The Arrow #153

Hello friends.

A lot of stuff today, so let’s get going.

Meat on the Menu in 1899

I meant to put this up on Thanksgiving, but forgot about it then. But it’s still holiday feasting time, so apropos.

Below is a copy of the Thanksgiving menu for the Plaza Hotel in 1899. Prices are in cents. Take a look at how much meat is on the menu versus plant foods. This isn’t just because it’s Thanksgiving, it’s because, unlike fresh fruits and vegetables, fresh meat was always available. It was always plentiful on menus year round.

Today, thanks to electricity, we have refrigeration. Fresh produce is available everywhere year round. But not so in 1899. Refrigeration then required ice and was an expensive proposition. Take a look at the price of “ribs of prime beef” above and compare it to the prices of fresh fruits. The prime rib is 60 cents; most of the fresh fruits are 40 cents. Compare that differential with what you would pay today in a nice restaurant. Or at the grocery store.

Overproduction of Elites

As I teased last week, here is my review of End Times: Elites, Counter-Elites, and the Path of Political Disintegration by Peter Turchin.

As I mentioned before, I love this book. Nothing I have read in the last couple of years has made me think as much as this book has. I can’t get it out of my mind. And what’s funny about it is that I almost quit reading it early on. I found it in a bookstore and flipped through it. It looked interesting, so I grabbed it on Kindle. (I’ve gone to Kindle of necessity, because I have too many books I want to read, and I travel so much, I just can’t schlep them all around with me. I just took a photo of my nightstand. You can see my blue Kindle-app-enabled iPad on the top of the front left stack of books. The iPad currently contains about 1,300 books. The nightstand only a fraction of that. So, much though I love physical books, necessity (and MD) have driven me to Kindle almost exclusively.)

After I’m about two pages into the book, I’m ready to quit reading it. Why? Because the author’s theories are based on a model he and his colleagues have created called cliodynamics. If I’ve learned nothing else from Matt Briggs, I’ve learned that models tell you what the creators of the models want you to know. Think climate change predicting. It’s all done with models. And they all say what those who make them want them to say.

But because I had found the book so interesting while flipping through it at the bookstore, I decided to forge ahead despite my misgivings.

And am I glad I did.

Before we get into it, here is the author’s description of cliodynamics, a field he was involved in developing.

…my colleagues in this endeavor and I have built out a flourishing field known as cliodynamics (from Clio, the name of the Greek mythological muse of history, and dynamics, the science of change).

Cliodynamics involves studying multiple civilizations and countries over centuries that all pretty much follow the same trajectory. In fact, the same trajectory the United States is following now.

...when a state, such as the United States, has stagnating or declining real wages (wages in inflation-adjusted dollars), a growing gap between rich and poor, overproduction of young graduates with advanced degrees, declining public trust, and exploding public debt, these seemingly disparate social indicators are actually related to each other dynamically.

In the author’s theory, there are three important parts to any society: elites, the state, and everything else.

The elites are those who are in control. They basically run things. And they come in a variety of flavors. They are

simply those who have more social power—the ability to influence other people. A more descriptive term for elites is “power holders.”

But power holders differ in how they hold power. You’ve got those who hold social power mentioned above, but there are others.

The second kind of power is wealth (or accumulated material resources, more generally).

—

The third and more subtle kind of power is bureaucratic or administrative.

—

The fourth and “softest” kind of power is ideological—the power of persuasion.

The state can be any number of governmental structures from a constitutional republic to a communist dictatorship. The same events transpire in them all.

And the rest is made up of everyone else.

As long as the elites, the state, and everyone else is in a sort of equilibrium, the typical outcome is progress, prosperity and a societal good mood. Once things fall out of equilibrium, the society begins to fall apart.

What typically throws things out of balance is an overproduction of elites.

Elite overproduction develops when the demand for power positions by elite aspirants massively exceeds their supply.

In general terms, here is what happens.

People work hard and try to improve their lives. As they do so, their children become better educated. A better education leads to an aspiration for a better, more prestigious job. The next generation’s children are even better educated. They don’t just stop at college, they go to law school, business school, etc. And they aspire to join the elites.

But there are just so many positions for the elites to occupy. They try to create more of them, which is one of the reasons everything now—universities, high schools, medicine, for example—is filled with administrators. New positions for the growing number of elites to occupy. Most universities have more administrators than they have professors.

