Around the Web; Cancer, Infections, Cholesterol, and Nitrates Edition

[1] Summer Meet-up: We’ve chosen July 23 for the meet-up at Plum Island off Newburyport. We’ll be at the beach at the south end of the Island between 4:30 pm and 6:30 pm and will be happy to picnic and hang out with anyone who cares to join us.

[2] Interesting posts and news: A six year old cancer patient, Diamond Marshall, got a visit from the Kate, the Duchess of Cambridge. What struck me was that her mother had died of cancer at age 32, when Diamond was 18 months old. Coincidence? Or contagion?

Before you answer: a new paper reports that IL-8 and CRP – both markers of infection – predict future cancer.

Chris Kresser interviewed Emily Deans, a combination that is self-recommending. Among many noteworthy tidbits, Chris is working with an 83-year-old Alzheimer’s sufferer who is doing well on a Perfect Health Diet-style ketogenic diet.

Evidence that nitrate-rich foods, such as spinach and beetroot juice, are beneficial for vascular health and athleticism came out recently. Julianne Taylor has a few links. I might add that nitrates are also beneficial for immune function. Another recent study showed that exercise upregulates nitric oxide which is then stored as nitrites with long-term benefits. Nitrates also lower triglyceride levels and help cure hypertension. So, eat your spinach and exercise!

Seth Roberts reminds us of a good quote (modified from Beveridge): “Everyone believes an experiment except the experimenter; no one believes a theory except the theorist.” In another post, Seth reports that health in the US as measured by age of disease onset has not improved since the 1960s, life expectancy in the US peaked in 2007 and is now declining, medical care has stagnated, and this should be a big story.

Seth is right. Deteriorating results with exploding costs is not a good combination. We believe a focus on diet, nutrition, and antimicrobial medicine would deliver far more benefits at much lower cost than the current approach.

Pål Jåbekk notes something I’ve been meaning to blog about for quite a while:

[Y]et another study finds that overweight people have higher life expectancy than their lean counterparts, albeit with greater risk of disabilities. Perhaps our focus should be on natural foods and exercise, rather than on the significance of some extra padding. (study here)

Pål also gave us a thoughtful response to Stephan’s series on food reward. Highly recommended.

Hans Keer added starch to his diet, felt better, and decided he needs a new name for his site: Goodbye CutTheCarb.

Giardia infections account for 6.5% of cases of IBS in Italy. If you have digestive problems, it’s probably due to some kind of infection.

Via Craig Newmark, epidemiologist Tara C Smith:

As I’ve laid out this week (part 1part 2part 3), the realization that a fairly simple, toxin-carrying bacterium could cause a “complex” and mysterious disease like hemolytic uremic syndrome came only with 30 years’ of scientific investigation and many false starts and misleading results.

Infections should be the first suspect in any disease, not the last.

We mentioned the Flynn effect in our book: intelligence rose steadily through most of the 20th century. A group of economists offers a possible explanation: Lead poisoning caused depressed IQ in the 19th and early 20th century, and cessation of the use of lead in plumbing gradually returned IQs to normal.

Nothing to do with health, but very entertaining: Steve Sailer on Racehorse Haynes.

[2] Just to show how cultured we are, some classical music: Beethoven’s Fifth translated into sign language.

[3] The turtle doesn’t seem worried:

Via Yves Smith.

[4] It’s not so bad to be the smallest loser: If I do a blog post on why the overweight live longer, this might be a good place to start. In mice on calorie-restricted diets, those who lost weight quickly had shortened lifespans, those who lost little weight had lengthened lifespans:

[S]trains with the least reduction in fat were more likely to show life extension, and those with the greatest reduction were more likely to have shortened lifespan…. [F]actors associated with maintaining adiposity are important for survival and life extension under dietary restriction.

Having trouble losing weight? Maybe you’ll have a few extra years to figure it out.

[5] High serum cholesterol is healthy: In a paper reviewed by Dr Briffa, Japanese investigators provide further support to an idea that I believe we discussed in our book: serum cholesterol protects against stroke.

People with TC over 6.2 mmol/l (240 mg/dl) had a 77% lower risk of stroke (96% lower chance of hemorrhagic stroke) than those with TC below 4.1 mmol/l (159 mg/dl).

It looks like high serum cholesterol almost totally eliminates hemorrhage risk. Worried about stroke? Ask your doctor how you can raise your cholesterol.

