One of the great ones

Tara Parker Pope of the Wall Street Journal is one of the two best science and health reporters in America. (The other one, Sharon Begley, left the Journal a few months ago and now writes superb features for Newsweek.)

Tara Parker Pope been writing well-researched, unbiased stuff since 2000. Her mission has always been to empower people with information and that passion comes through loud and clear.

Today was her final column in the Wall Street Journal.

You can read it here.. It's very moving- and very telling.

I'll miss her greatly.

cholesterol and the subprime mortgage crisis

First things first: The term "meme" (which originated with the biologist/philosopher Richard Dawkins) means a "unit of cultural transmission"- in other words, a shared cultural concept or notion that everyone basically buys into and is in the general storehouse of "common knowledge".

One "meme" is the idea that home ownership is always better than renting. Think of all the things you've heard over the years: renting is like throwing money away. You'll make more money on your home. The real estate market always goes up. Owners are always better off than renters.

Another "meme" is that cholesterol causes heart disease and lowering cholesterol saves lives.

Today's Wall Street Journal did a great piece on the first meme: The idea that home ownership is always a good idea. Carolina Katz Reid, a grad student at the University of Washington, did a 2004 study in which she found:

1) 36% of low income people who became homeowners returned to renting in 2 years, and over 50% returned to renting in 5 years. Most never went back to homeowning later on.

2) The average price appreciation gain of their homes was under what it would have been if they'd invested the money in plain old Treasury bills.

3) The typical low-income household spent half the family income on mortgage, leaving less money for education or a rainy day

4) The typical low-income homeowner saddled with a home was less than half as likely to move when a better job opportunity came up in another city

5) The so called "tax advantage" disappeared when people had little money to "shelter" from taxes.

The "meme" that home ownership, under all conditions- especially for low income people- turned out to be a huge case of "the emperor has no clothes".

Which brings us to cholesterol.

Maybe it's time to get serious about blowing holes in the "meme" that cholesterol causes heart disease or death or that lowering cholesterol does much of anything.

This meme is so entrenched in our society, in our economy, in our way of doing business, that dislodging it is going to be Herculean task, and we may not see it accomplished in our lifetime. That doesn't mean we shouldn't try.

Jane Brody is the nutrition columnist for the NY Times, has been for years. Why a person of this monumental cluelessness should occupy a place of such importance, respect and distinction is completely beyond me. Yesterday she published her own "cholesterol odyssey". You can read it here.

I sent it on to my good friend Michael Eades, MD who wrote a reply to it on his blog. I can't do much better than he did, so I'm just going to point you there.

Let's review for the record:

1) Cholesterol does not cause heart disease
2) Lowering cholesterol does not save lives except in a very very specific select sub-population (middle aged men who have already had a heart attack)- and even then the number it saves is miniscule
3) Statins have a number of serious side effects and they are under-reported
4) To the extent that statins do any good, it is not by lowering cholesterol, but by lowering inflammation (a far more important goal than lowering cholesterol)
5) There has never been one single study- ever- of the effect of statin drugs on women


Please read Mike's blog today for a fuller report. And don't think for a moment that he's the only qualified MD who is saying this stuff. If you're up for it, you can explore the International Network for Cholesterol Skeptics website. Especially recommended: This (and other) essays by Malcolm Kendrik, MD.

cage free eggs

This morning, the New York Times ran a front page article on the increasing demand for cage-free eggs.

In it, they discussed the fact that a number of high profile businesses- among them Ben and Jerry's and Burger King- have recently announced they will only use and purchase cage-free eggs in their products. Consumer awareness that there even is such a thing as "cage free" is increasing.

OK, this is good, at least in principle. But let's never underestimate the American consumer's preference for a nice feel-good slogan over substance.

Battery cages for hens- about the square footage of a laptop computer- are horrendous, and getting rid of them is a good first step (though don't worry, not many factory "farmers" are doing it). But throwing 18,000 chickens into a barn in which each one has barely enough room to turn around isn't the perfect answer.

