The Arrow #158

Hello friends.

Greetings from Dallas.

Where I’m bummed. I was scheduled to play in a golf tournament this coming Saturday, teamed with my son, and it was just announced yesterday that the course will be closed due to weather. I’m bummed because he and I don’t get to play that often, and I was really looking forward to it. Now they’ve rescheduled the thing for a time when we will have company and he will be out of town.

The weather has been unreal for the past couple of weeks. One day it’s gorgeous; the next it’s raining and the wind is howling. This has been literally what’s been going on for at least ten days. And I’m not using “literally” as the Millennials or the Gen Zers do, as in I was, like, literally, dead on my feet. I’m using it in its correct sense. The weather has literally been bright and sunny one day, then cold, windy, and rainy the next. Then rinse and repeat. It was beautiful yesterday, and it’s beautiful today, so we’ve had a couple of days in a row for the first time in a couple of weeks. Up till then it was alternating and now the forecast is for it to drop way below freezing over the weekend. But the current weather report shows it to be almost the same on Saturday as it is today, and the course is open today with golfers all over the place. So why the course closure announcement three days before the scheduled event? Sucks.

Covid Fatigue

I got a comment in last week’s Arrow that caused me to do some thinking. Here it is:

I subscribed this week (paid) even after struggling with all the COVID content that is seemingly endless here. I am begging you, sir, to please give me more information that can improve my life going forward as opposed to the endless chatter about Covid. I am certain that you have made your points by now and we have received them and if not we never will. [My bold]

I received one other comment re my posting on Covid:

On the “Are you sick of Covid” poll, yes with comment. I want to see heads roll! I want to see these arrogant buffoons’ feet held to the fire. My gut tells me there’s as much chance of that as seeing any of the creeps on the Epstein list prosecuted. A guy can wish, can’t he?

The poll came in a little more than 50-50 on the side of Covid fatigue, so there are plenty of folks still interested, but more that aren’t.

Let me defend my position on the issue, then I’ll tell you how I will deal with the problem.

I am obsessed with the entire Covid/lockdown/vaccine situation because it has been the most significant event in my professional life. It has shaken the very foundation of medicine and shattered our faith and trust in the institutions of public health, while showing Big Pharma for what it really is. And it has shown us how governments can go from zero to warp speed moving from bureaucratic to autocratic. And dishonest. And disreputable. All the while throwing potloads of money into the pockets of a few.

The last few years have left me much changed. My only real disputes with mainstream medicine previously were its failure to adopt the low-carb diet, its ungodly attachment to statins, and its propensity to overprescribe. Other than that, I was a pretty mainstream guy. Had Covid not come along, I still would be.

When the Covid vaccines first hit the scene, I was not averse to them. I thought the technology sounded brilliant. I have a friend who is a law professor in New York. He is also a frequent guest on Newsmax. The folks at Newsmax asked him if he knew any physicians who would comment on the new Covid vaccines. He suggested me. They called me, and I agreed to be on whatever show it was that wanted me.

I went on. The host asked me about Tiffany Dover. She was the nurse in Tennessee who fainted right after getting her Covid shot on air, which event had just happened. I told them that a lot of people faint when they get shots or get blood drawn. It’s not uncommon. And this nurse was probably a little apprehensive since she was on TV, so the situation was ready made for a faint. Which, as it turned out, was what happened.

They asked me what I thought about the vaccines. I told them time would tell, but that I thought the technology was amazing.

Then the host asked what I thought about a case in Colorado in which two people who were murdered happened to test positive for Covid and were declared Covid deaths. I told them I didn’t really know about the case, but if it were as described, it was insane. And I may have mentioned that there were payment incentives for the hospital.

Fortunately, I was ill-prepared to do an online interview from a technical perspective. My internet provider at the time sucked, so I had a lot of frozen screens and static. At least so my lawyer friend who watched the episode told me. They never called again.

So, somewhere buried in the archives of Newsmax is a segment with me basically touting the vaccines. Thank God the quality was horrific.

