What I see everyday. Stroke, Dementia, heart disease

(karen) #26

No no no, life is short BECAUSE it’s sweet! Life should be long and salty, like bacon. :stuck_out_tongue_winking_eye: :hugs:

(Ken) #27

OK Doc, I’ve a question for you. Since HDL, if I read it right, has the ability to reduce amyloid plaque and threrfore alleviate Athero, what role does circulating ketone bodies play? I have always considered it probable that they also play a role in plaque reduction as they are essentially solvents, so their effect would be similar to the effects of alcohol on chronic alcoholics, preventing the accumulation, of plaque.

(Milton Alvis, MD) #28

Amyloid refers to proteins: https://www.google.com/search?q=Amyloid, Not atherosclerosis.

Plaque is a catch-all term for accumulations of materials within tissues in many different diseases, including around teeth, under gum line. It is not at all specific for atherosclerosis.

Atherosclerosis is an accumulation of living and dead white blood cells within the walls of arteries. The cells are ingesting fat carrying lipoprotein particles which have become oxidized. The overlying endothelial cells express surface proteins triggering monocytes to stop, squeeze out between gaps between the endothelial cells into the space below the endothelial cells, transform into macrophages and ingest the oxidized lipoproteins.

If the macrophages stay too long, ingesting more and more lipoproteins, become foam cells (refers to their appearance under a high resolution microscope, oil-immersion lens) and subsequently die in place releasing all their fat membranes and ingested fats, then the atherosclerotic process starts and can proceed.

Typically starting in childhood, the disease become more and more complex over decades, though the muscular wall of the artery stretches out to make room for the accumulations, thus zero lumen narrowing or symptoms for decades until plaque ruptures, debris and clots block blood flow; most events without symptoms which people or physicians ever recognize.

The old term “fatty streaks” was started by a pathologist who thought the early deposits (autopsies of children who died for other reasons) looked (grossly) like fat deposits under the endothelium lining of arteries (even though no adipose cells are present) over atherosclerotic deposits.

Lipoproteins are complex assemblies of proteins (made & excreted into extracellular water by liver and intestinal cells) which transport all fats (lipids in medical jargon). They have long been divided into 5 major groups by density compared to the surrounding water and are the primary driver over atherosclerosis, as first published 1950: http://goo.gl/QMpZiI.

The separation method was density compared with the surrounding water. Thus: Higher Density than Water Fat Carrying Proteins (HDL), Lower Density than Water Fat Carrying Proteins (LDL), Intermediate Density compared with Water Fat Carrying Proteins (IDL), Very Low Density compared with Water Fat Carrying Proteins (VLDL) & Ultra Low Density compared with Water Fat Carrying Proteins (ULDL). The last group historically called Chylomicrons, and the only ones, if very large (~1,000 microns), can be seen under a light microscope.

A single LDL particle typically transports ~3,000-6,000 fat molecules.

Which fat molecules? Whichever ones are present. Cholesterol (made by every animal cell on the planet: https://en.wikipedia.org/wiki/Cholesterol) is only one of the fat molecules being carried.

For comparison, red blood cells are typically ~7,000 to 8,000 microns outside diameter yet routine pass through ~5,000 micro capillaries because of their biconvex shape & ~30% cholesterol molecules within RBC membranes which enables flexibility (researchers use the term “fluidity”).

LDL through ULDL fat carrying proteins are fat delivery particles to cells throughout out entire body. HDL particles are fat remover particles.

HDL particles have also long been divided into 5 subgroups. By what characteristic? You guessed it: density compared with surrounding water.

If HDL particles remain small flat disks with a single Apo-A organizing protein, like out body makes them, are they carrying any fat? No, fat molecules take up space and enlarge the particles if being carried.

So which of the 5 sub-groups of HDL particles correspond to lower rates of cardiovascular events? Only the two largest. Liposcience terms these two groups Large-HDL (very practical).

ZERO evidence (or reason to believe) that ketone bodies, a complex group of molecules (from liver gluconeogenesis converting fats into glucose), have any value for atherosclerosis regression.

Physiological processes, though compliant with all known chemistry principles, are vastly more complex than just simple inorganic chemistry.

