Category Archives: health policy

Regenerative Agriculture: A potential “cure” for climate change.

In a previous post I praised the recently released book SACRED COW which discusses regenerative agriculture, creation rather than destruction of soil through better farming models, the need for cattle (ruminants) in soil creation, the myths concerning vegetarian diets-saving-the-planet, and many issues related to nutrition and health of the planet.

A recently published white paper on the topic of regenerative agriculture states “there is hope right beneath our feet” to address the climate crisis and global food security at the same time.

You can read about this topic here:

https://regenerationinternational.org/2020/09/28/regenerative-agriculture-and-the-soil-carbon-solution-new-paper-outlines-vision-for-climate-action/

You can download a PDF for the full paper here: http://Regenerative Agriculture and the Soil Carbon Solution (pdf)

The most profound conclusion of this paper provides hope for the climate crisis:

“Data from farming and grazing studies show the power of exemplary regenerative systems that, if achieved globally, would drawdown more than 100% of current annual CO2 emissions.”

Regenerative agriculture is

“a system of farming principles that rehabilitates the entire ecosystem and enhances natural resources, rather than depleting them.”

Comparing regenerative agriculture to present day industrial farming an eco-artist has created this image.

Mono-agriculture on the left, Regenerative agriculture on the right.

“In contrast to industrial practices dependent upon monocultures, extensive tillage, pesticides, and synthetic fertilizers, a regenerative approach uses, at minimum, seven practices which aim to boost biodiversity both above and underground and make possible carbon sequestration in soil.

  • Diversifying crop rotations
  • Planting cover crops, green manures, and perennials
  • Retaining crop residues
  • Using natural sources of fertilizer, such as compost
  • Employing highly managed grazing and/or integrating crops and livestock
  • Reducing tillage frequency and depth
  • Eliminating synthetic chemicals”

“When compared to conventional industrial agriculture,” the authors write, “regenerative systems improve”:

  • Biodiversity abundance and species richness
  • Soil health, including soil carbon
  • Pesticide impacts on food and ecosystems
  • Total farm outputs
  • Nutrient density of outputs
  • Resilience to climate shocks
  • Provision of ecosystem services
  • Resource use efficiency
  • Job creation and farmworker welfare
  • Farm profitability
  • Rural community revitalization

A movie KISS THE GROUND, highlights the importance of a transition from present day mono-agriculture to a Regenerative approach. You can view the trailer here.

Along these lines, be on the lookout for a similar movie version of the book SACRED COW.

The US military has determined that the greatest threat to global security is CLIMATE CHANGE.

Alternative energy sources and elimination of fossil fuels can cut our carbon emissions but will not sequester the carbon in our atmosphere. REGENERATIVE AGRICULTURE can sequester carbon, create new living soil, and feed the planet a healthy diet.

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID 19: Masks and Distance not enough, where we have faltered and failed

  1. Test
  2. Trace
  3. Isolate

That is where we have failed. Those countries that rapidly instituted masks, social distance, frequent hand washing, PLUS Test/Trace/Isolate succeeded in limiting the speed of spread, protected the Medical Care (hospital) system from being over-run, and protected it’s citizens and economy. Those countries bought time to learn enough about the virus to lower the mortality rates by developing treatments that decrease risk of death AND probably disability and to ramp up the hospital care system and PPE.

The US has failed to meet the challenge.

Death may not be the worst outcome, depending on one’s views relative to the balance between longevity and quality of life. Chronic disability (such as congestive heart failure, severe pulmonary insufficiency, kidney failure requiring dialysis, stroke, etc.) can be lifelong and devastating following this infection. Some may consider that shortness of breath after walking 100 feet, requiring a rest before moving on, or kidney dialysis 3 times per week the price one must pay to survive a serious infection. Others may think this sort of severe disability is not acceptable. Many in our society are clueless about these potential outcomes (usually that means they are in denial, a very common defense mechanism used to deal with a terrible threat).

This did not have to be our present state, but it is.

In December US intelligence agencies (including the CIA) and the US military intelligence were already issuing reports about an emerging deadly respiratory virus in China. This went up the chain of command but was ignored by the Whitehouse. In January, Doctor Fauci, at the annual BIOTHREATS CONFERENCE in Washington DC, announced to the bio-tech industry representatives in attendance that this virus was already “beyond containment” and stated that aggressive biomedical development (drugs, vaccines, etc.) would be required. He told attendees that the NIH would “find the money” to support these efforts and that this was a national and global emergency.

Undoubtedly, this was reported to the Whitehouse. These early warnings were not only ignored, they were also widely denied publicly by our highest public official. (The warnings issued in senatorial and congressional committee meetings however, prompted many privileged senators and congress people to sell pandemic-sensitive stocks very early in the “denial phase”).

It is clear that masks and social distancing are effective in limiting spread. Super-spreader cases, case studies of spread in restaurants (China) , call centers (South Korea), and choir rehearsals (Washington State) suggest that both droplet and aerosol transmission occur in non-medical procedure settings.

We already knew that aerosol spread occurred in operating rooms when nasopharyngeal surgery and similar aerosol generating medical procedures were performed. In one operating room event, all 11 doctors and nurses who spent any amount of time in that operating room (despite everyone wearing N95 masks) became infected and the surgeon died from the infection (he had the most exposure). This was reported early on documenting aerosol spread in medical settings.

