False dichotomies: serum cholesterol level vs all-cause mortality. Cause or effect?

Here are some plots from the MRFIT study.

From http://sph.bu.edu/otlt/MPH-Modules/PH/PH709_Heart/PH709_Heart5.html

Although the relative risk (RR) for coronary heart disease (CHD) and cardiovascular disease (CVD) mortalities increase with serum total cholesterol (TC) level, all-cause mortality follows a U-curve.

According to Low Serum Cholesterol and Mortality: Which Is the Cause and Which Is the Effect?, certain illnesses that increase mortality lower TC levels. This is the Iribarren hypothesis.

According to Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study, TC that's low and is still low 20 years later results in a 64% increase in the RR for mortality relative to TC that's intermediate and is still intermediate 20 years later.

Table 4 Relative risk for mortality based on change in cholesterol between examinations three and four

Is low TC level the cause of, or the effect of fatal illnesses? I think that it's both. Cholesterol is an important substance, as a severe lack of it is bad news, as per Smith–Lemli–Opitz syndrome. If certain illnesses result in a depletion of cholesterol and cholesterol synthesis is too low, there's insufficient cholesterol to allow recovery.

Interestingly, TC that's low but is intermediate 20 years later results in a 30% increase in the RR for mortality, whereas TC that's low but is high 20 years later results in a 5% increase in the RR for mortality.

P.S. There's a false dichotomy for vitamin D level vs illness. Ditto for carbohydrates vs calories.

Molested milk: there's more to it than bovine xanthine oxidase.

The idea for the title came from Molested fats, Op. 139. Thank you, Bill!

Image from http://suppversity.blogspot.co.uk/2012/08/mutant-milk-new-research-fuels-flames.html

Homogenising/homogenizing milk has certain advantages, as per Creaming and homogenization.
"No link has been found between atherosclerosis and milk consumption." Hurrah! Not so fast...

According to Mutant Milk!? New Research Fuels the Flames on Hushed Up Concerns About Ill Health Effects of Homogenized Milk, homogenised milk has a different effect in the body (and not in a good way, if you're over-fat) from non-homogenised milk.
"...mice who received the regular formula with small lipid droplets were fatter and had compromised lipid and blood glucose levels, as well as pathologically increased leptin levels." Yeah, mice.

I drink Tesco Finest Channel Island Milk (a.k.a. Gold Top Milk). It's "past your eyes" (by law, all shop-bought milk in the UK must be pasteurised) but unhomogenised milk from grass-fed (during the summer) cows. During the summer, the cream is much more yellow than during the winter. To distribute the fat throughout the milk, you have to shake the bottle. Does that smash the milk fat globules to buggery? I think not.

Raw (i.e. unpasteurised) milk is legal in the UK, but the nearest farm where I can buy it is Meadow Cottage Farm in Churt. I used to buy it from them at a Farmer's Market in Aldershot, but that closed.

EDIT: I just noticed something in Why Doesn’t Medical Care Get Better When Doctors Rest More? (hat-tip to Yoni Freedhoff).
"Take heart failure—the most common reason for admission to the hospital in the United States—and a problem that I, as a cardiologist, deal with often." In the US, heart failure is now more common than blocked coronary arteries. See Is Coenzyme Q10 a supplement or a drug? It all depends. Statins reduce Coenzyme Q10 synthesis. Just saying.

R.I.P. HP Deskjet F380. Long Live HP Deskjet 3520.

Last year, I had a problem with my HP Deskjet F380, in HP Deskjet F380 Ink Cartridge Error. On Monday 19th August, it happened again. This time, I threw the baby out with the bathwater and bought a new HP Deskjet 3520 e-All-in-One printer/scanner/copier (the F380 was over 6 years old).

From http://www.shopping.hp.com/en_US/home-office/-/products/Printers/HP-Deskjet/CX056A

This product has mixed reviews - people either love it or they hate it.

My initial observations:- It makes a lot of whirring noises - I hope this doesn't mean that it's going to wear out quickly. I like the fact that it can do double-sided printing. I like the fact that the menu screen is easily readable, with the printer on the floor underneath a telephone table. I don't like the fact that I can no longer see a print preview when printing from Notepad. I will use WordPad from now on. I prefer to not use "fancy" word processors like Microsoft Works Word Processor or Microsoft Word for simple documents like lyric/chord sheets. I can control all functions from my lap-top. Although the product has wireless capability, I'm using a USB cable, as with the F380.

Having imported an existing lyric/chord sheet into WordPad, I've reduced all margins to 3mm, as the HP 3520 adds borders by default. I've also had to use bold face to make the text as easy to read in dim light (typical open mic night setting) as the old sheets.

False dichotomies: moderation.

Feel like you're walking a tightrope? I sang this at Open Mic night on Wednesday, including the orchestration!


