Saturday, January 5, 2013

Overfeeding and Elevated Insulin

It's commonly accepted in the obesity research community that fat gain causes insulin resistance and an increase in circulating insulin, and that this is a major reason why obese people usually have insulin resistance and high circulating insulin. Part of the rationale is that substantial fat loss by almost any means improves insulin sensitivity and causes circulating insulin to decline, and substantial fat gain from deliberate overfeeding causes insulin sensitivity to decline and circulating insulin to increase.  I recently cited three references to support this contention on another blog, and was challenged, so I decided to revisit these references to make sure I had understood them correctly (1, 2, 3).  Since I took the time to do this, I figured I may as well write it up for my readers, since these studies are quite informative.

As I had recalled, in all three studies, overfeeding and fat gain caused an increase in circulating insulin (123).  But there's an even older overfeeding study I didn't cite at the time, much of which appears in a 1968 review paper in AJCN, which is quite interesting as well.  The full text of the paper is available for free, so please have a look if you're interested (4).  This is an old school study design that probably wouldn't pass a modern human subjects research review board.  Volunteers (sort of-- they were prisoners) were intensely overfed for a period of 3-5 months, gaining a full 26 percent of their initial body weight.  Investigators found that these volunteers experienced an increase in fasting and post-meal insulin that was similar to what is observed in common obesity:
As in spontaneous obesity the fasting immunoassayable serum insulin as well as the ratio of insulin to glucose is increased in experimental obesity. 
Our findings in experimental obesity are consistent with those of Perley and Kipnis and Kreisberg et al. in spontaneous obesity in that there is greater secretion of insulin, in response to a comparable stimulus than in the normal [lean person].
For our purposes, the most interesting study of the three I cited originally was published by Drs. Johannes Erdmann and colleagues in 2007 (1).  There are several reasons why I like this study:
  1. Weight gain occurred gradually over a period of 4.5 months
  2. Overfeeding was only by a relatively modest 300-500 calories per day, in contrast to the more intense overfeeding in certain other studies
  3. They measured body fat directly
  4. They measured both circulating insulin and insulin sensitivity
This study started with lean, ostensibly healthy people.  Here is the overfeeding protocol:
The subjects were instructed by a dietitian to increase daily food intake by 300–500 kcal in addition to what they were consuming. The energy surplus was achieved by food items of higher energy density considering individual taste preferences, palatability, etc., or by increasing meal size, portion size of snacks, or the number of meals, respectively. A further alternative to increase energy intake was the exchange of water to energy-containing beverages such as fruit juice or lemonades.
Basically it sounds like they replicated roughly what has happened spontaneously in the US over the last 50 years: more calorie-dense, highly palatable foods, more snacks, and more sweetened beverages, leading to a higher overall calorie intake and fat gain.

After 4.5 months of overfeeding, participants gained an average of 13.6 pounds (6.2 kg) of body weight, and 7.1 pounds (3.2 kg) of body fat.  Not nearly as much as in the previous study, but nothing to sneeze at.  Fasting insulin increased more than two-fold from 11.5 to 25.1 pmol/L, and post-meal insulin also increased substantially.  At the same time, insulin sensitivity decreased substantially.  Here's the authors' summary (basically, a more detailed version of what I just said):
The present study demonstrates for the first time that intentional weight gain within the normal range of subjects who are lean to begin with leads to a significant elevation of basal plasma insulin, C-peptide, and glucose concentrations, whereas after ingested or injected stimuli only insulin levels were raised. An increase of insulin resistance is indicated by HOMA-IR in the basal state, by comparable glucose levels despite higher insulin concentrations following oral stimulation, and by a reduced rate of glucose disposal despite higher insulin concentrations during a glucose clamp at physiological hyperglycemia.
Here's another key quote (hang with me, I'll explain it):
Following a meal or glucose-induced stimulation of insulin secretion the glucose response above baseline remained unchanged after weight gain. This indicates that in the postprandial state the augmented insulin resistance can be counterbalanced, most likely via an alteration of hepatic insulin metabolism so that postprandial glucose homeostasis remains unchanged. When changes of body weight and the degree of insulin resistance become greater, the previously demonstrated augmentation of postprandial insulin secretion apart from clearance is additionally required for maintenance of glucose homeostasis in overweight and obese subjects.
For our purposes here, the main point they're suggesting is that fat gain causes insulin resistance, and the body adjusts insulin levels upward to compensate.  To be fair, their data can't really tell us whether elevated insulin is a reaction to insulin resistance, or the reverse, but overall the evidence supports the former scenario. In any case, it doesn't matter much because both were caused by overfeeding and fat gain.

Body fatness isn't the only influence on circulating insulin, so the correspondence between the two is far from perfect on an individual level (though it is quite strong on a population level).  But it does appear to be a major factor.

106 comments:

IcedCoffee said...

This might be a semantic quibble, but wouldn't it be better stated that cellular over-nutrition causes insulin resistance, rather than fat gain per se? One can gain fat and maintain insulin sensitivity.

Stephan Guyenet said...

Excellent point, yes I think that is at least partially correct.

Basically, cellular energy overload happens due to 1) consuming too much energy relative to energy needs, and 2) fat stores becoming inefficient at clearing excess energy (often because they are enlarged).

But inflammation in fat tissue is another factor strongly suspected of contributing to insulin resistance (though the evidence hasn't always supported the role of fat tissue inflammation specifically), and that is partially independent of whole-body cellular energy overload per se, but may reflect overstuffed sick fat cells.

Saying that excess body fat causes insulin resistance is really just shorthand for what I wrote above. Body fat normally protects against energy overload in other cell types, but when it gets too full it becomes less effective at doing that, and also becomes inflamed.

Stephen Ferguson said...

Great post. I'm surprised by the magnitude of insulin changes for a relatively small increase in body fat. It gives me inspiration to lose more weight and further reduce my own insulin resistance.

"Following a meal or glucose-induced stimulation of insulin secretion the glucose response above baseline remained unchanged after weight gain"

Wheras that's true in moderately obese people, the relationship obviously breaks down in truly metabolically deranged people (such as T2 diabetics or pre-diabetics). Our response to glucose induced stimulation is hyperglycemia.

I guess that happens when the pancreas hits its maximum insulin output (pre-diabetes) or when pancreatic function starts to decline (diabetes).

dan said...

This is not surprising.

dan said...
This comment has been removed by the author.
arnoud said...

This indicates that force-feeding someone more calories than what would be consumed in excess of normal 'appetite,' results in high insulin and high fat accumulation.

Didn't we all know that already?

Dave said...

Stephan,

I know you've stated in the past that scientists generally don't lend much credence to the idea that insulin plays a major causal role in common obesity. So an honest question to you is do you feel this "movement" out there in the blogsphere is a threat to public health policy, similar maybe to how low-fat diets became the norm in the SAD due to bad science?

Otherwise I'm not sure why you even waste your time getting belittled by members of the church of the insulin fairy by trying to show them the error of their ways.

Sanjeev said...

Since low carbohydrate can be useful at least for some and at least temporarily[0], to lose fat mass without adverse side effects it shouldn't be a "popular myth based public health hazard".

the one component that probably is deleterious is the relatively new stance (even Atkins never believed it) that absent dietary carbohydrate one may eat infinite calories and not gain fat mass.

[0] and in fact is proven effective at treating some forms of epilepsy and anecdotally according to Paul Jaminet some other neurological conditions

Sanjeev said...

> (even Atkins never believed it)

I suppose his private position could have been more extreme; we get hints of this in his book's "fat fast" chapter

but we must go on his public writings & speeches

Sanjeev said...

> Didn't we all know that already?

Read this post from the beginning:

The motivation for this post is that another blogger[0] claimed that Stephan interpreted the studies wrongly - and/or misquoted the results

As someone who appreciates sarcastic humour as much as anyone else I would tell that blogger that constant abuse wears thin, especially when it's in the service of hiding bullcr*p.

Works to keep gulled, sycophantic worshippers/fanbois in line though.

[0] who I used to enjoy but have ignored for a long time now because of this kind of thing

Galina L. said...

Dave,
it looks like many or at least some of opponents of Dr.SG oppose his ideas not because they are engaged into anty- insulin religion but because they are concerned about public health issues. It looks for me that the dispute on the Hyperlipid blog mainly is the dispute between people with clinical experience and the people who do medical research.I wonder, are there clinicians who would side with Dr.Guyenet? To illustrate the clinicians point of view, here the citation from a psychiatrist from Ireland (aka Sidereal) -

"What have mainstream medicine, "real professors of science" and neurobiology researchers done for us? Nothing but harm, actually. Most recently, there was a concerted attempt (which thankfully failed) to include obesity in the DSM-5, the upcoming revision of the diagnostic bible of psychiatry. What evidence was offered for this attempt to psychologise a clearly medical problem? Oh well, SOME people with obesity have binge-eating disorder and display behavioural patterns analogous to addiction, plus we have a lot of rat research carried out by people like Guyenet where rats enthusiastically press levers to self-administer more sucrose to get the dopamine hit (invariably called "a high-fat diet" in both the title, abstract, and the discussion of the published paper ;) ), therefore all obesity must be caused by an addiction and so it should be in the DSM.

Those of you who are neither fat nor clinicians may not understand why I'm getting so exercised over this but this would have enormous clinical implications on the way we conceptualise treatment for obesity and now suddenly you would have justification for inpatient admissions on psych wards to treat fat people with useless harmful therapies like forced exercise, cognitive behavioural therapy, antidepressants. If you are emotionally neutral about this, have a look at the "success" of these psychological approaches for the treatment of chronic fatigue syndrome (another mitochondrial disorder like obesity) in the United Kingdom where the Simon Wessely "they are crazy" school of thought won."

TanyaL said...

