Mark's Daily Apple

My Beef with Beef

I can’t tell you how furious I am about what I feel is the meat industry’s blatant disregard for human health. While I’m no vegetarian, I saw this study in the Archives of Internal Medicine, and let’s just say, I’m not buying the “Happy Cows” line.

The researchers looked at 90,000 women. That’s a huge study. They compared US and UK women, and here’s what they found:

Eating more than 1.5 servings of meat daily doubles a young woman’s risk of breast cancer. What concerns me is the type of cancer which had double the risk: hormone receptor-positive breast cancer. To me, that says something pretty sobering about the meat industry’s production habits.

Both the study, and the BBC News article that covered it, are cautious to merely “suggest” a link between eating red meat and increasing – doubling – the risk of breast cancer. It doesn’t take much to read between the lines here.

The reason I think this study is really important to highlight is not because I hope to bandy a statistic like “double the risk!” about. (Remember the Statistics Game: always consider context and relative risk or results.) It’s important because the women who ate high amounts of red meat had double the risk of hormone receptor-positive breast cancer. That is a big issue, namely, because the American meat industry uses growth hormone like it’s manna from Heaven. Growth hormone helps the animals get bigger, faster, which translates more profit – but I’m pretty skeptical about how this practice could possibly be in the interest of public health. I just wonder how these people sleep at night knowing their profits come at the expense of other human beings.

Personally, I believe it’s clear that human physiology supports being omnivorous. No culture anywhere at any time has done without some sort of animal flesh, whether it’s fish, beef or reindeer. So I’m not “anti-meat”. However, I am strongly opposed to the way meat is produced in this country: quickly, unethically, with little regard for the animals or the people eating the animals. That’s why I only buy meat that is free-range, local, organic and definitely hormone-free.

The researchers were careful not to draw any ultimate conclusions. I think we can probably begin to draw our own, with some additional critical considerations:

1) Processed meats generally contain a chemical known as heterocyclic acid, which has been shown to cause cancer;

2) Red meat, of course, contains iron, which can sometimes encourage the growth of some types of tumors (though this isn’t a significant concern, likely);

3) The standard line: “The biggest risk factors for breast cancer remain gender and increasing age.” This from specialist Maria Leadbeater, quoted in the BBC article. Fair enough.

Technorati Tags: breast cancer, beef, red meat, cancer, factory farming, growth hormone, omnivore, Maria Leadbeater, BBC, hormone receptor, heterocyclic acid, risk factors

Posted By: Mark Sisson

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Bite Me, Big Pharma

Lying, Twisting and Manipulating: The Statistics Game Drug Companies Play

Faced with high insurance rates, long hours, endless paperwork, and high-pressure demands, doctors don’t have an easy time of it. If you’re blessed enough to have a thoughtful, proactive, cautious M.D., let them know, by all means. Doctors are inundated with free drug samples, bonuses and perks from Big Pharma, and even the most well-intentioned practitioner can face dilemmas.

Case in point: even the most careful doctors are getting misleading information from many medical journals.

It’s one of the most serious problems facing healthcare and medicine today. Scientists and medical experts are expressing increasingly loud concerns about the ethical standards of medical publications. Some journals and publications have essentially become an extended limb of advertising for drug companies.

The problem isn’t just in the expensive pharmaceutical ads that provide a means of financial survival for scientific and medical news publications.

Many of the studies themselves are funded directly by pharmaceutical companies, making the journals de facto supporters of such companies. Or, doctors participating in the studies also serve positions in various companies.

It’s troubling enough that independent news sources, supposedly impartial and peer-reviewed by other scientists and medical experts, are vulnerable. But even government agencies aren’t immune. The CDC, FDA and NIH have all faced huge criticism in recent years for obvious conflicts of interest.

How is Big Pharma getting away with this? Simple: we let them.

Here is what frequently occurs:

For starters, when companies fund studies of their own drugs – big shock – there are almost never unfavorable results.

When there are, they’re simply omitted, or a new study is funded. A fairly recent review found that when a study is funded by the company producing the drug, positive results happen four times more often than when impartial studies by independent researchers are conducted.

According to the Public Library of Science, an impartial public access resource (check it out in my Daily Reads at right), “between two-thirds and three-quarters” of the studies reported in the top journals are paid for by pharmaceutical companies.

According to the Library, companies aren’t bold enough (or unwitting enough) to skew the results. They simply ask questions they know will yield the “right” results. How convenient.