At some point the number of elite aspirants becomes much larger than there are spots for them. Then the troubles begin.

But it’s not just that. A bunch of disgruntled elite aspirants aren’t enough to cause trouble. There have to be other situations that have gone to the dogs.

And there usually are.

As the elite class grows, it has to be fed. How is it fed? Usually by turning on the “wealth pump,” a wonderful term created by the author. A wealth pump pumps wealth from the everyone-else class to the elites, who, for the most part, aren’t all that productive.

How does a wealth pump work? Let’s look at immigration. Immigration typically brings in a bunch of low-skilled workers, who drive labor costs down. Which means the everyone-else class makes less money, while the elite class makes more. Income inequality rises.

At the risk of sounding like a name-dropper, I can tell you that the last one-on-one conversation I had with Bill Clinton was about this very thing. We both grew up in small towns—mine much smaller than his—at about the same time, and we both experienced the same thing. There was not a big class distinction. People who ran filling stations were as educated as the people who ran the bank. Pretty much all of them had high school educations (which actually meant something then) and started at the bottom and worked their way up.

People who worked in factories maybe earned $6,000 per year, while the CEO of the company may have made $40,000 per year. Now the workers make maybe $60,000, if they’re lucky, while the CEO makes millions. Just yesterday, someone sent me the graphic below, which pretty much perfectly describes the situation we find ourselves in.

My grandfather was the superintendent of schools in a small town that was the educational center for a large rural, agricultural area in the Ozarks. He, unlike most other residents, actually had a college education. After work every day he came home, and he and I went downtown (to the town square, which was all of downtown) and stopped off at Mr. McMahon’s gas station, where Mr. McMahon and my grandfather would discuss the events of the day. They had been friends for years, yet both of them called one another by their surnames. It was Mr. McMahon and Mr. McKinley for as long as they were both alive.

Then it was off to White’s, the big (a relative term) general store that had groceries along with a bunch of other products. My grandfather would chat with the various clerks there—all using surnames. It would have been unthinkable for me to call an adult by his/her first name. I still wince when I hear kids call adults by their first names. Maybe it’s just a Southern thing. All my Southern grandkids still call adults by their last names. Of course they were raised by parents who were raised in the South by parents who also grew up in the South.

My point with all this is that back then—at least in small-town America—there wasn’t a big class differential. Clinton talked about the same thing in the town he grew up in. He told me about a guy he grew up with who had taken four years of Latin, was well-read, could intelligently discuss foreign affairs and ran a machine shop. He said, You don’t see that now. And he’s right. Those people get educated and get out. And become elite aspirants.

Now, in many cases, small towns are miserable cesspools of drugs, unemployment, and misery. Which the author of End Times calls “immiseration.”

As the wealth pump pumps, immiseration sets in on the everyone-else class, while the elites, who are the beneficiaries of the wealth pump, continue to prosper. All alone, this would be an unstable situation, but when you throw unhappy elite aspirants into the mix, it becomes positively volatile.

What I didn’t realize until reading this book was that most revolutions were driven by counter-elites, who are elite aspirants denied admission into the elite category. It has been the counter-elites who provoke the unhappy masses into revolt. If the everyone-else category is happy and prospering, they are not in a mood to revolt. If there is enough room in the elite class to accommodate the elite aspirants, there isn’t a problem. But when there is widespread immiseration and elite overproduction, big trouble is brewing.

End Times lays out the history of how these situations have ended. Almost always not good. But also presents a couple that managed to work their way out, which always involves the elites giving ground.

Reading this book is like re-watching a movie with a surprise ending. The first time you watched the movie, you didn’t see the ending coming. When you see it the second time, you see all the clues the screenwriter put in that you missed the first time you watched it. End Times provides you with the clues on the first reading.

Okay, let’s catch up on the New Zealand vaccine data fiasco. But before we do, I have to make an appeal.

To become a paid subscriber to The Arrow costs a measly 20 cents per day (19.78022 cents, to be exact, and that’s if you sign up monthly). If you sign up for an annual subscription, it’s only 16.438356 cents per day. A bargain to be sure. A single scoop of Cherry Garcia costs about five days’ worth of The Arrow. And The Arrow won’t raise your insulin.

