The Food Policy Institute at the Consumer Federation of America just published a report showing the amount of carbohydrate and the number of calories in the 26 best selling alcoholic beverages.

The report is in chart form in pdf format. You can download it here.

Put it on your refrigerator or keep it some place handy, so that you’ll at least know how many carbs and cals you throw back when you quaff one or five or your favorite drinks during the hot dog days of summer.

And remember as you’re trying to lose weight the oh-so-true quote (from I don’t know whom – I’ve seen it attributed to several, including Mark Twain):

Will power lasts about two weeks and is soluble in alcohol.

Truer words were never spoken. My will power last night became soluble in the alcohol found in two margaritas. It became way soluble in the Johnny Walker Blue generously provided by my brother in South Carolina at his daughter’s wedding a couple of days ago. Had I had this nifty chart with me, I could have calculated the damages in real time.

I just sat down to deal with the 45 or so comments that have stacked up over the past few days and somehow deleted them.  The comment that was the top one on the list was a spam comment.  I thought I checked the box next to it, but somehow I checked the box (that was right above it) for all comments and hit the Remove Spam button.  Suddenly all the comments were gone.  I’ve fiddled around for the past half hour or so trying to get them back, but to no avail.  They are history.  If you’ve had a comment pending, I apologize.  Please resend.

One of the reasons this happens is that most of the comments aren’t comments – they’re questions.  If I don’t have the time to answer them, they stay in the awaiting moderation queue.  They stack up until I have some downtime to sit and answer them.  As of late, I haven’t had much time, consequently the questions stack up.

I think I’m going to start doing like everyone else who blogs and simply post the comments as they come in without answering them individually.  Many are asking the same general questions, so they can be answered with one comment from me instead of multiple individual responses.  We’ll see how that works.

Once again, I’m sorry if your comment got zapped.

I have a close friend who was an investigative reporter for the Wall Street Journal for 13 years, during which time he broke a number of large stories. He left the WSJ to start a company to help businesses deal with the media. He had seen from the inside how businesses had tried to influence him and his colleagues, and he knew the business men were going about it all wrong. For the last 15 years or so he’s helped them get it right.

A couple of times per year my friend puts on seminars for people wanting to learn about how the media work. He invited me to one a few years ago in Las Vegas, and I can tell you, it was an eye-opening experience. The program started with my friend asking the attendees to write a few sentences describing what they thought constituted ‘news.’ Before you read on, stop for a moment and come up with your own definition of news. Have you got it? At this meeting virtually everyone (including yours truly and his lovely wife) came up with something on the order of: ‘News is when something happens of sufficient importance to the readers or viewers of a particular media format in a defined local (could be local – could be national) that it requires reporting.’

My friend gathered the papers and started reading them to the group. One after the other was a variation on the theme above. After he had read a dozen or so, he looked at the crowd and said: “Let me define news for you. News is what the media wants you to know.”

In the previous post I wrote the media wanted you to know that the Atkins diet was dangerous, so that’s how they reported it. A reported went in to an oral poster presentation, a tiny sub-meeting of the larger overall meeting, and reported on non-peer reviewed data in such a way as to make a perfectly safe and sensible way of eating, practiced by literally millions of people over the last 30 years, appear to be a danger to health. That’s news because that reporter and his editors said it was.

I’m stressing this because the American Heart Association (AHA) also reports the news, which, in its case, is what it wants people to know. The AHA has an entire publicity arm that sends reports out to doctors all over the world telling them what the AHA wants them to know. And guess what? In none of these reports is the study on the Atkins diet mentioned.

I got these reports by email for every day of the conference. You can click on them by day – Sunday, Monday, Tuesday and Wednesday – to see what the AHA wanted doctors interested in this conference to know. If you burrow down into all the links and follow where they lead, you’ll find that none of them (at least none that I could find) lead to the Atkins diet presentation. Probably because the study wasn’t very important relative to the others, and because any one with a modicum of scientific understanding would see right through it.

But not the public. Members of the public aren’t trained to even find the relevant study much less analyze it critically. So that’s where the reports were sent. To the public. Not to the doctors. I find it interesting to say the least.

One other thing, then we’re through with this travesty of a study. A number of people wrote comments wondering about the inflammatory markers that went up in the folks who went on the pseudo Atkins diet. Here is the full text of a study done by Jeff Volek and his group at the University of Connecticut showing that real low-carb diets bring about a decrease in inflammatory markers. And here is another demonstrating that real low-carb diets bring about improvements in atherogenic lipid profiles in subjects who do not lose weight. So, it’s the diet that does it, not the weight loss that usually accompanies such a diet.