For those who have not read my previous discussion of aerosol vs droplet spread:

Aerosol = very small lighter-than-air particles containing infectious virus that float in the air and can be recirculated through air-conditioning vents or linger suspended in the air, especially indoors where the air is still.

Droplets = larger particles that fall quickly onto surfaces but can also with a cough, sneeze, scream or singing be transmitted to someone in very close proximity before falling .

Then we learned that carriers/transmitters of the virus can either remain completely without symptoms or develop symptoms as late as 10 days after initial exposure, all the while transmitting the virus to others around them. Assymptomatic transmission makes COVID 19 different from and more dangerous than most other viruses that infect humans.

Let me say that again.

Aerosol transmission makes this virus more dangerous than most other viruses.

Asymptomatic transmission makes this virus more dangerous than most other viruses.

And finally we have learned that this virus is more lethal than most other viruses. For example, COVID 19 is 25 times more lethal than the H1N1 influenza pandemic (references provided in previous post).

https://practical-evolutionary-health.com/2020/07/12/covid-19-update-what-have-we-learned/

To summarize, the combination of easy transmission, asymptomatic transmission, and high mortality rate make this virus exceptionally dangerous and difficult to control.

How did the US respond?

Instead of rapidly ramping up PPE, testing, tracing, and isolation public health capability we instead had national leadership that said this was just like “another flu” virus and would “go away”. The narrative constantly shifted, but more importantly, effective action was not taken, and still has not been taken.

Testing remains woefully inadequate.

In many areas of our country it can take 5 days to schedule a test and 10 days to get the results. Such tests are useless. To effectively implement TEST/TRACE/ISOLATE we need rapid and widespread testing, rapid reporting, and a system to then trace contacts and isolate infected and exposed individuals. The US still shamefully lacks these essential services.

John’s Hopkins University early on developed an on-line contact tracing training program. But public funding to hire such trained individuals has been inadequate.

Isolation requires facilities in which exposed or infected individuals have their own bathroom and bedroom, have food provided, and are medically supervised until they are no longer infectious.

The US does not have such facilities. Individuals, unless they are financially very secure, do not have access to a home or other environment where this is possible. Worse, those essential workers (meat packers, food delivery, nursing aids, etc.) who earn the least, usually live in cramped housing conditions with multi-generation households in which isolation is impossible. Such individuals often live from paycheck to paycheck, so staying home from work means the family does not eat or the rent is not paid. So they go to work infecting others.

The result has been not just death and disability but horrible economic consequences.

Our shutdowns could have been shorter had we acted quickly and effectively.

Had we responded rapidly and appropriately, we would not be in our present economic predicament. So ironically and tragically, those that complain that shutdowns “were not necessary” and masks “are not necessary” contribute to the worsening economic consequences. As the virus surges following relaxation of restrictions, further restrictions and economic consequences become necessary.

Compounding this situation is the denial on the part of many individuals regarding the science and facts about this virus. Part of this denial is the result of our con-artist in chief, (and some governors) misrepresenting the facts to the public and displaying inappropriate behavior (such as refusal to wear a mask until most recently).

The other component of this denial is based on the natural tendency of humans to ignore data that is threatening and not consistent with personal ideology and beliefs. Beliefs such as “the government lies, the government is not to be trusted, the government cannot tell me what to do” presents obstacles to social behavior that would protect not just oneself and family, but the community (and economy) in general.

Contact tracers have reported that sometimes people hang up on them, refuse to cooperate, sometimes saying that it is an “invasion of privacy” or a “government hoax”.

Such beliefs and behaviors are encouraged by misinformation in the social media, shock-jocks such as Rush Limbaugh, conspiracy theories, and supported by dangerous politicians who have placed party over country, ideology over science, the next election over the good of the country.

The best way to mitigate the dire health and ECONOMIC CONSEQUENCES of this pandemic include all those components that have worked in other countries:

  • MASKS4ALL
  • SOCIAL DISTANCE
  • FREQUENT HAND WASHING
  • SOCIAL BUBBLE

TEST/TRACE/ISOLATE

This is a sad state. In the meantime what can you do?

In the context of the COVID 19 pandemic I will close with the usual summary.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory “vegetable oils” from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

Fat Fiction: this movie could save your life

The USDA Dietary Guidelines are about to be published again with an update. Unfortunately, despite much input from the scientific community requesting that the dietary guidelines address the epidemics of obesity and diabetes, it looks like nothing will change. More than 50 scientific papers that support a Very Low Carbohydrate approach to address obesity, diabetes and pre-diabetes will be ignored.

But if you want a more scientific perspective I suggest you watch this movie. You can watch it free on Amazon Prime.

If you have read Good Calories Bad Calories by Gary Taubes or Big Fat Surprise by Nina Teicholtz. then you have already been exposed to the sad history of dietary recommendations in the United States and the tragic results.

Both books are well researched and present accurate science. The movie Fat Fiction reviews the sad history of dietary advice in the US. It presents many examples of patients whose lives were changed and improved by following the advice of nutritionists and physicians who have instead, followed the science and abandoned the ideological-unscientific USDA dietary guidelines.

The American Diabetes Association has finally recognized a VLC ketogenic diet as a valid approach to treating type 2 diabetes. In fact, a ketogenic diet is the only diet that has ever been documented in controlled clinical trials to reverse diabetes type 2 and get patients off insulin and oral medications used to treat diabetes.