So it sounds like all of this is happening before blood glucose levels rise above normal/healthy? Am I understanding that right?

arnoud said...
This comment has been removed by the author.
arnoud said...

Perhaps my understanding of the subject issues, is not at all adequate, but at a level somewhat removed from the details, this is what it looks like to me:

1. Researchers are seeking to understand the reasons for people to overeat (high food-reward? faulty diet? insulin/glucose roller coaster? These are hugely important questions that hopefully will lead to an understanding of how to prevent a 'broken metabolism' and obesity issues from ever developing.

2. Once some-one's metabolism is 'broken' the VLC diet appears to be a most effective solution to reduce/maintain weight at low hunger levels.

I grew up with wheat (porridge at breakfast, sandwiches for lunch, frequent cookies/cake snacks), potatoes (one pound per day from 18 - 22 yr old), vegetables, a small portion of meat/fish daily, mostly milk for frequent daily drinks. Always slim, but once I moved to North Amerika, I gradually started gaining weight, eventually towards a BMI of 29. What changed? Age? Diet? Both.

Now, when I adhere strictly to a VLC/HF diet as discussed at Hyperlipid, I can control my weight easily, and urges to binge-eat on cookies, bread, pasta are non-existent (when I stick to VLC closely).
Butter, bacon, and sour cream without carbs just doesn't seem to be driving weight gain.

Once I fall off the bandwagon though, after a nice croissant or two, or some tasty lasagna, weight climbs, and it can take a long time to get back with the discipline of VLC.

So, hopefully research will lead to answer those questions that help ensure healthy people stay healthy with efficient working metabolisms. Those people do not seem to need to live on a VLC diet from what I can surmise, but I do not think that is a certainty.

Once one's metabolism is broken, those research questions may be less relevant, as the focus shifts towards management/treatment of the condition, and a different set of diet questions/issues take priority in helping to make one's daily diet decisions.

Stephan Guyenet said...

Hi Galina,

Your psychiatrist friend is talking nonsense. Is she claiming I, or my colleagues, had something to do with the attempt to classify obesity as a disease in DSM-5? Last time I checked, my colleagues and I are not a psychiatrists and had nothing to do with DSM-5. Nor do I claim that obesity represents addiction, in fact I have repeatedly stated that I do not believe obesity represents addiction, including in two posts on the extremely popular blog Boing Boing.

Second, my research is not about rats pressing levers. I do not directly study reward-- the information I present on reward here was collected by other investigators. I study the mechanisms of homeostatic regulation of body fatness by the hypothalamus, and no my professional research is not going to lead directly to a cure for obesity next week, nor is it reasonable to expect it to.

Third, it is common among zealots to claim that that our high-fat diets are actually high-sugar diets, but again that is nonsense. The most common diet we use is Research Diets D12492, which is only 6.7 percent sugar by calories-- less than half of what the average American eats. It is not high in sugar, and it is quite low in carbohydrate overall: 20% carb, 20% protein, 60% fat. On this high-fat, low-carb, low-ish sugar, zero trans fat diet, we can double a rat's body fatness in two weeks, and make him obese in one month.

Does that mean low-carb diets are fattening in humans? No. But I take offense to this kind of agenda-driven misinformation. It's like these people live inside their own imagination, where the truth is irrelevant and whatever seems convenient becomes dogma.

I'm going to stop there because honestly I'm wasting my time.

Stephan Guyenet said...

Hi Dave,

Yes, sometimes I wonder why I spend time writing about it as well. I don't do it to convince the zealots, that's for sure. I do it to convince the people who are not already true believers, and particularly the researchers and clinicians who aren't very familiar with the field and may be vulnerable to misinformation.

Stephan Guyenet said...

Hi Arnoud,

I'm glad you've found a diet style that works for you. Your reaction to LC is not uncommon. However, I think it's fair to point out that VLC doesn't work well for everyone, and in fact from what I understand in the long term most people do not do well on it.

I agree with you that we can draw a distinction between what causes obesity and what treats obesity effectively, and I think that's an important point.

Dave said...

"2. Once some-one's metabolism is 'broken' the VLC diet appears to be a most effective solution to reduce/maintain weight at low hunger levels."

Yet in 12-24 months the advantage all but disappears in free living studies. WHY?

Also has anyone tested macro-agnostic whole food diets (ie. Paleo) against VLC to see whether it is the carbs per se that leads to short term spontaneous calorie reduction?

Jim Oliver said...

Garett Jones wrote:
"Pet obesity, child obesity at all-time highs. Shouldn't I seek same explanation-corporate greed, parents, etc.-for both?"

I think that it is simply affordability of food and the rest of this stuff has very little effect.

Sanjeev said...

> "Pet obesity, child obesity at all-time highs. Shouldn't I seek same explanation-corporate greed, parents, etc.-for both?"


more information on this on carbsanity.blogspot.com

search for Carson & Chow - two biophysicists that matched up US obesity trends with food waste

Also Carson Hall has put up some software that simulates weight loss/gain based on some models and curve fitting he's worked on.

I find Hall's software is a good way to disabuse folks of the "3500 calorie deficit congruent to 1 pound of weight lost", not a necessarily veridical scientific explanation.

Sanjeev said...

figures I would get it wrong - KEVIN hall and Carson CHOW, NOT Carson Hall.

phhhhhhtttttttt


to be completely work safe, copy & paste into your URL box:

https://www.google.ca/search?client=ubuntu&channel=fs&q=site%3Acarbsanity.blogspot.com+carson+hall+chow&ie=utf-8&oe=utf-8&redir_esc=&ei=n_vpUNXkI8vaqwHH0IFQ

or click here

a specific link:

http://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&ved=0CEwQFjAE&url=http%3A%2F%2Fcarbsanity.blogspot.com%2F2010%2F10%2Fconservation-of-energy-biophysicist_09.html&ei=n_vpUND8Lsv1qwH544DAAQ&usg=AFQjCNHp-3IBuBE4vepvv8eE1D9JRd3mUw&bvm=bv.1355534169,d.aWM

Gretchen said...

21121Stephan, You said, "in the long term most people do not do well on it" [a LC diet].

Please define "do well."

karl said...

Not sure what your point is? It is rather well known that as adipose cells get large and distended, they become less insulin sensitive (insulin resistant). Our bodies efforts to keep BG under control increases insulin.

One way to understand the function of adipose tissue is it protects us from elevated BG. Thus if our adipose tissue becomes less insulin sensitive, I would expect the insulin level to be higher. The interaction between both of these feed back loops is understandable.

BUT - there are other things that effect insulin sensitivity. Inappropriate PUFA consumption can increase insulin sensitivity and thus likely causes calories to be diverted to adipose tissue. The western world consumes several times the amount of PUFA as was the case in the 1960's when obesity and T2D was rare in school children.

If it is the case that PUFAs are causing an inappropriate amount of calories to be stored - this can explain a change in set-point of one's weight homeostasis.

One other thing that effect insulin sensitivity appear to be ROS - and the length of the FA chains may determine the amount of ROS.

The question is if DNL produces longer chains when over fed? ( I would guess we would make longer chains particularly in response to fructose and excess carbs in the diet).

The importance of maintaining BG is often overlooked by low-fat proponents - fats become toxic as BG increases - LDL oxidizes to oxLDL - AGE (Advanced Glycation End-products) develop - cancer rates increase.

Neil Timms said...

Stephan,

Your post starts: "It's commonly accepted in the obesity research community that fat gain causes insulin resistance and an increase in circulating insulin, and that this is a major reason why obese people usually have insulin resistance and high circulating insulin. "

Is the order of processes important? Why not ...increase in circulating insulin causes fat gain and insulin resistance?

Thanks

Neil

Jane said...

@Galina
You may be interested to hear that your psychiatrist friend has diagnosed me with psychosis. Her professional opinion is that clozapine is required.

Your friend's colleague ItsTheWooo, who is a nurse and knows about these things, had offered her opinion that I suffer from psychosis, and she agreed. The tell tale symptom is that I spend my days reading the scientific literature.

I am not making this up.

Dave said...

"Nor do I claim that obesity represents addiction, in fact I have repeatedly stated that I do not believe obesity represents addiction, including in two posts on the extremely popular blog Boing Boing."

Stephan,

Isn't food reward exactly how an addition works in the brain? Couldn't you say that people who chronically overconsume calories do so because they are at least physically addicted to the food?

Galina L. said...

@Jane,
The psychiatrist from Ireland is not my friend, but it doesn't actually matter. I don't think she was serious when she discussed mental health of a person on internet she never met .It was not nice, for sure, but it couldn't be meant to be a serious remark.
In my first comment I just pointed out that there are people who work with actual patients with clinical experiences who are opponents of the idea that overeating starts as a behavior problem .

Since I returned to what Stephan said in his answer, I just want to mention that the diet Diets D12492 looks like the really fattening one for me. Way too much carbs for the fat content.If somebody for example eats 2000 calories a day, then it would be 100 grams of carbs, the same amount of protein, and approximately 160 grams of fat. Probably, with such amount of fat, 2000 calories is too much.

Brad Dieter said...

Dr. Guyenet,

Once again you have put together a great post. It is salient, coherent, and to the point. I really enjoyed the take away message and am looking forward to using this piece to formulate an argument for discussion in class this semester.

-Brad Dieter

Sue Staltari said...

It's about 133g fat.

Chris Wilson said...

Stephan, you should put the information about the lab rats diet as its own post. Coupled with Dr. Johnson's cogent defense of why research is done with rats in the first place (i.e. genetic knockouts, etc.), it should clear the air of some of this confusion.