As a group the elderly are keenly health conscious. Probably as a percentage of their population more elderly try to eat right and take care of themselves than any other group. And with good reason since the Grim Reaper is lurking right around the corner waiting to harvest them at the earliest opportunity. Senior citizens have seen their friends and relatives succumb to disease and realize more than most how precarious life really is.

But the elderly have a problem. Most of them get their health information from the mainstream press. And as regular readers of this blog know, the mainstream press is more often wrong than right. (See Gina Kolata’s review of Gary Taubes’ book in last Sunday’s New York Times and you’ll see what I mean.)

Based on what they read in the press, most people of retirement age or beyond are busy cutting the fat and cholesterol from their diets, obsessing on their cholesterol levels, avoiding saturated fat like death, and loading up on plenty of complex carbs. If these folks have a cholesterol reading that’s a little above ‘normal,’ their doctors usually start them on statin drugs. And these patients take them religiously.

Problem is as I reported earlier, the statin drugs have never been shown to be effective in preventing illness in people over 65. In fact, the opposite has been shown – elderly people taking statins are more likely to die from cancer. But their doctors don’t know that because they have been sold a bill of goods by the pharmaceutical industry working feverishly to tap the elderly as a source of revenue for statins.

The majority of the medical data out there shows that a higher cholesterol is correlated with better health and longevity among the retirement set, but few of them know it. And fewer yet know that a lower cholesterol level is associated with cognitive decline.

If there is one thing that elderly people fear more than heart disease and cancer it is probably Alzheimer’s disease or any kind of mental decline. Unfortunately, their fixation on their cholesterol levels are herding more and more of them in that very direction.

The brain represents about 2 percent of a person’s overall weight yet contains about 25 percent of the cholesterol in that person’s body. Just those figures alone ought to tell you that cholesterol is pretty important in cognitive function, but most people aren’t aware of those figures. And won’t learn them from the mainstream press (which get’s its info from the pharmaceutically-driven medical press), but will continue mistakenly to think of cholesterol only in terms of heart disease risk.

A group of researchers in the Netherlands did a study looking at cholesterol levels and cognitive decline and found that the elderly with the highest cholesterol levels were able to think better than their counterparts with low levels of cholesterol. Their paper has been accepted by the journal Neurobiology of Aging, and is awaiting publication.

The researchers divided a group of 1181 elderly people (ave age 75) into groups of high cholesterol, medium cholesterol and low cholesterol levels. They administered reliable tests designed to determine general cognitive function, memory and information processing speed. Across the board subjects with the highest cholesterol levels performed the best, followed by those with medium cholesterol levels. The group with the lowest cholesterol levels performed the worst.

The scientists followed these groups of people for about six years and found that all groups followed about the same trajectory of mental decline, but the group with the highest cholesterol levels ended up with better function than the other two groups simply because they started from a better position at the beginning.

The research team also studied members of the group of subjects who were carriers of a certain genetic marker that is associated with greater rates of Alzheimer’s disease. The folks in this group that had the lowest cholesterol levels had a more precipitous decline in mental function over the six years than did those who had the same genetic marker but were in the high cholesterol group.

This is not the only study that has shown the cholesterol is protective against cognitive decline – it’s only the most recent. And I doubt that you will read much about it in the mainstream press. I doubt that it will be picked up by every newspaper and TV news station as was the idiotic ‘study’ that was totally misreported on red meat and colon cancer that I posted about earlier.

It’s truly unfortunate that our parents and grandparents who are so desperately trying to maintain their health are so wrapped up in trying to rid themselves of the very molecule – cholesterol – that will do the most to keep them from falling prey to the cognitive decline they dread so much.

If you want to improve the health of your elderly relatives, the best thing you can do is hide their statins and buy them a steak dinner.

A commenter today made me remember yet another reason that observational studies such as this one are never to be used to determine causality that I didn’t mention in the original post. It’s important enough that I want to post it here so that those who don’t read the comments and/or my responses to them will read it as well. Here is my response to the comment:

Another big problem with these studies in which researchers arbitrarily place certain foods in certain categories then use these categories to determine which is best is that there is room for a ton of hanky panky. For example, in the colon cancer study fruit juice ended up in the prudent dietary pattern category. Why? Because the researchers volitionally put it there. Many studies have shown fruit juice to be little better than sugary sodas in terms of what they do to one’s metabolism, so fruit juice could just as easily have been placed in the Western dietary pattern category. Ditto for a number of the other foods categorized. What this means is that the researchers could have (and I’m not making this accusation; I’m simply pointing out the possibility) fiddled with the data to get it to come out how they wanted it to come out. Let’s say that fruit juice was first in the Western dietary pattern, and when it was there the overall outcome changed. There was no difference in rates of death between the two categories. So one simply moves fruit juice to the other category and runs the program again, and Viola! there are more deaths in the Western pattern. With all the variables from which to chose, it’s easy to manipulate these kinds of studies to get the results one wants.

