Does cholesterol cause heart disease?

Briefly, the cholesterol hypothesis proposes that by getting into arterial walls and causing atherosclerosis (plaque buildup in arteries), cholesterol increases the risk of cardiovascular disease (CVD) and cerebrovascular disease (strokes). However, according to a perhaps unlikely source – the American Heart Association: “Exactly how atherosclerosis starts or what causes it

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Cholesterol Treatment Guidelines

As long ago as 2005 an audit of just 18 patients, admitted to an emergency department, reported that there were 3,679 pages of clinical guidelines associated with their conditions.  Imagine what it is like 13 years later. What started out as support for evidence-based medicine, and as a means for

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Cardiovascular Risk Calculators

Primary care for cardiovascular disease (CVD) – the prevention of a CVD event in people who have not experienced one before – is an established objective in clinical practice.  The premise is that certain health or lifestyle indicators associate with the risk of a future CVD event, such as a

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The marketing science of Lipitor

Statins have become the most profitable class of drugs in the history of medicine, and the most profitable of them all has been Lipitor (Atorvastatin), manufactured by Pfizer (the largest pharmaceutical company by revenue). Here is a Lipitor advertisement from the early 2000’s highlighting that, in patients with multiple risk

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The life and times of Cholesterol

We are told about good cholesterol and bad cholesterol. However, the good cholesterol is only considered good because it is carried by high-density lipoproteins (HDLs)  to the liver, which then has the option of sending it to the intestine to be eliminated in faeces. So, it’s only good because we

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Fat Trafficking

We are water-based lifeforms. However, we need fats and fat-like molecules such as cholesterol (collectively known as lipids) for a host of important cellular functions – as critical as building cells and providing cellular energy. Consequently, we have evolved a means of transporting fat around our bodies in water-friendly capsules

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Making body fat, without eating it

Carbohydrates dominate our food landscape and are endorsed by current dietary guidelines that recommend getting something like three-quarters of our calories from them. Carbohydrates are built with molecules of glucose, and from the perspective of our metabolism, they are simply a source of glucose, including glucose from starch (rice, wheat,

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Red meat and Health – is it science?

Many people accept that we should eat less red and processed meat for a variety of reasons, one of which is our health. This is unfortunate, because there is no sound scientific evidence to support such a recommendation. Certainly, many nutritional studies have been published on this issue, however, the

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Dietary iron and red meat

Health authorities advocate restricting red meat in our diet, even though they can’t agree what red meat is, and even though carnivory drove our evolution. If pressed about what it is about red meat that makes it a health risk (e.g. for colorectal cancer, CRC), the common answer is haem-iron

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What is red meat

Health, environmental and ideological objections are regularly levelled against our evolutionary super-fuel, red meat. What once provided the energy and the nutrients for expanding our brain size, and for us to be us, is now vilified. So, if red meat is bad, how is it defined? For example, is it

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Red Meat: Our carnivorous evolution

Meat, particularly red meat and its fat, is getting bad press, and the health police continue to attack it. Increasingly, plantarian-style diets are encouraged. We don’t hear about ‘meat and veg’ anymore (in my day that was healthy eating), we hear about ‘fruit and veg’ instead. The health, environmental and

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Sugar substitutes

Sugar, in its many guises (dextrose, high-fructose corn syrup, honey, agave nectar, fruit etc.), needs to be minimised on a ketogenic diet, or eliminated as far as practicable. This can be a sticking point for those who are used to, or even addicted to, sweet food. As people and health

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Some tips for a ketogenic diet

I have written much about the ketogenic diet (KD), the state of ketosis, and its underlying science and clinical relevance. The ‘politics‘ of dietary advice too. However, I am aware that I have offered minimal practical advice. I have outsourced that to other sites, particularly for recipes and meal-plans. I

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Metformin

Medicine is a pragmatic discipline. This means that sometimes a treatment can evolve from experience, well before it is understood scientifically. This is true for the drug metformin, for the treatment of type 2 diabetes (T2D). It is the most widely-prescribed oral medication for T2D, it is often the first-line

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How to safely pit an avocado

The Secretary of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), Simon Eccles, was recently in the news for raising awareness of hand injuries sustained by removing an avocado pit by impaling it with a knife. He himself sees an average of 4 cases of ‘avocado hand’ a