New Zealand Vaccine Data Fiasco

It is a fiasco. For those without a scorecard, here is a brief history to this point.

A data specialist working for the New Zealand Ministry of Health became troubled by what he found to be extremely high death rates of NZ residents who had been given certain batches of the Pfizer mRNA vaccine. He apparently sent the data to Steve Kirsch, a noted vaccine skeptic who loves this kind of info. Kirsch sent it to another data guy named Kevin McKernan and to William Briggs and, I’m sure, to a few others.

Then the data specialist at the NZMH, a guy named Barry Young, decided to become a whistleblower and publicly out the abnormal death rates. Which he did in the video I posted last week. But at that time, his name wasn’t known. He made his data public with the help of an investigative journalist, lawyer, former candidate for parliament, anti-vaccine activist named Liz Gunn. You can see the full outing here, but she uses a pseudonym for the whistleblower, who looks just about as hangdog as a man can look.

Since then, the NZMH has come to life and gone on the offensive. They have arrested the whistleblower and had him held without bail. (I think he is out now, but I’m not sure.) Liz Gunn went into hiding as the NZMH was after her, too.

Steve Kirsch publicized the fact that he had the data and had shared it with Kevin McKernan. The NZMH was somehow able to persuade the data storage companies used by these two men to be shut down without notice and their data removed. Here is Kirsch’s description of what happened.

Wasabi suspended my account with no notice and without even talking to me to hear my side of the story (I did not violate their terms of service). They inactivated my account on Friday Dec 1 at 6pm EST. They have NEVER reached out to me to get my side of the story and there is NO publicly available information on my site that violates anyone’s privacy or is a copy of anyone’s data. In my view, Wasabi should never be trusted to host anyone’s data. When I reached out to their CEO urging him to call me to hear my side of the story, he ignored me. 

Kevin McKernan mirrored my data and MEGA deleted everything in his account. Everything. All the links to his research in his Substack are now BROKEN. All his data was permanently deleted and they wouldn’t give him a copy.

HE IS PISSED. He has a right to be pissed. NOTHING in the data he posted is owned by the NZMH. Nothing. Nothing. 

Avoid MEGA unless you want to lose all your data even if you’ve done nothing wrong.

All of these actions of the NZMH pretty much activated the Streisand Effect, and now everyone has heard about it.

I contacted a friend of mine who is an academic epidemiologist in NZ and asked him what the word was there. He said the whistleblower was legit, and the data was legit. And he sent me a link to a tweet I hadn’t seen of NZ docs discussing the situation.

As I mentioned above, Kirsch also sent the data to Matt Briggs to analyze. Which he did and wrote about it in his Substack yesterday.

After a thorough analysis, here is what he had to say:

We cannot tell cause from this data. Not with any certainty. We also can’t tell if the shot prolonged anybody’s life. No control group again. But, if New Zealand could release the age and date of death of people with no shots for this same time period, then we’d really be in business. There’s no reason not to, not after the shot data is already out there.

Control data could also prove, as Experts claim, if the vax prolonged lives. Why should we trust them that it did? Answer: there is no reason to trust them. Even better is to have data with official causes of death. Think we’ll get it? As Santa would say: Ho Ho Ho.

This analysis, which is in conjunction to all the other work out there, will please no one. It does not say the vax was a great killer, nor does it say the vax was harmless. Because, using this data alone, we are very limited in what we can say.

It would really be nice to have the data from the unvaxxed crowd, but I doubt it will be made available. The fact that NZHM has been acting the way they have instead of just making the data public speaks volumes. But that’s public health agencies for you these days. Try getting similar data from the CDC.

You can read Briggs’s entire analysis, which is fascinating, below. And I recommend that you do.

New Zealand Vaccine Data: Possible Injuries & Misleading Signals

Troubling Nature Article on mRNA Vaccines

I just read about this paper today in Jeff Childers’s Coffee & Covid daily missive. I haven’t had time to go through it in detail, because I just saw it for the first time moments ago, and because it is quite a complex paper written using a lot of jargon. But it is an incredibly important paper about something I’ve wondered about since the first book I read on how the vaccines were developed.

