Doctor in the House – Watch Diabetes Not Being Reversed Using Low Carb on BBC, While LCHF'ers Freak Out.

This post is about Doctor in the House – Watch Diabetes Reversed Using Low Carb on BBC, While Old-School Dietitians Freak Out.

The YouTube videos may be gone, but the image lives on!
Available to view in the UK on iPlayer 'till 19.12.15 at http://www.bbc.co.uk/iplayer/episode/b06q6y95/doctor-in-the-house-episode-1

In Dr. Eenfeldt's blog post, he makes some schoolboy errors.

1. T2DM (type 2 diabetes mellitus) Reversed with LCHF (low-carb, high-fat) diet. Uh, nope!
a) Sandeep's HbA1c fell from 9.0 to 7.0, which is an improvement but by no means a reversal, as Dr. Chatterjee agrees in https://twitter.com/drchatterjeeuk/status/669875378568171520.
b) Sandeep has T2DM, not T1DM. See When the only tool in the box is a hammer...
Sandeep's BG (blood glucose) went down on LCHF, but what about his dyseverything elseaemia? *sound of crickets chirping*

2. Old-school dietitians freak out. Uh, nope!
In BDA alarmed by controversial and potentially dangerous advice in BBC’s ‘Doctor in the House’, Dr. Duane Mellor sounds pretty cool, calm & collected (though I expect that he sustained injuries from all of the eyeball rolling, as he had to refute for the umpteenth time yet another load of LCHF bullshit).

3. He plays the Shill Gambit card.

Oh, the comments! In typical echo-chamber fashion, LCHF commenters praise Eenfeldt's flawed points. I wonder how long my comment will stay up for?

My comments on the programme (c/p'ed from Facebook):-
"6 minutes in. I think that Priti is deficient in Magnesium (Mg), from her stress levels, anxiety, headaches and difficulty in getting to sleep. Blood tests are useless, as they don't correlate with Mg stores. Need CSF (cerebrospinal fluid) test (lumbar puncture - very painful).

12 minutes in. Priti's blood test results normal. Sandeep has hypovitaminosis D, which is a cause of IR (insulin resistance, it's what caused mine). This important fact is not mentioned. unsure emoticon See http://www.ajcn.org/content/79/5/820.full.pdf

16 minutes in. Talked about sugar in foods & drinks but ignored the large amount of cheese that Sandeep ate earlier. Cheese is *very* energy-dense. Sandeep has been in positive Energy Balance for *way* too long.

24 minutes in. Priti's getting sugar cravings in the morning. Lack of Magnesium also causes IR & poor BG regulation. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549665/

29 minutes in. HIIT (high-intensity interval training) for Sandeep is good for increasing his IS, but little use for reducing his VAT (visceral adipose tissue). You can't out-run your fork.

33 minutes in. Walking for Priti to lose weight? You can't out-walk your fork. If 1,000 steps takes 10 minutes and burns an extra 40kcals, then 10,000 steps takes 100 minutes and burns an extra 400kcals = one chocolate bar.

33:47 minutes in. Sareena has had a full-time job working indoors for the last year. Less sun exposure = falling Vitamin D3 level = deteriorating immune system, deteriorating mood & deteriorating IS. See http://nigeepoo.blogspot.co.uk/2008/12/vitamin-d.html

I don't think that I can watch much more of this programme!"

followed by:-
"In conclusion:-
1. Anyone who suffers from chronic anxiety is probably deficient in Mg.

2. Anyone who lives in the UK (United Kingdom :-D) and has coloured skin and/or works indoors is probably deficient in Vitamin D3.

3. ~85% of people who have T2DM have excessive VAT. Asians who were skinny in early adulthood have limited SAT (sub-cutaneous adipose tissue) hyperplasia, resulting in small skin-folds but large bellies. A LCHF diet is not suitable for over-fat people with T2DM. It should be a LCLF diet i.e. a low-calorie diet, to deplete over-full cells. Calories count.

4. You can't out-walk/run your fork.

5. Dr Chatterjee has a strong bias. This is not a good trait for someone who's supposed to be practising Evidence Based Medicine."

It's interesting that Priti is fatter than Sandeep, yet Priti doesn't have T2DM and Sandeep does. Priti was most likely fatter than Sandeep in their respective childhoods, for whatever reasons. Priti had more SAT hyperplasia than Sandeep, so she has more storage capacity for dietary fat than Sandeep does. Priti can gain more SAT, which protects her from developing T2DM. Sandeep can't, so he gains VAT, which has limited storage capacity and is more metabolically-active than SAT.

See also Adipocyte Hyperplasia - Good or Bad? and A *very* special dual-fuel car analogy for the human body that I just invented.