I also enjoy reading your posts, and think you do a good job with your blog. I'm honestly shocked at some of the rancor that goes on in the blogosphere. While I'm a huge proponent of democratizing knowledge and information, the internet/blogosphere also work to encourage extremists and personality cults (a few special ones in Paleo-land come to mind:)), because you can be super-selective in what you choose to read (i.e. opinions or interpretations you already agree with). Almost anyone can become an expert on anything, it's more about marketing, style, saying the right things, etc. than substance.

I hope it doesn't discourage you too much...

Chris

gunther gatherer said...

I'm simply amazed that no one will admit that it could be the fat content of that lab diet that makes rats fat. Especially those from the LC camp. They will desperately pull out the kitchen sink looking for any other variable that could save their hypothesis. Like the 6% of carbs in an otherwise VLC diet. These are incidentally almost the same macro proportions that Hyperlipid recommends.

Carbs don't wind up as bodyfat as easily as dietary fat, in fact only about 30% EXCESS carbs will become bodyfat, since the rest gets burned in the conversion or gets stored as glycogen. I think this is well established by now.

Though, at the same time, the high fat could be damaging the hypothalamus, and that's where Stephan comes in.

Jane said...

@Galina
If a psychiatrist says somebody is psychotic, it's serious. If a nurse with experience of dealing with psychotic patients says somebody is psychotic, it's serious. End of story. To me it's entertaining, but I don't have a career like Stephan does. This psychiatrist and nurse have said far worse things about him than about me.

'..I just pointed out that there are people who work with actual patients with clinical experiences who are opponents of the idea that overeating starts as a behavior problem. ..'

So who's saying it starts as a behaviour problem? You are very naive if you think Wooo and Sidereal report accurately what Stephan says or thinks.

Dave said...

Wooo and sidereal (or anybody else who associates with Wooo) are crazies. Most of their "debunking" of Stephan is little more than ad hominem attacks. When people disagree with them, all they do is insult and bully them because that's all they got since their beliefs aren't based on real science. I hope people reading hyperlipid can see right through their BS. I have no respect for most of the commenters over there the way they are bashing Stephan instead of criticizing his arguments, if they really think he's wrong they should be able to explain why.

gunther gatherer said...

Sorry, I meant "20% of carbs" above.

I still think 60% fat is enormous, though not compared to VLCers like Peter I guess.

Galina L. said...

@Jane,
I am relieved that you found speculations about your mental health entertaining. I was afraid it could hurt your feelings. I am glad it didn't. Often people who chat casually on a blog with a very small following get a false sense that it is an equivalent of a private conversation. Fortunately it is hardly possible that any comment made by an anonymous blogger about state of health of anyone could be taken as the serious one.
As I understand, Wooo doesn't agree with the idea that insulin abnormalities are the function of overfeeding.

Stephan Guyenet said...

Hi Nigel,

Apologies for deleting your comment, but I am not going to host links to Woo's blog here.

Nigel Kinbrum said...

No problem. I won't post any more links to there.

Jane said...

@Galina
'..Fortunately it is hardly possible that any comment made by an anonymous blogger about state of health of anyone could be taken as the serious one. ..'

Hardly possible, is it? Where do you think Peter at Hyperlipid gets his awful opinion of Stephan from? Does he read Stephan's blog? No. He gets it from Wooo.

'..As I understand, Wooo doesn't agree with the idea that insulin abnormalities are the function of overfeeding.'

I imagine you mean that Wooo doesn't think overeating causes the hyperinsulinemia which she believes causes obesity. Actually hyperinsulinemia appears to be due largely to magnesium deficiency. If Wooo thinks hyperinsulinemia causes obesity, she must think Mg deficiency has something to do with it. Her problem is that overeating per se can't cause Mg deficiency. It must be certain kinds of foods, either ones that have had Mg removed, or ones that alter gut bacteria in such a way that Mg absorption is reduced. Refined carbs or a high fat diet. I can't understand why Wooo doesn't see this, it's so obvious.

Galina L. said...

@Jane,
I would never guess that "serious" could mean something like potentially bad influence on dangerously vulnerable veterinarian Peter who so obviously gets his ideas from some unmentionable here sourses.

gunther gatherer said...

Hi Jane,

"It must be certain kinds of foods, either ones that have had Mg removed, or ones that alter gut bacteria in such a way that Mg absorption is reduced."

Can you please explain a bit more about foods that alter gut bacteria in this way. The more I research health, the more I'm seeing gut bacteria as a central player.

Jane said...

@Galina
So it's obvious where Peter gets his ideas about Stephan from, is it? Why then did you say this on Wooo's blog yesterday: 'Last comment on WHS I read from Jane looked completely unreasonable. She can't be serious.'

Sounds to me as if you were very surprised indeed to hear where Peter gets his ideas from. I can only conclude that you believed Peter's opinion of Stephan came from a critical appraisal of his work. This is interesting to say the least.

Jane said...

@Gunther
Yes I agree. And this is hitting the mainstream media bigtime. Over Christmas there was an article about it in the Financial Times of all things. The paper it discussed is titled 'An opportunistic pathogen isolated from the gut of an obese human causes obesity in germfree mice'.
http://www.nature.com/ismej/journal/vaop/ncurrent/full/ismej2012153a.html

They fed an obese human on 'whole grains, traditional Chinese medicinal foods and prebiotics' and after 6 months he/she had lost the bad gut bugs and 50 kilos.

Here's a paper I posted earlier about magnesium deficiency in obese children, suggesting it might be causing their hyperinsulinemia, and that the benefits of fermentable fibre could be due to enhanced Mg absorption.

RESULTS Serum magnesium was significantly lower in obese children... Serum magnesium was inversely correlated with fasting insulin... Dietary magnesium intake was significantly lower in obese children... Dietary magnesium intake was inversely associated with fasting insulin...

CONCLUSIONS ...Obese children consumed a higher percentage of total calories from fat and a lower percentage of calories from carbohydrates. Fiber intake was lower in the obese group... potential causes of lower serum magnesium in obese youth include reduced magnesium absorption secondary to higher fat intake and lower fiber intake. ...several human studies have shown that fermentable oligo- or polysaccharides enhance magnesium absorption...
http://www.ncbi.nlm.nih.gov/pubmed/15855585

Kern River said...

Re: increased insulin production/decreased insulin sensitivity (regardless of which is the cart and which the horse)as a result of overeating/increased fat mass: is this reversed as weight and body fat percentages decline?

Galina L. said...

@Jane,
Yes, I still can't believe you are serious. Peter Dobromylskyj usually discusses results of various medical studies and obviously has more sources than blogs to form his point of view. He also treats his own sick patients.Here is an example of his thoughts as a result of his experience - http://high-fat-nutrition.blogspot.com/search/label/Earning%20a%20crust. Certain nurse's ideas just don't contradict his own ones.
The nurse and the psychiatrist we are talking about now are medical professionals who successfully managed to deal with significant levels of their own obesity and are frustrated with the official advise for treating such condition and with recommendations of Dr. SG. I think it was unreasonable for you to expect from them to avoid discussing their disappointment on a very small blog out of concern that the author of the Hyperlipid blog may read it and form a negative opinion about Dr. Guyenet.

Evelyn aka CarbSane said...

@Galina,

There is NO false sense of private conversation. If you think so then you are not as intelligent as I have given you credit for. Whether Wooo's blog is read by 20 or 20K, she has a small but vocal following that comments elsewhere. Wooo's penchant for misrepresenting what people say is legendary. When people come to her blog to object her over-the-top rhetoric, she whines that it's just wordz on teh internetz and how dare the trolls "invade" her "personal" "diary" blog. Newsflash -- she can change the settings tomorrow so that only members of the blog can read it. She doesn't.

Speaking of this nurse's personal experience, it includes short-lived obesity that she reversed around age 20. Followed by a year or so participation in leptin replacement trial. Including two extensive cosmetic reconstructions (as she describes them). Her maintenance is confounded by extreme and ever changing supplementation regimes, not to mention recent voluntary experiments with "mango juice" that should be troubling to all. She was banned from here for over the top attacks on Stephan, not his views/ideas, but him personally. It is appalling that Peter/Hyperlipid allows her and others to continue that to this day.

In my own case, I could care less what she rants on about, but when she blogs erroneously about something I SUPPOSEDLY said, that is inexcusable. Either she needs to read better or refrain from doing it, because my email Inbox is routinely filled with alerts to the latest crap being said about me over there. Including the terms of our agreement regarding her posting on my blog. Hint: She was never banned and she knows it. And you know it too, but you continue to stir the pot all about the net ... for what? Entertainment?

Apologies to Stephan for posting this here, but here is where Galina has chosen to stir the pot.

Galina L. said...

Probably, it would be more reasonable for me to try to continue my conversation with Jane about Peter getting his ideas mainly from blogs elsewhere in order not to stir the pot on the WHS blog (I sincerely apologize). However,yes, we all in one big conversation room.
I am leaving my house in 30 minutes , I will be back in couple days(taking my son to South Florida for internship position he got by chatting on net about cellphones, so yes, I understand that virtual life has connection with real one), and unfortunately right now I have only little time to address briefly what Evelyn said.
Nobody who is not delusional thinks that the web is a private place, it is for sure. However, I noticed that sometimes people behave on small blogs like they are engaged in a private conversation for whatever reason.I guess they may get into the false sense of intimacy, or there are other possible explanations.May be they wrongly assume anyway that not everyone can keep a track of all staff which is out there, or don't care much, how could I know. I personally think that Wooo's flamboyant and intentionally provocative style meant to deffer serious attention.

Galina L. said...