Just as a little review, let’s quickly go over how proteins are created. mRNA transcribes the genetic code for the particular protein from the DNA. The m in mRNA stands for messenger, which tells you the mRNA is carrying a “message” to the ribosome to be used to make a protein. Transfer RNA (tRNA) then attaches to specific amino acids, which are taken to the ribosome and assembled as per the mRNA instructions (or message). After the message from mRNA is converted to protein, the mRNA is quickly degraded.

Here is a brief video showing how it all works.

The code for the protein to be built is specific and made of a series of three codons that each represent an amino acid to be included in the protein.

Manufacturers of the vaccine were able to figure out the genetic sequence for the spike protein. They then created mRNA with that exact sequence and tested it. The thinking was if they could generate spike protein—which, at the time, they didn’t know (supposedly) was the most dangerous part of the SARS-CoV-2 virus—in muscle, the body would mount a defense against it and provide long-term immunity.

The problem was that the body degraded the mRNA before it could do its job. So, they fiddled with the mRNA codons and substituted synthetic products, which ended up preventing the mRNA from being so quickly degraded. When I first read about his, I wondered if it wouldn’t end up creating some other issue, what with the law of unintended consequences and all. Turns out it does. And, at least according to this paper, does so in about 25-30 percent of people who get the jab.

Childers was alerted to this paper by an article in The Telegraph, a Brit newspaper. The article tries to whitewash the issue, but in reading the actual paper, there appear to be a lot of looming problems.

Here is the heart of The Telegraph piece

It was thought the minor tweak to uridine [the ribonucleotide replaced with the synthetic] caused no problems in cells, but a team of researchers at the University of Cambridge’s Medical Research Council (MRC) Toxicology Unit have now found when this partially synthetic code is read, the protein-making machine in the body sometimes struggles with the uridine analogues.

Because it is not a perfect fit for what is expected, there can be a momentary pause which causes the process to stutter and a letter in the code can get skipped, much like a bike slipping a gear.

This process, called frameshifting, throws out the way the code is interpreted as it relies on groups of three bases, known as codons, being read in the right order.

This issue, caused by the jab’s code, throws the process completely out of sync and the entire subsequent code becomes garbled.

In the case of the Covid jabs, the end result is a nonsensical and harmless protein, the team found, which the body attacks and leads to an immune system flare-up. The new study, published in Nature, found this occurred in around 25-30 per cent of people. [My bold]

As I say, The Telegraph kind of whitewashes what’s really going on.

Childers points out another sentence that jumped out at him.

But check out this very telling quote from one of the study authors, Anne Willis, who is a very upbeat kind of lady. She found that the problem just creates a very exciting opportunity for jab makers to fix it:

(Professor Anne Willis, Director of the MRC Toxicology Unit) adds it is very exciting that there is a way to fix the issue, which “massively de-risks this platform going forward”.

Screech! Hold on, wait just a minute! Slam on the brakes for a second. If fixing the issue “massively de-risks the (mRNA) platform” … that means … there are massive risks to be fixed. And that quote, ladies and gentlemen, gave away the entire game, right there, and showed us what the study authors are really thinking.

In the short time I spent looking at the actual paper (not The Telegraph), a few troublesome things jumped out at me. The first was the very first sentence in the body of the article:

A key feature of therapeutic IVT mRNAs is that they contain modified ribonucleotides, which have been shown to decrease innate immunogenicity and can additionally increase mRNA stability, both of which are favourable characteristics for mRNA therapies. [My bold]

Remember, we have two types of immune systems operating. The first is the innate immune system, which is the first line of defense against infection. The second is the adaptive immune system that basically memorizes the structure of the offending invader and rapidly mobilizes against it in subsequent exposures. The adaptive immune system is why you develop natural immunity and why, if you’ve had, say, the measles, you’ll never get it again. Well, unless your immune system fails.

The innate immune system acts immediately while the adaptive can take a week to do its thing. Since, according to the above sentence, the substitution of one ribonucleotide for another in the mRNA Covid vaccines decreases the activity of the innate immune system, maybe that’s why the vaccinated get re-infected so often. And, I would bet, get more colds and other respiratory infections, many of which would have been thwarted by the innate immune system.

The next sentence, which lead off the next paragraph, also caught my attention.

Despite their widespread use, surprisingly little is known about how ribonucleotide modification affects protein synthesis, particularly for translation of therapeutic IVT mRNAs. [My bold]

“Little is known…” What?!?! I thought these were the most studied vaccines in the history of vaccines. And yet we know little about how they affect protein synthesis? Are you kidding me?