HDL particles are fantastically complex, 1, 2 or 3 Apo-A proteins per particle (depending on size) along with 80 to 100 helper proteins (still poorly understood) and many issues, including how they function, share fat molecules back to LDL particles (a CETP function) remain poorly understood.

The most potent Apo-A for atherosclerotic regression is Apo-A-Milano, a rare mutant form of the Apo-A protein, first discovered in a few residents of the small isolated town Limone sul Garda in northern Italy in the early 1980s.

After about two decades of expensive research by Esperion pharmaceuticals and impressive results to reverse atherosclerosis (in only 5 weeks in a small trial of administering two different doses of Apo-A-Milano, produced in E. coli bacteria, compared with placebo: https://jamanetwork.com/journals/jama/fullarticle/197579), the over four decades of work on Apo-A-Milano and hundreds of millions spent in research, still no commercially available variant exists which works.

Jim Otvos’ methodology and his company: LipoScience (which developed the Vantera analyzer, https://www.youtube.com/watch?v=OkKn4pLY3AU, over two decades of expensive entrepreneurial research work) remains the ONLY available both validated & reasonable cost technology to measure both lipoprotein particles and particle size.

Yet there remains a huge number of poorly understood issues & commonly promoted yet untrue ideas, including among researchers.

The medical industry has long promoted simple attractive-sounding ideas which turn out, over time (with very slowly advancing knowledge) to be bogus, not infrequently harmful.

Living creatures are high-tech, medical industry low-tech and science is only a method, extremely difficult to perform well, routinely promoting ideas which turn out to be not true. Study: http://goo.gl/Blh6rW

Another basic issue: Living creatures reflect extremely complex engineering. Yet do most physicians have much, or even any, engineering experience? No!

The video “Science For Smart People” is a reasonable introduction: https://www.youtube.com/watch?v=y1RXvBveht0

What group of people started promoting cholesterol even though they knew, from over 20 years of research, that it was not the correct issue?
The government (nearly 2 decades after starting Medicare), specifically the NIH.
Why?
Money. (In the 1970s: Several hundred for cholesterol, ~$5,000 for lipoproteins.)
Why?
Less expensive to measure.
But does cholesterol correlate well with LDL particles?
No! Commonly quite discordant.

What is the average cholesterol, in the US (from over 2 decades of retrospective data), prior to people having obvious heart attacks (ST-elevation myocardial infarctions, in medical lingo). Answer: 170 mg/dL, which the government continues to term “normal”.

Medicare has fully paid for NMR lipoproteins since available in the later 1990s.
What does LipoScience (Now owned by LabCorp) charge for NMR lipoproteins? ~$80.
Is it available for a lower copay when commercial insurance will not pay?
Yes. ~$14 when sent via Cleveland (thought the Cleveland Heart report presentation is very misleading compared with the LipoScience presentation.)

Milton Alvis
http://www.PureHeartSmart.com

(Edith) #29

Thanks for taking the time to write such detailed explanations.

(Chrissy Calabrese) #30

Great rant! That’s it! I was telling my best friend that I was blessed to have a father who was reading the nutritional literature and cutting edge nutrition in the 1960’s. He applied it to our eating at home and I saw him, juice, drink flax seeds, eat all kinds of interesting things and take lots of supplements but most of all he cultivated a culture of concern. His 4 children grew up with this and we all work at it. There are some things, we can’t control but we can certainly lower our exposure and give ourselves a fighting chance.

Thanks for the rant and keep it up!

(Bunny) #31

Even if the Ketogenic Diet is not something one would want to follow or adhere to, too much sugar is the number one concern whether it comes from carbs, processed carbs or sugar itself.

Simply staying away from processed foods and why eating too much sugar and carbohydrates is bad for us is a start without the “keto” connotation when we play with the “Ketogenic Diet-LCHF” terminology that is like asking asking for a war, you may win the battle but you won’t win the perpetual war with fascist corporate control of governments, if your not eating the sugar and processed carbs, they make no money and pharmaceutical companies go bankrupt, including the banks themselves (Ludwig).