Probably, it would be more reasonable for me to try to continue my conversation with Jane about Peter getting his ideas mainly from blogs elsewhere in order not to stir the pot on the WHS blog (I sincerely apologize). However,yes, we all in one big conversation room.
I am leaving my house in 30 minutes , I will be back in couple days(taking my son to South Florida for internship position he got by chatting on net about cellphones, so yes, I understand that virtual life has connection with real one), and unfortunately right now I have only little time to address briefly what Evelyn said.
Nobody who is not delusional thinks that the web is a private place, it is for sure. However, I noticed that sometimes people behave on small blogs like they are engaged in a private conversation for whatever reason.I guess they may get into the false sense of intimacy, or there are other possible explanations.May be they wrongly assume anyway that not everyone can keep a track of all staff which is out there, or don't care much, how could I know. I personally think that Wooo's flamboyant and intentionally provocative style meant to deffer serious attention.

Alessandro Ana said...

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Jane said...

@Galina
You have completely misunderstood me. I am talking about Peter's opinion of Stephan. He does not have time to read WHS himself, so he relies on Wooo to tell him what Stephan says and thinks. She is a senior nurse with responsibility for >100 patients, and she has overcome massive obesity herself, so it's natural that he should do so. Sidereal is a psychiatrist who also comments on Hyperlipid, and since she agrees with Wooo, Peter has all the more reason to believe what Wooo says. I comment on Hyperlipid too, but these two medical professionals have far more credibility than I have because after all, I was thrown out of my job for saying people should eat whole grains and less meat. Peter sees patients all the time suffering from awful diseases because they ate whole grains and less meat. Cats and dogs, of course.

Evelyn aka CarbSane said...

Sidereal is a psychiatrist? Meanwhile, I think you make a good point Jane. Wooo's telling of events and perceptions are highly skewed (even hardcore LC'ers were aghast at Taubes' behavior at AHS11 and thought Stephan the better, cooler cat in that exchange!)

Jane said...

@Evelyn
Agreed. I would add one more thing: Stephan banned Wooo mainly because she was so muddled. She would write one enormously long opaque comment followed by a second, a third and even a fourth. It was impossible to work out what she meant, and impossible to point out her mistakes and inconsistencies, because there were so many. The point of Stephan's post would be lost in all the muddle.

Jane said...

@Evelyn
Oh I didn't see your latest comment before I posted mine. Are you saying Sidereal isn't a psychiatrist? What is she? I only know what Galina says. Sidereal says she works in a hospital, that's all I know.

Evelyn aka CarbSane said...

I was around at that time and remember how difficult it was to follow conversations because of the lengthy replies. The banning was rightly enforced because she couldn't keep personal attacks out of it. No blogger should have to deal with being called an idiot and worse on their own blog. So Wooo retreated to hers and several took up the case of the "wrongful" banning to Peter's. I think it was to his disgrace that he allowed that. I understand the reason Stephan deleted Wooo's posts, but in a way it is unfortunate that he did because now people read Wooo and friends talking about Stephan's unreasonable censorship. They have done the same with mine.

Wooo was not banned from my blog, she banned herself. She began posting, and at times even long diatribes. So long as she didn't bash me or other bloggers like Stephan, I allowed discussion. But I got tired of her posting on my blog then running back to hers and writing "look at what I wrote on Carb Insane b*tch's blog" and shadow conversations going on there. It wasn't just the nasty attacks, it was the misrepresentation of what I have said. An entire rant on how LC doesn't cause menopause comes to mind, when I never said it did (In a personal anecdote I wondered aloud how I would never know whether it may have contributed to my early meno). And that was mild. More recently I'm sure you read her musings on how I must be bigoted against Ukranians.

But nowadays people complain about Wooo's unwarranted ban from my blog because she was so polite and unWooo-like in her comments there. That's the point of my post here, because these bloggers can't have it both ways, and Galina, nasty comments made on those blogs are meant to be read. Repeat: meant to be read.

I go back and forth whether to respond to the various alerts to what these people are saying about me now that land in my Inbox with great regularity. On rare occasions I will because there are a number of people who read/comment both places and they deserve to know the truth, not Wooo's version, of my position.

I don't know what Sidereal is/does. I seem to recall mention of working in a lab or being a scientist of sorts. If she's a psychiatrist there's a whole lot wrong with her online relationship/advice with Wooo.

OnePointFive said...

Notice that according to Galinas quote Sidereal doesn't think much of Simon Wesseley.

So it's perhaps ironic that Prof Wesseley recently was a joint winner of the Maddox Prize for standing up for sciencein the face of intimidation and harassment)
As the Times put it
If Scientists are silent; loony ideas will win.
see
http://www.nature.com/news/john-maddox-prize-1.11750

Medjoub said...

The thing I find most appalling/intriguing about Woo is that she has managed to insinuate herself into the broader discussion with little more than personal anecdotes and inflammatory attacks on blogs, bloggers and commenters of virtually every stripe. Now she is regularly referred to -- as an authority, God help us -- in casual discussion on pertaining topics. But the reality is, in my thinking, that someone as obviously intelligent as Peter enjoys Woo for her snarkiness -- and that she creates a smokescreen of vitriolic unintelligibility. His blog is virtually unreadable itself, but the comments regularly transform into pure bedlam. Those that claim to understand his arguments are being very, very generous with his willfully obscurantist writing style. I think Woo plays perfectly into this approach. But like I said, he's a smart guy and I doubt that he is somehow pulling a totally self-deluding feint. Though he might be more skeptical than he allows his many sycophants to see. Cherry-picking is itself nothing exceptional or unusual, especially when to stop doing so might require a total restructuring of one's perspective. Woo, on the other hand, is clearly totally convinced of her angle's veracity and such intensely emotion, personal support is exactly what the sycophants need...

Stephan Guyenet said...

"Woo" was one of only about 4 people I have ever banned from this blog since 2008, placing her among the top 0.001% rudest and most aggressive people ever to show up here. By her own admission, she has emotional problems. I know I don't have to justify myself here, but for the record, here is why I banned "Woo":

-She frequently wrote massive, multi-part comments each of which maxed out the word limit for comments

-Those comments were often aggressive and insulting toward myself and other commenters

-Her writing was often difficult to understand

-She never provided any evidence for her ardent claims-- I don't recall a single scientific reference

-I was extremely patient with her as she aggressively dominated my comments section for months. I warned her very politely on at least four occasions but she was unable to play nice

-I have a low threshold for anonymous internet ranters. Giving your full, real name means accountability for what you write

I only deleted a few of her comments; the rest of them, hundreds probably, are still on my blog.

Jane said...

Stephan, she did sometimes give scientific references. Just before you banned her she gave two, if I recall.

You will remember that you and I had a disagreement by email around that time. I think it might be a good idea, if I could make a suggestion, that you discuss on your blog the things we disagreed about. It was McCarrison's work, the Hunza, and the 'toxicity' of wheat. And the superiority of the paleo diet, which I argued had not been demonstrated.

I know you are a very busy man, but I think you should find time to read The Wheel of Health, which is by far the best account of McCarrison's work and the Hunza. The book is quite short, and very readable. You told me you thought McCarrison's experiments were not good ones, but you never explained why. McCarrison is in your Research Hall of Fame, and if his experiments were no good he does not deserve to be there.

Jane said...

The Wheel of Health, GT Wrench MD, 1938
http://www.soilandhealth.org/02/0203cat/020301wrench/02030100frame.html

LeonRover said...

Mind you McCarrison did not provide his rats with running wheels - consequently, in contrast to the Hunza, his Coonor rats had no opportunity to simulate any movement required for food gathering.

This contrasts with results found in "Wheel running eliminates high-fat preference and enhances leptin signaling in the ventral tegmental area"

- http://www.ncbi.nlm.nih.gov
/pmc/articles/PMC2867328/

Fascinating stuff.

Gabriella Kadar said...

When anyone makes speculative, hypothetical postings on their blog about personal physiologic or neurologic response to anything ingested, food/drug/pseudofood/dietary supplements, the 'red flags' go up for me.

Self diagnosis is for fools. Anyone who considers this sort of activity to have any bearing on reality is also a fool.

The individual to whom Galina et al. refer in comments here has admittedly not obtained any form of blood testing for any easily quantified measurements. This person has no medical insurance and does not consider it of sufficient potential value, interest or proof to obtain objective data on anything from blood glucose to TSH.

There is all sorts of speculative musing about sleep without taking the initiative of participating in a sleep study.

Considering that this person is a 'healthcare paraprofessional' working in a facility, interacting with both doctors, nurses, patients and their families, the claims and self experimentation reports are indicative of a very cavalier attitude.

The fact that there are individuals who are supportive of this fantastic self experimentation just goes to show how many people have not been educated sufficiently to have developed any capacity for critical thought.

Since the blog does not provide personal identification, this person can and does participate in activities which under some circumstances would be considered justification for termination of employment. The personal irresponsibility and the indulgence of gratuitous comments about co-workers let alone other bloggers on the internet cannot but result in a reader concluding that this person is emotionally out of control at times. The fact that this person has serious responsibilities at a healthcare facility is troubling.

Robert said...

Gabriella Kadar: Many of those statements are demonstrably untrue. And you're a *dentist* -- who are you to condescend to Wooo on obesity?

And who are you to agitate for her destruction for not bending the knee to her *dentist* overlord?

v/vmary said...

evelyn said: "I go back and forth whether to respond to the various alerts to what these people are saying about me now that land in my Inbox with great regularity. On rare occasions I will because there are a number of people who read/comment both places and they deserve to know the truth, not Wooo's version, of my position."

why don't you ask people to stop sending you alerts. Those people who you say deserve to know the truth of your point of view told in your own words know where to find you on the internet. you don't need to worry about them. if they don't seek you out, you can choose to view it as their loss and leave it at that.

geez, one of the earliest rules i taught my daughters is don't pass on negative stuff. that's just being an instigator. when someone starts to say to me 'do you know that so and so was talking about you" I cut them off and say i don't want to hear it. they can tell me to my face if they want. if comments rise to the level of libel, i have to show suffering is some provable way. so i skip the drama. if anything really harmful is being said, i'll hear about it from some authority.