Unfortunately, the USDA guidelines and the American Heart Association recommendations continue to recommend unhealthy inflammatory refined “vegetable oils” (processed/refined oils from corn, soy, safflower, peanuts, cottonseed, etc.) and high carbohydrate/low fat meals. The high carb/low fat approach to cardiovascular disease, obesity, and diabetes has been an absolute failure, increasing rather than decreasing the risk of heart attack and stroke as well as contributing to the explosive epidemics of obesity and DM2. The low fat dogma has fostered the obesity and diabetes epidemics since this dogma was first introduced in the mid 20th century. The low-fat ideology remains fully supported by financial contributions from the processed-food industry, creating a financial conflict of interest for the AHA and similar organizations.

In the context of the COVID 19 pandemic, where obesity, insulin resistance, pre-diabetes and diabetes type II are major risk factors for death from the infection, it is even more imperative that individuals suffering from these risk factors stop using medications to treat problems created by food and instead clean up their diet.

You can’t throw drugs at a nutritional disease and expect it to work” (Dr. Sarah Hallberg, TEDtalk)

You can fight systemic inflammation with the anti-inflammatory diet I present on this website, but if you have obesity, diabetes or pre-diabetes, the very low-carb version is the most effective and sustainable nutritional approach. Full fat dairy is optional (although technically not part of our evolutionary nutrition) and if you are obese, overweight, diabetic or pre-diabetic and full fat dairy is necessary for you to achieve a ketogenic diet, then go for it. But make sure you include an abundance of non-starchy vegetables which are an important component of a healthy ketogenic diet.

In the context of our present pandemic I will repeatedly say:

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Eliminate refined-inflammatory vegetable oils from your diet, instead eat healthy fat.
  10. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19, Lifestyle interventions more effective than drugs.

So far drug intervention trials for treating COVID-19 have been disappointing. No studies have shown benefit for hydroxychloroquine, with or without azithromycin. This topic has been covered in previous posts. Remdesivir has been FDA approved based upon one study that showed reduction in duration of symptoms. The mortality rate with Remdesivir, however, did not demonstrate a statistically significant difference when compared to “usual care”. https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19

Another study published in Lancet failed to show any clinical benefit from Remdesivir.

“No statistically significant benefits were observed for remdesivir treatment beyond those of standard of care treatment. Our trial did not attain the predetermined sample size because the outbreak of COVID-19 was brought under control in China. Future studies of remdesivir, including earlier treatment in patients with COVID-19 and higher-dose regimens or in combination with other antivirals or SARS-CoV-2 neutralising antibodies in those with severe COVID-19 are needed to better understand its potential effectiveness.”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

But we do know that certain underlying conditions such as obesity, diabetes, pre-diabetes (insulin resistance) and hypertension significantly increase risk of DEATH AND COMPLICATIONS with COVID-19. Since there are lifestyle interventions that can quickly and effectively mitigate these problems (diet, exercise, sleep, stress reduction….) now would seem like a good time to take our epidemics of obesity and diabetes in hand with aggressive lifestyle interventions to decrease the mortality rate of COVID-19 infection. Such measures do not require expensive drugs or expensive drug trials, they simply require knowledge, guidelines and the will to implement change in our daily habits. Yet there has been little discussion about this in the media or on the part of public health officials.

Lets look at obesity in the US.

From 1999–2000 through 2017–2018, the age-adjusted prevalence of obesity increased from

30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2%.

The most effective tool for addressing obesity and diabetes is a very low carbohydrate diet.

Effects of the Low Carbohydrate, High Fat Diet on Glycemic Control and Body Weight in Patients With Type 2 Diabetes: Experience From a Community-Based Cohort

https://pubmed.ncbi.nlm.nih.gov/32193200/

This study was a done in a community-based program, not an academic practice setting. That is significant since it demonstrates feasibility outside of academic centers with standard community resources. The results of this study confirmed the results of many previous studies done in academic settings including better blood sugar control, reduction or elimination of diabetic medications, and significant weight loss.

All patients following the LCHF diet who initially took
insulin had either a reduction or discontinuation of
this therapy by their healthcare provider when clinically
indicated, compared with less than a quarter of
those receiving usual care.

In another study done in Italy, significant weight reduction (7 kg), waistline reduction (7 cm.), fat mass reduction (3.8%) and systolic blood pressure reduction (10.5 mmHg) were achieved in 3 months with a Very Low Carbohydrate diet.

Middle and Long-Term Impact of a Very Low-Carbohydrate Ketogenic Diet on Cardiometabolic Factors: A Multi-Center, Cross-Sectional, Clinical Study (https://pubmed.ncbi.nlm.nih.gov/25986079/

Nina Teicholz had an opinion piece published in the Wall Street Journal on May 30, discussing the USDA dietary guidelines that have largely ignored a massive body of evidence supporting a Very Low Carbohydrate Diet for obesity and diabetes. She cites many studies that have been ignored by the USDA dietary guidelines committee. Here is here opening statement.

“Americans with obesity, diabetes, heart disease and other diet-related diseases are about three times more likely to suffer worsened outcomes from Covid-19, including death. Had we flattened the still-rising curves of these conditions, it’s quite possible that our fight against the virus would today look very different.”

You can read the full article here:

https://www.wsj.com/articles/a-low-carb-strategy-for-fighting-the-pandemics-toll-11590811260

But think about that simple statement, THREE TIMES MORE LIKELY TO SUFFER WORSENED OUTCOMES FROM COVID-19. Yet these conditions are highly responsive to lifestyle interventions that not only mitigate obesity, insulin resistance and high blood pressure, but also enhance immune function.