Another problem: even though journals are usually reviewed by colleagues, if companies are using the same study again and again, but presenting it in different ways, editors have no way of knowing. Editors try to maintain strict ethical integrity, but it can be next to impossible to know the origin, conflicts or “right questions” involved in some studies.

Before I started Primal Nutrition, I served a stint as an editor of a large national health magazine, and I certainly empathize with editors – as my staff knows all too well, information is always changing and getting to the truth is a ceaseless quest that demands constant vigilance. Of course, the truth is worth it. The stakes – Americans’ health – are too high.

Clearly, this is frustrating for anyone who’s even remotely health-minded and trying to arm themselves with the right information about health. If drug companies are paying for studies in order to get certain results, how safe, really, are these drugs? (Yet stevia must be sold as a skin-care treatment.)

There are several ways pharmaceutical companies get around the suspicions of journals and experts:

- They often test their new drug against an old one already proven to be useless or inferior.

- They test their drug against a weaker dose of the competitor’s drug (or a stronger dose, if there are side effects).

- They sponsor ongoing trials and pick information at points where results are most favorable.

- They sponsor tiny trials that only study a few people or a specific group of people.

My biggest contention is what I call the Statistics Game. Crass manipulation of statistics happens more than any of us wants to know. For example, a drug company will study 1,000 people with a particular illness or disease. Let’s say 6 of the 1,000 died. The company then creates a drug that reduces that number to 3. You can guess what the headline will say (because the company will provide the media with it): “Deaths cut by 50% with new drug!” when the real headline should say: “.3% die instead of .6%” or, better yet, no headline at all, because three people out of 1,000 is not even close to being statistically significant. Statistical significance is a benchmark standard in all science. In medicine, 15% is typically what’s required to be considered worthy of any attention, funding or recommendation. You can see where the Statistics Game gets manipulated here.

In other words, using my example (which, unfortunately, is all too real), what doctors should say is:

“If you don’t take this drug, you will be among the 994 of 1,000 that still live regardless. If you do take this drug, you will suffer a loss in quality of life, put up with side effects and complications and will be among 997 of 1,000 that live.”

What can you do?

First and foremost, seek a preventive lifestyle that avoids the need for possibly harmful medications. Vitamins, antioxidants, a fiber-rich diet, and daily exercise are proven, in hundreds upon hundreds of ethically-conducted studies, to be the best course in your journey towards good health.

Every month, new research from prevention-minded resources like the American Journal of Clinical Nutrition and the Public Library of Science reveal that simple lifestyle changes like exercise, diet, supplements and stress management are the true keys to unlocking great health.

Simply losing weight can halve your risk of diabetes, heart disease and other common health concerns. Doctors say the majority of arthritis sufferers would benefit if they just exercised on a daily basis. The vast majority of heart attack victims could help avoid these life-threatening incidents by simply reducing inflammation. (Ways to do this include taking Omega-3 fish oil supplements and exercising, in addition to cutting out alcohol, stress, smoking and high salt intake.)
Of course, I’m on a relentless mission to help you get started in the right direction. One way I can do that is to share my knowledge of studies with you. Here’s what I personally look for: studies that are reasonably controlled, have a variety of patients, and examine a large enough number of individuals over a long enough time period. I watch for drug company sponsorships in the hundreds of studies published every month, and my goal is always to separate the health from the hype. (One of my favorites: the big dairy campaign that claims three daily servings of milk or cheese will help you lose weight. Want to know what that was based on? A University of Tennessee study, funded by the Dairy Industry. The results? Even with Big Dairy backing the study, the average difference in weight loss between dairy-dieters and non-dairy participants was two pounds. Yes, two whole lb’s, folks. Unless you’re a five-year-old, I think many of us could lose that by skipping a dinner or two.)

Finally, you are your own best judge. Only you can decide what is best for your health. If something seems too good to be true, or appears to be a band-aid solution, it probably is. There’s no short-cut, drug or device that can give you good health. On the other hand, good health isn’t about deprivation or misery, either. It’s about smart daily decisions over a lifetime.

To do this, you don’t need to be a scientist or doctor – as this post shows, even the experts are vulnerable to biased influence. Let common sense be your guide and a positive, preventative lifestyle, your approach. And tell me what you think.