Gabriella Kadar said...

Okay Robert whoever you are lacking the guts to put your full real name on Google, demonstrate what is not true about my assertions.

I wasn't being condescending. Also I am no one's 'overlord'. However, it would be a good thing if people learned to govern their own minds.

Evelyn aka CarbSane said...
This comment has been removed by the author.
Galina L. said...

Wow, while being away I missed so much of conversation,that I don't know how to pick-up the conversation line now, but I think I could try.
First of all, I did a mistake referring to Siderail as a psychiatrist, and I apologize for my mistake.
@Jane,
You suggestion than the author of Hyperlipid blog forms his opinion about about GS from reading Wooo's blog doesn't look logical, especially after reading their blogs.I saw Peter's comment on other blogs, but newer on Wooo's, he mostly blogs about his interpretation of results of scientific research,
even Stephan Guyenet noticed in his comments in Hyperlipid blog that Peter reads not only WHS blog, but even comment section
" Now that we've figured out exactly where Peter got his inspiration for the above post, let's review what we've established:
1) The above post, ad hominem attacks and all, was a reaction to a single sentence I wrote in the comments section of one of my own posts...".

Galina L. said...

@Evelyn,
Wooo lost 160 out of 280 lb, and after so massive weight loss obviously needed skin removal surgery. It was not a short-leaved obesity, she started to develop her problems in a childhood. She entered a leptin trail after loosing most of her weight already. BTW, she was the only formerly obese person there, the rest were normal weight but leptin deficient females who got into such state by being heavily engaged in sports.

Galina L. said...

@Gabriella Kadar,
Many have to rely on self-diagnostic and to take care of own health without expecting much from GP. It took me several appointments to convince my family doctor in Canada to test me for TSH because I thought I had an under-active thyroid, but he didn't think so because I was lacking some symptoms, the story repeated itself when it was difficult for me to convince my GP in US to give me prescription for the natural dessicated thyroid(the switch of meds made big difference). I had migraines since twelve, but it got much worse after I came to Canada at 35 yo, so I started to look for a professional medical help. However , no doctor in Canada or US was of much help, I was prescribed different pills, even antidepressant at one point, nothing worked well enough. I payed out of pocket for electroencephalogram and some other tests in my native country ,and it was found out my migraines were some sort of epilepsy, and the medical treatment, based on such finding, started to produce results. BTW, I will be grateful to Wooo forever for her suggestion of the supplement Taurine ,which I use it for the migraine prevention during times when migraine is very possible.
In my family we manage our health issues ourselves most of the time despite having medical insurance.

Robert said...

Gabriella, why don't you first explain why you appear to be trying to damage someone's career just because you don't agree with their opinions about obesity (which isn't even your field?) Some might find that a bit mean-spirited.

And aren't you at least as exposed as Wooo? Because when people in Ontario are searching Google for a Toronto dentist, oral surgeon or dental surgeon (or just for "Gabriella Kadar DDS" or "Dr. Gabriella Kadar"), wouldn't you want them to find evidence that you're a nice person, rather than your post above?

Jane said...

@Galina
You have misunderstood me yet again. I did not say Peter gets his opinion of Stephan from reading Wooo's blog. I said he gets it from Wooo. Don't you remember the long comment she wrote on Hyperlipid describing in detail what Stephan thinks? I did not recognise anything she said, and told her so. Did Peter believe me or her? I don't know. This happened just after Stephan had blogged about a paper showing that palatability alone can cause weight gain, and Wooo did a post on her blog claiming the paper had not shown that. It had. She hadn't read it properly. This is her problem: she spends so much time writing she does not have any left to evaluate critically what she's writing about.

BTW, Peter has said on his blog that he no longer reads WHS.

Jane said...

@LeonRover
Do you think that's the criticism Stephan has of McCarrison's experiments? That the rats had no exercise wheel?

It seems to me that if you want to say 'wheat is toxic' (and I don't think Stephan really wants to say that, but he did say it once) you have to find a population of people who have eaten whole wheat and no refined wheat all their lives, observe their health, and then do experiments on rats to find if the wheat-based diet produces in them the same state of health it produced in the humans. No modern population fits the bill, but the Hunza did, and fortunately for us McCarrison spent 7 years as their doctor. They were spectacularly healthy, and so were the rats, as you know. So the idea that wheat is toxic goes out the window.

Perhaps modern wheat is different. I have not read Wheat Belly but Chris Masterjohn has, and he has not found anything in it supporting the idea that modern wheat is toxic. Its mineral content is slightly lower.

Jane said...

@v/vmary
It's very important indeed to know what people are saying about you. If you don't, you can get nasty surprises. Then you may be unable to stop yourself from responding unwisely. Avoid nasty surprises, and you will behave in a way you will not regret. This is the essence of 'turn the other cheek'. The man who said that didn't say it because he was a wimp, but because he had observed that it works.

IcedCoffee said...

@Jane,
Are you therefore unpersuaded by the growing evidence of a widespread response to gluten and gluten-like proteins? Or is this simply a product of refined wheat consumption?

And regarding the Hunza, are you unpersuaded by Clark's account of them? Although I'm sure a lot of geopolitical factors could lead to their physical decline, the fact that they didn't calculate their age based on orbital years but rather based on personal assessments of wisdom calls their supposed longevity into question.

The only thing I see worth replicating about the Hunza is their amazing mustache growth.

Gabriella Kadar said...

Galina, please re-read my initial comment. I named no one. I described behaviour which I think is problematic. Please go back and read that person's comments targeting Stephan. Is that what you would consider appropriate or is it savagery? And I am not referring here to the latest diatribes consequent to Peter D's blog.

The problem with the entire medical profession in Canada and probably in the US as well is physicians don't spend enough time to know their patients. They don't focus and they don't have a checklist which would at least ensure that they are doing things in a logical sequence and miss anything.

I don't know how long ago you lived here, but the doctors in Ontario are being encouraged (possibly, I haven't said for sure, with financial incentives) to minimize the amount of money the government pays out for testing of any kind. Doctors who now have a dedicated roster of patients get paid monthly for each and every patient on their roster regardless if they actually see that patient for years at a time. There is even less incentive to spend time with these patients than when they were paid per appointment. People are people and regardless what they do for a living, they'll find the easiest way to get paid. Since doctors in this province are civil servants and not self employed in the fullest sense of the word, 'customer service' does not exist. There is a severe shortage of Family Physicians, so there is no problem if a patient or even if a couple of hundred patients 'fire' their doctor. There are people waiting in line for the opportunity to get an appointment. In addition, doctor's practices are worth nothing when the doctor retires. They cannot retire with dignity. The money they make from their practice is all the money they'll ever get from all the time and energy they've invested in it. Other professional businesses have value and can be sold.

The best 'Blast from the Past' are the thousands of doctors in the USA who 'performed' and billed for Pap smears on women who had had full hysterectomies. Oops, they all got caught.

True migraine headaches are associated with Cranial Nerve 5 (Trigeminal). These are not epileptic in origin. Which is not to say that a person may have terrible seizure type headaches, but they are not classic migraines.
You can call it a migraine if you want because then the awfulness and intensity of the pain will be understood by others and really, most people would not associate an epileptic type disorder to cause pain.

Manythings said...

@Gabriella Kadar

I refer to your comment above, concerning a young woman's blog about her experiences with obesity. 

Taking each part of your comment in turn:

Part 1

"When anyone makes speculative, hypothetical postings on their blog about personal physiologic or neurologic response to anything ingested, food/drug/pseudofood/dietary supplements, the 'red flags' go up for me.”

The postings about which you complain consist largely of empirical observations of obesity and post-obesity, mainly personal and occasionally of family members and anonymous patients. By definition, these empirical observations are neither speculative nor hypothetical. 

Your red flags are free to go up or down as you wish; but authors of internet blogs are, whether you approve or not, equally free to observe, to report and to speculate on the subject of obesity as they see fit.

"Self diagnosis is for fools. Anyone who considers this sort of activity to have any bearing on reality is also a fool."

In an ideal world, self-diagnosis would never be required. But medical professionals are not omniscient. It is, unfortunately, and in our imperfect world, sometimes not foolish, but necessary, to self-diagnose: see the illustrative examples provided in Galina’s comment above.  Self-diagnosis is at times an activity that has a very distinct bearing on reality, and perhaps even on one’s survival. It is, in our imperfect world, foolish to imagine otherwise.

"The individual to whom Galina et al. refer in comments here has admittedly not obtained any form of blood testing for any easily quantified measurements.”

As far as I am aware this is simply nonsense. The blog author patently refers from time to time to blood test results and other quantified measurements.

"This person has no medical insurance …”

I have no idea whether this is true or not, but it appears to have no relevance to any of your other complaints.

“This person … does not consider it of sufficient potential value, interest or proof to obtain objective data on anything from blood glucose to TSH.”

This also is nonsense. The allegation is that the blog author does not consider it of value to obtain “objective data on anything”. Surely you must see that this is an exaggeration. In fact, as observed above, the blog author refers from time to time to such objective data and by so doing clearly (contrary to your allegation) (a) has obtained objective data and (b) considers them of potential value, interest or proof.

"There is [sic] all sorts of speculative musing about sleep without taking the initiative of participating in a sleep study.”

One is entitled to muse speculatively about sleep with, or without, taking the initiative of participating in a sleep study. It is not reasonable to criticise a person for for this.

"Considering that this person is a 'healthcare paraprofessional’ …”

You have put the term “healthcare paraprofessional” between quotation marks. I do not know who (if anyone) has stated that the blog author is a “healthcare paraprofessional” or exactly what you mean by the term. Perhaps you seek to imply that the author is not a healthcare paraprofessional. Perhaps you disapprove of the term “healthcare paraprofessional”. Perhaps you dislike "healthcare paraprofessionals”. It is just not clear what you mean by this.