American tourist at Dauchau

A type of activism called fat acceptance activism – or in the words of all the isms we’re now afflicted with: Sizeism – is currently on the move. Overweight people who are the movers and shakers of the various fat acceptance groups are trying to make the point that it’s okay to be overweight and that one should revel in one’s fatness and not try to deal with it. I don’t really have a problem with this way of thinking as long as people are willing to accept the risks that ride along on obesity’s coattails.

I think it’s fine that overweight people are trying to gain acceptance. I don’t believe that they should be discriminated against anymore than I believe people with leukemia or high blood pressure should be discriminated against. But, obese people need to realize that in the vast majority of cases their obesity is self inflicted.

I can’t tell you how many patients I’ve seen in practice who say these very words: Doctor, I just can’t understand it. I almost don’t eat anything at all and I can’t lose weight. My husband (it’s usually a female patient that says this) eats everything and he never gains weight. As we’ve seen self deception is an easy task.
I’ve made it a hobby to watch people at all-you-can-eat buffets, and what I see is obese people piling the food on their plates- mainly high-carb food – and going back for more. Thin people go back to their tables with small plates of food. I often wonder how many of these people with the huge plates of food are telling their doctors that they don’t eat much of anything at all yet still can’t lose.

People who tell me that they almost never eat and still can’t lose weight drive me nuts because I know it doesn’t work that way. It puts me in a bad position because I know they’re either fooling themselves or trying to fool me and I either have to nod my head in understanding or basically call them liars. It’s a tough spot.

On our recent trip to Europe MD and I spent a day at Dauchau, the first Nazi concentration camp and the model for all the others. It was a sobering but incredibly interesting experience. Throughout the facility there are photos of the camp inmates during the years the camp was in operation (1933-1945), and I didn’t see a single fat person. These were truly people who “almost ate nothing at all” and they were all thin, very thin.

Most readers of this blog know that there are other ways to lose a lot of weigh without resorting to concentration-camp-style starvation, namely the low-carb diet. But I had to vent a little because I get so annoyed when people tell me that they don’t eat yet can’t lose weight.

The fat acceptance movement – which is what this post started out to be about – is nothing new. Way back in the early 1900s obesity in women was becoming accepted in this country as a positive thing. From the February 1919 Atlantic Monthly:

The fat woman has been so long accustomed to commiseration that it may be difficult for her to realize her new dignity; we have all pitied her, been sorry for the bursting glove-clasp, the exuberant girth, the sweets desired but denied, the chin whose apparent hauteur was so unjust to the kindly heart beneath it; and above all for that plump palm laid upon our arm with its accompanying tremulous whisper, ‘Am I as fat as she, or she, or she?’ [my italics]
But now all that evil time is forgotten. The anti-fat nostrum, the recipes for rolling, the panting mountain climb, all the many-doctored advice, all the beauty-parlor pummeling—all this is obsolete, for obesity has come into its own. The corpulent dame now has dresses made to exhibit, not to conceal, her shapeliness; these throng authentic fashion-sheets. She has her own clothes, not the adapted ‘line’ of the lean and lovely sylph. The fat woman is no longer done out of her inheritance by a cruel and carping world. She has become a ‘stylish stout.’

So sizeism -at least for women – is nothing new. But the country wasn’t yet so accepting of male obesity:

It is a curious fact that in neither East nor West has the stylishness of stouts been extended to the male sex. The norm for man is to be long and limber. As the hero of romance, a man may be brawny; but except in farce, he may not yet be fat. In America this ideal of masculine slimness is explained by our fondness for thinking of our men as lean wrestlers with frontier conditions, for the fact of a frontier is still a pleasant figment of our fancy. As a matter of brutal truth, both our men and our women have swelled perceptibly during a long period of plenty and of ease. Not all our Hooverizing has notably reduced the tendency of both sexes toward an opulent maturity. The pitiful point is that our men are not yet allowed by fashion to grow fat with dignity. Of course, it has never been so hard for a man to be voluminous as for a woman, because he thinks only of how uncomfortable he feels, and not, concomitantly, of how ungainly he looks. And yet the fat man has had pain enough in being the butt of the papers and of his pals; and from this anguish he cannot be relieved until fashion lifts its ban from his person as it has lifted it from that of the lady. No shop is as yet exhibiting styles for the stout man. He is still forced to squeeze himself into clothes designed for the stripling.