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Our gut microbes

In the previous post, I discussed our evolutionary connection with bacteria – all the cells in our bodies are evolved bacteria, and nearly all harbour evolved bacteria within them. Further, all the surfaces of our bodies are teaming with resident bacteria (and other microorganisms such as fungi or viruses). There

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Our bacterial beginnings

Fermentation gives us wine, beer, chocolate, cheese, coffee, sauerkraut, kimchi, yoghurt and much more. It is the process whereby microorganisms, such as bacteria and yeasts, break down glucose or other carbohydrates to produce energy for themselves and release other byproducts. However, it is not only bacteria and yeasts that are

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Curing Bacon at Home

The background, science and health of bacon were discussed in an earlier post (from 2015). But that post did not include the method for curing bacon at home. Some reasons for home-curing are: 1) ketogenic dieters may eat a lot of bacon, and so industrial-processed store-bought bacon should come under scrutiny; 2) store-bought bacon contains sugar;

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Death by glucose – understanding (and reversing) type 2 diabetes

Regular readers will know that glucose from starchy carbohydrates or sugars can be dangerous and damaging for us. Glucose does this damage by a combination of inflammation, glycation, fat accumulation and insulin resistance. This can either result in, or contribute to, non-communicable diseases that are rife in western societies and that

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The carbohydrate-insulin model of obesity

There is likely more than one reason for gaining weight across a population. This post is directed at those who follow western dietary guidelines (high-carbohydrate; low-fat) and who are nevertheless overweight, obese or diabetic. This is a significant (and increasing) proportion of the population. In particular, those who have not had

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The nutrition fallacy of fruit

Fruits are glorious and compelling – colourful, aromatic, crunchy or juicy and, not only do they look ‘healthy’ they are promoted as such by all relevant authorities. So, you may be surprised to know that fruit is not particularly nutritious, and that there are no nutrients to be found in fruit

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Caloric restriction and fasting

Caloric restriction is usually associated with dieting, often combined with exercise – the ‘move more, eat less’ cliche. However, as I have mentioned elsewhere, even though this seems intuitive (calories in – calories out), the strategy fails because it ignores our biology. Rather than going into details here, I refer

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Is alcohol a risk-factor for obesity?

This question is really two conflated questions: [1] is ethanol (i.e. the active ingredient in all alcoholic beverages) a risk-factor for obesity, and; [2] are alcoholic beverages themselves a risk factor for obesity. There’s a third, related question: [3] does consuming food with either of these (ethanol or beverages) alter

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Parmesan-crusted scrambled egg omelette

The video (from Lennard Young) shows a simple but effective method for an omelette that I only recently became aware of (but that might be widely known to others). It is excellent. Three layered textures and flavours: crispy parmesan outer crust holding a simple egg omelette encasing a decadent scrambled egg centre. Plus,

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99.9% – an update on antibacterial hygiene products

Around 2½ years ago, I summarised the health, environmental and efficacy concerns being expressed about antibacterial hand and body washes and soaps. The post was called 99.9%, because most manufacturers make the sweeping claim that their products are this effective (and by inference safe). At the time, the FDA had given manufacturers until 2016

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Inflammation

The immune system and inflammation are inseparable – the immune system invokes inflammation as part of its armoury, while inflammation provokes an immune response. So, understanding inflammation is helped by an appreciation of the immune systems that constantly (and usually imperceptibly) protect us. Our immune Systems We have two immune

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Diabetes – update

I recently uploaded a post on how to reverse type 2 diabetes (T2D) (here). It’s a dietary solution (ketogenic diet) to a dietary problem. Some call it a cure because medication can usually be stopped. If you think of diabetes as ‘glucose intolerance’, then the answer is don’t eat glucose.

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Oxidative stress and diet

The reactive oxygen species (ROS) are a diverse group made up of free radicals, ions or small molecules – their common feature is that they need another electron to form more stable configurations. They grab this electron indiscriminately from any weak point on another molecule (fatty acid, protein, DNA etc,

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Diabetes and Diet

People who are gluten intolerant solve the problem in a straightforward way – by not eating gluten. Likewise for lactose intolerance or any other intolerance or allergy, with one remarkable exception – glucose intolerance. Health professionals still recommend that people who are glucose intolerant continue to eat glucose (carbohydrates), and then prescribe

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Calories-in Calories-out

Most people intuitively understand energy balance, particularly when it comes to weight management. This is known as the ‘calories-in calories-out’ (CICO) model, and its premise is that weight loss will occur when calories-out (CO) are greater than calories-in (CI). This is the basis for most diets, which rely on reducing

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Exercise and nutritional ketosis

A low-carbohydrate high-fat ketogenic diet has multiple potential health benefits, but how can one exercise muscles on a high fat diet that restricts glucose?

