. The body simply can only take so much harm. I know the damage done to my own body and mind from growing up in this sick society and I hate to see even worse happening to the generations following.

To emphasize this point, the testing of newborn babies in the United States shows that they’ve already accumulated on average more than 200 synthetic chemicals from within the womb; and then imagine all the further chemicals they get from the breast milk of their unhealthy mothers along with all kinds of crap in formulas and in their environments (e.g., carcinogenic fire retardants that they breathe 24/7). Lead toxicity has decreased since my own childhood and that is a good thing, but thousands of new toxins and other chemicals have replaced it. On top of that, the hormones, hormone mimics, and hormone disruptors add to dysbiosis and disease — some suggesting this is a cause of puberty’s greater variance than in past generations, either coming earlier or later depending on gender and other factors (maybe partly explaining the reversal and divergence of educational attainment for girls and boys). Added to this mix, this is the first generation of human guinea pigs to be heavily medicated from childhood, much of it medications that have been shown to permanently alter neurocognitive development.

A major factor in many modern diseases is inflammation. This has many causes from leaky gut to toxicity, the former related to diet and often contributing to the latter (in how the leaky gut allows molecules to more easily cross the gut lining and get into the bloodstream where they can freely travel throughout the body — causing autoimmune disorders, allergies, asthma, rheumatoid arthritis, depression, etc). But obesity is another main cause of inflammation. And one might note that, when the body is overloaded and not functioning optimally, excess toxins are stored in fat cells — which makes losing weight even more difficult as toxins are released back into the body, and if not flushed out causing one to feel sick and tired.

It’s not simply bad lifestyle choices. We are living in unnatural and often outright toxic conditions. Many of the symptoms that we categorize as diseases are the bodies attempt to make the best of a bad situation. All of this adds up to a dysfunctional level across society. Our healthcare system is already too expensive for most people to afford. And the largest part of public funding for healthcare is going to diabetes alone. But the saddest part is the severe decrease in quality of life, as the rate of mood and personality disorders skyrockets. It’s not just diet. For whatever reason (toxins? stress?), with greater urbanization has come greater levels of schizophrenia and psychosis. And autism, a rare condition in the past, has become highly prevalent (by the way, one of the proven effective treatments for autism is a paleo/keto diet; also effective for autoimmune conditions among much else).

It’s getting worse and worse, generation after generation. Imagine what this means in terms of epigenetics and transgenerational trauma, as nutritional deficits and microbiotic decimation accumulates, exacerbated by a society driven mad through inequality and instability, stress and anxiety. If not for nutrients added to our nutrient poor food and supplements added to our unhealthy diet, we’d already be dying out as a society and our civilization would’ve collapsed along with it (maybe similar to how some conjecture the Roman Empire weakened as lead toxicity increased in the population). Under these conditions, that children are our future may not be an affirmation of hope. Nor may these children be filled with gratitude once they’ve reached adulthood and come to realize what we did to them and the world we left them. On the other hand, we aren’t forced to embrace fatalism and cynicism. We already know what to do to turn around all of these problems. And we don’t lack the money or other resources to do what needs to be done. All that we are waiting for is public demand and political will, although that might first require our society reaching a point of existential crisis… we are getting close.

The stumbling block is that there is no profit in the ‘healthcare’ industry for advocating, promoting, incentivizing, and ensuring healthy diet and healthy conditions for a healthy population. Quite the opposite. If disease profiteering was made illegal, there would be trillions of dollars of lost profit every year. Disease is the reality of capitalist realism, a diseased economic system and social order. This collective state of sickliness has become the norm and vested interests will go to great lengths to defend the status quo. But for most who benefit from the dysfunctional and destructive system, they never have to give it much thought. When my mother brought my nephew to the doctor, she pointed out how he is constantly sick and constantly eating a poor diet. The doctor’s response was that this was ‘normal’ for kids (these days), which might be true but the doctor should be shocked and shamed by his own admission. As apathy takes hold and we lose a sense of hope, low standards fall ever lower.

We can’t rely upon the established authority figures in seeking better health for ourselves, our families, and our communities. We know what we need to do. It might not be easy to make such massive changes when everything in society is going against you. And no doubt it is more expensive to eat healthy when the unhealthiest foods (e.g., high fructose corn syrup) are being subsidized by the government. It’s no accident that buying off the dollar menu at a fast food is cheaper than cooking a healthy meal at home. Still, if you are willing to go to the effort (and it is worth the effort), a far healthier diet is possible for many within a limited budget. That is assuming you don’t live in a food desert. But even in that case, there is a movement to create community gardens in poor neighborhoods, people providing for themselves what neither the government nor economy will provide.