Fibromyalgia: It's the food, again! (probably).

From http://stickmancommunications.co.uk/Keyring-Card-Fibromyalgia

Serendipity strikes again! On Facebook, I saw https://www.facebook.com/PaleoDietNewZealand/posts/763653980371516 . That linked to Fibromyalgia and non‑celiac gluten sensitivity: a description with remission of fibromyalgia.

For people unfamiliar with scientific terms, here are some definitions:-
Non-celiac gluten sensitivity: A reaction to gluten, not due to Celiac (Coeliac in the U.K.) Disease.
Remission: (medicine) An abatement or lessening of the manifestations of a disease.

So, is Gliadorphin-7 (formed during the digestion of gluten) to blame?

Probably.

Could Beta CasoMorphin-7 (formed during the digestion of A1 cow's milk) also be a problem?

Possibly.

Is Increased/Excessive Intestinal Permeability allowing the above large molecules to pass through insufficiently tight junctions?

Definitely, maybe.

Is there really no cure for Fibromyalgia? It's possible to tighten-up insufficiently tight junctions. Insufficiently tight junctions can be caused by:-

1. Insufficient sun exposure, causing hypovitaminosis D. See http://www.ncbi.nlm.nih.gov/pubmed/?term=%22Vitamin+D%22[All+Fields]+AND+%22tight%20junction%22+AND+hasabstract[text]

2. Excessive consumption of oils high in polyunsaturated fatty acids. See Dietary Fat Can Modulate Intestinal Tight Junction Integrity.

3. Excessive consumption of Wheat. See http://www.ncbi.nlm.nih.gov/pubmed/?term=%22Wheat%22[All%20Fields]%20AND%20%22tight%20junction%22[All%20Fields]%20AND%20hasabstract[text]%20AND%20%22humans%22[MeSH%20Terms]

4. Excessive exercise. See Shedding Some Light on the Leaky Gut <> Exercise Connection. Plus: 20+ Things You Should or Shouldn't Do to Protect and Restore the Integrity of Your Intestinal Wall.

5. Lack of dietary Sulphur. See Sulphation and Autism: What are the links? A good source of sulphate is Epsom Salts.

See also Physiology and Immunology of Digestion.

And finally...
If a science person ever tells you "Increased/Excessive Intestinal Permeability a.k.a. "Leaky gut" just doesn't exist because, you know, I'm a scientist.", point out that it's an Appeal from authority fallacy, and demand that they provide high quality evidence to support their statement.

Because, you know, I'm a retired Electronic Engineer! :-)

A tale of the unexpected & an analogy.

The tale.

A friend had a faulty lap-top mains adaptor. It was one of these:-

From http://www.pchub.com/uph/laptop/46-33769-9191/Toshiba-Common-Item-Toshiba-AC-Adapter-Laptop.html

I offered to fault-find it. I measured the output voltage with my multimeter.

The output voltage was 0V.

I felt the lead where it exited the connector. It didn't feel right, so I cut the connector off & stripped-off some insulation. Lo and behold, the inner conductor (it was co-axial cable) was broken. I prepared the conductors, tinned them, soldered them and powered the adaptor, with a sense of impending triumph.

The output voltage was 0V.

I tested the continuity from conductors to connector. That's when I discovered that there was a short-circuit between the inner and outer conductors. I snipped-off the connector and confirmed that it was the connector that was short-circuited, not the adaptor or cable. I fitted a replacement connector and powered the adaptor, with a sense of impending triumph.

The output voltage was 0V.

At this point, I decided that the adapter was Beyond Economic Repair and advised the friend to buy a new one, which subsequently worked perfectly.

So, how did the adapter get to have not one, not two but THREE faults on it? It turned out that the lead had been yanked sideways, which bent the connector. The friend had straightened the connector with pliers (!). This short-circuited the connector, resulting in an internal fuse blowing in the adapter. The friend then "jiggled" the connector in the socket, in a vain attempt to make it work. This broke the inner conductor of the co-axial cable.

The analogy.

 

Some health problems are multi-factorial. Fixing only one, but not all of the problems, results in not fixing the problem. So, if you try "A" and there's no improvement, either "A" isn't one of the problems, or "B", "C"......"Z" need fixing, too.

This post was inspired by Effects of 12 weeks high dose vitamin D3 treatment on insulin sensitivity, beta cell function, and metabolic markers in patients with type 2 diabetes and vitamin D insufficiency - a double-blind, randomized, placebo-controlled trial.

Taking an effective dose of Vitamin D3 for a reasonable length of time didn't make a significant difference to insulin sensitivity or beta cell function. It did for me, as my only problem was Vitamin D insufficiency. I got lucky.

Good criticism, bad criticism.