So, our fearless leaders have been commanding us to take these jabs, yet ‘little is known’ about the main mechanism by which they work? Jesus wept.

It goes on.

5-methylC [one of the substitutions] has previously been shown to increase misreading during mRNA translation in prokaryotes, but its effect on eukaryotic [us] mRNA translation fidelity has not been explored.

What?

If I have the time this next week, I’ll dig a little deeper into this paper and tell you what I find next Thursday.

Childers adds this to what we’ve already found out about these vaccines that were supposedly studied and tested and tested and tested.

For some reason Substack won’t let me put block quotes around anything with a list in it, so I don’t have the numbered points quoted in the way I normally do. But what follows is a direct quote from Jeff Childers’s piece today with link included.

“Let’s recap the four major jab low-lights — all from just this year:

1. In February, Kevin McKernan brilliantly discovered unexpected DNA plasmid contamination in the mRNA shots.

2. Kevin equally-brilliantly discovered something hiding in plain sight that apparently every other scientist on the planet — including the FDA — somehow missed: the mRNA shots unexpectedly include parts of an oncogenic simian virus (associated with cancer).

3. In August, I reported on a study showing the way spike protein (and thus the shots) cause autoimmune problems by unexpectedly binding to C4 immune cells, in my post titled, ☕️ JACKPOT ☙ Tuesday, August 8, 2023 ☙ C&C NEWS 🦠.

4. Then yesterday, in this newest study, we learned about the fourth major, unexpected problem with the jabs, which goes to their very design: random protein production.”

As he says, and I agree, the FDA needs to pull these shots ASAP before there is any more harm done. And they and the CDC need to release the data on the vaccinated vs the unvaccinated so we’ll all know the real truth. It will be interesting to see how history treats this debacle.

What Are Ultra-Processed Foods?

Well, I can tell you a writer at the Wall Street Journal is clueless. An article appeared yesterday titled Is That Food Ultra-Processed? How to Tell. It starts off like a regular article, then morphs into one of those kind of multimedia online things I hate. I’ve put the picture at the top of the article below.

The author then goes on in the multimedia part of it (which is behind a paywall, but I’ve linked it above without the paywall) to show how you can compare the products in the above picture to tell which ones are ultra-processed and which aren’t. How do you think you do it?

By reading the labels.

According to the author of this article, ultra-processed foods are those that have a lot of ingredients that you have no idea what are listed in the label. Of the products in the above picture, half our author defines as ultra-processed. The other half she says are fine. I can give her a clue, and she won’t even have to buy it: With the exception of the Van Leeuwen ice cream and one of the two yogurts, they are all ultra-processed. At least by my definition.

When foods are in their natural state, they are unprocessed. When they go through some sort of procedure in which they are changed, they are processed foods. It’s not the ingredients added to them, most of which are preservatives, that make them ultra-processed. It is the processing itself that does it.

All the crackers are made of wheat. Wheat is the food in its natural state. Once it is roasted, milled, and converted to flour, it is a processed food.

As we’ve discussed numerous times in these pages, processed foods—foods that have had their structural integrity damaged—generate a high incretin response when they are eaten. This high incretin response stimulates a high insulin response, which is what we don’t want to have happen. The various preservatives don’t stimulate an incretin response—or at least I don’t think they do. I’ve never seen a study looking at it.

The Fage yogurt is pretty pure. The Chobani contains some processed soy products in it, which, if these stimulate an incretin response, might qualify it as processed. The author of the article puts a red box around the “natural flavors” in the label, which is insane.

Various chemicals contained in the foods we eat stimulate our taste receptors. If you take, say, strawberries and keep analyzing them until you find the specific chemicals—often organic esters—in them that make them taste like strawberries, you can then reproduce the exact taste of strawberries by using these chemicals. And they are the same chemicals the strawberries themselves produce. They aren’t some off-the-wall strange chemicals—they are exactly what the strawberries make.

So manufacturers can make these chemicals inexpensively and put them in products to make them taste just like strawberries. And no one can tell the difference because they are the same chemicals made by strawberries.