Revolutions always begin from the bottom up. Or failing that, the foundations of our society will crumble, as the health of our citizenry declines. It’s a decision we must make, individually and collectively. A choice between two divergent paths leading to separate possible futures. As we have so far chosen suicidal self-destruction, we remain free to choose the other option. As Thomas Paine said, “We have it in our power to begin the world over again.”

* * *

Primal Nutrition
by Ron Schmid, N.D.
pp. 99-100

Parallels Between Pottenger’s and Price’s Work

While the experiments of McCarrison and Pottenger show the value of raw foods in keeping animals remarkably healthy, one might wonder about the relevance to human needs. Cats are carnivores, humans omnivores, and while the animals’ natural diet is raw, humans have cooked some foods for hundreds of thousands of years. But humans, cats, and guinea pigs are all mammals. And while the human diet is omnivorous, foods of animal origin (some customarily eaten raw) have always formed a substantial and essential part of it.

Problems in cats eating cooked foods provided parallels with the human populations Weston Price studied; the cats developed the same diseases as humans eating refined foods. The deficient generation of cats developed the same dental malformations that children of people eating modernized foods developed, including narrowing of dental arches with attendant crowding of teeth, underbites and overbites, and protruding and crooked teeth. The shape of the cat’s skull and even the entire skeleton became abnormal in severe cases, with concomitant marked behavioral changes.

Price observed these same physical and behavioral changes in both native and modern cultures eating refined foods. These changes accompanied the adoption by a culture of refined foods. In native cultures eating entirely according to traditional wisdom resulted in strength of character and relative freedom from the moral problems of modern cultures. In modern cultures, studies of populations of prisons, reformatories, and homes for the mentally delayed revealed that a large majority of individuals residing there (often approaching 100 percent) had marked abnormalities of the dental arch, often with accompanying changes in the shape of the skull.

This was not coincidence; thinking is a biological process, and abnormal changes in the shape of the skull from one generation to the next can contribute to changes in brain functions and thus in behavior. The behavioral changes in deficient cats were due to changes in nutrition. This was the only variable in Pottenger’s carefully controlled experiments. As with physical degenerative changes, parallels with human populations cannot help but suggest themselves, although the specific nature of the relationship is beyond the scope of this discussion.

Human beings do not have the same nutritional requirements as cats, but whatever else each needs, there is strong empirical evidence that both need a significant amount of certain high-quality raw foods to reproduce and function efficiently.

pp. 390-393

Certain groups of these cats were fed quality, fresh, undenatured food and others were fed varying degrees of denatured and processed food, then the effects were observed over several generations. The results from the inferior diets were not so startling for the first-generation animals but markedly and progressively so in subsequent generations. From the second generation on, the cats that were fed processed and denatured diets showed increasing levels of structural deformities, birth defects, stress-driven behaviors, vulnerability to illness, allergies, reduced learning ability, and, finally, major reproductive problems. When Pottenger attempted to reverse the effects in the genetically weakened and vulnerable later-generation animals with greatly improved diet, he found it took fully four generations for the cats to return to normal.

The reflections that Pottenger’s work casts on the health issues and dietary habits of modern-day society are glaring and inescapable. […]

Pottenger’s work has shown us that progressive generations with poor dietary habits result in increasingly more vulnerable progeny and that each subsequent generation with unhealthy dietary habits results in impaired resistance to disease, increasingly poor health and vitality, impaired mental and cognitive health, and impaired capacity to reproduce. It is all part of what we are seeing in our epidemic levels of poor health and the overwhelming rates of autism, violence, attentional disorders, childhood (and adult) behavioral problems, mental illness, fertility issues, and birth defects.

Deep Nutrition, Why Your Genes Need Traditional Food
by Catherine Shanahan, M.D.
pp. 117-123

The Omega Generation

When I was living and working in Hawaii, four generations sometimes came in to my clinic for an office visit all at once, giving me a front-row view of the impact of modern food. Quite often, this is what I saw: great-grandma, born on her family’s farm and well into her eighties, still had clear vision and her own set of teeth. Her weathered skin sat atop features that looked as though they were chiseled from granite. More often than not, she was the healthiest of the bunch and had a thin medical chart to prove it. The youngest child, on the other hand, often presented symptoms of the whole set of modern diseases: attention deficit, asthma, skin disorders, and recurrent ear infections. Like many of today’s generation, one or more of his organs wasn’t put together quite right. Maybe there was a hole in his heart, or maybe he needed surgery to reposition the muscles around an eye. While the exact effects may be hard to predict, what is predictable, given the dwindling dietary nutrients and proliferation of toxic materials, is some kind of physiologic decline.