I went back and looked at early versions of The Arrow that started about the same time I did the interview. As it turned out, in the very first issue of The Arrow—called the No Name Newsletter #1—I laid out my thoughts. I would simply link it here, so that those interested could read it, but I can’t do that as it isn’t in a linkable form and hasn’t been since I left my last email host.

So, here it is in full. This was written on January 7, 2021, so Trump was in the last couple of lame duck weeks of his presidency, and the vaccines were just starting to roll out.

WHAT ABOUT THE NEW VACCINES?

Well, I'm not sure where to start. What with all the cancel culture roaming wild today, it's hard to say anything even remotely negative about vaccines without running the risk of being labeled an anti-vaxxer. And being canceled.

First, let me say that I have taken numerous vaccines myself and have given thousands of them through our clinic. I have also taken a lot of medicines in my life and prescribed thousands and thousands of doses of medicine to my patients. But I always do so carefully, because medications are not always benign. 

When I first started practice I was queried by a drug company as to how eager I was to prescribe a new medication. The categories were:

• Willing to prescribe when medication first available

• Wait a few months to see if problems develop over time

• Wait a year to see if problems develop and to see if meds are effective.

• Wait several years.

• Probably won't ever give a new drug.

I went with the first choice because I figured all the drugs had been thoroughly tested and were safe and effective. I thought only old fashioned docs, long out of medical school and far from the mainstream of 'new' medical thought, would not want to use these new wonder drugs.

Then I ran into Zomax.

Zomax was a new non-steroidal anti-inflammatory drug in the same category as ibuprofen. I began Zomaxing patients with complaints of pain and inflammation right and left. At first, there were no problems, but then I had a patient go into anaphylaxis, then another. I obviously wasn't the only doctor prescribing this drug, and other docs had their own patients who had bad experiences as well. In short order the drug was off the market never to return.

This history is common to more drugs than you might imagine. Moving them through the intensive, mandated FDA testing process before release doesn't mean that no problematic drugs make it through. Testing a drug on 30,000 subjects doesn't reveal all the problems that become manifest when given to 10 million patients. So drugs are recalled right and left. As a consequence, I've moved down the list above to the Wait a few years category.

As to the new SARS-CoV-2 vaccines, I'm optimistic. I love the science behind them. They are mRNA vaccines, which I believe are the future of vaccines, if for no other reason than they can be produced so quickly. These new vaccines were produced from start to finish in about nine months, which was a Herculean feat. Up till this vaccine, the shortest amount of time it took to come up with a vaccine was four years for the mumps vaccine developed in 1967.

Until these new vaccines, the old way was to incubate the viruses in eggs or other culture mediums, which took forever to grow enough virus to make vaccines for millions of people. Once there were enough, the viruses had to be treated to make them non-infectious yet still capable of causing the body to mount an at least semi-permanent immune response against them. Which was no easy feat.

With mRNA vaccines, all you have to have is the genetic sequencing of the virus, which is relatively easy to get. Instead of having to grow the viruses, then making them non-infectious, you have only to re-create the mRNA of one of the components of the virus--in this case the spikes on the SARS-CoV-2 virus--that will stimulate the immune response and get it into the cells. Then the cellular machinery will use the mRNA template to reproduce not the entire virus, but just one component that will stimulate the immune response. It's brilliant technology well described in this article by STAT.

Having said all that, I myself am going to wait a few months to see what happens before I get the vaccine myself. Why? Because it's been tested for efficacy on about 40,000 subjects, which means the actual vaccine was given to around 20,000 subjects. (The other 20,000 subjects in the trial got the placebo.) And a number of those subjects had side effects. What kind of side effects are we going to see when the vaccine is given to 20 million people?

I don't know. No one does.

And I'm not in a high-risk population. I'm not overweight, don't have diabetes or heart disease. I've never smoked. I'm pretty fit. I'm not taking any medications for anything. So, I am in a low-risk group. So, I'm going to wait to see what happens as more and more people get vaccinated. If I were 80 years old, overweight, and had diabetes, I would be clamoring for one of the first shots. But I see it all as a matter of risk-reward. I have very little risk, so the reward of being immune to something that I may have already had is small.

I thought I may have already had Covid, because MD and I had been on a transcontinental flight just the month before, and both of us had come down with something that sounded much like Covid. Later testing, however, showed we had not been infected.