More from Teicholz’s opinion piece:

Other studies have found that dietary changes can rapidly and substantially improve cardiovascular risk factors, including conditions like hypertension that are major risk factors for worsened Covid-19 outcomes. A 2011 study in the journal Obesity on 300 clinic patients eating a very low-carbohydrate diet saw blood pressure quickly drop and remain low for years. And a 2014 trial on 148 subjects, funded by the National Institutes of Health, found a low-carb diet to be “more effective for weight loss and cardiovascular risk factor reduction” than a low-fat control diet at the end of the 1-year experiment.

In a recent letter to the editor published in the journal METABOLISM, Dr. Casey Means points out:

A diagnosis of diabetes has been a key indicator of the severity of
COVID-19, and in this regard, the virus has relentlessly highlighted our
global Achilles heel of metabolic dysfunction, and points to a prime opportunity
to fight back.
That fight, however, is not going to be won with Clorox, Purell,
masks, or anti-IL-6 drugs. The fight will only be won through a serious
commitment to improving everyone’s foundational metabolic health,
starting with the lowest hanging evidence-based fruit: dietary and lifestyle
interventions.

Read the full letter here: https://www.metabolismjournal.com/article/S0026-0495(20)30118-9/pdf

In 2 pages the letter describes multiple benefits of better glucose control relative to COVID -19 infection and the immune system as well as reduction of factors that lead to cytokine storm (terminal event for many COVID-19 patients). The letter also discusses the benefit of reducing environmental toxins (discussed in previous posts about COVID-19 and other health problems) that would likely benefit COVID-19 patients.

Research published April 18th, 2020 found that patients exposed to
highest amount of environmental nitrogen dioxide (NO2) had increased
risk of death fromCOVID-19, and that long-term exposure to this pollutant
may be one of the most important contributors to fatality by
compounding lung inflammation [20].

Minimizing exposure to environmental
pollutants may serve a role in quelling the underlying pro-inflammatory
state that characterizes metabolic disease and COVID-19 associated
cytokine storms
.

Other environmental toxins, including persistent organic pollutants
(POPs) found in air, water, and food generated from pesticides
and industrial chemicals, are also strongly implicated in the pathogenesis
of metabolic syndrome; promoting “clean living,” toxin-avoidant
strategies for patients as simple as emphasizing organic foods, home
air purification, and non-toxic home supplies could be considered, although
the clinical utility of these measures in the acute setting is unknown
[21].

In discussing the white elephant in the room he states:

What is starkly missing is the clear, simple, and strong recommendation for no added
sugar or ultra-refined carbohydrates, both of which are known drivers
of postprandial hyperglycemia and inflammation. As a medical community, we must not miss the opportunity to serve patients with straightforward, evidence-based nutritional and lifestyle strategies to assist in glycemic control.

I would encourage you to follow the link and read the 2 pages supported by multiple peer-reviewed references.

Evidence based nutritional and lifestyle strategies, so often discussed on this website include:

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. Follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.
  9. Clean up your home environment and minimize your family’s exposure to environmental toxins by following recommendations at EWG.org with regards to household products, personal care products, and organic foods. (https://www.ewg.org/)

If you have obesity, diabetes or pre-diabetes the Very Low Carbohydrate version of the anti-inflammatory diet linked above would be the fastest and most effective intervention you can immediately employ to reduce your risk of succumbing to COVID-19. (Of course wear a mask, follow good hygiene with hand-washing frequently, and practice social distancing)

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19: Hydroxychloroquine and Chloroquine, BAD NEWS.

The most comprehensive study on the use of these 2 drugs, including 96,032 patients in multiple hospitals and multiple countries shows increased risk of death with either of these two drugs in patients hospitalized with COVID-19. This was a retrospective study but offers the most amount of data to date on the issue of clinical efficacy and risk. You can read the full article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext.

TreatmentDeath rateventricular arrhythmia
No drug9.30%0.30%
Hydroxychloroquine18%6.10%
Hydroxychloroquine plus Macrolide23.80%8.10%
Chloroquine16.40%4.30%
Chloroquine plus Macrolide22.20%6.50%
Macrolide is an antibiotic like Zithromax.
Differences between no drug and all drug treatment categories statistically significant.

This was not a randomized prospective controlled clinical trial. However the data were adjusted for:

age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity.

So far it is the best information we have available.

There have been many physicians who have supported the use of these drugs without randomized controlled trials based on anecdotal reports in the medical literature. Given the desparate situation without a known effective drug that is understandable.

The authors note:

The absence of an effective treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led clinicians to redirect drugs that are known to be effective for other medical conditions to the treatment of COVID-19. Key among these repurposed therapeutic agents are the antimalarial drug chloroquine and its analogue hydroxychloroquine, which is used for the treatment of autoimmune diseases, such as systemic lupus erythematosus and rheumatoid arthritis.

However, the use of this class of drugs for COVID-19 is based on a small number of anecdotal experiences that have shown variable responses in uncontrolled observational analyses, and small, open-label, randomised trials that have largely been inconclusive.

 The combination of hydroxychloroquine with a second-generation macrolide, such as azithromycin (or clarithromycin), has also been advocated, despite limited evidence for its effectiveness.

This study is an important milestone, disappointing but illustrative of a common phenomenon in medicine.