Within a given family, the earlier the abandonment of traditional foods for a diet of convenience, the more easily perceptible the decline. I’m thinking of one little boy in particular, the great-grandchild of one of Hawaii’s many wealthy missionary families who developed an ear infection during his visit to Kauai from another island. This little boy bore none of his great-grandmother’s striking facial geometry. His jaw was narrow, his nose blunted and thin, his eyes set too close, and his cheekbones were withdrawn behind plateaus of body fat. The lack of supporting bone under his eyes made his skin sag into bags, giving him a weary look. His ears were twisted, tilted, and protruded, and his ear canals were abnormally curved, predisposing him to recurring external ear infections.

Narrow face, thin bones, flattened features—sound familiar? This is a dynamic symmetry shift. The nature and degree was something I’d expect to see if he were child number three or four of siblings born in quick succession. But the young man sitting on my exam table was only the couple’s second child, and though mom had given herself a full four years between the two, it hadn’t protected his health. He was the fourth-generation product of a century of nutritional neglect and the consequential epigenetic damage. The last century has derailed our entire culture from the traditions that sustained us, so he is far from alone in enduring visible epigenetic damage. And the consequences impact more than a child’s skeletal system; his entire genome is at risk. I believe this is why, according to a landmark 2003 Center for Disease Control (CDC) report, this child, like all others born in 2000, had a one-in-three chance of developing diabetes, a condition that reduces life expectancy by between ten and twenty years. 179 What is going unreported is the fact that it isn’t just diabetes on the warpath. Every year, growing battalions of familiar diseases are cutting a wider and wider swath of destruction through the normal experiences of childhood. 180

Whereas in previous centuries part of a parent’s responsibility was to work hard to prevent their children from getting sick, today so many of us are sick ourselves that we’ve grown to accept disease as one of life’s inevitables—even for our children. Today’s kids aren’t healthy. But rather than make such a sweeping and terrifying declaration, we avert our eyes from the growing mound of evidence, fill the next set of prescriptions, and expand our definition of normal childhood health to encompass all manner of medical intervention. This latest generation of children has accumulated the epigenetic damage of at least the three previous generations due to lack of adequate nutrition along with the overconsumption of sugar and new artificial fats found in vegetable oils. The family genome has been getting battered relentlessly for almost a century—even during key, delicate periods of replication. The physiologic result of these accumulated genetic insults? Distorted cartilage, bone, brain, and other organ growth. Many physicians have noted an apparent increase in young couples complaining of problems with fertility which, given the implications of epigenetic science, should come as no surprise. Children born today, I’m afraid, may be so genomically compromised that, for many, reproduction will not be possible even with the benefit of high-tech medical prodding. This is why I call these children the Omega generation, referring to the last letter in the Greek alphabet.

Born by cesarean section (often necessitated by maternal pelvic bone abnormalities), briefly breast-fed (if at all), weaned on foods with extended shelf lives—the human equivalent of pet foods—these Omega generation children see the doctor often and, whether first-born or not, will likely suffer from both biradial and dynamic symmetry shifts. In the same way we talk about bracing for the aging baby boomers’ medical needs, we had better reinforce the levees of our medical system for the next rising tide: medicine-dependent youth. These children will age faster, suffer emotional problems, and develop never-before-seen diseases. In my experience as a doctor, parents have an intuitive sense that their children are already dealing with more health problems than they ever did, and they worry about their future, for good reason. But no parent is helpless. If you have children, or are planning to, I can think of at least one child who can do something to avoid all this illness and start getting healthy—yours.

Restoring Your Family’s Genetic Wealth

If having an Omega generation baby sounds terrifying, you can do something about it. You can get off the sugar and vegetable oils that would block your child’s genetic potential. That means cutting out processed food, fast food, junk food, and soda. And you should give yourself at least three, preferably four, years between pregnancies and make every effort to fortify your body with vitamin-rich foods (or if you can’t, at least use prenatal vitamins) before conception. Those who want to do everything possible to have a healthy baby will find additional instruction throughout this book. But this discussion opens up a new question: If I do everything right, how beautiful and healthy can I expect my child to be?