“ … [W]orking in a facility, interacting with both doctors, nurses, patients and their families…”

The blog author, as you should know, is a nurse and as part of her duties has every right to interact with doctors, other nurses, patients and families.

Manythings said...

@ Gabrielle Kadar Part 2


“ … [T]he claims ... “

It is not clear to which claims you refer. The blog author’s principal “claim” is that she has obtained very substantial remission from the symptoms of chronic, gross obesity and further that she is one of the (vanishingly small) number of people who have maintained a large weight loss for something in the order of 10 years. Perhaps you mean to say that you doubt these claims. If so, your doubt appears to be groundless. Perhaps you would be wiling to concede the truth of the claims, but object to formerly obese people discussing their condition in their internet blogs. Or, perhaps, you object to such formerly obese people doing so if they are also “healthcare paraprofessionals” or nurses. It is difficult to understand what you mean to say.



“ … [A]nd self experimentation [sic] reports …”

It is not clear to which self-experimentation reports you refer. You have stated above that you object to people posting on their own blogs their speculations about their personal responses to, among other things, food. One imagines that you would therefore regard as self-experimentation any deliberate change of one’s personal diet, if this were done with a view to observing and evaluating the effects of such a change. Changing the diet from time to time with a view to observing what happens is exactly what most people do throughout their lives. It is true that not everyone reports the results of their changes of diet on their internet blogs, but it is by no means clear why, if they choose to do so, you or anyone else should object.

“ … are indicative of a very cavalier attitude.”

I repeat my comment above, that "self-experimentation" in respect of one’s personal diet is what most people do throughout their lives. It is not “indicative” of any “attitude” and in particular it does not of itself indicate any "cavalier attitude”.

"The fact that there are individuals who are supportive of this fantastic self experimentation just goes to show how many people have not been educated sufficiently to have developed any capacity for critical thought.”

Again, you have not expressly referred to any “fantastic”, or indeed any, particular, alleged “self experimentation [sic]”. This makes it difficult to determine who might be the “individuals” you consider to be supportive of the alleged self-experimentation. Nor can I determine whether any such “individuals” have not been educated sufficiently to have developed any capacity for critical thought. 

If the self-experimentation to which you object is, indeed, the blog author’s voluntary changes of diet (as discussed above) then that begs the question: how might one support, or not support, a blog-author in changing their diet from time to time? For myself, if a blog-author reports that a particular dietary regime enables her to lose weight, maintain weight loss or obtain some other health improvement, then I am pleased for her. Sometimes I might communicate that pleasure through the blog comments. Does that mean that I am (in your terms) an “individual [who is] supportive”? Perhaps. 

If I am, according to this definition, an “individual [who is] supportive” does it follow that I must "have not been educated sufficiently to have developed any capacity for critical thought”? I do not know to what extent you, Ms Kadar, have been educated. You are a dentist in general practice and it is possible that your education is superior to mine. I would not wish to argue that I have any very great capacity for critical thought. But I would have to take issue with any claim you might make that I did not have any capacity for critical thought. That would be an exaggeration.

"Since the blog does not provide personal identification …”

Others have remarked on your arguable lack of judgment in posting your comments in what appears to be your own name. I would not criticise anyone (as you impliedly seem to do) for posting on their internet blog anonymously. 

Manythings said...

@Gabriella Kadar Part 3

“ … [T]his person can and does participate in activities which under some circumstances would be considered justification for termination of employment. …”

The alleged “activities” are not specified so it is difficult to understand what exactly you mean by this. As far as I am aware, it is an utterly groundless allegation which has, moreover, been made maliciously. By maliciously, I mean that your motive appears to be to cause harm to the reputation of the blog author. In the circumstances in which your comments were made there is clearly no defence of privilege or qualified privilege available to you. Please note that the fact that you have not named the person whom you have apparently defamed does not exculpate you. Anyone who reads your comment can easily find out who it is to whom you refer.

Given these circumstances, the above statement by you is (as are further statements by you, discussed below) on the face of it potentially unlawful and defamatory. Please do not take my word for this:  seek the advice of a lawyer who is qualified in these matters.

“... The personal irresponsibility …”

No allegation of any specified or substantiated “personal” or any other "irresponsibility" is made but on the face of it this appears to be a further unlawful defamation.

“ … [A]nd the indulgence of gratuitous comments about co-workers “

If an anonymous blogger has made anonymous comments about co-workers, that does not on the face of it seem to be any concern of yours or anyone else's. I am not sure what is meant by “gratuitous”, as opposed to any other, type of anonymous comments. Perhaps you mean that comments are made about anonymous co-workers that are undeserved. If so, I wonder how you could possibly know this.

“ …. [L]et alone other bloggers on the internet …"

This seems to amount to a complaint that the blog author has made “comments" (whether “gratuitous" or not is not clear) about other bloggers on the internet. This is, by any reckoning, a non-complaint. The very blog on which you have posted your comment illustrates quite clearly that bloggers on the internet frequently make comments about one another. One might go so far as to say that one of the purposes of blogs is to enable debate and comment. It follows that the fact that comments have been made about other bloggers does not support any of your other complaints.

“ … [C]annot but result in a reader concluding that this person is emotionally out of control at times. …”

To recap, your argument, Gabrielle Kadar, is that "a reader" must conclude that a blogger, an anonymous person that neither you nor they have ever met, “is emotionally out of control at times” because: (a) of an unspecified and unsubstantiated allegation by you of “personal irresponsibility”; (b) the blogger complained anonymously to internet friends about anonymous co-workers; and (c) the same blogger made “comments” about other bloggers on the internet.

I do not accept your premise, Gabrielle Kadar, that these three allegations must, even if they were true, (which they appear not to be) lead a reader to any particular conclusion about the blog author or anyone else. However, it may be argued that the apparently deliberate and unlawful defamation of a healthcare worker (the blog author) by a qualified healthcare professional (you) amounts to “personal irresponsibility”. It is, moreover, undeniable that you have engaged in the “indulgence of gratuitous comments about … bloggers [or at least, one blogger] on the internet”. 

Gabrielle Kadar: With the greatest possible respect to your profession as a dentist and with the clear caveat that I do not accept your premise (as set out above) I have to point out that by your own reasoning (not mine) it logically follows that you arguably are a person “emotionally out of control at times”. I do not say this to allege that you are emotionally out of control, but rather to illustrate the absurdity of your reasoning when it is applied by you to others.

Manythings said...

@ Gabriella Kadar

Part 4 (Final)

"The fact that this person has serious responsibilities at a healthcare facility is troubling.”

I might as well claim that I found it “troubling” that you, Gabrielle Kadar, were (as you indeed appear to be) in charge of a dental practice with responsibility for a number of patients. Of course, I do not hold any such an opinion. Again, I simply wish to illustrate the absurdity of the apparently defamatory allegations made by you against against the healthcare worker and blogger referred to above.

The internet is full of quacks who solicit payment for their self-published health-related publications. In sharp contrast, the blog author whom you now criticise publishes all of her insights on her blog entirely freely of any charge. She does not even solicit Paypal contributions.

Some of the paid-for internet quacks misrepresent their qualifications. In contrast, the blog author who is the subject of your criticism is at times almost painfully honest about her qualifications and limitations. 

Why you chose to examine this particular blog author is a mystery. But as you seem to have the time and energy to seek to police the internet, you do not have to look far to find more worthy objects of your critical interest.

It would be wise to seek to avoid falling foul of the many laws applicable to the internet, including (but not limited to) the laws concerning defamation.

Item 12 of your Code of Ethics is also worth bearing in mind.

ann. said...

How is Gabriella Kadar damaging W's career? Or defaming (this must be unintentional humour) W? By stating facts that have been publicly stated by W herself? In other words W is doing the damaging all by herself. If anyone is trying to damage others' careers and "defaming" it's W.

One can't be serious if one thinks anyone reading Gabriella Kadar's post above about W. is going to think G. Kadar is not a "nice person"? One look att W's blog or comment history on other blogs will have them convinced G. Kadar is a master of understatement.

I think someone's surprisingly just realised that employers with employees who blog might see it that way too.

Stephan Guyenet said...

Hi Manythings,

I seem to recognize a certain commenting style here... who could be on the other side of that username?

You are writing multi-part comments that max out comment word limits, and you seem to be awfully familiar with Woo's blog...

I also noticed your account was created in January 2013 and has only been viewed 4 times, indicating that it was probably created for the purpose of writing these comments defending "Woo".

Who could you be?

Gabriella Kadar said...

Thank you Ann.

Stephan, sorry for the trouble but really, there are limits to everything.

Galina L. said...