Previous warnings about potential lethal heart rhythm issues were viewed with skepticism by armchair pundits claiming that there was not much data on sudden death related to use of these widely used drugs. Those pundits failed to understand that sudden death caused by prolonged QT interval (effect of these and many other drugs) cannot be diagnosed without an EKG during the event. When this occurs outside the hospital setting, or even in the hospital without a continuous EKG monitor on the patient, it goes unrecognized.

An important dictum in medicine is “first do no harm” (primum non nocere).

In the meantime, we do know what reduces risk:

Test/Trace/Isolate, social distance, MASKS4ALL, wash hands frequently, disinfect surfaces, show consideration for others. To understand why and how these measures can make a big difference you can go to this website. https://www.erinbromage.com/

In addition you can read a great article about the same topic here. https://www.newyorker.com/science/medical-dispatch/amid-the-coronavirus-crisis-a-regimen-for-reentry

I will close with the sermon on lifestyle and COVID-19.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. You must follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

COVID-19 Sweden vs Other Countries

5/21/2020 deaths/ million 7 day running average doubling time
cumulative deaths/million/day days
SWEDEN 379 3.3 46
Norway 43.6 0.13 241
Finland 54.9 0.52 138
Denmark 95.6 0.49 120
USA 282 4.02 49
NZ 4.3 0 598
stay home test-trace leadership
isolate example
SWEDEN no yes ?
Norway yes yes good
Finland yes yes good
Denmark yes yes good
USA late/variable POOR poor
New Zealand yes excellent excellent

Sweden was a source of controversy for the choice against instituting a stay-home policy. As you compare Sweden with other Scandinavian countries above you will see a dramatic difference in deaths per million (cumulative), running 7 day average deaths per million per day, and doubling time. The higher the doubling time (in days) the more a country has slowed the spread. New Zealand is the obvious winner. Early and aggressive action, effective test/trace/isolate, excellent leadership and example by the president are the hallmarks of success in New Zealand. Of course New Zealand is a small island with minimal international business and tourism so the comparison is not fair. HOWEVER, their success and strategy are obvious.

The US failed (and continues to fail) on test/trace/isolate despite the bluster and misrepresentations from the Whitehouse. California and Washington instituted early measures with respect to stay-home but without adequate test kits all of US states have been unable to execute the test/trace/isolate strategy proven effective in other countries. President Trump promised California 100,000 nasal swabs per week three weeks ago. They have not arrived. (California Department of Public Health)

Thus comparing USA to Sweden we see that with adequate social distancing, test/trace/isolate, Sweden did almost as well (or as poorly) as the US where stay at home was employed on a variable time line and to different degrees between the states.

You can review worldwide data, download spreadsheets, choose countries for comparison here.

Test/Trace/Isolate + Social distance + Masks4all + cooperation = SUCCESS

Had the US responded early and effectively, stay-home could have ended very quickly and safely with much less economic disruption.

Poor Management = inadequate Test/Trace/Isolate and other measures.

The New England Journal of Medicine published an article discussing the failure of the
USA relative to Test/Trace/Isolate.

Failing the Test — The Tragic Data Gap Undermining the U.S. Pandemic Response

 

The importance of  Reviving the US CDC after annual cuts by the Trump Administration is discussed here.

On March 25 the NEJM published an editorial on responding to the pandemic.

We did not follow the recommendations.

The AMERICAN ENTERPRISE INSTITUTE, a conservative think-tank, published a comprehensive Roadmap to Reopening.

Unfortunately we have not followed that roadmap.

So boost your immune system and meet the challenge with your personal behavior. Be smart.

  1. Avoid alcohol consumption (alcohol wreaks havoc with your immunity)
  2. Get plenty of sleep (without adequate sleep your immune system does not work well )
  3. You must follow good sleep habits
  4. Exercise, especially out of doors in a green space, supports the immune system
  5. Get some sunshine and make sure you have adequate Vitamin D levels.
  6. Eat an anti-inflammatory diet rich in micronutrients.
  7. Practice stress reduction like meditation and yoga which improves the immune system
  8. Eliminate sugar-added foods and beverages from your diet. These increase inflammation, cause metabolic dysfunction, and suppress immunity.

THIS WEBSITE PROVIDES INFORMATION FOR EDUCATIONAL PURPOSES ONLY. CONSULT YOUR HEALTH CARE PROVIDER FOR MEDICAL ADVICE.

Eat clean, drink filtered water, love, laugh, exercise outdoors in a greenspace, get some morning sunlight, block the blue light before bed, engage in meaningful work, find a sense of purpose, spend time with those you love, AND sleep well tonight.

Doctor Bob

 

Western Diet (high sugar, refined carbs, unhealthy fats) alters genes and causes inflammation

New study (in mice) shows fast food makes the immune system more aggressive in a detrimental way.

Major points:

  1. The immune system reacts similarly to a high sugar, high (unhealthy) fat and high calorie diet as to a bacterial infection.
  2. Unhealthy food seems to make the body’s defenses (innate immune system) more aggressive in the long term. Even long after switching to a healthy diet, inflammation towards innate immune stimulation is more pronounced.
  3. These changes may be involved in the development of arteriosclerosis and diabetes.
  4. These changes are due to alterations in gene transcription (up-regulation of genes associated with inflammation)
  5. This up regulation of pro-inflammatory genes persists even after converting to a healthier diet.