[6] How do you do it? Dr. Walter Willett knows: In our book we quoted Dr. Walter Willett of the Department of Nutrition at the Harvard School of Public Health disparaging coconut oil. Dr. Willett has become friendlier toward fat in recent years, and when we saw he was re-addressing coconut oil in the Harvard Health Letter, we hoped to find an endorsement. Alas, he still favors vegetable oils. The trouble with coconut oil is that it raises serum cholesterol:

I don’t think coconut oil is as healthful as vegetable oils like olive oil and soybean oil, which are mainly unsaturated fat and therefore both lower LDL and increase HDL. (http://pmid.us/21702109)

[7] Shou-Ching’s photo art:

[8] Not the weekly video: Evidence that nurture defeats nature:

Via The Anchoress.

[9] Weekly video: Plains Milky Way from Randy Halverson:

Leave a comment ?

21 Comments.

  1. All of this talk about infections is very helpful, it is the elephant in the room that I wasn’t considering before. If I heard that CRP was correlated with cancer I would simply say that more inflammation leads to more cell death, circulating insulin, poorer DNA repair and whatnot, and would attribute it to dietary factors. While all of that is true it certainly could be a bad infection, and probably the combination of infection and dietary causes.

    Raccoon and turtle: Ha! Turtles are formidable foes. When they go into their shells not even the best raccoon knife can stab them. That guy came ill-prepared for battle. You gotta pick your spots.

    Obesity sometimes better than being lean, higher cholesterol better than lower, coconut oil better than soy oil?! Now you’re just being silly! Keep it up.

  2. Diseases and infections?

    “Both Kinlen’s ‘population-mixing’ hypothesis and Greaves ‘delayed infection’ hypothesis summarize the considerable evidence that childhood leukemia may be the consequence of an abnormal response to a common or uncommon infection(s).”

    From:
    “Unusual space-time patterning of the Fallon, Nevada leukemia cluster:
    Evidence of an infectious etiology”

    https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0Bxsc1b28aVDcOWQyMTBmN2UtMzc2Yy00OWQ5LWEwMTYtMzAxODdlNTE4ZWRm&hl=en_US&pli=1

  3. I’m not convinced on the cancer via infection thing but I’m keeping an open mind. I STILL haven’t read your book, damn I’m such a slacker. It’s ridiculously high up on my things to do list. OK, I vow to order it as soon as I post this comment.

  4. Hi Stabby,

    Simple solution: pot. water. fire. turtle soup.

    Thanks, Tony. I think I cited that paper in a previous Around the Web. Or maybe you posted it in the comments previously. Hard to remember what happened on my own blog sometimes.

    Hi Sean, It’s speculative … but almost certainly true.

    Think of infections as risk factors which contribute a bit toward establishing the cancer phenotype. Cells are self-healing if you have a small number of risk factors present, but if you get enough risk factors together, they compound each other and the cellular state can move permanently away from the normal equilibrium.

    Chronic infections are omnipresent and they alter cellular state, often toward the cancer phenotype. Pathogens want to suppress autophagy which destroys them, cancer needs to suppress autophagy. Etc.

    Most processes in nature tend to have power-law probability distributions, indicating that many independent elements need to occur for an event to develop. Cancer, I expect, is like that.

    Maybe cancer typically needs 6 causes, and non-infectious causes have a 10% chance of developing. If you have 0 infections the odds of getting cancer are 1 in a million. If you have 3 cancer-promoting infections they’re 1 in 1,000. If you have 5 they’re 1 in 10.

    This is a dumb model of course, but you can easily reach a conclusion that infections “cause” 99.99% of cancers in the sense that the cancer rate would be 10,000 times smaller without them. And preventing or treating the infections might effectively cure cancer.

    Thanks for your order!

    Best, Paul

  5. OK, I finally did it. Free shipping to the Czech Republic by the Book Depository is really cool, the fact that they don’t grok non-standard address characters such as ž, not so cool, but as long as it arrives in one piece I’ll be happy.

    Expect a scathing (more likely glowing) review on my tiny blog some time in the near future.

  6. Paul, you make a very compelling argument. I’m looking forward to reading the book.

  7. A review would be an honor.

  8. Paul,

    I always enjoy your posts exploring the infectious origin of disease, and all of the strategies for combating and preventing them.

    But I haven’t seen too much on detection. That is, what should people be asking of their doctors to find out if infections in fact do exist? What are the tests? I imagine this varies depending on pathogens, symptoms, etc.

  9. Tim (another one)

    Hi Paul,

    You say: serum cholesterol protects against stroke.
    But couldn’t that study instead just suggest that stroke (caused by some pathogen) isn’t as common in those without those pathogens and that the cholesterol is just a marker of lack of infection?

