Red Meat and Your Health

      This article is long overdue.  I've touched on red meat before, and whether or not it contributes to chronic diseases like coronary heart disease, diabetes, and cancer, but I've been meaning to do a more comprehensive write-up on it.  It's time to drive a stake right through the heart of this whole red meat = death hypothesis, because to be honest the idea is completely absurd.  I think you'll be amazed at how easily this myth falls; it doesn't take much when it's built like a straw house, just ask the Three Little Pigs.  And hopefully then we can all stop poo-pooing on red meat and enjoy a steak.

Firstly, let's clarify something... no one has ever proven that red meat causes heart disease, diabetes, cancer, or any other chronic disease.  In fact, there hasn't been a single randomized, clinical trial conducted on the subject.  The best we can say for sure is that red meat is associated with all of these diseases.   In other words, people who consume more red meat tend to have an increased chance of developing these problems.  I'm not arguing that fact.  Many studies have demonstrated this association and it is a relatively consistent finding.  What I am arguing, however, is that there are several key factors that explain this common link between red meat and chronic disease, and none of them involve red meat being inherently deadly.  Prepare yourself for a series of truth bombs...

My Thoughts On Obesity

The other day in one of my classes, we began a "Weight Management" unit, which is one of my favorite aspects of nutrition.  Despite the fact that I've never had a weight problem, I find it fascinating learning about what makes people gain weight and how to lose it.  But I was quickly reminded how much I completely disagree with the conventional model.  Or maybe I'm being nice... let me rephrase that.  The conventional model is completely wrong.  Allow me to explain myself...

The conventional model of obesity is as follows:  Eat more calories than you expend and you'll gain weight.  To paraphrase my professor, it really is just a simple math equation.  And for weight loss, burn more calories than you take in and you'll lose weight. That's not the part I disagree with.  That is an established fact.  But the problem is that conventional obesity paradigm ends there.  Really?? That's it?? I'm paying for a top quality nutrition education, and we're not going to delve any deeper than that?  I would expect this in a high school health class; you don't need to bother high schoolers with the finer details that they likely wouldn't even care about.  But this is an advanced course in nutrition... I expect more than the "all you need to lose weight is a calculator" mentality.

This calories in, calories out model of obesity says that if you've gained weight, you've consumed more calories than you've burned, but it does nothing to explain why someone has consumed more than they've burned.  Imagine walking into a room full of people.  You ask someone, "Why are there so many people in this room?"  And the response you get is, "Because more people entered the room than left it."  That would be a stupid answer, something a 2nd grader might tell you when they first learn about addition and subtraction.  But that is essentially the same as telling someone they got fat because they consumed more calories than they expended.  It's obvious, but it doesn't really tell us anything about why that is the case.  While excess caloric intake causes obesity, you can go much deeper than that (that's what she said).

New Study: Low Cholesterol More Deadly Than High Cholesterol

I hate to say I told you so.  But I did.  Like a million times.  Yet, the fear of cholesterol continues.  What is it?  Is it the Lipitor ads?  Is it your cholesterol-phobic doctor, determined to get your cholesterol under 200 mg/dl at all cost?  Whatever it is, it's about time we stopped worrying so damn much about high cholesterol.  This new study, entitled "Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid?  Ten years prospective data from the Norwegian HUNT 2 study.", shows us why.  Did anybody hear anything about this one in the media??  I didn't think so, not with a catchy title like that.  At least now the 3 people that read my blog will be aware of it.  The researchers followed 52,087 Norwegians aged 20-74 who were free of cardiovascular disease (CVD) for 10 years, then assessed the relationship of total cholesterol with total mortality, CVD mortality, and ischemic heart disease mortality (IHD).  (Just to be clear, CVD mortality signifies deaths from any disease of the cardiovascular system, while ischemic heart disease refers only to diseases involving restricted blood flow to the heart.)  Let's jump straight into the data then, shall we?  And another note:  since this study comes from Europe, the units for blood cholesterol are shown in mmol/L, rather than the mg/dL that we are used to.  The researchers classified the participants into four groups, based on their blood cholesterol.  Here are the converted unit values in mg/dL for the four groups...  <193, 193-229, 230-269, and >270

First, the least shocking data.  This graph compares the association between cholesterol levels and death from ischemic heart disease.  For the men, it looks like there's not much variation.  Deaths from heart disease rose slightly along with cholesterol levels, but nothing dramatic.  Women, on the other hand, yielded a much more interesting result.  Clearly, by a LARGE margin, cholesterol below 193 mg/dL was most predictive of death from heart disease.  All other groups, including the group with cholesterol over 270 mg/dL, showed significantly lower risk.  Yes, seriously.  On to the next graph!

Why Stomach Acid Actually Prevents Heartburn

GERD (gastroesophageal reflux disease), or heartburn as it's commonly known, is the most common digestive disorder in the United States; approximately 10-20% of Americans experience symptoms at least once a week.  Conventional treatment is to take antacids.... chances are you've probably used these drugs at one time or another.  Tums, Zantac, Pepcid... ring any bells?  Or if you're really serious about your heartburn, maybe prescription Nexium?  Drug stores sell these things like candy.  Literally.  Tums is placed right next to the candy and gum in the checkout area, and for the first ten or so years of my life, I thought it was candy.  On the prescription side, Nexium was the number two best selling prescription drug on the market in 2006, just behind Lipitor (don't even get me started), bringing in $5.1 billion.  People generally find heartburn relief in these medications, so all is well right?  Not quite.

Although this topic may seem tame, there is more than you know going on behind the scenes.  I recently read a fantastic set of articles by Chris Kresser about the physiology and treatment of GERD that brought this to my attention.  It's a long six-part series, something I probably wouldn't have made time for if not for the combination of my iPhone and a boring afternoon class.  Since I will be summarizing a large amount of material here and simplifying some of the concepts, it would be unrealistic for me to cite all of my claims like Chris did.  So if you don't believe me, just refer to the link above.