Technorati Tags: Big Pharma, pharmaceutical, medical journals, medical studies, medicine, FDA, pharmacology, reduce risk, diabetes, heart disease, arthritis, prevention, inflammation, obesity, CDC, Public Library of Science, PLoS

Posted By: Mark Sisson

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Sisson Says: Don’t “Loaf” Around

CARB CONCERNS

Apples are asking what I think about bread. The short answer: not very much. But this is an ongoing issue worthy of some debate, so let’s get it started:

In general, the best source of carbohydrates is a vegetable, not a grain (unless you are an athlete, in which case, you’re probably just trying to consume as many calories as possible).

Among other things, grains contain lectins, a mild toxin (is there such a thing as a mild toxin?). Technically, grains don’t “want” to be your next meal. They didn’t really evolve to be our food source – we humans exploited them when we figured out how easy they were to grow. Consequently, they’re in everything – especially processed foods – because they’re cheap and can be made into just about anything, from sauces to syrups to candies to side dishes.

The occasional slice of whole-grain-only toast (especially those sprouted-grain types that aren’t really flour at all) is fine. And a little pasta – if it’s loaded with veggies and tomato sauce and lean protein – is okay, too. But most Americans get way too many calories from bread and other carbs, especially the refined kind.

It’s not for nothing that our ancestors ate only flesh (meat and fish), nuts, roots, fruits and berries, and grabbed at wild greens for fiber. In fact, there’s a whole dietary movement – sometimes called the Caveman diet, sometimes the Paleo diet – we cautiously subscribe to (I’m uncomfortable with extreme diets, though I also am uncomfortable with how we define “extreme”!) Why? Grains are a relatively new thing for humans, and the evidence increasingly points to the notion that this isn’t a good development. If you’re into learning more, check out our Carbs category.

I recommend that you stick to just one or two servings of grains a day. A reader asked what kinds of carbs I eat. For breakfast, I sometimes eat a slice of sprouted-grain toast with organic nut spread (like almond butter). A few times a week, I enjoy brown rice or whole-grain pasta with my dinner vegetable plate. I favor squashes and legumes over grains. But on the whole, I stick to vegetables and protein – I just don’t really “do” carbs. Vegetables have far more vitamins, fiber and minerals than grain-sourced carbohydrates, and they are much lower in calories, giving you room for protein and vital fat. Vegetables also keep your blood sugar levels at a healthy, low level, so you don’t start pumping your pancreas to death.

Scientists point out that the human body was designed to subsist on a mixture of fresh vegetables, good fats (from nuts, fish, oils, and meats), and protein (from fresh meats, beans, a little dairy, and fish). Add in plenty of water, occasional fruit, and you’re set. On the whole, avoid the processed, unnatural, refined, sugary stuff. Try it for just one week and you’ll notice a big difference – really.

Technorati Tags: caveman diet, paleolithic diet, paleo diet, no-grain diet, sugar, blood sugar, grains, fiber, paleodan, anthropology

Posted By: Mark Sisson

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Mark Sisson Is Not Afraid of Fat

Evolution is all about adaptation – to the environment, to circumstances, to stress and even (or especially) to food. In this context of adaptation, it’s truly amazing how “inventive” the human body has become in finding novel (and perhaps heretofore uncontemplated) ways to repair damage we do to ourselves through our diets and other lifestyle indiscretions. And most of these changes are less than a few hundred years old, which makes the adaptations even more remarkable.

Let’s use cholesterol as an example. Cholesterol is actually very beneficial. Among other duties, it’s a necessary component of every cell membrane and it’s involved in hormone production. The body makes about 1400 mg a day just to keep up!

Now let’s take a stressful lifestyle (show of hands, please), add in a bad diet and lack of exercise and we get an inflammatory process in the arteries that causes lesions. This inflammation problem is completely unrelated to amounts or types of cholesterol.

Nevertheless, the ever-inventive human body adapts to this inflammation sequence by using cholesterol as a band-aid to cover up the lesions until healing can take place – which, of course, almost never happens since the silly human continues to live the same pro-inflammatory lifestyle. Eventually, the cholesterol band-aids harden (sclerosis), narrow the arteries and sometimes break off causing a heart attack.

Of course, we blame the cholesterol for all this and embark on a national campaign to rid the body of this important substance instead of focusing on the foods (and other stresses) that promote inflammation in the first place!