Or these very same chemicals can be extracted from a shitload of strawberries and be used for the same purpose. But, according to US labeling laws, only the chemicals extracted from strawberries can be labeled as “natural flavors.” The exact same chemicals synthesized in the lab have to be labeled “artificial flavors.” As you might imagine, “artificial” flavors are vastly less expensive than “natural” flavors even though they are the same chemicals. Which runs up the price of any product containing “natural flavors.”

If you don’t want to worry about it, just eat strawberries.

Of the two ice creams, one contains wheat flour and a bunch of other stuff, so it definitely qualifies as ultra-processed. The Van Leeuwen not so much. But, as we’ve learned over the last couple of weeks, the combination of fat and carbs generates a huge incretin response, so eating this ice cream—though made of whole foods—is not without consequence.

Does Protein Damage the Kidneys?

My first impulse was to say, No, and move on. But instead I’ll tell you about a great new paper I just read. I’ve been waiting for this paper for a long time.

Thirty years ago when I was going about giving talks on the benefits of the low-carbohydrate diet for all kinds of health problems, I was always asked during the Q&A about too much protein damaging the kidneys. I did some looking around in the literature, which was much more difficult then than now, and came up with a 1989 study done in Israel by Blum et al.

The group compared vegetarians to omnivores in an age and sex related fashion for kidney function as measured by creatinine clearance. The study group was small—31 subjects in all. And it was an observational study, so it could not prove causality. But it was the only study I could find, so I got my money’s worth out of it thanks to the chart below.

The graph shows kidney function in vegetarians and omnivores (or non-vegetarians as they’re called in the paper). As you can see, the sad fact is that kidney function deteriorates with age, and it doesn’t make any difference if you’re a vegetarian or an omnivore. The supposition based on dietary histories was that the omnivores ate a lot more protein, especially animal protein, than did the vegetarians, yet kidney function declined at the same rate for both.

Now comes a brand new study by Weimbs et al titled Ketogenic Metabolic Therapy for Chronic Kidney Disease—The Pro Part. It’s one part of a two part pro/con on protein and kidney disease. To be honest, I haven’t even looked at the con part, mainly because I’ve heard the con part for the last 30+ years I’ve been doing this. Everything MD and I have seen in our practice conforms to what is presented in this paper. I will read the con part, and will report on it if there is anything worth reporting.

In the first paragraph, the authors write

KMT [ketogenic metabolic therapy] can be as effective as pharmacological interventions and is a therapeutic option that should be in the armamentarium of every physician and dietitian.

I’ve said my own version of this countless times. I’ve told other doctors who have had no experience with a low-carb diet that they need to prepare themselves if they use it on patients. It is more powerful than most drugs, and, until they see them themselves, they will not believe the changes such a diet brings about. Or how quickly.

The authors of the paper point out that ketogenic diets were developed over

150 years ago that substantially restrict carbohydrates, e.g. ≈20–50 g/day (as opposed to 100–>300 g/day in most societies). To compen- sate for the reduced energy supply from carbohydrates, the dietary fat intake is increased in typical ketogenic diets. Some ketogenic diets also increase the intake of protein, but this is not a general feature of KMT. The carbohydrate restriction in ketogenic diets leads to lower blood glucose levels, and consequently low insulin levels, depletion of glycogen stores, release of fatty acids from adipose cells and production of ketones by the liver. In contrast to continuous fasting, ketogenic diets can be administered as KMT for long periods of time without leading to nutrient deficiencies because the person under KMT continues eating without other restrictions.

They refute the oft repeated argument that carbs are essential.

A common misconception is the incorrect belief that carbohydrates, also commonly abbreviated as carbs, are essential nutrients. As known in biochemistry, they are not. The human body can synthesize all needed carbohydrates. Humans are able to adapt to low carbohydrate intake. It is often mistakenly believed that the body has to ‘run on glucose’ or that the brain requires high blood glucose levels to function. If this were correct, taxo- nomically higher animals would have long gone extinct because they have evolved the need to go in and out of ketosis due to variable food availability. It is important to remember basic physiology and that the human body stores fat (triglycerides in adipose tissue, liver and other organs) besides glucose (glycogen). The brain is well adapted to utilize ketones over glucose as its energy source.

They also address the fallacy (believed by no one reading this newsletter, of course) that ketogenic diets are simply high-fat diets much in the same way that the typical Western diet is a high-fat one.