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Beyond a ketogenic diet for weight loss: Your Brain

Because I do brain research (my professional link is here), I am often asked what is the best thing to do for maintaining brain function – crosswords, reading, lumosity, ‘brain foods’? My answer has always been: “Exercise.” It hasn’t always been a popular answer though. Physical exercise is beneficial for

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The KETO-DIET page

I have been posting on the high-fat, low-carbohydrate, adequate-protein ketogenic diet for a while now. However, a topic like this can become fragmented, as posts dealing with separate aspects of the diet get loaded (in semi-random order) over time. Therefore, there is a new page, accessible from the top menubar, just

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Beyond a ketogenic diet for weight loss: Cancer

Recently, I have been posting on the fat-burning ketogenic diet, so called because the body adapts to use ketones (derived from fat), not glucose (from carbohydrate) for fuel. It is a high-fat, adequate-protein, low-carbohydrate eating pattern, and a fairly effortless way to shed weight because the dieter doesn’t go hungry

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Summer Menu 2016

About once a year, in summer usually, I go to a bit of trouble to cook a dinner for various friends. This year it was  a 9-course menu, with a loose theme. The first and last courses were eggs in an eggshell though, just to bookmark the experience. Links to previous years

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Fat as fuel

Anyone following establishment dietary guidelines will be dependent on glucose (carbohydrates) for meeting energy demands. However, the body can be trained to burn stored fat for energy instead. It only takes a few weeks. You can lose weight by eating fat.

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Mayonnaise

Making your own mayonnaise can be tricky, but with a stick blender it is fast and easy. The reason for this post is to share the method. If you want to skip my usual diversions (this time into the Battle of Minorca and the science of oil-in-water emulsions), then click

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A brief guide to rendering fat

The simplest method is to accumulate it. That’s how it used to be done, collecting ‘dripping’ from roasts etc in a jar and reusing it. But, this has its limitations – the fat will be flavoured, contain suspended solids and water/gel and may not be enough for the purpose (e.g. deep

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Eating and inactivity as symptoms, not causes, of obesity

What if eating and inactivity are symptoms of obesity, not causes? In that case, it is pointless to target these symptoms, it is necessary to identify the cause and target that.

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The trouble with refined plant oils

Otherwise known as vegetable oils. However, none, or not many, come from vegetables (depending on how vegetable is defined). Plant oils would be a better term. They come from seeds (grapeseed, sunflower seed), grains (maize, rice bran), fruits (avocado, olive), nuts (almond, walnut) or legumes (peanut, soy). A product labelled

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Deep-fried bacon

In lard, of course. Bacon and lard – two ingredients that are demonised (and needlessly so). Previously, I suggested that bacon does not deserve its reputation. More recently, I have argued that we could be healthier if we ate more animal fat (our heritage fats). So, it makes sense to put the two

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On the origins of nutritional slogans III: The 8-glass rule

‘Drink at least 8 glasses of water a day’ – it seems you will be healthier if you’re waterlogged. However, the science has never existed for this slogan, and still doesn’t. Furthermore, how much water a person may ‘need’ depends on age, gender, environment, physical activity, health and a host

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Kindle eBook

Sous vide (pronounced soo veed) is the biggest advance in home cooking methods since the microwave oven. I hope by the time you have read this little monograph you will agree. Sous vide cooking is cooking food in plastic bags (with air removed) in water that is kept at a constant temperature (to better than 0.5C accuracy).