Yes. I know it's an axe (slang name for guitar). Blame Google Image Search!

From http://scottberkun.com/essays/35-how-to-give-and-receive-criticism/

I wondered from where "Mr Messiah" got his arguments against Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. They came from Vitamin D and Cancer Prevention: Strengths and Limits of the Evidence.

"Randomized clinical trials designed to investigate the effects of vitamin D intake on bone health have suggested that higher vitamin D intakes may reduce the risk of cancer. One study involved nearly 1,200 healthy postmenopausal women who took daily supplements of calcium (1,400 mg or 1,500 mg) and vitamin D (25 μg vitamin D, or 1,100 IU―a relatively large dose) or a placebo for 4 years. The women who took the supplements had a 60 percent lower overall incidence of cancer (6); however, the study did not include a vitamin D-only group. Moreover, the primary outcome of the study was fracture incidence; it was not designed to measure cancer incidence. This limits the ability to draw conclusions about the effect of vitamin D intake on cancer risk."

1) The women who took the supplements had a 60 percent lower overall incidence of cancer. Yeah, so? The following result was ignored: When analysis was confined to cancers diagnosed after the first 12 mo, RR for the Ca+D group fell to 0.232 (CI: 0.09, 0.60; P&lt: 0.005). The women who took the supplements had a 77 percent lower overall incidence of cancer, if they didn't already have cancer. Incomplete data dismissed.

2) The study did not include a vitamin D-only group. Yeah, so? It was looking at the effect of Ca+D on cancer risk, not D only. Ca+D greatly reduced cancer risk. Argument dismissed.

3) Moreover, the primary outcome of the study was fracture incidence; it was not designed to measure cancer incidence. Yeah, so? It measured cancer incidence. There's a little clue in the title of the study. Argument dismissed.

4) This limits the ability to draw conclusions about the effect of vitamin D intake on cancer risk. See 1), 2) and 3). Argument dismissed.

Do you get the feeling that someone, somewhere is more interested in collecting loadsa money than trying to reduce cancer risk?

I see stupid people - Part One: Live to take the p*ss.

This is a take on I See Weak People – Part Three: Live to add, not subtract.

Dunning-Kruger strikes again!

George Henderson recently said in a comment to flip:- "If you're one of the sensible ones, as Nigel seems to think you might be, it's easy to see why he won't post on "that" blog again.
Myself, I wonder how Nigel does it. Everywhere he goes he seems to start a fight these days. We are thinking of locking him inside when we go out in future."

How do I do it? Simples! I make sure that my brain is properly nourished with Vitamin D3 for razor-sharp wit & biting sarcasm, EPA & DHA for stable mood and Magnesium to stay cool, calm and collected when all around me are behaving like complete and utter tosspots & twats (UK usages and not meant affectionately!).

The danger of science denial: It happens even on Science-Based blogs.

Poor Benjamin Franklin. I know how he felt! ;-)

I do not believe that he wanted to be doing that!

This post will be highly critical of Dr. David Gorski MD, as some of his comments have been either trolling, downright stupid, or both. They're definitely in denial of science. This post is intended to encourage Dr Gorski to leave comments here, as I will never leave any further comments on any blogs that he edits, for reasons mentioned previously. I will be copying comments from his blogs and pasting them here, with my comments after. If this is considered to be "bad form", I really don't care. Leaving derogatory comments about me on blogs on which the commenters know that I will never return (because I told them so) is definitely "bad form".

I will also be quoting other commenters on Dr Gorski's blog, for the same reason. Everyone is free to leave comments here, that meet my fairly lax moderation criteria. In Vitamin D, cancer, cliques and flouncing. , a commenter from Dr Gorski's blog called flip was initially whitelisted, to allow his comments to appear without me having to moderate them. I eventually blacklisted flip after I detected intellectual dishonesty. That's how I roll. If you don't like my rules, don't let the door hit you on the way out! By the way, calling me a liar on here is a sure-fire way to get yourself blacklisted.

I've just turned Blogger word verification back on, as although Disqus automatically deletes anonymous comments containing links, I still get email notification of them. I've been getting a lot of email notifications. This may or may not have an effect on commenters.

Firstly, please read http://www.sciencebasedmedicine.org/index.php/a-closer-look-at-vitamin-injections/#comment-127850 , as it's my "letter of resignation" from that blog. With that in mind, read on.

# David Gorski on 27 May 2013 at 9:49 am
Regarding Lappe et al, one notes that that study is not the be-all and end-all of vitamin D research. It’s an old study, for one thing. Also, cancer was not its primary endpoint. Finally, there was no vitamin D alone group, as I recall, only a vitamin D + calcium group, a calcium group, and a placebo group.
There is a recent review of the literature from the Endocrine Society, which includes Lappe et al and puts it into context:
*quoted text redacted*

# Nigel Kinbrum on 27 May 2013 at 11:16 am
David Gorski said…

Regarding Lappe et al, one notes that that study is not the be-all and end-all of vitamin D research. It’s an old study, for one thing.