Now let’s consider fat. For years we believed fat was nothing more than nature’s way of storing extra calories for some future famine. That would be a handy little adaptation in and of itself if that’s all it were. But when you do the math, you see that it doesn’t require a lot of fat to survive or even migrate for long periods. A 165-pound person with only 13% body fat has 21.45 pounds of fat. Being generous and assuming that you need a minimum 3% just to carry on basic survival functions, that leaves 10% or 16.5 pounds of fat to live off. At 3500 calories per pound of fat and 100 calories per mile walking, you’d theoretically have enough fat to survive weeks and migrate several hundred miles.

So maybe fat has another purpose, and this is where my friend Art De Vany’s description of fat as a toxic waste site (my words) comes in. Modern humans have so thoroughly altered foods to focus on simple carbohydrates (sugars) that we now consume hundreds of excess grams of it every day.

As Art has explained, the body recognizes excess sugar (glucose) as a toxic load – and remember, it doesn’t take a whole lot of it to be excessive – and the body starts the adaptive process of secreting insulin to take sugar out of the bloodstream and deposit it into the muscles.

Two problems arise immediately:

First, there’s not a lot of room in those muscles. Ask any athlete who’s ever tried to carbo-load for an event. Secondly, most people aren’t athletes and have lost significant utility of their muscle through atrophy, further diminishing storage. Furthermore, they don’t burn off the already-stored glycogen because they don’t exercise.

But here’s where the body has become so elegantly adaptive once again. It creates little storage facilities in the form of additional fat cells. Not because it’s trying to store calories for some future famine, as modern medicine might have you believe, but because it’s trying to find novel and effective ways to rid the body of this very toxic glucose excess.

And it’s a pretty good solution. Insulin allows glucose access to these fat cells which grow larger and more numerous over time. Problem is, it’s always one step behind, so the fat cells fill up just as the muscle filled up, leaving excess glucose in the bloodstream after the next high carb or high calorie meal until more fat cells can be made.

And so the spiral continues as 40 million Americans are headed towards type 2 diabetes.

Technorati Tags: glycogen, glucose, saturated fat, cholesterol, diabetes, type 2, carbs, sugar, insulin, obesity, Art DeVany, evolution, adaptation, evolutionary fitness, triglycerides

Posted By: Mark Sisson

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Paging Dr. Luddite

MY 12-YEAR-OLD MANAGES TO DO IT, AND HE’S PROBABLY TAUGHT THE DOG

A recent piece in the Los Angeles Times just goes to show how much room for improvement there is in the medical business…that is, the medical establishment. (Sometimes I have to remind myself.) The gist of the article is that doctors are among the most resistant to using email. Teachers, professors, lawyers – even car mechanics are more likely to use email as a way to improve and increase communication with their students, clients and customers. Yet when it comes to giving patients a helping hand by opening up the lines of communication, the medical establishment is exceptionally hesitant. Evidently, this “new” email technology is so advanced, you’ll just have to be (pun alert)…patient.

One of the Bees put it bluntly: “What is it with the medical industry’s refusal to join the world we all actually live in?”

Now, I understand that hospitals might be worried about their practitioners being inundated or wasting precious time. Like teachers, cops and nurses, docs have plenty of paperwork to do already. Here’s the obvious challenge: doesn’t that signify a need for innovation, not resistance?

Frankly, I was surprised when my G.P. volunteered his personal email address. (He’s one of the scant 25% of doctors who use email with patients.) I’ve challenged him on some things, sent him some studies, and he’s gained insights. Likewise, I’ve learned really valuable “insider” information about drugs, medical history, and what doctors really think about their patients.

Hospital and HMO executives say that the “danger” of email is that it could become very time-intensive and run the risk of burdening doctors with administrative questions instead of health questions. There’s also the issue of liability. And of being a grown-up.

But the Times article found that, generally at least, doctors are open to email. Here’s the real deal: It’s not the doctors who have a problem with it – it’s the executives. These are big boys and girls, and when they cop to pathetic excuses like “these things are just very new” – I’m actually embarrassed for them. Very new? Yes, just like cell phones and CDs.

Wouldn’t email be a great way to make the patient and doctor invest more in each other? I’m sure some whiz 20-year-old out there could even come up with some cool community interface not unlike what we’re doing here.

Of course, that would require taking some responsibility.

Technorati Tags: Mark Sisson, Los Angeles Times, medical establishment, doctors, email, HMO, technology, medical industry, hospitals, innovation, healthcare

Posted By: Mark Sisson

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