Some investigators think that ‘high fat Western’ diets are the same as ketogenic diets. High fat Western diets are frequently used in animal experimentation, where they wreak havoc on the metabolism of rodents, but these diets invariably also have a high carbohydrate content that prevents the state of ketosis. By definition, a ketogenic diet must have a very low carbohydrate content and must induce ketogenesis. An illustrative example is a recent press release by the American College of Cardiology reporting on a conference abstract about a study of ‘keto-like’ diets. The diets they investigated (25% of energy from carbohydrates) were not ketogenic. Nevertheless, this and similar uninformed press releases are often reflected in the lay press and touted as proof that ketogenic diets are harmful.

The paper on keto diet and kidney function that we’re discussing here includes a nice graphic showing the difference between the Standard American Diet (SAD) and the Ketogenic Metabolic Therapy (KMT). You would much rather be on the right side than on the left.

The really interesting part of the paper is the discussion on using KMT for chronic kidney disease (CKD).

A quintessential rationale is the premise that diabetes is by far the leading cause of CKD. Whereas the exact mechanisms may still be opaque, chronic hyperglycemia has direct effects on the kidneys, eventually causing vascular and tubular damage, chronic inflammation and fibrosis. If hyperglycemia triggers CKD, it is a logical conclusion that hyperglycemia should be ameliorated as much as possible to prevent further renal health deterioration. KMT is an effective method of decreasing baseline blood glucose levels and reducing spikes. Numerous studies suggest that ketogenic diets are more effective in glycemic control, weight loss and decreasing hypertension than low fat diets. A randomized trial comparing head-to-head the Dietary Approaches to Stop Hypertension (DASH) diet to a ketogenic diet over a 4-month period in overweight or obese adults with hypertension and prediabetes or T2D found that both diets had benefits but the ketogenic diet resulted in greater improvements in all outcomes, including improvement of hypertension, glycemic control, hemoglobin A1c (HbA1c) and fat weight loss. [My bold]

I’m surprised the authors didn’t use the term “glucose toxicity” here as applied to the kidneys. Glucose is toxic to many organs and tissues. I just did a search on PubMed and discovered that as of the time of my search, there are 24,202 papers on glucose toxicity, so it’s not something I just made up.

They discuss SGLT2 inhibitors (my absolute least favorite drugs on the market for diabetics) in a way I hadn’t thought about.

It should be noted that sodium–glucose cotransporter 2 (SGLT2) inhibitors, which are now widely prescribed to CKD patients and often hailed as a breakthrough treatment, work on the same principle as KMT, albeit less effectively. SGLT2 inhibition causes renal excretion of up to 80 g of glucose per day, thereby partially relieving the high carbohydrate burden from patients’ diets. Arguably, the same effect could be achieved by ingesting 80 g less sugar/starch per day, which is the equivalent to about two cans of soda. Using a ketogenic diet, sugar/starch consumption can be further reduced. SGLT2 inhibition also leads to elevation of blood ketone levels, which likely contributes to the benefit. Altogether, SGLT2 inhibition could be considered a ‘light’ version of KMT that, unfortunately, is accompanied by drug-induced adverse effects.

The discussion continues as to how, after diabetes, hypertension is the second greatest risk for CKD. It has been my experience that 75-80 percent of hypertension can be gotten rid of simply by going on a low-carb diet. The other 20-25 percent that is refractory usually becomes less severe after some time on the diet. And there is little doubt that reducing blood pressure prevents kidney damage.

Same with inflammation. It is a risk factor for kidney damage, and a ketogenic diet is terrific at damping inflammation.

The authors discuss a host of animal studies showing the ketogenic diet to be of great benefit in treating or preventing CKD, but it was the human studies that got my attention. They discussed a handful, but it was the two randomized, controlled trials I was interested in.

A randomized controlled trial comparing a 2-year intervention with a ketogenic (low carbohydrate, high fat/protein) diet versus a Mediterranean diet versus a conventional low fat diet in 322 overweight or obese participants with mild–moderate CKD (stages 1–3) showed that the dietary interventions led to weight loss and improved renal function. The ketogenic diet generally had the greatest beneficial effect on renal function, especially in participants with CKD stage 3 [estimated glomerular filtration rate (eGFR) improvement by 7.1 points over 2 years].