My first answer to that question is that, of course, all children are beautiful. But if you’re asking if your child will have extraordinary health, excel scholastically and in sports, and be so physically striking as to elicit the envy of peers, then the answer is, It depends. It depends on how much genetic wealth you gave him. Which, in turn, depends on what you inherited from your parents.

Genetics is all about information. Your genetic wealth is a function of how much of the information in your genes has been damaged or remains intact, and how well the supportive epigenetic machinery is able to express the surviving data contained in your genetic code. To gauge the present condition of your genetic data, you can begin by asking your parents and grandparents what they ate when they were little. Find out if you were breastfed. Were they? Learn whatever you can about who was born when (including birth spacing). Dig up as many family pictures as you can find to look for the telltale signs of Second Sibling Syndrome. The more you know about your family history, and the more objectively you measure your health and appearance along with that of your partner, the more clues you will have to assess your genetic, and epigenetic, health.

Let’s give it a try. Let’s attempt to gauge a person’s genetic momentum using Claudia Schiffer as our case subject. Though both her parents were tall and reasonably attractive, you wouldn’t guess they could produce the superstar beauty they did. Their genetic equation was complicated by the fact that her father and mother were born during the Depression and raised under the conditions of post-war food shortages. Claudia’s secret weapon of genetic wealth may be that her great-great-grandmother grew up in the most wholesome and remote of farming communities in Austria, a town near Elbigenalp, which changed very little in the thousands of years before Claudia’s grandmother’s birth. 193

This close relation to someone living in a successful, stable, indigenous society is truly a rare gift. Adding to this, Claudia’s father’s family was affluent, meaning that (during their formative years) he and his parents presumably had access to the best foods of the early twentieth century. Put the two together, and keep the good food coming, and— voilà —a genome operating under moderate duress for a spell is effectively rehabilitated.

Let’s look at a broader example of genetic rehabilitation, this time dealing with height. Height is one of the most desirable proportions for a man. Aside from the obvious social and mating advantages, the professional advantages gained with every additional inch of height are well documented. Studies show that tall men take home higher salaries, obtain leadership positions more often, and have more sex. 194

Hawaiian archeological evidence shows that for hundreds of years a man’s stature helped to secure him a better official position in the class hierarchy. Our language—”big shoes to fill,” “big man on campus,” “someone you can look up to”—reflects society’s universal preference for the tall. The positive perception of the taller among us often extends to women, as well. I am not suggesting that taller people are better, only that height affords certain physical and social advantages. With that in mind, can relatively diminutive parents who want those advantages for their children have a baby who might someday walk tall and rise above the fray to stand head and shoulders above the rest?

Absolutely! This potential is encoded in our genetic memory. We’ve all heard that we used to be a lot shorter, how few of us could fit into one of those little suits of armor worn by medieval knights. But around the world, accumulating evidence suggests that thousands of years prior, our Paleolithic predecessors were at least as tall, if not taller, than most of us are today. 195 Even in the early Middle Ages, 1,000 years ago, European men were nearly as tall as they are now. What caused the temporary skeletal shrinkage? As the population grew, crowding reduced access to nutrients until stature reached an all-time low in the early 1700s. 196 Improvements in agricultural technology, most notably the series of inventions attributed to lawyer-turned-farmer Jethro Tull, revolutionized the process of tilling soil, vastly increasing productivity. 197 By the late 1700s, having recovered some of its former nutritional inputs, the European genome rebounded—and with it the average European’s height. But it would probably have dipped again, so that a tall man today might measure just over five feet, were it not for the early twentieth-century invention of refrigeration. The ability to freeze food meant that fishermen could travel as far as they needed and fill their hulls to brimming. Refrigeration also meant that even during winter, wealthy countries could reach down to the tropics for summer fruits and vegetables, making it profitable for millions of acres of rain forests around the globe to be converted over to crop production. For the past 100 years, industrialized nations have had consistent access to enough nutrition to achieve our Paleolithically pre-programmed height. Of course, height doesn’t equal health. But generally speaking, when a genome has access to a surplus of complex nutrition, it is far better positioned—and may be said to have a built-in preference—for the production of offspring with more robust, larger frames.