Nice juxtaposition of ads, eh?

To see some more less than optimally placed ads, click here.

Said heiress Paris Hilton as she was led off to jail:

In the future, I plan on taking more of an active role in the decisions I make.

What’s even more pathetic than this actual sentence is the fact that it was in a statement released by her lawyer to the press. One would think that the Hilton’s could afford a legal team that wouldn’t let this kind of idiocy slip through. Perhaps celebrity lawyers are as feebleminded as the celebrities they represent.

In reading through Gary Taubes’ book Good Calories, Bad Calories I came upon the following dialog that I found all too familiar. It took place in 1973 during the first hearing of George McGovern’s Senate Select Committee on Nutrition and Human Needs. A number of speakers made presentations on the adverse effects of carbohydrates on human health. British nutritional researcher John Yudkin was one of the presenters.

Yudkin blamed heart disease exclusively on sugar, and he was equally adamant that neither saturated fat nor cholesterol played a role. He explained how carbohydrates and specifically sugar in the diet could induce both diabetes and heart disease, through their effect on insulin secretion and the blood fats known as triglycerides. McGovern now struggled with the difficulty of getting some consensus on these matters.

“Are you saying that you don’t think a high fat intake produces the high cholesterol count?” McGovern asked Yudkin. “Or are you even saying that a person with a high cholesterol count is not in danger?”

“Well, I would like to exclude those rare people who have probably a genetic condition in which there is an extremely high cholesterol,” Yudkin responded. “If we are talking about the general population, I believe both those things that you say. I believe that decreasing the fat in the diet is not the boest way of combating a high blood cholesterol…I believe that the high blood cholesterol in itself has nothing whatever to do with heart disease.”

“That is exactly the opposite what my doctor told me,” said McGovern.

I know just how Yudkin must have felt. I’ve had the same conversation with patients countless times.

Gary’s book is filled with accounts of low-fat advocates clinging to the low-fat hypothesis despite the lack of evidence that it was valid. In fact the evidence had been accumulating showing that dietary fat didn’t have anything to do with heart disease in particular and that it was rapidly losing its status as a risk factor for all diseases in general. The low-fat advocates tenaciously clung to any research – no matter how flimsy – showing any connection with fat consumption, especially saturated fat consumption, and disease while totally disregarding much stronger evidence that fat wasn’t the problem. Papers presenting data showing the lack of causality between fat consumption and disease or data indicating that carbohydrates might be the problem were written off as inconclusive while totally inconclusive data was not only accepted as gospel, but presented as a smoking gun.

Many of these low-fat researchers will read Taubes’ thoroughly researched book that meticulously lays out how and why they went wrong and instead of saying ‘Geez, we really blew that one,’ they’ll say his whole book is BS and if they could just get the right study they could prove to the world that they have really been right all along.

Sad but true.

Reminds me of a line from one of my favorite songs written by John Lennon:

Living is easy with eyes closed, misunderstanding all you see.*

In my years of experience I’ve always been amazed at this ability of many extremely smart people to blind themselves to the evidence staring them in the face. I read a book recently that has helped me to understand.

When MD and I were packing for Europe I rooted through my pile of unread books looking for paperbacks that would travel easily. I found a book that I had ordered a while back on the basis of a good review but hadn’t read. It was the right size so I threw it in my carry on. It turned out to be one of the better books I’ve read in a long, long time; it shed a lot of light on how people can maintain their set opinions in the face of mountains of evidence that they’re dead wrong.

The book is titled Stumbling on Happiness, and was written by a Harvard professor of psychology named Daniel Gilbert. I didn’t read the book when I first got it because I was led astray by the title. I – logically enough – assumed the book was about increasing one’s happiness quotient by accident, and since I’m a happy enough guy anyway, I didn’t figure stumbling onto a little more would make my life better by enough to invest the time in reading. Boy, was I wrong. The book isn’t really about happiness much at all; it’s about how the brain works to deceive us in all kinds of situations. And, au contraire to most books written by Harvard professors, this one is a real gem. It’s well written, funny, easy to read, and crawling with valuable information about how we all think. I can’t recommend this book highly enough. Get it while you’re waiting for the Taubes, and you’ll be better able to understand much of the stupidity he writes about and the stupidity you see all around you and the stupidity that we (you and, sadly, I) often exhibit oursleves.