For starters, let's talk about what exactly GERD is.  Out of Taber's Medical Dictionary, GERD is:  "A common condition in which acid from the stomach flows back into the esophagus, causing discomfort and, in some instances, damage to the esophageal lining."  You see, there is a one-way door between the esophagus and the stomach called the lower esophageal sphincter.  In digestion, food moves through this door to the stomach, and when everything is functioning correctly, nothing comes back up.  In GERD, small amounts of stomach acid are able to creep up into the esophagus, causing burning and damage to the wall of the esophagus, which can lead to a number of problems including esophageal cancer if left untreated.

Poking Fun at the Lipid Hypothesis

Quick one today about saturated fat and cholesterol.  If you haven't noticed, I really get my jollies off by poking fun at the lipid hypothesis.

Ancel Keys, the man largely responsible for convincing everyone that saturated fat clogs your arteries and gives you heart disease, published a few observational studies on the subject in the 1950's.  While his data showed a clear association between a high fat intake and increased risk of heart disease, the studies were extremely flawed.  Keys essentially cherry-picked the data from certain countries that would support his idea.  See this for a full explanation.

So, I thought I would share with you today some other, more convincing data on saturated fat consumption and heart disease death risk.  The following tables were assembled by Dr. Malcolm Kendrick, using the 1998 data from the World Health Organization.  He sorted through all of the data on European countries and found the seven countries with the lowest consumption of saturated fat, along with the seven countries with the highest consumption of saturated fat, and compared their death rates from heart disease. 

Here are the seven countries consuming the least saturated fat:

And here is the data on the seven consuming the most saturated fat:

At first glance, you may do a double take.  But your eyes are not deceiving you... the countries consuming more saturated fat are suffering fewer deaths from heart disease.  The country consuming the most saturated fat, France, consumes approximately three times more than the country at the opposite end of the spectrum, Georgia, but at least six times more Georgians die of heart disease.  These numbers are not made up guys.  This is real.  In fact, every single one of the seven countries with the lowest saturated fat consumption has significantly higher rates of heart disease than every single one of the seven countries with the highest saturated fat consumption.  Now, explain to me again how saturated fat causes heart disease...

Grass-Fed Beef vs. Grain-Fed Beef

The popularity of grass-fed beef has been on the rise lately, thanks in large part to the various pieces of media that are exposing the horrors of conventional meat production.  In my case, it was the film Food Inc. and Michael Pollan's outstanding book The Omnivore's Dilemma that brought the issue to my attention.  For those of you who don't know what I'm talking about when I say "grass-fed beef", here's a brief explanation:  Cattle have evolved over time to eat grass.  They get all the nutrition they need from grass alone.  However, in modern beef production, cattle are fed a diet of mostly corn and other grains, which can cause all sorts of health problems, but it fattens them much more quickly and increases production.  While this allows farmers to produce more beef faster, the whole process is extremely wasteful and destructive to the environment.  And although the price on the beef you see in the supermarket is affordable, this does not in any way reflect the true cost of that beef.  When you factor in all the corn grown specifically to raise the cattle, the antibiotics needed to keep them in decent health, and the environmental problems, just to name a few of the costs, the actual price of that beef looks a little different.  The only reason it's available to consumers at such a low price is because of government subsidies.  As a result of all of this, an increasing number of people are opting to seek out grass-fed beef, meaning that the cows only eat grass and are allowed to graze in fields as they please.  This type of beef production is healthier for the cattle, better for the environment, and is a much lower-input process overall.  In addition to the philosophical reasons to choose grass-fed beef, though, there are a number of nutritional benefits as well, and that will be my main focus for today.

Do Cholesterol-Lowering Drugs Save Lives?

If you read my last post about cholesterol-lowering drugs, then you understand some of the problems that can arise from their use.  Statins can produce some nasty side effects.  But side effects aside, statins save lives right?  I mean, doctors prescribe them to just about everyone, they must be effective.  Not quite... the story is not as simple as it may seem.

When looking at the statin drug clinical trials, it's important to keep a few things in mind.  Firstly, and most importantly... total mortality is more important than heart disease mortality.  If a drug prevents you from dying of heart disease but doesn't affect your chances of dying in general, then that drug is not worth taking.  What's most important is whether or not the drug will extend your life.  Secondly, you must consider that different groups of people may respond differently to the drug.  Women, middle-aged men, the elderly, and those with preexisting heart disease may all respond differently to treatment. 

I'd like to begin by talking about women... both because I like women, and because they don't respond well to statins.  Although many statin studies notoriously neglect to reveal the all-cause death data for women, there are a few studies that do.  Check out the Scandinavian Simvastatin Survivial Study (4S), which was one of the most positive trials to date.  The big pharma folks must have been partying it up when this one came out.  This was a secondary prevention trial, meaning that participants all had pre-existing heart disease (previous heart attack or angina).  For future reference, a primary prevention trial would be an experiment in which the participants did not have pre-existing heart disease.  So, half of them took simvastatin and half of them took a placebo.  The results were great across the board: heart attack numbers were reduced, along with deaths from heart disease and all-cause mortality.  But there was one group that clearly didn't benefit:  women.  Over the duration of the 5.4 years of the trial, 27 (6.6%) of the women taking the statin died, while only 25 (6%) of the women taking the placebo died.  So despite the rest of the data, which was very supportive of statins, there was actually a slight increased risk of death in women from taking the statin.  As you'll soon see, this finding is consistent throughout all of the statin trials, yet it is completely ignored by mainstream medicine.  These drugs simply don't work for women.