179. Lifetime risk for diabetes mellitus in the United States, Venkat Narayan, KM, JAMA, 2003, 290:1884-1890.
180. America’s children in brief: key national indicators of well-being, 2008, Federal Interagency Forum on Child and Family Statistics.
[…]
193. Anna Stainer-Knittel: portrait of a femme vitale, Kain E, Women’s Art Journal, vol. 20, no. 2, pp. 13-71.
194. Mirror, Mirror … The Importance of Looks in Everyday Life, Hatfield E, SUNY Press, 1986.
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197. The Cambridge World History of Food, Cambridge University Press, 2000.

Parasites Among the Poor and the Plutocrats

Hookworm rates in parts of the United States have reached the levels seen in developing countries.

This was a major problem in the past, specifically in the rural South. It was thought to have been largely eliminated, although that might not have been true. The most harmed populations just so happen to be the very populations most ignored — these are mostly poor rural populations with little healthcare and hence limited availability of public health data. The problem was maybe more hidden than solved. Until a study was recently done, it apparently wasn’t an issue of concern beyond the local level and so there was no motivation to research it.

As hookworm is a parasite, with it comes the problems of parasite load. Parasitism and parasite load effect not just general health but also energy levels, neurocognitive development, intelligence, and personality traits; for example, toxoplsasmosis is correlated to higher rates of neuroticism and parasite load is correlated to lower rates of openness. Populations with heavy parasite load will behave in ways that are stereotyped as being poor, such as acting lethargic and unmotivated.

Research indicates that poverty rates are an indicator of diverse other factors, many being environmental. People dealing with such things as stress, malnutrition, and parasites literally have less energy and cognitive ability available to them. Under these oppressively draining conditions, the body and mind simply go into survival mode and short-term preparedness. This is seen on the physiological level with stressful conditions causing early sexual maturity and increase in fat reserves.

This relates to the worsening poverty in many parts of the country, exacerbated by growing inequality across the country. But in many cases these are problems that aren’t necessarily worsening, as they have simply been ignored up to this point. Put this also into the context of problems that are clearly worsening, specifically among lower class whites: unemployment, homelessness, stress-related diseases, mental health conditions, alcoholism, drug addiction, and suicides. It’s not just poor minorities that have been shoved out of the way in the march of progress. Even the middle class is feeling the pressure, many of them falling down the economic ladder.

This is why most Americans at present neither trust big government nor big business. And this is why economic populism has taken hold. Since the DNC silenced Sanders in order to maintain the status quo, we got Trump as president instead. If we ignore these basic problems any longer, we are looking toward the possibility of an authoritarian takeover of our government and that would mean something far worse than Trump. That is what happens when a large part of the citizenry loses faith in the system and, unless a democratic revolution happens, are willing to look to a strongman who promises to do what needs to be done.

Simply put, we are long past the point of tolerating this inequality. This inequality is not just of income and wealth but also of political representation and public voice, of life opportunities and basic health. We shouldn’t tolerate this because the oppressed will only tolerate it for so long. Once we get beyond the point of collective failure, there is no turning back. The upper classes might prefer to continue ignoring it, but that isn’t a choice that is available. If push comes to shove, the upper classes might not like the choice that the oppressed will eventually demand by force. That is precisely why FDR created the New Deal. It was either that or something far worse: fascist coup, communist revolution, or societal collapse.

It would be nice if we Americans proactively solved our problems for once, instead of waiting for them to become an emergency and then haphazardly reacting. We probably won’t be so lucky to get another Roosevelt-like leader with a sense of noblesse oblige, belief in the duty to defend and uphold the public good. With that in mind, a useful beginning toward preventing catastrophe would be taking care of the basic the public health issues of rampant parasitism, lead toxicity, etc. That is the very least we can do, assuming we hope to avoid the worst. If we need an existential crisis to motivate ourselves and gain the political will to take action, we appear to be at that point or close to it.

Yet before we can deal with the parasites in poor areas, we might have to purge the body politic of the more dangerous parasites breeding within the plutocracy. That might require strong medicine.

* * *

Hookworm, a disease of extreme poverty, is thriving in the US south. Why?
by Ed Pilkington, The Guardian

These are the findings of a new study into endemic tropical diseases, not in places usually associated with them in the developing world of sub-Saharan Africa and Asia, but in a corner of the richest nation on earth: Alabama.