Read more at News from IRT

Here: Fast food makes the immune system more aggressive in the long term: Study shows that even after a change to a healthy diet, the body’s defenses remain hyperactive — ScienceDaily

And here Western Diet Triggers NLRP3-Dependent Innate Immune Reprogramming: Cell

This study is an example of epigenetics, where an environmental factor (diet) alters the expression of genes. We know that regular consumption of a variety of colorful vegetables mediates many beneficial effects and part of that process involves altering the transcription of many genes related to health and our ability to defend against Oxidative Stress .

The epigenetic effect of nutrition can be transmitted to the next generation.

The epigenetic effects of diet include many aspects of health including  cancer risk.

And epigenetic changes in humans can begin  before birth in response to maternal nutrition and maternal exposure to environmental toxins .

Diet also effects the gut microbiome, which in turn affects health .

So avoid fast food and other forms of processed-refined foods. Eat a whole foods-ancestral diet that includes a variety of organic colorful vegetables and fruits, grass fed/finished meats and wild seafood. This will not only provide important micro and macro nutrients but will also turn up and turn on genes that prevent disease.

Live clean, sleep well, laugh and love.

Doctor Bob

GMOs are dangerous, no doubt. Roundup and glyphosate are bad players.

 

I have discussed the dangers of GMO foods and Roundup before.

The evidence continues to mount.

“A peer-reviewed article, published  November 7, 2017, in the International Journal of Human Nutrition and Functional Medicine, demonstrates that GMOs are likely taking a heavy toll on our health. And a survey of 3,256 people who avoided them reported astonishing improvements in 28 health conditions.”

You can find a summary of the salient points from this scientific article here.

But I suggest you read the first few pages of the full article here.

The first few pages of this article describe the history of GMOs and how the warnings of  FDA scientists were silenced by regulatory executives who were shills for the likes of Monsanto and other dangerous players in this sad history.

11 genetically modified food crops are currently grown for commercial consumption. The six major crops are soy, corn, cotton, canola, sugar beets and alfalfa which are used to feed humans and animals. Cottonseed and canola are also processed into “food-grade” oils and sugar beets are refined to make sugar.

  • All six major GMOs are engineered to be herbicide tolerant, to survive spray of weed killer (such as Roundup)
  • 89% of GMOs grown in the US are herbicide tolerant
  • The most common herbicide involved is Roundup
  • 94% of soybeans grown in the US are Roundup Resistant (RR)
  • Some varieties of corn and cotton have genes inserted that produce a toxic insecticide called Bt toxin.
  • 76% of corn grown in the US is both Bt-producing and herbicide tolerant, 80% of cotton are both Bt and herbicide tolerant.

Roundup is not only used to kill weeds, but it is now sprayed heavily on crops immediately before harvest as a desiccant (drying agent) and large measurable amounts are found in the foods that you purchase in the supermarket.

In 1998 the FDA was sued by the Alliance for Bio-integrity and forced to turn over tens of thousands of pages of internal memos related to GMOs. FDA scientists repeatedly warned their superiors that GMO foods could create serious health risks such as allergies, toxins, antibiotic resistant diseases and nutritional problems. Michael Taylor, the former outside attorney for Monsanto and subsequent vice president of government and regulatory affairs for Monsanto was the political appointee in the FDA charged with overseeing GMOs!

On May 8, 2009,, the American Academy of Environmental Medicine published their policy paper on GMOs citing animal studies that revealed:

  • infertility,
  • immune dysregulation,
  • accelerated aging,
  • dysregulation of genes associated with cholesterol synthesis,
  • faulty insulin regulation, cell signaling and protein formation,
  • changes in the liver, kidney, spleen and gastrointestinal system

The AAEM recommended that the US government implement a moratorium on all GM foods and urged physicians to prescribe non-GMO diets.

But Monsanto prevailed and FDA officials ignored the warnings of their own scientists.

The three general categories of GMO danger include:

  1. consequences of the GMO transformation process
  2. the Bt toxin found in GMO corn and cotton
  3. the herbicides-particularly Roundup, that are sprayed on most GMO foods and consumed by those who eat GMO food.

A study of Monsanto’s RR corn revealed 117 proteins and 91 small molecule biochemicals significantly different from natural corn. Some of those differences “enhance the effects of histamine, thus heightening allergic reactions” and two of the polyamines in the GMO corn have been implicated in the formation of carcinogens (nitrosamines).

The GMO process can produce a host of unintended changes in RNA, DNA,  proteins and genes. And these changes can migrate and hybridize with non-GMO foods when the wind blows seeds from GMO plants into fields planted with non-GMO plants.

Altered Genes (transgenes) from GMO foods may “horizontally transfer” to humans or other organisms including the gut bacteria in humans that control much of our physiology.

Studies of rats fed GMO potatoes demonstrated adverse effects on every organ in young rats. Most changes occurred within 10 days. Disruption of organ growth, immune suppression and damage to organs of the immune system, thickening of the stomach and intestinal lining were noted.

Monsanto’s own data show that GM soybeans contain up to seven times the level of a natural allergen (trypsin inhibitor which also impairs protein digestion) and a doubling of soy lectin which impairs nutrient absorption. These were unintended consequences of the GMO process.

Monsanto’s MON810 Bt corn has 43 genes significantly altered in levels of expression. One of these genes which is normally switched off in non-GMO corn is switched on in the GMO version and it produces an allergenic protein.

Glyphosate is the major antibiotic in Roundup (yes Roundup is classified as an antibiotic). I have discussed the great hazards of glyphosate before. On October 24, 2017 JAMA published a study of the increase in measurable levels of glyphosate in humans.