Every time we slam down massive amounts of sugar and processed carbohydrates like there is no tomorrow, the set point (Fung) damage begins, like winding a spool of thread that takes an equal amount of time (months-to-years) to unwind, the type of foods we eat today are not something we would conveniently have acccess to, if there were no processed foods to eat let’s say 1,000 years ago…

Most of the health problems that lead to mortality could be reduced and possibly snapped out of existence if some very sane and basic principles (lowering sugar intake with a little more fat) could be implemented with-out the emphasis being placed on a hardcore Ketogenic regimen?

Eating Whole Organic Natural Foods (metaphor; straight from the vines of Eden or hunt and gather?)

Excessive\Un-natural:

Processed foods;

Processed oils/fats (oxidized/rancid)

Grains (not used within 48 hours of being milled)

Refined Starches

Refined Sugars

Meat if processed even with LCHF?

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High fiber all-bran cereal with zero net carbs - Keto friendly?
(Milton Alvis, MD) #32

You are welcome, a complex topic.

Because of your thank you, I added some additional highly relevant detail.

(Ken) #33

My thanks as well. An excellent explanation. It has relevance to myself, as I’ve been eating the fat based, glucagon secreting, lipolytic pattern for nearly 20 years now. I certainly hope my athero risk now is minimal, and your HDL explanation leads me to believe it, although I suspected ketones were involved as well.

I wonder why athero deposits are referred to as amyloid plaque is so many articles on the subject? Your explanation makes much more sense, especially in regard to embolisms. Also, do you consider Athero, in some degree, is a reaction to hyperinsulinemia?

Thanks again.

#34

I am also in the medical field as a Nurse Practitioner in a large hospital. I see the same. Day after day! I occasionally have the opportunity to share keto and IF with some patients, but I am walking a fine line. I am tired of seeing patients going for amputations and dialysis and they are not taught that they can help themselves. It breaks my heart.

#35

What breaks my heart is that for so many years as a coronary care nurse I instructed patients about eating low fat, lots of grains and low salt!!
I really feel bad about it now, but it was what we were told was the standard of care.

If I had the energy, I would retrain as a nutritionist/dietitian and try to right the wrongs I have caused, but all I can do at the moment is try to influence those around me.

(Clara Teixeira) #36

I am equally frustrated but see things from a different perspective. I work with 2 yr olds in a day care setting on a daily basis and it breaks my heart to have to convince them to eat the food that is packed for them by their own parents. Many don’t want the sugary coated grain products and some cry that their stomachs hurt after a few bites. Chronic skin rashes, bloated bellies, terribly swollen tonsils, and bad coughs are always present. I want so badly to just tell the parents to stop it already. They are giving their children eating habits that will land them in an early grave. As a toddler teacher I am encouraged to eat my lunch with the children to help provide a family atmosphere and they are always asking questions about my food. Wanting to grab it and watching me eat it. There is something primal in the way they want the fatty cuts of meat I pack. Sadly I can’t share it with them!

(Kern) #37

Thanks for the rant. It is really the truth. I am a Pharmacist, still licensed, 75 years old, and been doing keto now for 1 year. The results for me are encouraging. I just did a presentation for the WNC Keto Lifestyle Meetup group here in Asheville this past Tuesday 6/19/2018. I have done diabetes presentations before,and also have done vegan presentations. However, keto is the way to go.
I guess its all right for me to give my email: stronghands1@gmail.com
Appreciate feedback,suggestions as to how to wake up the diabetic community which has been lulled to sleep by Big Pharma.
My presentation shows the progression of diabetes when the patient does not take care of themselves and continues to eat upwards of 320 grams of carbs daily (Mayo Clinic). Chasing carbs with a needle is stupid. Reducing carbs and sugars will let the body heal itself. Unfortunately, doctors have tie-ins with Big Pharma, and are NOT truly educated on how the body metabolism works. Also, most do not even dco the Fasting Insulin Blood test which tells how much insulin the pancreas is putting out. Fortunately here in Asheville, NC we do have some doctors that can think outside the box. Thanks again. Just keep on keeping on the KETO and let the stupid ones continue to be stupid.