There's another internet "punch-up" over moderation in what people eat. Apparently, there are only two options:-

Everything in moderation,

Image from http://www.deltadentalarblog.com/2013/07/ditch-the-junk-help-your-kids-eat-better/

or Nothing in moderation.

As always, it's a case of "It all depends". If, when you're at home, you keep raiding the chocolates from the box or sweets/candies from the tin and you don't want to, don't have them in the house. However, if when you're not at home, someone offers you a chocolate or a small sweet/candy, unless you're so desperate that you'll steal some more or go to a shop and buy some more, eat the chocolate or small sweet/candy. Five grams of sugar won't harm you, even if you're diabetic.

If you have Coeliac Disease and mustn't eat any significant gluten, moderation isn't an option. Ditto, if you have impaired gut integrity and you feel better avoiding gluten. If consuming stuff doesn't cause you medical problems or make you desperate to consume even more, moderation is fine.

EDIT: Sometimes, I ramble in a way that makes it hard for people to understand what I'm talking about. I've emphasised the word "Apparently", as this post is about a perceived false dichotomy (perceived by the "Nothing in moderation" group).

Protein reduces endurance (in mice), food processing vs food refining & Schrödinger.

I saw the following study via Twitter. Dietary protein decreases exercise endurance through rapamycin-sensitive suppression of muscle mitochondria.

Mmm, protein!

Hmmm! In mice, a high protein diet significantly decreased the amount of muscle mitochondria, the mitochondrial activity and the running distance at 50 weeks, although it increased muscle mass and grip power.

A mouse's natural diet is fruit or grain from plants, though mice will eat virtually anything, including Kevlar insulation on wiring. Fruit & grains aren't particularly high in protein, so it's quite possible that eating a sub-optimal diet results in sub-optimal health.

If the results do translate to humans, we have a choice between endurance, and muscle mass & strength in our old-age. I know which I would choose. You'll have to prise the proteins from my cold, dead fingers!

More from Twitter:  A Major Communication Challenge of Our Times: What on Earth Do We Say About Processed Foods? The word "refine/refined" doesn't appear in the above article. I don't have a problem with food processing. What I do have a problem with is food refining. Just after the Mid-Victorian period, it became fashionable to eat foods that had been stripped of "impurities". Goodbye essential co-factors. Hello, degenerative diseases.

Finally, today is the 126th anniversary of Erwin Schrödinger's birthday. I have only one comment:-

Blatantly stolen from http://memegenerator.co/instance/31138345

:-)

Thursday thoughts - acetyl groups.

Who'd a thunk that something as simple as an acetyl group could be so useful?

Acetyl group on Wikipedia

A common substance which is mostly an acetyl group is acetic acid, the acid in vinegar. Vinegar has quite a few medical uses, as well as making fish & chips/fries taste great.

I was reading stuff on the internet (as you do ;-) ) when it occurred to me that several substances had acetyl groups in them, e.g. Aspirin (acetylsalicylic acid) , Paracetamol/Acetaminophen (N-acetyl-p-aminophenol), Heroin (diacetylmorphine), DCA (dichloroacetic acid), Acetylcholine, Acetyl-CoA, Acetylcysteine & Acetyl-L-carnitine.

Here's an amusing (unless you are/were an addict) snippet of information about Heroin (emphasis mine) from History:- "From 1898 through to 1910, diacetylmorphine was marketed under the trademark name Heroin as a non-addictive morphine substitute and cough suppressant." Oh, whoops!

Acetylation makes substances more active in the body & increases their ability to cross the blood-brain barrier, as well as having other functions in the body (e.g. changing the expression of proteins & genes).

Completing the trine: vive la différence!

First, the obligatory picture of Hannah Spearritt :-)

Women have a harder time losing weight than men. Women retain water more than men for hormonal reasons, but a factor that's overlooked is that, on average, healthy women have higher body-fat percentages than healthy men. This is because women have babies and men don't. Who knew? On the plus side, women produce more DHA than men.

Why should having higher body-fat percentages make a difference to weight loss? See What is the required energy deficit per unit weight loss? The energy deficit required to lose 1lb of body-weight increases with increasing body-fat percentage. It's rarely 3,500kcals per lb.

If you really love mathematics, see The Dynamics of Human Body Weight Change by Carson C. Chow and Kevin D. Hall.

From the above paper:- ΔU = ΔQ - ΔW

where ΔU is the change in stored energy in the body, ΔQ is a change in energy input or intake, and ΔW is a change in energy output or expenditure. This is the Energy Balance Equation. As I said back in Back to black, CIAB, pharmaceutical drug deficiencies & nerds.

Where body weight is concerned, calories count (but don't bother trying to count them).
Where body composition is concerned, partitioning counts.
Where health is concerned, macronutrient ratios, EFAs, minerals, vitamins & lifestyles count.

N.B. Poor health can adversely affect body weight and/or body composition, by increasing appetite and/or by adversely affecting partitioning.