Irrelevant.

Also, cancer was not its primary endpoint.

Irrelevant.

Finally, there was no vitamin D alone group, as I recall, only a vitamin D + calcium group, a calcium group, and a placebo group.

Irrelevant.

# David Gorski on 27 May 2013 at 12:28 pm

Finally, there was no vitamin D alone group, as I recall, only a vitamin D + calcium group, a calcium group, and a placebo group.

Irrelevant.

How so? It’s actually very, very relevant, as is the issue of cancer not being a primary outcome measure of the study. That you don’t understand why these issues are so relevant indicates to me that you don’t understand clinical research very well.

#Nigel Kinbrumon 27 May 2013 at 1:42 pm
David Gorski said…

Finally, there was no vitamin D alone group, as I recall, only a vitamin D + calcium group, a calcium group, and a placebo group.

Irrelevant.

How so? It’s actually very, very relevant, as is the issue of cancer not being a primary outcome measure of the study. That you don’t understand why these issues are so relevant indicates to me that you don’t understand clinical research very well.

1) The RCT used Ca + D. Therefore, the conclusions apply to Ca + D. If they’d wanted to test D alone, they would have. They didn’t. Why don’t you write a letter of complaint to Joan M Lappe about it?

2) Whether the outcome was primary, secondary, tertiary, quaternary or n’ary is irrelevant because the parameter in question (all-cancer diagnoses) was still accurately recorded. That you can’t understand such a simple concept boggles my imagination.

#David Gorski on 27 May 2013 at 2:34 pm

As I’m leaving permanently, what’s the point?

Ah, flouncing off again. It’s probably long overdue. I’ve been getting a few complaints about you here as well. Perhaps you should ask yourself why complaints seem to follow you wherever you go.

“Whether the outcome was primary, secondary, tertiary, quaternary or n’ary is irrelevant because the parameter in question (all-cancer diagnoses) was still accurately recorded. That you can’t understand such a simple concept boggles my imagination.”

I rest my case that you do not understand clinical trial methodology and interpretation. I couldn’t have demonstrated it better myself to anyone who actually does understand clinical trial methodology and interpretation. Thanks!

You sir, are an asshole. I spelled it the American way, just for you!

I rest my case that you're either trolling, or stupid, or both. Whether the outcome is primary, secondary, tertiary, quaternary or n’ary is completely and utterly irrelevant. It always has been and it always will be. You're effectively saying that only the first item in a shopping list should be bought because all of the other items in the shopping list are irrelevant. Bullshit!

Denice Walter May 27, 2013
@ Marc Stevens Is Insane:
I believe that Nigel is like two bright guys I know: they are well educated and professional in fields outside of SBM/ life sciences (business). Thus they read alt med ‘research’ (also see today’s post by Orac) and don’t get how it DOESN’T work in reality. It sounds like nutrients can do all of these wonderful things – that they can’t- at least not in RL. But the woo-meisters don’t tell you that part. We do.

So of course they think that these products are very useful- and they need celtic salt or ground organic flaxseed- as I know all too well.

However, if they’re smart- we can talk to them:
explaining how that *in vitro/ in vivo* thing works.
Or- as I often do- illustrating how much of the so-called science they read ( woo) is actually more accurately called “advertising copy”.

Businessmen seem to grok that.

Denice, seriously? I'm disappointed. I thought that you were one of the few reasonable posters on Gorski's blog and then you go and write that crap?

I do not read "alt med ‘research’", unless you're calling what's on PubMed "alt med ‘research’"? I've been reading studies on PubMed for years, so I know about the use of shoddy methodology to fudge results. The Lappe study doesn't use shoddy methodology. It's a Randomised Controlled Trial using double-blinded placebos and randomly-selected subjects who were post-menopausal women. Try to pick holes in it.

flip May 29, 2013
Hmmm… it occurs to me I probably haven’t been that overt about one other thing:

Lilady, I am sorry that you were called those things, and I certainly don’t think you should have been called names. I do think Nigel was wrong and do think he should be called out for it.

And I’m sorry for not making that clearer before.

flip, I'm not going to question your intelligence. However, why you're apologising to lilady boggles the imagination. lilady is a despicable human being. She pushed me to the point where I called her rude names, names that were not misogynist and for which I apologised. I explained about "twat" on SBM. I even posted a link to Wiktionary! You don't read things thoroughly before commenting.