The researchers compared urine excretion levels of glyphosate and aminomethylphosphonic acid (AMPA) in 100 people living in a Southern California community who provided samples during five clinic visits that took place between 1993 to 1996 and 2014 to 2016.

“What we saw was that prior to the introduction of genetically modified foods, very few people had detectable levels of glyphosate,” . “As of 2016, 70 percent of the study cohort had detectable levels.”

In July 2017, glyphosate was listed as a carcinogen by California.

A 2014 review concluded that:

Evidence is mounting that glyphosate interferes with many
metabolic processes in plants and animals and glyphosate residues have been detected in both.
Glyphosate disrupts the endocrine system and the balance of gut bacteria, it damages DNA and is a driver of mutations that lead to cancer.

There are many reasons to follow an organic, GMO-free, whole foods ancestral diet. Contamination with Roundup presents yet another compelling reason to choose your food wisely.

Some folks prefer videos to research articles, so below you will find both.

 

Here are a few links that will take you to articles related to this topic and quoted above.

Survey Reports Improved Health After Avoiding Genetically Modified Food

Genetically engineered crops, glyphosate and the deterioration of health in the United States of America

Environmental and health effects of the herbicide glyphosate. – PubMed – NCBI

Glyphosate: environmental contamination, toxicity and potential risks to human health via food contamination. – PubMed – NCBI

Aluminum and glyphosate can synergistically induce pineal gland pathology: connection to gut dysbiosis and neurological disease

GMO crops increase pesticide use

The high cost of pesticides: human and animal diseases

Is roundup the toxic chemical that’s making us all sick

Scientists Back Up WHO’s Classification of Glyphosate as “Probably Carcinogenic”

Food for thought: Are Herbicides a Factor for the Increase in Allergies and Autism?

Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance

Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies

Glyphosate, pathways to modern diseases IV: cancer and related pathologies

Glyphosate pathways to modern diseases V: Amino acid analogue of glycine in diverse proteins

GMOs, herbicides, and public health

Glyphosate induces human breast cancer cells growth via estrogen receptors

Glyphosate‐based pesticides affect cell cycle regulation

Glyphosate-based herbicides are toxic and endocrine disruptors in human cell lines

Environmental and human health impacts of growing genetically modified herbicide‐tolerant sugar beet: a life‐cycle assessment

Unidentified inert ingredients in pesticides: implications for human and environmental health

The possible link between autism and glyphosate acting as glycine mimetic—A review of evidence from the literature with analysis

Eat organic fruits and vegetables, avoid GMOs, enjoy better health.

Dr. Bob

Obesity Epidemic Requires a Paradigm Shift

The obesity epidemic requires a paradigm shift. Several medical myths stand in the way of taking the most effective steps to safely help patients lose weight. The most important myth relates to saturated fat. Saturated fat consumption does not contribute to cardiovascular disease. This must be understood and accepted by the medical community so that sound advice can be given.

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.( Am J Clin Nutr. 2010 Mar;91(3):497-9. )

In fact, as early as 2004, Mozaffarian et. al. investigated the influence of diet on atherosclerotic progression in postmenopausal women with quantitative angiography and found that:

In multivariate analyses, a higher saturated fat intake was associated with a smaller decline in mean minimal coronary diameter (P = 0.001) and less progression of coronary stenosis (P = 0.002) during follow-up. (Am J Clin Nutr. 2004 Nov;80(5):1175-84)

In addition, they further found that:

Carbohydrate intake was positively associated with atherosclerotic progression (P = 0.001), particularly when the glycemic index was high.

            Polyunsaturated fat intake was positively associated with progression when replacing other fats (P = 0.04)

These findings should come as no surprise given the basic science of atherosclerosis. Oxidized and glycated LDL stimulate macrophages to become foam cells initiating the creation of plaque. Cellular receptors that allow macrophages to ingest oxidized LDL are specific for oxidized LDL. These receptors do not recognize normal LDL to a significant degree.

Holovet et. al. studied the ability of oxidized LDL versus the Global Risk Factor Assessment Score (GRAS) to detect coronary artery disease. GRAS identified coronary artery disease 49% of the time, while oxidized LDL was correct 82% of the time.

In a large prospective study, Meisinger et al found that plasma oxidized LDL was the strongest predictor of CHD events when compared to conventional lipoprotein risk assessment and other risk factors for CHD.

Polyunsaturated fats are easily oxidized, saturated fats are not. It is the polyunsaturated fatty acids (PUFA) in the membrane of LDL particles that become oxidized and then initiate the cascade of inflammatory events leading to atherosclerosis. The major source of these PUFA in the American diet are “vegetable oils” (corn oil, soy oil etc.)  rich in the omega-6 PUFA, linoleic acid.

So why is this important to understand relative to the obesity epidemic? Because the most effective weight loss “diet” is arguably a low carbohydrate/high fat (LCHF) diet. This approach does not require calorie counting. This approach has been demonstrated to spontaneously reduce caloric intake whereas low fat diets require calorie counting and result in persistent hunger.

When compared to low fat calorie restricted diets  the LCHF approach has been equal or superior with respect to weight loss, insulin sensitivity, blood pressure reduction, and lipid profiles whenever these parameters have been measured.

But LCHF has not been embraced by the medical community due to the perceived dangers of saturated fat consumption and a low-fat ideology that lacks legitimate scientific evidence.

Once we dispel the mythology of saturated fat, the safety and efficacy of LCHF will be more readily accepted by physicians, the media and the lay public.