Cage-free conjures up images of a small, local farm where some chickens run around pecking at their natural food- worms, grass, seed- out in the open air. In practice, it's rarely like that, as Michael Pollan explains in vivid detail in his brilliant book, The Omnivore's Dilemna. To be able to legally say their products come from "cage-free" hens, producers merely have to give "access" to the outdoors, sometimes for as little as two weeks during the year. Frightened, stressed chickens that spend most of their lives in a tiny battery cage sometimes don't even recognize the outdoors, let alone bother to take advantage of the open doggie door.

If you're not a animal rights person, there are still plenty of reasons to care about the conditions under which the animals you eat are raised. Cage-free chickens from small local farms and grass-fed cows eating their natural diet have a higher content of omega-3's in their meat and eggs, and are usually free of additional hormones, antibiotics and steroids. Are cage-free and grass-fed more expensive? Sure. As Pollan says, "pay more and eat less"

I wrote about the whole cage-free/ grass-fed/ organic labeling issue in my book The 150 Healthiest Foods on Earth. I buy cage-free and organic, and without question grass-fed meat. I'm glad awareness of these categories is increasing and demand is going up.

But the danger is in letting the demand be for the label rather than the concept behind it. (Many dedicated farmers who raise grass-fed cows in the best of conditions may actually not meet the standards for the label "organic", but their product is infintely superior than the meat from factory feedlot confined cows eating "organic grain".

Let's not get too hung up on the label, and let's not lose sight of what the label is supposed to represent. What it represents what we should be demanding.

It's only a matter of time before huge factory feedlots figure out how to get around the spirit of the regulations, while complying with the letter of the law.

Then we'll have plenty of "cage-free" eggs, but not necessarily any healthier hens.

the dangers of high fructose corn syrup

From 1977 to 2001, the consumption of sugar-sweetened beverages containing fructose has increased 135%. Think that doesn't matter? Think again.

Fructose used to enjoy something of a good reputation as sugars go, largely because- unlike other sugars- it doesn't raise blood sugar very quickly. This property made it a long-standing favorite of diabetics and those who treated them. But like so much other "conventional" wisdom, this turned out to be anything but wise.

Fructose- and it's "steroid" version known as high-fructose corn syrup- have become "ubiqui-foods". They're everywhere, we consume them in insanely high amounts, and the health costs are just beginning to be recognized. New research points to some of the possible consequences.

In one study, overweight and obese adults were instructed to eat their usual diet along with sugar sweetened beverages. One group was asked to consume 25% of the day's calorie requirement as a specially made beverage sweetened with glucose. The other group was given an identical beverage sweetened with fructose. Both groups were allowed to eat as little or as much of their usual diet as they wanted, but were required to drink the sugar beverages.

Not surprisingly, all subjects gained weight. But the fructose-consuming subjects gained intra-abdominal fat, whereas the glucose subjects did not.

Why does this matter? Because intra-abdominal fat- the kind that makes you more of an apple than a pear- is the most dangerous kind of fat to carry around. It puts you at greater risk for diabetes, heart disease and a constellation of symptoms called Metabolic Syndrome, an almost certain path to either heart disease or diabetes. The fructose-consuming subjects also had increases in fasting insulin and in fasting glucose, both of which are associated with a greater risk of metabolic syndrome and diabetes.

Triglycerides have long been recognized as an independent risk factor for heart disease. In many of the previous human studies on fructose, researchers have measured fasting triglycerides, and fructose didn't always have much effect on fasting levels. But in this study, researchers measured triglycerides after eating- what's called a post-prandial measurement. In the fructose group, post prandial triglycerides more than doubled.

While the research is preliminary and needs to be borne out by future studies, high fructose consumption could well be setting consumers up for atherosclerosis. The overweight men and women assigned to drink the fructose-sweetened beverages developed a more athrogenic lipid profiles in just two weeks.

Consider that In 2006 five different publications came out showing that adolescents, college students and adults under 50 were consuming as much as 15-20 percent of calories just from sugar sweetened beverages- and that doesn't include the sugar calories from cakes and desserts. Most of this sugar comes from high-fructose corn syrup.

Do the math.