(Kern) #38

My email: please copy this to your email, the email that reddit uses I cannot get as it does not go through. Just thought I would make note of that.

(Empress of the Unexpected) #39

You are exactly right. We have a friend with T2D, and numerous other health problems. His friend and I have tried to talk to him about diet. He once ended up in a coma in the hospital for three days. His answer: “Not a problem, since I had cheesecake and a sandwich, I will just go to my truck and inject some insulin.” How does one get through to people like that? So many people think a pill is the answer.

(Empress of the Unexpected) #40

Oh, another horrid example. My boss has Type 2. He is obese, which contributed to his needing a knee replacement. He was excited about the surgery, but when they did pre-surgey blood, his doctor said his blood glucose was way too high to tolerate surgery. He was so bummed. He was put on two new drugs, and during the visit the doctor said: “Bet you didn’t think diabetics could eat ice cream? Well once in a while it is okay.” So, of course, that’s like telling an alcoholic that a drink once in a while is okay. My boss: Went out to lunch and had a large coke, large fries, hamburger and THREE ice creams… Why on earth would a doctor encourage such a thing? But then again, he has admitted to me that he can’t give up the beer and bread. So, it comes down to commitment. But doctors should not be enablers.

(Kern) #41

Yeah. There is an inherent built-in denial system that mentally wants the status-quo to always be the same. He wants his lifestyle not to be interfered with, and thinks insulin is the answer so he can go on living the way he
wants to.

Actually, a doctor’s diagnosis is really a form of a curse provided by hypnosis effects. Think about this: the patient knows nothing about his body, does not understand food, and the dr says you are diabetic.

The dr is like a god to him. G-d has spoken. (God or g-d…universe, “the force”) whatever suits. The patient’s mind is wide open to receive, and this goes deep, and they think they cannot avoid whatever diagnosis (curse) is put on them.

No, its just that I see people succumb to this, and knuckle under.

I got a doctor mad at me because I refused bypass surgery…wrote up my adventure in Well being journal, Jan Feb 2006…“Bypassing the suggested bypass”. That was Feb12, 2004, discharged from hospital as NOT having a heart attack. 14 years ago. Dr. was furious I would not have a stent or bypass. Went on a vegan diet, got some chelation, so far I’m still here.

I appreciate the ketogenic forum, and those in the WNC keto lifestyle group. I had to surround myself with as many alternative out of the box thinkers as I could to stay healthy.

Keep on keeping on.

(Kern) #42

DIABETICS SHOULD NOT AND CANNOT EAT ICE CREAM. The "doctor’s a fool. How many is he killing with that attitude? The fact is that doctors ARE telling the typ2d that the pill or the insulin will take care of the diabetes. The patients are fools to accept that. The built in denial system is working well with some people.
OH: I use the My Fitness Pal to record what I eat…carbs, sugars, fats, protein.
Keep on keeping on.
“Live well and Prosper”
Kern

(Kern) #43

hey, jennyellen
the training for nutritionist/dietitian in the normal channels is guided and controlled by Big Pharma.
If you do that, find something out of the box that is real and to the point.
You would be fighting uphill battles constantly. through regular channels.
just a rant.
Kern

(Kate) #44

HI Mark,
I’m 62, so you and I probably had similar eating habits as kids. I have been low carb since 2013 and I flirt with ketosis, but I don’t measure blood ketones. I live in a pretty affluent area in the US, where everyone tries to be health conscious, but the tidal wave of sugar and “vegetable” oils is drowning us.
The two books that started me are Nina Teicholz’s “Big Fat Surprise” and Gary Taubes’ “Why We Get Fat and What to do About It.” Both are very readable, and at least for me, life changing. Look up Dr. Jason Fung on line. He has three books out, but there are lots of YouTubes and other free resources available as well.
Good luck!

(mark) #45

Yes, I was born in 1961 in Queensland Australia. If you’ve never been here? its similar to the States, but with fewer people yet still big. I imagine that the diets would be similar as well.
Thank you for the reading suggestions ill look them up. I’m sick of all the conflicting info I read about whats good and whats not, I think the greeks have the answer.
As Spock would say live long and prosper.
Mark.