Marc Stephens Is Insane May 31, 2013
Oooooh, Nigeepoo is ANGRY! He’s pulled a DJT, posting a “rebuttal” to all the comments here and on SBM. I’m suprised it’s taken him this long.

He’s calling Orac an a**hole and stupid, among other things. He’s invited us all to comment on his blog because he has an “open moderation policy” and “allows all comments.”

http://nigeepoo.blogspot.com.au/

I see that you idiots on RI are still reading my blog. I'm not the slightest bit angry, so you can give the projection crap a rest. For the record, most of you come across as assholes. You can't even quote me correctly. I said that I have fairly lax moderation criteria. Do try to get something right, for once in your miserable lives.

Anyway, you lot are now boring me with your never-ending inability to discuss things either accurately or rationally, so I'm not going to bother polluting my blog with any more of your crap.

P.S. I still occasionally read the comments on Gorski's blogs, so for the benefit of you peeps who read mine:-
1) "Black-list" means exactly what it says. It means that you're banned from posting comments.
2) The Lappe et al 2007 study was a good study. Just because some Messiah-like person says that it's a bad study and applies false reasoning to back himself up, doesn't make him right and me wrong. As I've previously pointed out, surgery's not exactly rocket science is it? I designed complicated electronic communications systems for 29 years. Just saying! ;-) Denice, I've got nothing against you. You've just been drinking Gorski's Kool-Aid for way too long. That's not a euphemism, by the way! :-D

Look what I just found. Exposing Dr. David H. Gorski, M.D., Ph.D. who believes he can use a cloak of anonymity and character assaults to discredit opposing views. Sorry Doc, but your game is up.

He's not the Messiah. He's a very naughty boy! :-D

\ curves and U curves: Vitamins D3 and K2 again.

Here are some curves relating to Vitamin D. Ref: http://www.ncbi.nlm.nih.gov/pubmed/23601272

Hazard Ratios (HRs) vs serum Vitamin D level

The solid lines are the 95% confidence intervals (CI) & mean for all-cause mortality. 95% CI's are the values within which 95% of the subjects tested fall. 2.5% fall below the lower CI and 2.5% fall above the upper CI. The dashed lines are the 95% CIs & mean for coronary heart disease (CHD) mortality. Most of the curves follow a \ curve, indicating that more Vitamin D is better, up to 66ng/mL (150nmol/L, the level that I'm at). The interesting curve is the upper dashed line, which follows a U curve.

The U curve indicates that a Vitamin D level of greater than 30ng/mL (75nmol/L) increases the Hazard Ratio (HR) for CHD in the top 2.5% of subjects only, relative to 30ng/mL, even though the mean HRs for CHD & all-cause mortality (the more important parameter) are decreasing, up to 66ng/mL. What's occurring?

See Vitamin K. The increase in HR for CHD mortality above 30ng/mL in the top 2.5% of subjects only is almost certainly due to calcification within artery walls, due to under-carboxylation of osteocalcin in bone Matrix Gla Proteins, caused by insufficient Vitamin K2 rather than excessive Vitamin D. This is why I supplement with Vitamin K2. See also Vitamin D toxicity redefined: vitamin K and the molecular mechanism.

Prevention vs Cure, quackery, bias and conflict of interest.

I believe in the maxim "Prevention is better than cure".

Image from www.nationalarchives.gov.uk

Some definitions:

Prevention. Cure. Quackery. Bias. Conflict of interest. Logical fallacies. In the case of the maxim, prevention means hindrance, as it's impossible to 100% stop illness from occurring. To someone who already has an illness, the maxim is obviously moot!

Quackery:

I have been accused of quackery. Despite having provided evidence to refute the claim, the person has refused to retract the accusation or provide proper evidence (other than Logical fallacies) to support it. EDIT: I blocked the person on Twitter. I am no longer on that person's quackery list.

Bias:

A long time ago, I mentioned a study Intensive lipid lowering with atorvastatin in patients with stable coronary disease.

"RESULTS: The mean LDL cholesterol levels were 77 mg per deciliter (2.0 mmol per liter) during treatment with 80 mg of atorvastatin and 101 mg per deciliter (2.6 mmol per liter) during treatment with 10 mg of atorvastatin. The incidence of persistent elevations in liver aminotransferase levels was 0.2 percent in the group given 10 mg of atorvastatin and 1.2 percent in the group given 80 mg of atorvastatin (P&lt:0.001). A primary event occurred in 434 patients (8.7 percent) receiving 80 mg of atorvastatin, as compared with 548 patients (10.9 percent) receiving 10 mg of atorvastatin, representing an absolute reduction in the rate of major cardiovascular events of 2.2 percent and a 22 percent relative reduction in risk (hazard ratio, 0.78; 95 percent confidence interval, 0.69 to 0.89; P&lt:0.001). There was no difference between the two treatment groups in overall mortality."