Here is an excerpt to the point:

When facts challenge our favored conclusion, we scrutinize them more carefully and subject them to more rigorous analysis. We also require a lot more of them. For example, how much information would you require before you were willing to conclude that someone was intelligent? Would their high school transcripts be enough? Would an IQ test suffice? Would you need to know what their teachers and employers thought of them? Volunteers in one study were asked to evaluate the intelligence of another person, and they required considerable evidence before they were willing to conclude that the person was truly smart. But interestingly, they required much more evidence when the person was an unbearable pain in the ass than when the person was funny, kind, and friendly. When we want to believe someone was smart, then a single letter of recommendation may suffice; but when we don’t want to believe that person is smart, we may demand a thick manila folder full of transcripts, tests, and testimony.

Precisely the same thing happens when we want or don’t want to believe something about ourselves. For instance, volunteers in one study were invited to take a medical test that would supposedly tell them whether they did or did not have a dangerous enzyme deficiency that would predispose them to pancreatic disorders. The volunteers placed a drop of their saliva on a strip of ordinary paper that the researchers falsely claimed was a medical test strip. Some volunteers (positive-testers) were told that if the strip turned green in ten to sixty seconds, then they had the enzyme deficiency. Other volunteers (negative-testers) were told that if the strip turned green in ten to sixty seconds, then they didn’t have the enzyme deficiency. Although the strip was an ordinary piece of paper and hence never turned green, the negative-testers waited much longer than the positive-testers before deciding that the test was complete. In other words, the volunteers gave the test strip plenty of time to prove they were well but much less time to prove they were ill. Apparently it doesn’t take much to convince us that we are smart and healthy, but it takes a whole lotta facts to convince us of the opposite. We ask whether facts allow us to believe our favored conclusions and whether they compel us to believe our disfavored conclusions. Not surprisingly, disfavored conclusions have a much tougher time meeting this more rigorous standard of proof.

It takes much more evidence – in fact, it’s got to smack us in the face – for us to believe something that we disagree with at our cores. And only a smidgen of evidence to keep us clinging to our own misbegotten notions. The low-fat guys (and gals) for all the reasons that Taubes lays out are convinced beyond any doubt that reducing the fat content of the diet will improve health. I doubt that their minds can easily be changed, no matter how much contrary evidence is thrown at them.

The great physicist Max Planck once wrote:

An important scientific innovation rarely makes its way by gradually winning over and converting its opponents: it rarely happens that Saul becomes Paul. What does happen is that its opponents gradually die out and that the growing generation is familiarized with the idea from the beginning.

At least the nice thing about the low-fat-ophiles is that if they follow their own dietary recommendations the day they lose their influence may come earlier than predicted by the actuarial tables.

*If you want to hear an absolutely fabulous rendition of Strawberry Fields Forever you should get the Beatles Anthology 2 and listen to the first and second cuts on the #2 CD. It’s John Lennon doing first a demo version of the song then on cut #2 a much, much better (in my opinion, anyway) version of the song than what they ultimately came out with.

Fiesta – a long time Santa Barbara tradition – starts tonight, and lasts through Sunday. My bride long ago signed us up to provide a charity event for the Choral Society tonight at our house. I’ve been dragooned into helping get everything together for this Fiesta feast, which is NOT low-carb. One can follow a low-carb diet and still partake of much of the food, but not all. And certainly not the dessert: capirotada, a northern New Mexican bread pudding, which is the best bread pudding I’ve ever put in my mouth. One of my jobs today was to caramelize the sugar for this treat, which I will definitely eat a little of. I’ll take some pictures and share.

In order to help my beloved wife I’ve had to pretty much abandon my blogging duties today. I’m in the middle of a long post that I think everyone will find interesting. I’ll be back at it tomorrow.

One of the great things about coming home from Europe is that I get to chow down on MD’s home cooking once again. One of her specialties is Frenched rack of lamb. Here is a photo of my dinner plate night before last.

I took the picture just before I doused the meat with my addition to the meal: a malt vinegar mint sauce. I finely chop a bunch of fresh mint from our garden, then put it in a bottle of malt vinegar and shake it up. Tastes great and easy to make. My kind of sauce.

Last night we had one of my golfing buddies come over for dinner. He brought steaks and cooked them on our grill. MD was knee deep in Fiesta dinner preparation, so she tended to that. I got the grill going, selected the wine (a 2002 Sequoia Grove Cabernet, if you’re interested), and poured it. Once again, my kind of meal. Delicious and requiring minimal effort on my part.

Here is my plate before I tucked in. Grassfed beef steak with blue cheese, yellow squash, zucchini, and a poblano pepper – all grilled over the fire.

Yep, those icky low-carb fad diets. You really just don’t get any vegetables do you?