Scientists in Houston, Texas, have lifted the lid on one of America’s darkest and deepest secrets: that hidden beneath fabulous wealth, the US tolerates poverty-related illness at levels comparable to the world’s poorest countries. More than one in three people sampled in a poor area of Alabama tested positive for traces of hookworm, a gastrointestinal parasite that was thought to have been eradicated from the US decades ago.

The long-awaited findings, revealed by the Guardian for the first time, are a wake-up call for the world’s only superpower as it grapples with growing inequality. Donald Trump has promised to “Make America Great Again” and tackle the nation’s crumbling infrastructure, but he has said very little about enduring chronic poverty, particularly in the southern states. […]

The parasite, better known as hookworm, enters the body through the skin, usually through the soles of bare feet, and travels around the body until it attaches itself to the small intestine where it proceeds to suck the blood of its host. Over months or years it causes iron deficiency and anemia, weight loss, tiredness and impaired mental function, especially in children, helping to trap them into the poverty in which the disease flourishes.

Hookworm was rampant in the deep south of the US in the earlier 20th century, sapping the energy and educational achievements of both white and black kids and helping to create the stereotype of the lazy and lethargic southern redneck. As public health improved, most experts assumed it had disappeared altogether by the 1980s.

But the new study reveals that hookworm not only survives in communities of Americans lacking even basic sanitation, but does so on a breathtaking scale. None of the people included in the research had travelled outside the US, yet parasite exposure was found to be prevalent, as was shockingly inadequate waste treatment.

The peer-reviewed research paper, published in the American Journal of Tropical Medicine and Hygiene, focuses on Lowndes County, Alabama – the home state of the US attorney general, Jeff Sessions, and a landmark region in the history of the nation’s civil rights movement. “Bloody Lowndes”, the area was called in reference to the violent reaction of white residents towards attempts to undo racial segregation in the 1950s.

It was through this county that Martin Luther King led marchers from Selma to Montgomery in 1965 in search of voting rights for black citizens, More than half a century later, King’s dream of what he called the “dignity of equality” remains elusive for many of the 11,000 residents of Lowndes County, 74% of whom are African American.

The average income is just $18,046 (£13,850) a year, and almost a third of the population live below the official US poverty line. The most elementary waste disposal infrastructure is often non-existent.

Some 73% of residents included in the Baylor survey reported that they had been exposed to raw sewage washing back into their homes as a result of faulty septic tanks or waste pipes becoming overwhelmed in torrential rains.

The Baylor study was inspired by Catherine Flowers, ACRE’s founder, who encouraged the Houston scientists to carry out the review after she became concerned about the health consequences of having so many open sewers in her home county. “Hookworm is a 19th-century disease that should by now have been addressed, yet we are still struggling with it in the United States in the 21st century,” she said.

“Our billionaire philanthropists like Bill Gates fund water treatment around the world, but they don’t fund it here in the US because no one acknowledges that this level of poverty exists in the richest nation in the world.” […]

He added that people were afraid to report the problems, given the spate of criminal prosecutions that were launched by Alabama state between 2002 and 2008 against residents who were open-piping sewage from their homes, unable to afford proper treatment systems. One grandmother was jailed over a weekend for failing to buy a septic tank that cost more than her entire annual income. […]

The challenge to places like Lowndes County is not to restore existing public infrastructure, as Trump has promised, because there is no public infrastructure here to begin with. Flowers estimates that 80% of the county is uncovered by any municipal sewerage system, and in its absence people are expected – and in some cases legally forced – to provide their own.

Even where individuals can afford up to $15,000 to install a septic tank – and very few can – the terrain is against them. Lowndes County is located within the “Black Belt”, the southern sweep of loamy soil that is well suited to growing cotton and as a result spawned a multitude of plantations, each worked by a large enslaved population.

The same thing that made the land so good for cotton – its water-retaining properties – also makes it a hazard to the thousands of African Americans who still live on it today. When the rains come, the soil becomes saturated, overwhelming inadequate waste systems and providing a perfect breeding ground for hookworm. […]

“We now need to find how widespread hookworm is across the US,” said Dr Peter Hotez, dean of the National School of Tropical Medicine, who led the research team along with Rojelio Mejia. Hotez, who has estimated that as many as 12 million Americans could be suffering from neglected tropical diseases in poor parts of the south and midwest, told the Guardian the results were a wake-up call for the nation.

“This is the inconvenient truth that nobody in America wants to talk about,” he said. “These people live in the southern United States, and nobody seems to care; they are poor, and nobody seems to care; and more often than not they are people of color, and nobody seems to care.”