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On the origins of nutritional slogans II: Fibre

We can learn a lot about the basis for ubiquitous dietary slogans such as ‘eat more fibre’ by looking at how they became established in the first place. This is particularly true of the saturated fats slogan, as my recent post on its 50-year history summarises. That slogan started out as a campaign by a charismatic and

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Sherbets and Shrubs

A sherbet was a cold, sweet, non-alcoholic and refreshing drink that originated in the Middle East. The name derives from the Arab word for a drink – sharâb. However, later this word came to mean an alcoholic drink, and the word sharbât was used for the non-alcoholic version (‘to drink’, rather than

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Lost weight

We don’t want to lose our keys, our phones, our memory, hair, money, stuff… but the one thing we seem to want to lose is weight, in the form of fat. Which raises the question, if we lost it where did we leave it? The terms lost, shed or reduced

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On the origins of nutritional slogans I: Saturated fat

Eat less saturated fat. This slogan, along with others like it, has been pressed on us by nutritional authorities over the past 50 years or so. At a population level we largely listened and modified our behaviour. Meanwhile, obesity and other ‘diseases of civilisation’ steadily increased. Objectively, the message has

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Fish oil, omega-3 & supplements

The multi-billion dollar supplement industry might have peaked (in the UK at least). It has been a formidably effective industry, selling the promise of better health to the worried healthy. One supplement is holding out though – fish oil. Coming from a natural source (presumably fish) and with a beneficial nutrient

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Pink chicken meat near the bone

Cooked chicken can reveal disconcerting pink juices and meat around the bones. This raises concern about food safety, as we associate pink meat with under-cooking and we seem to worry about chicken more than other meats. However, these juices can be present even when the chicken has been cooked to a safe

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How nutritional science works

Nutritional science is difficult and demanding. Difficult because of the complexity of human biology and behaviour, and demanding because people want answers right now. The thing is that the real answers take time and money. Generally, nutritional research progresses through three stages that I will refer to as S1-3. The

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Sodium, salt, RDIs and health

Health authorities urge us to reduce our salt intake and mostly we have accepted that we should. However, the science behind this recommendation has been shaky (sorry) from the start. Even the authorities are unsure how dangerous it is. In the US, the American Heart Association (AHA) sets the recommended

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Sous vide yoghurt

Yoghurt (a word of Turkish origin meaning ‘thick’) originated in W. and C. Asia. It was something of a breakthrough for the times because it enabled milk to be kept longer, it had a refreshing tartness and it could be consumed by lactose intolerant individuals (i.e. most of W. and C.

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Animal fats

Lard, tallow, suet, dripping – animal fats that were ubiquitous before the modern era (mid-twentieth century) without obvious health issues. Then, as we became more sedentary and convenience foods became, well, more convenient, we gained weight and looked for a culprit (other than ourselves). It was easy to blame fat

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Scrambled eggs

Scrambled eggs are physically a gel, as are other cooked eggs. Raw egg proteins are very large molecules but they are normally folded in on themselves to form smaller lumpy balls that are separate and float in the egg’s water (eggs are 90% water). Agitation by heat unfolds these proteins. When

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Discounting calories

A calorie is a superceded unit of heat energy, defined as the amount of heat required to increase the temperature of 1g of water 1 degree (from 15.5C to 16.5C). A Calorie (capitalised) is the conventional unit of dietary energy; however, it is not the same as a calorie – it

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Tempering chocolate sous vide

After posting about dieting on a food blog, I thought I should make amends – an atonement by way of chocolate. While humans have been drinking chocolate for millennia, they only worked out how to turn it into a block fairly recently (not much more than 100 years). The process

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Diets and their traps

My ‘Four Diet Dictums’: 1: All Diets work in the short term. 2: All Diets work equally in the short term. 3: All Diets fail in the long term. 4: All Diets fail equally in the long term. This is my interpretation of the science. It may seem nihilistic, but I think it’s empowering.

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Melting cheese

The home cook has limited options for melting a non-melty cheese (e.g. cheddar), often resorting instead to a ‘manufactured cheese-like substance’ that has been engineered to melt (something from the Kraft line, for example). What is the problem with melting cheese? It doesn’t melt as an emulsion, it separates into a

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Truffles

Fungi belong to neither the plant nor animal kingdoms. They have their own kingdom (unsurprisingly called the fungi kingdom). Inhabitants include mushrooms, yeasts and moulds. A restaurant truffle lunch next week (it’s the height of the season here), prompts me to look at this most prized (and priced) fungus of

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How to cook a national emblem

In Australia, the kangaroo is a national symbol (sharing the coat of arms with the emu) and readily identified by most of the world. But, not many countries are as confused as we are about their national trademark – variously iconified, culled, harvested, treated as pests and sometimes protected. For

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