Tag Archive for: science

Causes and Risk Factors

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Rather than making this a statistics Memo, I’m going to use a couple of examples that illustrate the problems with establishing what prevents or causes disease.

Back in the late 1940s to early 1950s, there was a significant increase in cardiovascular disease. Trying to establish a single cause was complicated because there were so many variables to consider.

The Low-Fat Diet and CVD

If you read any background on the ketogenic diet, you’ll read about two factions: one that claimed a high-fat diet was the problem, while the other claimed carbohydrates from grains were the culprit. The high-fat diet faction won. While many suggest that era was the point when obesity and heart disease increased because of the explosion of carbohydrates, that was never true. They point to the Dietary Recommendations by the U.S. Senate Subcommittee on Nutrition, which focused on vegetables, fruits, and grains as the best sources of those carbohydrates. But without a decent Public Health Education Program, the recommendations were doomed to fail. The food industry flooded the market with simple carbohydrates and sugar; after all, they were carbohydrates.

Numerous randomized studies were conducted, and the largest ones failed because people didn’t follow a low-fat diet. The goal for one study was to reduce fat intake from an average of 38% to only 20%. It dropped to 24% after a year, but by six years fat had climbed back to 28%. Yet even last year, a ketogenic diet advocate was still claiming the low-fat diet failed and the study lied about the results; what the study really proved was that both reducing fat intake to 20% and increasing fruits, vegetables, and whole grains were difficult.

Cholesterol and CVD

The second story is about the relationship between levels of blood fats and CVD. It began with total cholesterol; that was the big deal for years. Then triglycerides became important based on large epidemiological studies. After that, it was LDL-cholesterol that really mattered. Then it was the ratio of total cholesterol to HDL cholesterol. The latest big thing is the size of the LDL cholesterol: fat, fluffy LDL doesn’t seem to be harmful, but small, dense LDL cholesterol does. I’d wager that tomorrow, there will be something else that will be The Big Thing.

The Bottom Line

The first story is about nutrition, and the second is about testing cholesterol. Can we predict with certainty whether you will get CVD if you follow the low-fat or high-fat dietary recommendations? No. Can a cholesterol test diagnose it? No. As the carbohydrate intake goes up, so will the risk of CVD; as blood cholesterol goes up or down, the rate of disease follows the same pattern. There’s no cause and effect. They seem to be related in some way, but they’re not predictive; they’re risk factors.

If you think back to Tuesday’s Memo when I gave the trillions of potential components that led to all the potential combinations, you can see why methods of prevention or causes of many diseases may never be known for sure. But it doesn’t change the approach to trying to find a solution: we can only know what we know today. With a methodical and rigorous approach to the scientific method, we’ll know more tomorrow.

Even if science veers in a new direction next week or next year, the only responsible course of action is for each of us to use the best knowledge we have today. And then be prepared to pivot if necessary. That’s how science works.

So what can the average person do with the flood of sometimes conflicting health information? One possibility is to let someone who understands science help you understand what’s significant and what’s not—which studies really mean something, and which are hopelessly flawed. That’s my job and my commitment to you: to sort through it all and keep you up to date on the best ways to improve your health.

What are you prepared to do today?

        Dr. Chet

What Is Science?

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Along with all the disagreements and conflicting info about covid-19, there has been some confusion about science. Many people seemed to think anything science discovered about covid was complete and final, but that’s not how science works. Science is a constantly changing body of knowledge, or as the Science Council puts it:

Science is the pursuit and application of knowledge and understanding of the natural and social world following a systematic methodology based on evidence.

We very rarely reach the end of the search. When does something become accepted science? When the evidence is irrefutable. For instance, it’s been proven beyond any doubt that polio is caused by the polio virus, but science rarely reaches that kind of definitive answer.

Does that level of certainty exist as to what causes or prevents other serious diseases such as cancer, cardiovascular disease, high blood pressure, and so on? The question is complicated. I don’t think we have—nor will we ever have—complete answers about what prevents or causes these diseases, and here’s why:

  • Each of our bodies contains trillions of cells, with 20 to 100 times more microbes in the microbiome.
  • We each have an enormous number of genes in our genome, somewhere between 25,000 and a half-million genes—we don’t even know the total number yet.
  • Add to that thousands of environmental factors.
  • And all of the above can interact.

The best we can do is to apply the scientific method and see where it leads. And while we do that, we need to keep an open mind and be prepared to adjust what we think we know.

I think the best way to explain it is to use some examples to demonstrate the complexity, and in that way, explain the difference between risk, cause, and established science. We’ll do that on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: https://sciencecouncil.org/about-science/our-definition-of-science/

Science at Work

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The challenge this week was to watch two video podcasts, think about what you heard, and then provide comments and questions. For those of you who did it, thank you. For those that didn’t, I recommend that you take some time this weekend and listen to them. I’m going to share my thoughts but there’s so much information, I’ll hit only the highlights. Suffice it to say, based on the questions, there are many subjects that will need to be explained. That will take months to research and present in Memos and Insider conference calls in a way that’s understandable.

The point of the interviews with Dr. Jay Lombard was to find out the relationship between the microbiome and pathogenic bacteria and neurodegenerative disorders (NDD). That includes everything from Alzheimer’s disease to depression to Parkinson’s disease. Here are the three things that stood out to me out of the many concepts presented.


Three Things I Learned

Leaky Brain Theory
The prevailing thought is that the blood-brain barrier prevents almost everything from entering the brain via a series of tightly packed blood vessels and cells. Nutrients are let through along with some medications, but bacteria are thought to be barred.