  10. Unfortunately, a lot of tests for infections are not particularly helpful. Doctors must be aware of how the infections might manifest as symptoms, such as as “irritable bowl syndrome”, and truly listen to their patients, not just slap some label involving the word “syndrome” on the patient.

    And speaking of infections, remind everyone to check themselves for ticks after the meet up in July.

  11. Hi Tim 1,

    That’s a really important issue. Better detection/diagnosis technologies are badly needed. This is why it can take 30 years to figure out the cause of hemolytic uremic syndrome, why whether XMRV causes chronic fatigue is disputed, etc. If it were easy to detect and diagnose pathogens, then the causes of disease would be sorted out fairly quickly. Unfortunately, it’s not.

    We now have some pretty good molecular biology technologies, so if there were a concerted effort a lot of progress could be made. Hopefully it will be.

    In the mean time, this is the weak link of contemporary medicine.

    The diagnostic problem is one reason I spend so much blog time on biomarkers like cholesterol. These can sometimes help diagnose disease. Low cholesterol can indicate a eukaryotic infection, see eg my response to Sheep Counteress http://perfecthealthdiet.com/?p=4021#comment-25881.

    We can also use diet for diagnosis. Ketogenic diets tend to make bacterial and viral infections better, fungal and protozoal infections worse.

    It’s a tricky problem. We sort of have to be detectives, pull in all the clues we can, run some experiments, then make an educated guess.

    Hi Tim 2,

    On the one hand, I like the way you think. And if some of these parasitic infections that lower cholesterol can also cause stroke, then your scenario may be the primary one in cases of stroke in hunter-gatherer populations.

    On the other hand, here’s some more information:

    Not all infections reduce serum cholesterol; most bacterial and viral infections, which are the ones most implicated in atherosclerosis and stroke, don’t.

    And then I happen to know that cholesterol is very important for cellular mobility and wound repair, and endothelial cells upregulate their LDL receptors and grab cholesterol when they need to close a vascular wound.

    So the stroke protection may be a result of the cholesterol delivery function of LDL.

    As we’ll get to shortly, LDL also has immune functions, as HDL does. So low serum cholesterols indicates a loss of immune function — immunosuppression.

    So an alternative would be that low serum cholesterol comes first and the immune suppression allows the infections that cause stroke to flourish.

    I think that scenario is uncommon but possible.

    So, good thinking, but my guess is, not the most common scenario.

    Hi Natalie,

    Yes. Well said. Many doctors are now not only out of practice and poorly trained for the kind of exploratory/experimental diagnosis that is needed, they’re also afraid to attempt anything unconventional. We have a lot of frightened, by-the-book doctors these days.

    Hi Emily,

    Thanks much. A great complement to Tony’s paper.

  12. Hi Dr. Jaminet,

    I recently bought and read your book and found it very interesting. I’ve liked Paleo for a while but do feel that balancing it with more carbs (e.g. sweet potato) makes me feel better.

    My question for you concerns Alzheimer’s risk and the apoe4 allele. I have two copies of this gene, and after finding this out I initially, to be frank, freaked out. However, it is merely a risk factor, not a diagnosis, plus the majority of people with AD don’t have a copy of this gene. (Though estimates vary; some say half the people with AD have the gene, but that still means half don’t.)

    What I’m wondering is, how worried should I be that I’m homozygous 4/4? And how much fat should I eat? I understand that typically, a lot is good, but I’ve read that 4/4s don’t metabolize it well. I’m in my early 30s and currently eating a diet similar to that you recommend, but sometimes I feel better with less fat (I eat a lot of coconut oil, animal fat, etc.). My gut is also recovering from some long-term antibiotic use (for a skin problem) so that’s somewhat of an issue.

    Any help/advice is appreciated; I’ve read a good bit about apoe4 and it’s limitations, but I’m wondering what an optimal diet would be.

    Thanks so much, and again, I enjoyed your book,
    Mary

  13. Hi Mary,

    I wouldn’t worry at all. You have the ancestral allele, and on the ancestral diet you’ll probably be fine.

    Alzheimer’s is I believe primarily due to bacterial or viral infections of the brain, and intermittent fasting plus occasional longer fasts and/or ketosis (say, via coconut oil consumption) are great ways to protect the brain and nerves from bacteria and viruses.