The nutritional villains in our society are highly refined and easily oxidized “vegetable oils” filled with pro-inflammatory omega-6 PUFA (linoleic acid), added sugar (especially HFCS) so prevalent in most processed foods and soft drinks, and the nutrient poor wasted calories of processed flour foods. These three culprits are responsible for our epidemics of obesity, insulin resistance and metabolic syndrome. These three conspire together to generate fatty liver disease, atherosclerotic plaque, and chronic inflammation.

When a LCHF approach is combined with  eating only fresh whole foods and avoiding added sugar, refined flour, and unhealthy  “vegetable oils”, we have the perfect recipe for our obesity epidemic.

The following references provide examples of studies that have demonstrated the efficacy, safety and  usual superiority of the LCHF  approach to weight loss.

Dig Dis Sci. 2007 Feb;52(2):589-93. Epub 2007 Jan 12. The effect of a low-carbohydrate, ketogenic diet on nonalcoholic fatty liver disease: a pilot study. Tendler D, Lin S, Yancy WS Jr, Mavropoulos J, Sylvestre P, Rockey DC Westman EC.

Fred Kummerow, PhD, fought the battle against Trans Fats for over 50 years.

Professor Fred Kummerow passed away on May 31 at his home in Urbana, Ill at age 102. He ate butter, red meat and eggs cooked in butter, along with plenty of fruits and vegetables. He avoided margarine, french fries and other fried foods, along with cookies, cake and crackers which contained artificial trans-fats. He conducted research in his nutrition science laboratory at the University of Illinois up until his death. he authored the book Cholesterol Won’t Kill You, But Trans Fat Could: Separating Scientific Fact from Nutritional Fiction in What You Eat

Fred warned the American public and scientists in the 1950s about the dangers of artificial man-made trans fats. His research was largely ignored and criticized by the food industry and by scientists who were funded by the food industry for decades. Despite mounting evidence in both animals and humans that artificial trans fats dramatically increased the risk of heart attacks, strokes, peripheral vascular disease, diabetes, obesity, and probably several forms of cancer, the FDA ignored his pleas to address the issue. In 2009 Professor Kummerow filed a petition with the FDA to ban the use of trans fats. Although federal law required that the FDA respond within 180 days to such a petition, the FDA remained silent. In 2013, approaching the age of 99, Professor Kummerow sued the FDA. Two years latter in 2015 the FDA declared that artificial trans-fats were unsafe and should be eliminated from the US food supply by 2018.

Through his lifelong work, Professor Kummerow has produced a policy change that will likely save hundreds of thousands of lives.

What are trans fats and why have they been in our food for 7 decades?

Although there are some forms of natural trans fats which are safe for consumption when consumed in whole foods, artificial trans-fats are produced by placing unsaturated fat (such as corn oil, soy oil) under high pressure and high temperature conditions and adding hydrogen in the presence of a metal catalyst. These fats were introduced to many American foods because they dramatically extend the shelf life of foods and give a pleasant mouth texture to a variety of processed foods. They remain in many foods still on the shelves today. You cannot rely on labels such as “NO TRANS FATS” OR “TRANS FAT FREE” because food companies are allowed to make this statement as long as the amount of trans fats does not exceed 0.5 grams per serving. No amount is safe!

The Institute of Medicine, on July 10, 2002 declared manufactured trans fatty acid (TFA) a serious danger to the health of our nation with a: “tolerable upper intake level of zero.”  This means there is no safe level of consumption. Despite that strong statement in 2002, it has taken the efforts of an elderly professor, including a lawsuit, to bring the FDA around to finally address the issue.

But it is not over yet, you can bet that the food industry will try to delay the implementation of the ban or possibly even argue against the overwhelming science that supports such a ban.

In the meantime read labels. If any food item contains “partially hydrogenated” oil of any kind or “hydrogenated oil” of any kind it contains trans fats. These foods are typically foods you should not be eating any way because they usually also contain added sugar, refined flour and/or refined easily oxidized inflammatory “vegetable” oils. They are not whole foods and therefore should not be consumed for many reasons. But if you want to eat cake, cookies, crackers, bread, or any other processed foods, beware and read the ingredients so as to at least avoid trans-fats.

You can read about Fred Kummerow, his life and research at these sites:

Fred A. Kummerow, scientist who raised early warnings about trans fats, dies at 102 – The Washington Post

Fred A. Kummerow, an Early Opponent of Trans Fats, Dies at 102 – The New York Times

Fred Kummerow, U. of I. professor who fought against trans fats, dies at 102 – Chicago Tribune

Fred also studied the effects of a oxysterols and oxidized low-density lipoprotein (OxLDL) both of which contribute to atherosclerosis.  In a  2013 publication Professor Kummerow stated

“levels of oxysterols and OxLDL increase primarily as a result of three diet or lifestyle factors: the consumption of oxysterols from commercially fried foods such as fried chicken, fish and french fries; oxidation of cholesterol in vivo driven by the consumption of excess polyunsaturated fatty acids from vegetable oils; and cigarette smoking.”

Yet the American Heart Association continues to recommend increased consumption of polyunsaturated fats from the likes of corn oil, soy oil, cottonseed and similar oils. I have discussed the problems with that advice here and here.

So the next time you avoid trans fats by reading food labels, think of Professor Kummerow who brought light to some very dark areas in the history of nutrition and food in the US.

Eat clean, live clean, and enjoy.

Dr. Bob