"CONCLUSIONS: Intensive lipid-lowering therapy with 80 mg of atorvastatin per day in patients with stable CHD provides significant clinical benefit beyond that afforded by treatment with 10 mg of atorvastatin per day. This occurred with a greater incidence of elevated aminotransferase levels."

Unfortunately, the statement "There was no difference between the two treatment groups in overall mortality." is incorrect. According to the full study (hidden behind a pay-wall) there were 26 more deaths in the 80mg/day group than in the 10mg/day group. That's not statistically significant, as the group sizes were ~5,000 each. However, the statement didn't mention statistical significance.

Therefore, the statement "Intensive lipid-lowering therapy with 80 mg of atorvastatin per day in patients with stable CHD provides significant clinical benefit beyond that afforded by treatment with 10 mg of atorvastatin per day." is also incorrect. Dying is worse than having major cardiovascular events (heart attacks & strokes), which are survivable.

Why is there a disparity between the publicly-viewable abstract, the full study and reality? From the full study:-

"Funding for the study was provided by Pfizer Inc., New York, New York. Dr. Shepherd has received consulting fees from AstraZeneca, GlaxoSmithKline, Merck, Oxford Biosensors, Pfizer Inc., and Schering-Plough, and lecture fees from AstraZeneca, Merck, and Schering-Plough. Dr. Kastelein has received consulting fees and lecture fees from Pfizer Inc., AstraZeneca, Merck, and Schering-Plough, and grant support from Pfizer Inc. and AstraZeneca. Dr. Bittner has received consulting fees from CV Therapeutics, Novartis, Pfizer Inc., Abbott, and Reliant, and grant support from Pfizer Inc., Atherogenics, Merck, Kos Pharmaceuticals, Abbott, CV Therapeutics, and the National Institutes of Health. Dr. Deedwania has received consulting fees and lecture fees from Pfizer Inc. and AstraZeneca. Dr. Breazna, Dr. Wilson, and Dr. Zuckerman are all employees of Pfizer Inc. Mr. Dobson is an employee of Envision Pharma Ltd., which was a paid consultant to Pfizer Inc. in connection with the development of the manuscript. Dr. Wenger has received consulting fees from CV Therapeutics, Sanofi-Aventis, Schering-Plough, AstraZeneca, Abbott, Merck, and Pfizer Inc., and grant support from Pfizer Inc., Merck, and the National Heart, Lung, and Blood Institute."

Atorvastatin is manufactured by Pfizer Inc.

Conflict of interest:

I like the article Is Vitamin D Shooting Me in the Foot?, because Dr. Ken D. Berry prescribes his patients an effective dose of Vitamin D3, even though it results in him losing money due to the drastic reduction in the number of benign skin cancers for him to freeze-off. Now, that's what I call integrity!

Can a breast cancer surgeon (who receives payment for curing breast cancer using surgery) give a truly impartial opinion on other cancer cures, or cancer prevention? Does he always clearly state his competing interest? I think not!

Cancer, part 2.

In cancer, I discussed omega-3 and methylglyoxal.

Methylglyoxal

This time, I'm just going to do a Research Review, by publishing a list of PubMed searches with the following Filters activated: Abstract available, published in the last 10 years, Humans.

Cancer AND "Dichloroacetic Acid".

Cancer AND "Magnesium".

Cancer AND "Methylglyoxal".

Cancer AND "Omega-3".

Cancer AND "Vitamin D3".

Cancer AND "Vitamin K2".

I added searches for Magnesium and Vitamin K2, as I supplement with those and want to see if they have a positive or negative effect on Cancer. I added Dichloroacetic Acid (DCA), as I've read about it.

Evidence that Dihydrogen Monoxide is ineffective and toxic.

This just in...

Image from www.inquisitr.com

The RDI for DHMO is ~2,000ml/day.

Erstwhile group of researchers "A" ran an RCT. The placebo group ate & drank normally. The intervention group was given 167ml/day of DHMO (RDI/12) in addition to their normal food and drink. The trial lasted for 4 years.

RESULTS: There was no statistical difference between the placebo and the intervention group.
CONCLUSION: In this trial, DHMO made no difference to the subjects well-being, weight, body-fat percentage or anything else, apart from a statistically-significant increase in urinary volume. DHMO is therefore ineffective and long-term use may result in kidney damage.

Meanwhile, elsewhere...

Erstwhile group of researchers "B" ran an RCT. The placebo group ate & drank normally. The intervention group was given 60,000ml once a month of DHMO (RDI x 30) in addition to their normal food and drink. The trial was intended to last for 3 months, but was terminated after 1 month.