    Best, Paul

  14. Paul,

    Thanks so much for your reassuring, informative, and timely response! I appreciate hearing your insights — and look forward to following your blog. And thank you again for the information; it helps a lot.

    Sincerely,
    Mary

  15. Hi Paul,

    A question on IBS if you will. When I went low carb 4 years ago I completely rid myself of IBS, it was great.

    However, before Christmas, I had an infection that the doctor insisted be treated with antibiotics. I complied and tried to stay eating right to minimise the risk of a co-infection.

    I seem to have failed as now my digestive problems are back and are not only not responding to diet, but junkfood and overeating are the only thing that make me feel better!

    I tried to go VLC again but it leads to rapid heartbeat and diarrhoea, both of which disappear when I take a antacid, the calming effect of it is palpable. I’m at a loss as to what to try next. Any suggestions?

  16. Hi Sarah,

    So sorry to hear this.

    It sounds like you have a different pathogen (or mix of pathogens) than before.

    The only clues we have are:
    – It flourishes under antibiotics. This could be protozoal, viral, fungal, or antibiotic-resistant bacteria. Evidence against a bacterial pathogen.
    – It doesn’t benefit much from carbs but does benefit from something associated with VLC – ketones? If so that would indicate a eukaryotic pathogen, protozoa or fungi. That carbs are well tolerated is also evidence against bacteria.
    – The antacid is a clue … but I’m not sure what it means. It could be the antacid effect, or it could be chemicals. Does calcium carbonate (Tums) have a different effect than sodium/potassium carbonate (Alka-Seltzer) than milk of magnesia than Pepto Bismol than Prilosec/omeprazole? You might experiment, that may be another clue.

    Another test you could do related to the systemic effects like rapid heartbeat would be to take a toxin-clearing agent like cholestyramine and see if that clears the symptoms. That would show that it’s toxins entering circulation from the gut causing problems, and that the pathogen produces fat-soluble toxins.

    The only thing I know for sure is that bacterial probiotics and fermented vegetables are advisable, since the disease was produced when those were lost.

    The best thing would be to get pathogen identification from your stool. They have sophisticated DNA tests now, a bit expensive but very helpful. Traditional methods involve culturing the stool, or examination of it. Ask your doctor for a test. A DNA test is the Metametrix GI effects profile.

    Once you know the pathogen, then an antimicrobial and probiotic strategy can be developed.

    Please keep me posted.

    Best, Paul

  17. It’s actually Calcium carbonate, magnesium carbonate (heavy) and simethicone that helps, I’ve tried simethicone separately and that does nothing so I think that’s why it’s the antacid that’s helping.

    Interesting what you say about the toxins! Does that mean some kind of die off could be in process? Should I grin and bear a couple of days to rid myself.

    I’m back on day one of healthy eating today. Was thinking of getting my glucose needs from glucose syrup instead of starch, lest anything untoward is being fed, a la SCD.

    I can’t really afford any fancy tests right now. But will have to look into it if I don’t have success with the latest strategy.

    Thanks as always for your thoughts.

    Sarah

  18. Bah, I used to eat tonnes (well 0.5-1kg a day) of spinach, before you convinced me that my ketogenic, high dark chocolate, high omega 3, high vitamin C consuming ways would guarantee me kidney stones! 😉 I wonder if there are any other good sources apart from beetroot…

    Also on the ‘health stagnation’ the BBC has a few things to say: http://www.bbc.co.uk/news/world-us-canada-14070090 Personally I don’t think that healthcare has stagnated, but only health.

  19. Hi Sarah,

    The glucose syrup is a good thing to test. May help.

    Hi David,

    Pick your poison!

    I think there will be some medical advances soon, as people move on from some failed conceptual paradigms and exploit modern molecular biology methods. But I think it’s easy for deteriorating diets to more than make up for medical progress. When diets turn around, that’s when we’ll see the big health gains. Also when medical research focuses more on infection diagnosis and antimicrobial therapy.

  20. Hi Paul, I’m really fascinated by the study on nitrates in spinach. I am, however, interested in what your thoughts are on the issue of oxalates in spinach. I was able to recover (after 2 years) from a baffling chronic condition that included cognitive impairment and IBS, by employing a diet that consisted almost exclusively of eggs, lard, and potatoes. It took me a long time to figure out this therapeutic diet by keeping a journal and adhering to evolutionary theory as a polestar. Naturally, I’m concerned about the slightest possibility of a return of my symptoms.
    Thank you so much for your unique and thoughtful contributions to evolutionary health. Hope to hear back. Sincerely, Mario Encinias

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