Monday, 30 March 2015

Jamie Oliver wants to teach our pigs how to sing.

The pigs being our kids. 

Or maybe it's our Government. 

I don't care if our Government is annoyed, so we'll stick with the kids.

Bad language warning. I haven't had time to write lately so the sweariness is bursting to get out.

Jamie Oliver knows how to cook, of that I have no doubt. I’m also supremely confident in his ability to talk a fair amount of bollocks on occasion. 

I suppose part of the reason why he’s so successful, and presumably influential, is because he has the talent to speak on a topic and appear knowledgeable, charming and believable. 

Salespeople have this talent and politicians and journos think they do. A person with an overdeveloped talent in this area is quite likely the CEO of an investment bank – make of that what you will.

Jamie’s movements are quite hard to keep track of because he likes to be in everything. He’s done so many different TV shows in the last 5-10 years I’m staggered his family remember what he feels like; although it does explain why he’s never had the time to deal with the line of broken bottles he calls teeth.

Cheap shots aside, I hear he’s in Australia at the moment, on a quest to convince our Government to make food education compulsory in our schools. If there’s one thing our current Government is up for, it’s retarded plans that will cost a lot and do fuck all good
yay, watermelon and corn to the rescue!!
Perhaps I'm being unfair. It certainly sounds like an admirable plan, except Jamie has also shared his feelings on nutrition, particularly on the paleo diet, which is where his plan falls in a big pile of poo. 

You see, Jamie “spends time with experts” and this makes him the fount of all nutrition knowledge. 

“I see world experts every two weeks for three hours on different specialisms … the reality is, these very specific diets are quite unsustainable,” Mr Oliver said.

Look, I work with very smart people with brilliant analytic minds, but I don’t kid myself that means I have any clue how to develop a financial model on the prospects of a new start up company or that my colleague’s methods are indisputably perfect. Some of them are even economists, for fuck's sake.

Pete Evans, our resident Paleo Prophet, has copped a lot of crap lately from journos because a kids’ cookbook he co-authored was withdrawn by publishers after “the authorities” were concerned that kiddies drinking bone broth would inevitably lead to the highest child mortality rate since humanoids stood upright. 

Don’t get me wrong, I don’t eat like Paleo Pete or think he has it all worked out, I just love the way he uses his profile to tell as many people as he can what a bunch of dishonest spastics they are at the Heart Foundation and how a lot of nutritionists don’t know the difference between a bowl of sugar and a bowl of cereal with the Heart Foundation tick of approval (i.e. fuck all).

Jamie thinks Pete’s ideas are bullshit. He’s entitled to that opinion. He certainly shares it with most nutrition experts in this country. What he’s not entitled to do, is to try and intensify the misguided belief that eating less and moving more will solve the obesity plague. 

'Everything in moderation and what you like. Can you have a burger every once and a while? Yeah. Can you have a beer? Yeah,' he said with conviction. 

I don't know about you, but when I hear someone say “eat everything in moderation” it’s a green light for me to translate anything else they say in to “I have no idea what the hell I’m talking about”.

I admire Oliver’s tenacity and his passion to improve the health of our kids. I just wish he’d actually listen to what he and his expert mates are saying. 

'Balance the rainbow, plants, oily fish, control your meats that are good quality, don't go nuts about avoiding carbs.'

Balance the rainbow? Fuck me. 

Everything in moderation doesn't work for most adults, why the hell would it work on the fussiest organisms on the planet? Seriously, serve any normal kid 3 serves of veggies and skinless chicken breast with brown rice and what do you get? My 6 yr old would tell you to fuck off, and rightly so. Where’s the flavour? Where’s the nutrition? Where's the satiety?

Jamie appears to be having another go at the same message experts have used for the past 5-6 decades. It won’t work. I’m confident it won’t work because it never has worked and apart from that, it’s based on the idiotic notion that, even though we're all immensely complicated organisms with an almost infinite number of differences, we will all benefit and our hormones will all react exactly the same, to a caloric deficit. 

I’m honestly curious why the message hasn't changed over the years – what, exactly, are they afraid will happen? Are all our kids going to blow up like the purple girl in Charlie's Chocolate Factory after the first meal of steak and eggs? Are their hearts going to explode?

I’m probably unfairly pre-empting Jamie’s master plan. If it gets kids to avoid sugar then I s’pose it’s better than nothing. If it reduces intake of pasta and bread, then that’s a bonus. But unless it adds in eggs and full fat dairy and fatty meat, then it’s clearly a waste of time. Removing one source of flavour and replacing it with another crap source has been done before. With shitty results.

Do I think that something needs to be done about childhood obesity? Absolutely. Do I think teaching them to eat to the rainbow and that everything in moderation will stave off that obesity?

Nope. But that's just my opinion.
And potentially leads them down a path to diabetes, obesity and health destruction.