Now I have made just about a complete 180. My views now pretty much mirror Nick Hudson’s, whose tweet was also posted by a reader in the comments last week.

Link

When I first started hearing rumbles about the vaccine, I began, as I usually do, by going to the medical literature. But it was too early. Nothing really there yet. I happened to catch a podcast by Bret Weinstein that included Robert Malone, whom I had never heard of. When I looked him up, I discovered he had done most of the early work on mRNA vaccines. I posted the podcast on The Arrow only to see it taken down by YouTube within a couple of days of my posting it. It was my first encounter with what has turned out to be the government’s little helpers preventing dis- and misinformation as determined by our leaders. But the helpers weren’t all that little. The helpers were Big Tech, and they were censoring information.

And doing it in incredible ways.

I found that Wikipedia (whose co-founder admitted was deeply involved with the CIA) had altered their entry on RNA vaccines to delete Malone’s name. Just like happened with the Ministry of Truth in Orwell’s 1984.

Here is the RNA vaccine Wikipedia entry early in 2021.

SOURCE

Compare that with the Wikipedia entry later in 2021 after Malone was getting some notoriety as an expert in mRNA vaccines who was warning people about them.

No mention of Dr. Malone whatsoever. It gave me the real heebie-jeebies to see how deeply the tentacles of government were squeezing internet information outlets.

At the same time I was becoming aware of the treachery involved here, I was reading all three of the books that had been rushed into print on the rapid development of the mRNA Covid vaccines. When I read about the difficulties in keeping the RNA in the shots from being immediately degraded until there was a substitution of a purine for a synthetic version, I became concerned. I knew that mRNA was always quickly degraded once it had been used as a template for a protein, so I wondered what would happen if it didn’t immediately degrade. How long would it hang around? And where would it go?

Somewhere along the way I got access to the results of the Pfizer study that demonstrated the much ballyhooed 95 percent efficacy. When I looked at the data, I realized that the 95 percent was a relative rate, not an absolute rate. Drug companies always use the relative rate, because it always favors the drug. But it is the absolute rate of infection that tells the tale. And looking at the absolute rate, I could tell that there was very little difference between efficacy of the mRNA vaccine and the placebo.

Then when I looked at the death rates, there were actually more people who died in the mRNA vaccine group than in the placebo group. The difference didn’t reach statistical significance (whatever that means, i.e., the p wasn’t wee enough), but what it did mean is there was no evidence the vaccines prevented death, although that’s what they were touted as doing.

Remember Biden’s remark about how the unvaccinated were going to experience a winter of death? There was absolutely no data from the study to base that on. It was scaremongering and an out and out lie.

And then came the mask mandates and the vaccine mandates. And on and on.

About this time, Nicholas Wade published a stunning essay on Medium explaining just how all the data pointed to SARS-CoV-2 being a manmade virus, not a virus from an animal vector. Which led to the only conclusion possible: the virus was man made as a consequence of gain-of-function research and was leaked in a lab accident. As it turned out, Anthony Fauci’s part of the NIH, the NIAID, had funded the Wuhan lab.

Fauci went on the defensive. As we all know now—at least those of us who want to know—Fauci wrangled a bunch of scientists in the field, all of whom had doubts about zoonotic spread of the virus, and most of whom were dependent on Fauci’s department for funding, into collaborating on an article stating the complete opposite. Fauci—who was extremely powerful—basically rammed the paper through The Lancet, and it became known as the “proximal origin” paper.

Once that paper was out, Fauci touted it relentlessly. Doubtless to divert attention away from his own culpability for funding Wuhan. Here is an example. In this short video (under a minute) he lies through his teeth so smoothly and so convincingly it fair takes your breath. I’ve watched this video 20 times at least, and I can never get over the brazenness of it. When you know the backstory, it is breathtaking to watch.