So, the very diet people worry about damaging the kidneys actually made them better.

A randomized controlled study of 40 individuals with T2D and mild–moderate CKD (eGFR >30 ml/min/1.73 m2) compared a 6-month intervention with a ketogenic, plant-based fasting- mimicking diet (5 consecutive days per month) to a Mediterranean diet. The KMT intervention led to numerous significant beneficial effects, including improved insulin resistance, glycemic control and HbA1c; weight loss; deprescription of diabetes medication; reduction in microalbuminuria and a slower decrease in eGFR based on cystatin C. In contrast, the Mediterranean diet had no significant effects and led to a continuing decline in eGFR. [My bold]

So the ketogenic diet proved better in terms of repairing kidney damage than did the much-vaunted Mediterranean diet that everyone seems to think is God’s gift to the dietary world.

I learned a new word in the last quote. Who knew deprescription was a word meaning getting rid of a prescription medication. I think it’s a made up word, but I applaud the sentiment. ‘Deprescription’ was always one of our goals with patients.

The paper discusses the risks of the ketogenic diet. One of which, according to the authors, is kidney stones.

A recent meta-analysis estimated that ≈8% of individuals on ketogenic diets develop kidney stones during a follow-up of ≈4 years. It is difficult to judge whether this represents an increase compared with the general population, which has a similar risk of developing kidney stones. However, interestingly, ≈50% of the kidney stones in subjects on ketogenic diets were uric acid stones and an additional 28% were mixed uric acid and calcium stones, suggesting a potential link to animal protein intake as a known cause of high uric acid burden. In contrast, calcium oxalate stones are by far the most common stones in the general population. Temporary increases in serum uric acid levels have been reported during the transition into ketosis, which is followed by a long-term decrease below baseline. Urine acidification that occurs in ketosis may increase the risk of forming both uric acid and calcium oxalate stones.

Based on our experience—MD and I didn’t see any bump in kidney stones in our practice—I don’t think the ketogenic diet really does cause kidney stones. But if you’re worried, drink a lot of water and increase your salt. And if you’re really worried, drink high Ph water, which you can get all over the place. It will alkalize you and help reduce your risk.

The other risk, of course, is an increase in LDL. By now you probably know my take on this one, so I wouldn’t worry about it a lot.

My only gripe with this paper is that one of the authors is involved with a company making a plant-based keto drink. Consequently, there is a tendency to lean toward a plant-based ketogenic diet. Which might well keep you in ketosis, but won’t provide you with enough good quality protein to maintain and build muscle mass.

This is a paper I would suggest you read. It’s really accessible and will give you loads of information and other sources you can look up. Which, I, myself, have been doing. It will eliminate your fear—should you be burdened with it—of protein damaging your kidneys.

Speaking of which, bodybuilders consume huge amounts of protein every day. If protein damaged kidneys, there would be throngs of them waiting in line at dialysis centers. MD and I looked for these long lines a few days ago, and this is the best we could find.

Okay, time for the video of the week.

Video of the Week

Usually I try to keep my videos of the week kind of pleasurable and/or upbeat. This one is kind of a downer and disgusting. Many of you have probably seen it. but I want to post it anyway. In a congressional hearing a few days ago, the presidents of Harvard, Penn, and MIT were asked a simple question, which should have been easy to answer with a resounding Yes. But watch how these leaders of three Ivys responded.

Here is the link to the full tweet, which gives the context.

These Ivy League presidents don’t want to incur the students’ ire, which is why they answered as they did. They are not doing their students any favors in trying to shelter them. There was a great article in the WSJ a few days ago about this sort of thing. The article is about free speech and the coddling of students. The final paragraph is pretty chilling.

More generally, Lukianoff [the subject of the article and the co-author of a book on coddling] argues that Americans would be better off “if we loosened elite higher education’s grip on society.” After “Coddling” came out, he says that heads of corporations and nonprofits called him to privately complain that young graduates from top schools were creating “serious problems” in the workplace by fixating on “minor interaction problems” with each other or with the institution itself. “My answer is, ‘Could you please tell the world that?’” says Lukianoff. “People need to know that the kind of product coming out of these elite schools is unworkable.”

Okay, time for a poll and we’re out of here.

That’s about it for this week. Keep in good cheer, and I’ll be back next Thursday.

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