Friday, 13 March 2015

Cardiology CIA

When you have blood-fat numbers like mine, stumbling on to heterozygous familial hypercholesterolaemia (HeFH) papers, that actually bother to look at something other than the lipids, can be a fascinating experience. I could be wrong, but they seem to be fairly rare and I’m often starved of some good confirmation bias.

In 1985, Sugrue et al ran some numbers on a small group of people with, what they defined as, HeFH. Without today’s genetic screening tools, the eligibility criteria was slightly more ambiguous, but the fact remains that they all had fairly high levels of cholesterol – dodgy LDL receptors or not.

Of the 61 people they studied, 32 had evidence of coronary heart disease and the other 29 did not.  

Without even looking at the rest of the paper, those numbers should be worth noting. The oldest heart-healthy person was 59. Why she/he wasn’t whisked off to the bowels of Cardiology CIA (c’mon, surely there is such a thing) to be studied and dissected will remain a mystery, because Sugrue certainly ain't telling.

Long story short – after comparing those with CHD and those without, coagulation factor VIII and fibrinogen were significantly greater in the CHD group.

“There were no significant differences in any lipid variables between the two groups”
I’m not for a second suggesting that such a small sample size is indicative of anything in terms of coagulation-CVD cause and effect, because I also found this interesting chapter of a PHD thesis – in which they found (sort of) the reverse, i.e. certain coagulation factors were decreased in those with CVD. 

I think the author was funded by pharma and the whole thing was pretty ugly to read, but there was one glaring consistency in both studies - this group of 106 HeFH ‘sufferers’ also had a proportion that were, according to the doctors, heart disease free. Or at least a group with no prior cardiovascular event. 

Can you guess what the “no CVD” percentage was? A quarter? A half?

Eighty one (76%) of the 106 HeFH patients did not have a previous CV event. 

The two groups had very similar lipids (total chol of about 10.4 mmol/l), but the CVD group were older, fatter and probably male. I suppose the CCIA would claim that the CVD percentage would rise to 100% given enough time.

Whether the coagulation factors are THE deciding factors in who does or doesn’t develop CVD remains to be proven - they most likely play a role. But one thing that seems fairly clear, in these two examples at least, is that it’s certainly not the lipids.

Just a side note on the second paper, I found this comment interesting - “After 6 months of high dose simvastatin therapy, the present study showed an increase (12%, p<0.0001) of fibrinogen.”

Of course they were pretty quick to conclude that “the increase of fibrinogen by simvastatin is not related to clinical outcome, but rather a ‘side-effect’ of statin treatment".

Ha. Well played, sir.
Katherine Gorge is pretty quiet this time of year

Friday, 6 March 2015

Liver donation and a chook with a sore vagina

My father in law has been waiting for a new liver (slightly used, one owner) since late last year, and being on the transplant list has meant moving 3,000 km away from family and friends, to be near the hospital with all the very clever liver mechanics. 

I'm lucky to have fantastic in-laws. My second mum and dad give us and our kids all the love and support we need, it's just that lately that has been a long distance, skype-type of love. 

After two false starts - twice he was called to the hospital, only to learn that the donors' livers were "no good" - he now has a cancer-free liver and first impressions are that his body has welcomed it with open arms. Another few months and hopefully he'll be home.

The liver is obviously an organ with borderline-magical abilities. Being able to regenerate lost tissue is just the start of a long list, probably incomplete, of what it does for its host. I do a bit of familial hypercholesterolaemia paper reading from time to time - and it seems a liver transplant can be quite handy for the homozygous FH patient
everyone over 50 should skip the statins and just have a liver transplant.
In papers such as this you will find a lot of comments that, if the situation wasn't so serious, would generate plenty of laughs. As it is, there is just bewilderment that the smart people in lab coats are so obtuse.

For example:

"In spite of treatment with a low fat diet, cholestyramine and simvastatin, his cholesterol remained greatly raised."  

Which is just plain weird considering they explain on the third page how useless statins and diet changes are for the unfortunate homozygous FH patient. 

Why they felt the need to mention that patient 2 was the son of a "first cousin marriage" is, sadly, not expanded on. Maybe they think FH is one of God's many sadistic punishments for sinners, it's not clear where they are coming from.

It would have been great if they'd gone to the trouble of measuring other things like coagulation factors prior to and after the transplant, but i guess you can't expect miracles from people with very large blood-fat blinkers on. 

Back to me, because this is really what my blog is about. My wife, understandably and with my encouragement, flew down to support her parents, which means I've been a single dad of three for just over a week. Which means I haven't had time to scratch myself or stop for "thinking time". The most exciting thing that happened in a week full of school lunches and stepping in puppy wee was one of our chooks laying the biggest egg I've ever seen.
Exciting stuff - yes, it was a double yolker

next to one their normal size and an XL from the shop
I'm aware that chooks don't lay eggs from their "vagina" - but I did think that for a long time, which is what you get when you live on Rick Mayall comedies while growing up.