Other than his fling back in the 1980s with an AIDS vaccine, which never materialized, Fauci has been pretty much out of the national limelight as he labored in anonymity in the bowels of the bureaucracy. When Covid hit, things changed for him. Suddenly, he was everywhere. I’m not sure he understood that statements he made would be preserved forever. And his lies or misstatements would be available for analysis. Take, for example, this collage put together by videographer Matt Orfalea, who works with Matt Taibbi on his Substack The Racket. I can’t imagine the brain damage involved in going through all the videos necessary to pluck these excerpts and collate them. Hat’s off to Matt Orfalea and The Racket!

Absolutely stunning!

Now it’s starting to catch up with Dr. Fauci. He was in a closed session of the House for a couple of days this week. He brought with him two of his own attorneys and two attorneys provided by the government (at our (the taxpayers) expense). Had he been totally honest from the get go, he could probably have gotten by with maybe only one attorney. The fact that he had four speaks volumes.

According to those who were in the hearing on the first day, Fauci used the “I don’t recall” excuse over 100 times. The hearing lasted for about 7 hours, so that means he couldn’t recall about every 4 minutes. You’ve all watched congressional hearings. It takes 2-3 minutes just to ask a question. So, obviously, they didn’t get a lot of info out of Dr. Fauci.

Another of his statements was along the lines of “there was no evidence for the 6-foot distancing rule; we just sort of made it up”.

When I think of all the business failures, suicides, military resignations, job losses, etc. brought on by Fauci and his ilk, I get infuriated. I want some justice. But we’re not going to get it as long as the Democrats are in control. If the shoe were on the other foot, we probably wouldn’t get justice if the GOP were in control, either. But the mandates and the vast majority of the damage has taken place since Biden took office. And as long as the Democrats control congress and the executive branch, nothing will happen. The GOP controls the House right now, but they won’t be able to get Biden’s DOJ to do anything. So, unless the GOP gets control of the executive branch, which can initiate investigations on its own, or gets control of a branch of Congress and the executive branch, we won’t get justice on any of this.

And who knows what will happen there? It’s all a mess right now.

But I do want justice at some point. All those who were our tormentors are now saying, We didn’t know; we didn’t understand; we were trying to protect people; please forgive us and let bygones be bygones. If you remember the attitudes that prevailed then, you can skip on down. If you’ve forgotten, then take the time to watch this video, also put together by Matt Orfalea (bless his heart):

If we forget, it will happen again. I can guarantee it. If there are consequences, the likelihood of it’s happening again in our lifetimes will fall precipitously.

And remember, back before Biden’s election all these same Democrats were bad mouthing the vaccine. I wish Orfalea would make a composite for all those negative comments about the vaccine Trump funded through Operation Warp Speed. It was the very same one they all mandated once they took over. What caused the change of heart?

In all my writings on the subject, I’ve tried to be as even handed as possible. And I’ve worked hard not to jump to conclusions based on faulty or incomplete data. For example, below is a graph you’ve probably seen a variation of many times.

Most of these graphs show higher numbers in 2020 and 2023, so this graph relied on incomplete data from those years. At first blush, it looks pretty damning for the Covid vaccines. But my take is a little more conservative, so, although I have posted a version of this graphic a time or two, I haven’t been waving it around because I thought about it for a bit.

If you look at the gradual increase in the VAERS numbers (VAERS stands for Vaccine Adverse Events Reporting System), they kind of correspond to the increase in number of vaccines available. But then they jump into the stratosphere when the Covid vaccines become available.

My thinking on this, and the reason I haven’t been putting this up on every post about the mRNA vaccines is because up until I spent a lot of time researching it, I assumed that vaccines were wonderful. God’s gift to man, so to speak. Vaccines were enveloped in the halo effect.

So, I assume everyone else felt that way, too. I suspect many still do.

If people thought vaccines were that good and noble and healthful, it’s unlikely they would associate them with horrific side effects. Sure, your arm hurts a little for a day or two. Or you might feel a little feverish. But that’s a small price to pay for the protection you supposedly get.

Since vaccines were considered by just about everyone as essential and in no way harmful, I suspect many vaccine injuries went unreported. I doubt that the people experiencing them (or their parents) connected the injury to the vaccine. Unless it happened immediately after the vaccine.

But once the Covid vaccines came out, the entire relationship with vaccines changed for a lot of people. There were many reports of Covid vaccine damage, and suddenly everyone’s awareness of vaccine injuries increased.