RESULTS: There was 100% mortality in the intervention group, compared to the placebo group.
CONCLUSION: In this trial, the RDI of DHMO killed 100% of the subjects. DHMO is therefore toxic.

Daily Mail Headline: Studies prove that DHMO kills! Parliament calls for an immediate ban.

DHMO is water (H2O).

The reason why I wrote the above spoof is because that's how Vitamin D3 is often tested in RCTs. Either daily "homoeopathic", or infrequent "standing on the sun" doses are used. Result? Failure. Therefore, Vitamin D is deemed to be either ineffective or toxic. See also Why randomized controlled trials of calcium and vitamin D sometimes fail.

The RDI for Vitamin D3 is 400iu/day, ~1/12 of what I take (5,000iu/day). Blood test results for 25(OH)D and Corrected Ca are in the RR (25(OH)D is near the top end and Corrected Ca is near the bottom end).

Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial.

This is Fig. 2 from the study in the title.

FIGURE 2.

Kaplan-Meier survival curves (ie, free of cancer) for the 3 treatment groups randomly assigned in the cohort of women who were free of cancer at 1 y of intervention (n = 1085). Sample sizes are 266 for the placebo group, 416 for the calcium-only (Ca-only) group, and 403 for the calcium plus vitamin D (Ca + D) group. The survival at the end of study for the Ca + D group is significantly higher than that for the placebo group, by logistic regression. (Copyright Robert P Heaney, 2006. Used with permission.)

The reason why I'm making this post is because I was accused (on Twitter) of being a danger to women who had breast cancer and I was added to a Quackery list. I was alleged to have claimed that taking Vitamin D reduces the risk of getting cancer in the first place and/or of getting recurring cancer.

Obviously, I wasn't happy about this! I do not recall ever having made such a claim. If I have, please point it out and I will make a full retraction and apology. The study in question is Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial.

Please note: Ignoring cancer diagnoses within the first 12 months removes results from women who had undiagnosed cancer at the start of the study.

What the study shows:

Taking 1,100iu/day of Vitamin D3 + 1,400-1,500mg/day of Calcium: When analyzed by intention to treat, cancer incidence was lower in the Ca + D women than in the placebo control subjects (P < 0.03). When analysis was confined to cancers diagnosed after the first 12 mo, RR for the Ca + D group fell to 0.232 (CI: 0.09, 0.60; P < 0.005). 0.232 is a reduction of 77%.

What the study doesn't show:

Taking Vitamin D3 only reduces the RR for cancer incidence. I believe that it probably does.
Taking Ca + D reduces the RR for cancer recurrence. I believe that it probably does.
Taking more than 1,100iu/day of Vitamin D3 reduces cancer incidence more. I believe that it probably does.
Taking Ca + D reduces the RR for cancer incidence in pre-menopausal women. I believe that it probably does.
Taking Ca + D reduces the RR for cancer incidence in men. I believe that it probably does.
Taking Ca + D increases the RR for breast cancer mortality. I believe that the opposite is the case.
Anything other than what the study shows.

See also Is Vitamin D Shooting Me in the Foot?

Vitamin D, cancer, cliques and flouncing.

First Google Image Search result for Vitamin D, cancer, cliques and flouncing.

This is a continuation of my previous post Enzyme kinetics, standing on the sun and weird blog comments sections.

Apparently, I didn't like the answers that I received on the blog in my previous post, so I flounced. The study that I asked for opinion on was Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. If I showed you an RCT where deaths from all cancers fell by 77%, what would be your reaction? My reaction would be "That looks promising. More work is needed to investigate it". One person (sophia8) reacted thusly. Other reactions that I received (with their logical fallacies) were as follows:-

Pure coincidence. Argumentum ad ignorantiam.

More than 1,100iu/day of Vitamin D is harmful. Straw man. I didn't say that people should take more than 1,100iu/day of Vitamin D (even though I take 5,000iu/day, which isn't harmful). Also, argumentum ad ignorantiam. See enzyme kinetics in the previous post.

You're cranky. Ignoratio Elenchi.

The study wasn't testing Vitamin D on its own. Straw man. I didn't say that it did.

By the way, “Nigeepoo”, taking supplemental vitamin D is not a proven way to prevent sunburn and is not an adequate method of protection from getting skin cancer (despite assertions in your blog). Straw man for the first part of the sentence. I didn't say that it was. Argumentum ad ignorantiam for the last part of the sentence.

Going for long drives with the top down and broiling gently without sunscreen on a repeated basis is dumb. Straw man. I didn't say that I did. I obviously don't go for long drives with the top down in the middle of the day on a sunny Summer's day. That is dumb. Like, duh!