@Gabriella,
I was in Canada from 1995 till 1999. They did MRI of my head in order to eliminate a possibility of a brain tumor, then doctors kept giving me different pills . My migraines could be quite severe, it may last tree-four days, and due to vomiting I can't even drink. In ketosis one - two days, less frequent, with less vomiting. I also have some mood problems.I had small epileptic episodes between 6 and 8 years old, and thought it all was gone.
In Russia I managed to have an appointment for electroencephalogram right at the time of a migraine, it would be impossible to have a walk-in appointment for such test in US. I don't know how to read electroencephalogram results , it was the doctor who read it who told me it was an epilepsy-like type of electrical brain activity, anty-seizure medication in a small dose was prescribed for me by the neurologist in Russia, together with some other drugs for the improving blood circulation in my brain and magnesium supplementation. That drag was very helpful for about one year, but the effectiveness was wearing off, and I began to notice some undesirable side-effects, so I started to use ketosis.
On several more occasions we as a family had to rely on self-care and self-diagnosis, I just cautious to place too long comment because it may be against the policy of that blog. I will risk anyway. My husband was having what looked like bile duct colic, GI testing gave no results. I finally used the Hungarian med No-Spa on him for the relaxing spasms in smooth muscle tissue which I brought from Russia.It work really well. My lady-friend went with similar set of symptoms to ER in Montreal, they found nothing during ultrasound examination, gave her Tylenol and sent her home. I have more stories like that, we have bunch of meds at home , some invented during World War first like the tar-based ointment for deep inflammation, or boric acid dissolved in glycerin, which I used to use for vaginal yeast infections, but low-carb diet removed my need in such remedy.
I don't think that only fools are engaged into self-diagnosis and self treatments. Fools do whatever doctors told them to do without questioning the advice.I am not advocating avoiding doctors, but it is better to understand what you can do for yourself first. The ability of a doctor to help is often limited by several factors, some of such factors you mentioned already. I like our family doctor as a person a lot, the same I can tell about myob/gynecologist, they are good and smart people functioning within unperfect system .

Gabriella Kadar said...

Galina, when there are health problems it is good for patients to advocate for themselves and if they are unable, that someone do it for them. A really excellent physician, like any person doing anything (plumber, architect, cashier at the supermarket, nutritionist, teacher ) is exceptional. If you've found doctors you both like as people and who are also very good at what they do, then you are a very lucky lady.

I don't know about you but I can count on one hand the number of really excellent teachers as a child. And around here, a cashier who actually thinks before putting my groceries in a bag (I don't just stand there, I bag my own as well) is refreshing.

Incompetence and lack of attention to detail is becoming increasingly pervasive.

' Fools do whatever doctors told them to do without questioning the advice' Exactly. Communication between treatment provider and patient is the most important thing.

Dr. William Osler taught that the doctor needs to listen to the patient's story and that the patient knows what's wrong, we just need to listen.

Listening goes in both directions. And this is where the trouble lies in today's interactions whether in the doctor's office or Home Depot.

We can only do one thing at a time, but there are those who are still convinced that multi-tasking can be successful.

healthmanagement said...

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Health Foods

Jane said...

@IcedCoffee
Yes, lots of people can't tolerate gluten. Lots of people can't tolerate lots of things nowadays. Are you going to blame the gluten or a poorly functioning immune system? Here's a paper showing that not wheat but beef 'was the predominant allergenic food in the whole population' in Cordoba, Spain http://www.ncbi.nlm.nih.gov/pubmed/20846474

'...And regarding the Hunza, are you unpersuaded by Clark's account of them?'

Is it relevant? Clark studied them long after McCarrison did, and long after their health had started to deteriorate due to episodes of starvation following population growth.

And does their longevity matter? I don't know whether McCarrison mentions it anywhere. I can't imagine he'd be that interested, knowing it couldn't be verified.

'...The only thing I see worth replicating about the Hunza is their amazing mustache growth..'

I hope your health is as good as mine. I am pleased to report that the Hunza diet works with modern wheat.

Manythings said...

@ Stephan Guyenet

You and I do not know each other; I am not Wooo.

Toxic said...

Manythings: hear, hear.

Gabriella Kadar: my undiagnosed celiac disease, which had brought me to the brink of death, was not spotted by any of my doctors in 50 years.

OTOH a delivery man cautioned me against eating so much Gaviscon, and wondered whether I had that "bread thing". I wish I had listened to him.

Shortly afterwards, my son's care assistant showed me her Raynaud's fingers, which matched my own, and said "I think your other problems must be autoimmune." I looked up Raynaud's, found "see also celiac disease, and following that was able to diagnose myself quiet easily, get tested and biopsied, and through MERE DIET cure my own ataxia, blindness, kidney problems, diarrhoea and abdominal pain. The celiac crisis cost me an appendix, an ovary and one kidney.

The prescribed gluten free diet (they actually issue packaged food here) was just a pile of vile carbs. I didn't get properly well until I went back to uber low carbing, and found the blogs of hyperlipid and wooo. I would rather trust the advice of a wise country vet and an insightful nurse than I would most doctors. Woo and Peter are saving my health very impressively. Would you rather I died?

My medical notes are annoted to record my views. Unless I have broken a nail, or something equally easy to see and fix, no one is allowed to send me in hospital to be neglected again, and berated for being fat.

As a general rule, I like to be with, play among, and learn from people with a keen sense of humor alongside their intelligence. I feel that is sadly lacking here, and in other places you seem to like.

And what of dentists in my life? Well I like my dentist. He is a very nice chap, and was the only person brave enough to treat me once I became allergic to latex and started throwing shocks. I also like him for apologising for not realising that my pitiful aphthous stomatitis, which was extensive, open, raw and agonising, was celiac-related. It cleared up within two days on a gluten free diet, after five years of suffering.

Had I ever seen him posting about anyone in the way that you have here, I would never set foot inside his surgery again.

Congratulations btw. I don't think I have posted anywhere for years. You winkled me out with your astonishing behavior.

Gabriella Kadar said...

That is very interesting.

The thing about latex allergy is if it were the actual latex, you would drop dead of anaphylaxis in the vegetable aisle of the supermarket because of the rubber bands used to hold various types of vegetables, like green onions or leeks in bunches.

People with 'latex allergy' don't drop dead when they pick up a bunch of green onions or broccoli because the process to manufacture rubber bands is different than the ones that are used to make gloves.

Reynaud's phenomenon and Reynaud's syndrome manifest in slightly different ways. The phenomenon is unforgettable: the fingers of the living look like the fingers of the dead. The syndrome is cold hands and bluish nailbeds. Anxious people who hyperventilate and upramp their sympathetic nervous system tend to exhibit this. It is a hypoxic situation that can have other aetiologies such as hypothyroidism.

Dr. Allesio Fasano is a very interesting Celiac disease researcher. It is worth listening to what he has to say. He has noted that the incidence of celiac disease increases with the age of the cohort he studied over several decades.




Toxic said...

@Gabriella Kadar:

What?

Neil Timms said...

@Gabriella Kadar


I think that your post at January 12, 2013 at 10:54 AM was uncalled for. Your following post at January 13, 2013 at 12:32 PM (...I named no one. I described behaviour which I think is problematic.....) appears to me to be disingenuous.

Henry Hale: I fear the presence of the outsiders will attract those of whom we do not speak.
Female Elder #2: But if you talk about those of whom we do not speak, have you not spoken of that about which we do not talk.
Henry Hale: Do not speak of that of about which we talk of not speaking... about.

I think it ironic that in a discussion related to the field of obesity research where observational studies, self-reporting and multiple variables abound your 'red flags' went up when an individual comments on their own eating and life experiences. I would agree [Listen, don't mention the woo. I mentioned it once, but I think I got away with it all right. ] has a somewhat brash delivery but her posts and comments appear to be informative and demonstrably helpful for some.

My own personal view is that the majority of people either do or can self diagnose for examples: common cold, compound fracture (a bit extreme but self obvious). I am not in any way downplaying the importance of medical professionals here but I hope to point out that self diagnosis is something that most people do to a greater or lesser extent most of the time. I certainly do and say foolish things from time to time - most people do - but I object to being called a fool. I quote from your post: "Self diagnosis is for fools. Anyone who considers this sort of activity to have any bearing on reality is also a fool."

And of course both your posts above and this post are off topic.

Cheers
Neil
(my real name and i am also not the woo)

Toxic said...

@Gabriella Kadar:

Let me expand. What???????????????

... such a swingeing non-sequitur.

Your punctuation, "Actual latex" and "latex allergy", would suggest that you do not believe I have a latex allergy.

I was diagnosed with Type 1 reaction to Natural Latex Rubber in 1995 by a leading consultant allergist. He did not struggle with this diagnosis. My turning up on a stretcher, borne aloft by shouting, panicking paramedics, and looking like a slab of raw steak was probably a very big clue. My subsequent collapsing with shock when exposed, variously, to: A balloon; carpet glue (which I couldn't even see); and the latex-gloved finger of an arrogant GP during an obstetric examination (whilst her screen flashed WARNING LATEX ALLERGY WARNING LATEX ALLERGY)also seem to bolster his diagnosis. If you can think of any other reason for these extreme reactions, please do say. I am tired of having to carry an Epipen around with me, even in my own house.

I beg you to examine your prejudices before you treat your very next patient. It is a commonly-held belief, among medical professionals and the public alike, that people claiming to have allergies have invented or exaggerated these. Such a belief could eventually prove deadly to someone you know.

I use the term latex allergy because it is most readily understood by any readership. Not everyone knows what I mean when I write Type 1 reaction to Natural Latex Rubber.

I don't know why you are talking about rubber bands or Raynaud's (either flavor) in this simplistic way. If it were to show a greater understanding, I am not sure you have entirely succeeded. Living with my degree of latex allergy is complicated and challenging, and affects every aspect of my life. Cautioning me to avoid rubber bands is like my cautioning you to wash your hands between patients: Patronising and simplistic.

Re. Raynaud's. I think there is a third flavor, and I had it - a Raynaud's impersonator. Two years after my celiac diagnosis I found I could quickly run a vegetable under the cold tap without screaming (I still can't hold it there without losing the color in my fingers). I was able to stop wearing fingerless gloves from September to June every year. (I had already stopped putting a large blob of Play-Doh on my nose in winter, to try to keep it warm, because the stuff contains gluten - I MISS doing that). It wasn't true Raynaud's (either flavor), it was the almost total collapse of my immune system. I hope that makes things a little clearer for you.

Nothing changes my original two points (that you ignored), which are these:

1. You don't have to be medically-qualified to be able to research a medical condition, nor will this kind of researcher inevitably be lacking critical faculties, nor be a hypochondriac. He or she will almost certainly have a doctor/s who is/are not listening properly, and whatever drug or other therapy has been dispensed is not working.