But evidently the toxins of some pathogenic bacteria are able to cross this barrier and affect the production of the proteome, an organism’s complete set of proteins. Remember the tau mice from last week’s Memos? The bacterial toxins impact the way the tau and other proteins are folded, which renders them unusable, thus resulting in misshapen structures that can contribute to NDD depending on which proteins are affected.

Antibiotic-induced Reduction in Fevers
In the treatment of patients with NDD, one characteristic that most seemed to share is the inability to get significant fevers with infections. The cause appears to be chronic use of antibiotics over a lifetime which somehow reduces the ability of the immune system to create high fevers. The rise in temperature is a natural part of the immune system when dealing with infections; without it, the immune system will not be as effective at combating viruses or bacteria.

Heat-Shock Proteins
Think of heat-shock proteins as the “cleaners” of the body. One of their functions is to collect the misshapen proteins and take them to the organelles inside a cell; that’s where they’re taken apart and the amino acids reused. If you can’t generate a fever that’s high enough, they can’t do that job as well.

There were several other items on my list, but those were the most profound. The first question in your mind is most likely “What can I do about these?”


How Science Works

The reason I chose to focus on Dr. Lombard with the purpose of showing how science works was two-fold. First, he asked good questions. Many physicians would think “How can I fix this?” and stop there. What Lombard and Hyman asked was “What caused this?” or “How did this happen?” You find that out only by asking the right questions of patients.

The second is that Lombard went to the current research to find out if there were any answers, and he discovered where he might have been incorrect because someone had tested it. Remember that in the first interview he was sure that the bacteria C diff was related to ALS; two years later he found that there was more than a single pathogen that could be related to ALS and other NDDs. He learned and adapted his hypothesis: that’s how science is supposed to work. Instead of spending time heading in the wrong direction, science guides the research he’s currently doing so that eventually he may discover effective treatments for these neurological conditions.


The Bottom Line

If you haven’t watched the video podcasts, I urge you to do that; you’ll learn much more than by reading my review. More than that, you’ll have more questions. One of the things both Drs. Lombard and Hyman agreed on is that “we know close to nothing.” I agree wholeheartedly. When you begin by asking the right questions, you have a chance of finding out the answers. Another point they agree on is that there’s no single cause of any NDD. There are multiple factors that contribute; finding out what they are may help develop effective treatments by focusing on a potential cause.

For those of you who want answers, whether about what I’ve written or about the many other things covered in the podcasts, I’ll write more as time goes on to satisfy that “What should I do now?” question. Obviously, you’ll want to keep your microbiome as healthy as possible (a search for the term microbiome on drchet.com will point you in the right direction); beyond that I have questions I need answers to before I can provide more answers for you. I’m on it and when I know, so will you.

What are you prepared to do today?

        Dr. Chet

How Science Works, Part 2

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How did you enjoy the first video? If you’re like me, there were some surprises and a whole lot more questions.

The second video is another interview with Dr. Jay Lombard recorded this year. Just like the other video, it isn’t an ad for a product but it does contain ads as do all YouTube videos. While the interviewer is different, the video demonstrates several things, none of which I’m going to tell you. The assignment is for you to learn how science really works. Listen closely to Dr. Lombard. If you want, send your thoughts and questions to [email protected].

Here is the link to the second video: https://youtu.be/aCTTpFnSsD0

We’ll finish this look at how science works on Saturday.

What are you prepared to do today?

        Dr. Chet

How Science Works, Part 1

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If there’s one topic we’re all interested in, it’s making sure that we keep our minds clear and able to learn and recall things every day we’re alive. That’s confirmed by checking the number of people who read last week’s Memos on EAAs and brain health.

A long-time reader sent me a link to a video called “Doctor Thinks He Knows What Causes Alzheimer’s, Parkinson’s, and ALS!” I decided to listen to it while I worked out on the bike. It was interesting, so I listened to another podcast with the same doctor two years later. It was at that point I decided to make this a project for you.

Assignment 1 is to listen to a video podcast from Dr. Mark Hyman, a well-known physician who treats the entire patient, not just the symptoms. He interviews Dr. Jay Lombard, a neurologist, on current ideas as to the possible causes of a variety of conditions including depression and Alzheimer’s disease.

When you’re done, write down a couple of things that you learned or had questions about. Enjoy the first video—pay close attention to the last five minutes: https://www.youtube.com/watch?v=ETKZS5e33VA

Tomorrow, I’ll send you a second link to another video. If you listen and watch these videos, I think you’ll begin to learn how science works.

What are you prepared to do today?

        Dr. Chet

Who Can You Trust?

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With the Internet, health information is everywhere. That creates the health hooliganism that I talked about on Thursday. Everyone seems to be shouting that “This is good, that’s bad, and everyone who doesn’t agree with me (or us) has some form of hidden agenda.” It’s not just limited to the anti-something people. Scientists have joined together to start shouting their view about the sugar or food industry. How should you evaluate who’s saying what? Here’s what I do.

I check to see if the person has the background they claim to have. Do they . . .

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Science Hooligans

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Seth Godin is an original Internet marketer and entrepreneur whose books and blog I really enjoy. His post from Monday articulately identified the problem that exists in the health field today, and I urge you to read it in its entirety (1).

This past weekend in Peoria, I was answering someone’s question about soy when another person began to give his opinion on the topic. It wasn’t related to soy itself but rather GMOs, another hot topic in health. Sometimes I can’t slough off a challenge without a response, but . . .

We're sorry, but this content is available to Members and Insiders only.

If you're already a DrChet.com Member or Insider, click on the Membership Login link on the top menu. Members may upgrade to Insider by going to the Store and clicking Membership; your membership fee will be prorated automatically.