I'm curious why you found my response to be satisfactory but lilady’s to be unsatisfactory. Could you explain? Ignoratio Elenchi.

Did I mention all of the mis-quoting?... Oy!

Maybe they should have done a bit of basic research, like:-

Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: Recommendations for clinical practice.

The effect of calcium and vitamin D supplementation on obesity in postmenopausal women: secondary analysis for a large-scale, placebo controlled, double-blind, 4-year longitudinal clinical trial.

Vitamin D, cardiovascular disease and mortality.

Why randomized controlled trials of calcium and vitamin D sometimes fail. Essential reading.

I'm the sort of person who's not interested in cliques or secret societies. I'm therefore not interested in joining a cliquey, ivory-towery blog where you have to conform to a set of unwritten "rules" to be accepted, some of which are eccentric (Question: Which blogs insist on the use of manually-typed blockquote tags? Answer: Only that one). I decided to leave. I even apologised to some commenters for my language in some of the arguments.

I wondered why that blog and its owner annoyed me so much. Then it hit me (like a discarded boomerang)!
 
Hmmm. See Brain Surgeon meets Rocket Scientist ;-)

Other comments:-

Orac
May 19, 2013
Nigel, you need to tone it down, too.
I’ve warned both of you once already. This is the second warning. There won’t be a third. To show you I mean business this time, your comments are going into automatic moderation. You two have already wasted more of my time than you’re worth.

Which part of "Can people please stop leaving comments aimed at me, unless it’s an acknowledgement. I don’t want to have to leave any more comments on here – ever." did you not understand?

MI Dawn
May 19, 2013
@Nigel: we responded to the Lappe information. It didn’t prove what you say it proved. Now, if you do have something to say, give the peer-reviewed proof.

Straw man. I didn't say that it proved anything.
Which part of "Can people please stop leaving comments aimed at me, unless it’s an acknowledgement. I don’t want to have to leave any more comments on here – ever." did you not understand?

lilady
May 19, 2013
Thank you Orac for your intervention.
The bottom line for Nigel and Lisa is that they, by their vicious unwarranted personal attacks, have drawn unfavorable publicity to themselves and their blogs.

There's no such thing as unfavorable (sic) publicity for my blog, as far as I'm concerned. What you have done, by your vicious, unwarranted, lying and malicious defamatory personal attacks on me, is to draw unfavourable interest from me.

flip
In a place where no federal police turned up today
May 20, 2013
What a pity they both seem to have flounced off without bothering to respond to the questions put to them. I am not surprised though.

Which part of "Can people please stop leaving comments aimed at me, unless it’s an acknowledgement. I don’t want to have to leave any more comments on here – ever." did you not understand?

Enzyme kinetics, standing on the sun and weird blog comments sections.

Firstly, enzyme kinetics.

How to Optimize Vitamin D Supplementation to Prevent Cancer, Based on Cellular Adaptation and Hydroxylase Enzymology from Edward Hutchinson

Secondly, see Standing on the Sun Will Not Prevent Depression.
"It is probably safe to say that giving 70 year old women massive doses of vitamin D3 once a year is a bad idea - bones and mental state accounted for. "Clinical studies of vitamin D in clinical populations with documented insufficiency remain warranted." And, indeed, at no time in history would we ever have been exposed to 500,000 IU vitamin D3 in a single day."

Thirdly, bearing all of the above in mind, see The quack view of preventing breast cancer versus reality and Angelina Jolie, part 2. I soon became aware of a weird "dynamic" in the comments section. Trolling of newbies (that was my first and last time posting comments there) was not discouraged by the blog owner. In fact, the blog owner (David H. Gorski, MD, PhD, FACS) implied that I was an old troll that had returned. Charming! If someone attacks me, I do not turn the other cheek. I "hit" them back - hard. I did a lot of "hitting".

The trolls noticed that I replied to every comment aimed at me, as that's how I roll. They then bombarded me with a large number of comments, riddled with logical fallacies to try to tie me in knots. I replied to every one. I was then put in "detention" (pre-moderation) by the "Principal" (David H. Gorski, MD, PhD, FACS) for posting too many comments. The victim got punished. The trolls remained free. What a way to run a comments section!

I've decided to not leave any more comments there - ever. That's the only blog I've been on where newbies are expected to instinctively know the "correct" way (typing the tags "blockquote" and "/blockquote" in every comment) to quote the commenter to whom you're replying (I was putting quoted text in ""). Ivory Tower, much?

@Everyone: Which part of "Can people please stop leaving comments aimed at me, unless it’s an acknowledgement. I don’t want to have to leave any more comments on here – ever." did you not understand? Sheesh!