2. Homespun health advice from someone sensible and observant can can be infinitely more accurate and valuable than some medical opinion.

I know. It saved my life.

Gabriella Kadar said...

There are several ways in which latex rubber is processed. Some make susceptible people react to it in an adverse way. This includes gloves, condoms, etc.

However, it is not the pure latex which causes the problem because then people with 'latex allergy' would be unable to shop at supermarkets.

I was concerned about this matter and checked into this years ago by contacting a person who is an expert on the matter. This was at the time when 'latex allergy' became problematic for certain individuals.

I have nothing whatsoever against 'kitchen medicine' if that is what you imply.

Several years ago a number of healthcare practitioners (I.e. doctor) found themselves in serious trouble because of material they posted on their blogs. The material did not even involve criticism or gratuitous slagging of coworkers or family members. Because their blogs were public, people recognized themselves. Therefore it was partly a 'heads up' when I wrote as I did. When personal photographs are also available on the blog, it is only a matter of time before someone finds a problem with the material in the blog.

There are private, subscription only blogs and given the intensely personal nature of some of the material presented, it may be a good idea if people who are convinced that the sort of material they post must find its way onto the internet, that a private blog situation may be a good idea.


Toxic said...

@Gabriella Kadar

Again, what??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? Are you OK?

I agree, though, that there is no point continuing this dialogue. It's Stephan's blog, and you are someone I find very closed-minded, who likes to disrupt rather than debate. All this is not so much off-topic; more like having an out-of-body experience.

You have absolutely no insight into your own behaviour, which reminds me of more homespun wisdom, especially:

1. People in glass houses shouldn't throw stones, and
2. When you find yourself in a deep hole, stop digging.

Think about it.

Over and OUT.

Toxic said...

@Neil Timms. LOL at compound fracture!

Manythings said...

@ Gabriella Kadar

Through your comments on this blog you inappropriately seek to practice medicine by giving advice to other blog readers, in that:

(a) You seek either (i) to contradict the diagnosis of migraine provided by the physicians of Galina (a reader of this blog) or (ii) imply that Galina has misunderstood the nature of their diagnosis. You seem to press upon Galina your supposedly alternative diagnosis of severe headaches caused by “epilepsy” and imply (apparently incorrectly: see below) that this purported alternative diagnosis excludes a diagnosis of migraine.

(b) Even more seriously, you seem to seek to encourage Toxic (another reader of this blog) to doubt, her diagnosis, made by a leading consultant allergist, of a severe latex allergy.

Such conduct is clearly inappropriate:

(a) You have neither met nor examined either of Galina or Toxic.

(b) You are not qualified as a physician. It follows that you are not licensed or insured to practice medicine.

(c) Although you are not a physician, you appear to seek to rely upon the prestige of your actual profession of dentist to afford your purported medical advice an authority that otherwise it would not possess.

(d) On a professional website for practitioners specialising in epilepsy, one learns (see the extract at * below) that migraine and epilepsy are highly co-morbid and furthermore, that where this co-morbidity exists, migrainous symptoms of patients with epilepsy are sometimes overlooked or mistakenly attributed to the seizure disorder. It would be wrong to speculate any further about the origin of Galina’s symptoms but it is fair to say that your understanding of the relationship between seizure disorders and migraine appears to be incomplete.

(e) As a dentist you should very well know that a severe latex allergy can lead to anaphylaxis. In the event that Toxic were to act upon your encouragement to doubt that she had any such serious, latex allergy, she may place herself at serious risk of death.

It seems unlikely that Toxic would act on your advice. That does not, however, excuse your conduct. A less well-informed and strong-minded individual might have accepted your advice at face value, with the most serious potential consequences.

Finally, I note that in your view:

"The problem with the entire medical profession in Canada and probably in the US as well is physicians don't spend enough time to know their patients. They don't focus and they don't have a checklist which would at least ensure that they are doing things in a logical sequence and miss anything.”

I respond to that as follows, Gabriella Kadar: Toxic, on January 15, 2013 at 5:21 AM, was kind enough to give you some good advice.

It’s over, and out, from me as well.



*"Migraine and epilepsy are highly comorbid.
Individuals with one disorder are at least twice as likely to have the other.1,4–7 Comorbid disease presents challenges in both differential diagnosis and concomitant diagnosis.8 When diseases are comorbid, the principle of diagnostic parsimony does not apply. Individuals with one disorder are more likely, not less likely, to have the other.

In the Epilepsy Family Study, among probands with epilepsy who were classified as having migraine on the basis of their self-reported symptoms, only 44% reported physician-diagnosed migraine.91 In the general population, 29% of men and 40% of women with migraine reported a medical diagnosis.12 The proportion of probands reporting a physician’s diagnosis of migraine was surprisingly low, given that all were already being treated for epilepsy.

Why is the comorbidity of migraine and epilepsy not recognized? Epilepsy may be viewed as a more serious disorder than migraine. As a result, the migrainous symptoms of patients with a diagnosis of epilepsy may have been overlooked OR ATTRIBUTED TO THE SEIZURE DISORDER [my emphasis].” [Author: SD Silberstein and RB Lipton] [http://professionals.epilepsy.com/page/migraine.html]

George Henderson said...

Paleo Drama aside, lets get back to that obesigenic pathogen.
http://www.nature.com/ismej/journal/vaop/ncurrent/full/ismej2012153a.html
It was hard to get facts from the paper but it seemed (from the separate appendix paper) that the medicinal herb component was Bitter Melon. This killed the pathogen in vitro.
Which is really interesting on account of Bitter Melon also have insulin-sensitizing and other antidiabetic effects.

Here we have a parallel and complementary effect at both the cellular and the microbial level. That ought to get the old grey matter humming.

George Henderson said...

Oh, some fool stated that "self diagnosis is for fools".
i just diagnosed pertussis in my community and family.
5 different G.P.s said "it can't be."
(only hospitalized infants get whooping cough, maybe).
Eventually insisted on a swab and whaddyakno, pertussis, confirmed to proper authorities.

Thanks Wikipedia and common sense.
More fool me.

Jane said...

@George
That is indeed interesting. What do you make of the idea that a diet based on whole grains can make an obese patient lose 50 kilos in 6 months? The paper was discussed in the Financial Times recently, and I take that to mean the drug companies are interested. And more importantly, that British government ministers will soon be demanding to know why people are saying you shouldn't eat whole grains, or why scientists claim it's only too much fat, salt and sugar that's wrong with the British diet.

Did you see the story about big pharma giving up the search for an Alzheimer cure? 'Drug giants give up on Alzheimer cure', Independent 19th Sept 2012. I imagine they found out that the problem is a diet of refined carbs + too much meat. They've wasted billions, and I can't imagine they're too pleased with academic scientists who failed to tell them.

FredT said...

It's great fun to sit back and watch cat fights. Obesity is a multitude of related issues driving toward overeating. Each expert (ego) thinks he has found "the" problem.

Medjoub said...

@ George -

While I think the idea that "self-diagnosis is for fools" is overstated, the droves of increasingly arrogant laymen "refuting" this and that, diagnosing themselves and others with (apparently) no real understanding of biology or metabolism and little to no clinical experience, is a symptom of a very muddled trickle-down of information and is deeply problematic. I'm glad that so many have achieved perfect health through their own applied strategies, but I take all these infinitely available anecdotal results with a very large grain of salt. What is being addressed in a few of the above comments, however harshly stated, is the brash irresponsibility of many of these claims -- claims given credence precisely because they conform to certain prevailing, cherished ideas on the subject. Ms Kadar uses the word 'cavalier' and think it is quite apropos, all things (and parties) considered.

Anyway: Why do think that the numerous doctors you approached ignored your very reasonable suggestion? I am not asking this question rhetorically. It's well known that pertussis has been on the rise of late. Even my daughter's pediatrician mentioned it in a routine check-up last month. But 5 GPs? That's truly maddening. Institutional arrogance is obviously just as dangerous as that of the layman -- more in some ways, less in others...

Travis Culp said...

Stephan, I really appreciate your work and feel bad that you repeatedly find yourself in a clusterfuck melee with various charlatans. I think you ought to therefore disable comments and make the occasional comprehensive post of replies to valid emails that you receive, as Colpo does.

Anyway, hang in there.

Stephan Guyenet said...

Folks, cool it please.

Stephan Guyenet said...

Hi Travis,

Thanks, I agree with your description of the situation.

Unknown said...

George Henderson,

In addition to Wikipedia, another site that can help you vis-a-vis clueless doctors is Google Trends. I believe you are in or near New Zealand. Here's the GT data for pertussis and whooping cough in NZ:

NZ:
http://www.google.com/trends/explore#q=whooping%20cough%2C%20pertussis&geo=NZ&cmpt=q

And if you look at the worldwide plots, you can see that NZ is comparatively off the charts at the moment:

http://www.google.com/trends/explore#q=whooping%20cough%2C%20pertussis&cmpt=q

Unknown said...

Interesting fact, btw: Folks in Bay of Plenty Googled tended to Google "whooping cough" more, while those in Wellington searched for "pertussis."

Google Trends (google.com/trends) is endless fascinating fun, btw.

Unknown said...

For the more cynical, here's one possible explanation for why many gurus are ditching the low carb label for paleo:

Google Trends: The sunset of "Low Carb" and ascension of "Paleo

Liton said...

Wonder full blog.
I’d like some advice too. Dr. Luis Fandos was born in Argentina where he finished his studies as Medical Doctor at the University of Rosario. He pursued a dream to study medicine in the United States and, ultimately went on to complete his anesthesia and critical care residency at Mount Sinai Medical Center in New York City.
Thanks for sharing.....