Had this newfound awareness been in place going back to 1990, I suspect there would have been a lot more people reporting a lot more vaccine injuries. And, if so, the graphic above would look a lot different. Which is why I haven’t made as big a deal out of it as I could have, because the graphic is horrific.

I’ve spent way too much time on this, but I think it is important. And I do think it has an effect on people’s lives. And will continue to going forward if we all forget about it and move on.

From now on, if and when I write anything about vaccines or Covid, I’ll put “Covid” and/or “Vaccine” in the bold heading, so those who are tired of it can just skip on down.

More On Ultra-Processed Foods

As I think I mentioned, I’ve been reading up on ultra-processed foods (UPF), and I have become more enlightened. My main source of information comes from a book titled Ultra-Processed People written by Chris van Tulleken, who is a doctor, scientist (sort of), journalist and sometime filmmaker. I modify scientist with the words sort of because he falls for all sorts of shenanigans that no scientist worth his/her salt would be taken in by. In this book, he’s acting more as a journalist than as a doctor or scientist. Most of the information comes from those he interviews rather than from his own work.

What I did learn from the book was that the official version of UPF is much different than my own definition.

Carlos Monteiro is a Brazilian doctor who has spent his research career studying and defining UPF. Out of his research grew the NOVA classification of foods, which is now how most people categorize the varying degrees of processing that food goes through on its way from the source to your mouth.

The NOVA system is fairly convoluted and is not how I would define the amount of processing a food would undergo.

Let’s take a look.

The NOVA system breaks foods down into four groups defined by the author’s own definition of the degree of processing involved.

GROUP 1. Unprocessed or minimally processed foods.

Unprocessed (or natural) foods are edible parts of plants (seeds, fruits, leaves, stems, roots) or of animals (muscle, offal, eggs, milk), and also fungi, algae and water, after separation from nature. Minimally processed foods are natural foods altered by processes that include removal of inedible or unwanted parts, and drying, crushing, grinding, fractioning, filtering, roasting, boiling, non-alcoholic fermentation, pasteurization, refrigeration, chilling, freezing, placing in containers and vacuum-packaging. These processes are designed to preserve natural foods, to make them suitable for storage, or to make them safe or edible or more pleasant to consume. Many unprocessed or minimally processed foods are prepared and cooked at home or in restaurant kitchens in combination with processed culinary ingredients as dishes or meals. [My bold]

GROUP 2. Processed culinary ingredients

Processed culinary ingredients, such as oils, butter, sugar and salt, are substances derived from Group 1 foods or from nature by processes that include pressing, refining, grinding, milling and drying. The purpose of such processes is to make durable products that are suitable for use in home and restaurant kitchens to prepare, season and cook Group 1 foods and to make with them varied and enjoyable hand-made dishes and meals, such as stews, soups and broths, salads, breads, preserves, drinks and desserts. They are not meant to be consumed by themselves, and are normally used in combination with Group 1 foods to make freshly prepared drinks, dishes and meals. [My bold]

Okay, so here is where it gets weird. Group 1 foods are easy enough. They are simply foods in their native state the way we typically eat them. Take a root vegetable, say, a potato for example. If we peel it, i.e., removing the unwanted part, and cook it, it is still a Group 1 food by NOVA definition. But if we were to add some salt and butter to our potato, it becomes a Group 3 food. Yes, we will have converted it to a Group 3 food.

Say what?!?!

GROUP 3. Processed foods

Processed foods, such as bottled vegetables, canned fish, fruits in syrup, cheeses and freshly made breads, are made essentially by adding salt, oil, sugar or other substances from Group 2 to Group 1 foods. Processes include various preservation or cooking methods, and, in the case of breads and cheese, non-alcoholic fermentation. Most processed foods have two or three ingredients, and are recognizable as modified versions of Group 1 foods. They are edible by themselves or, more usually, in combination with other foods. The purpose of processing here is to increase the durability of Group 1 foods, or to modify or enhance their sensory qualities. [My bold]

Crazy, right? The hierarchy here in terms of goodness for you runs from 1-3. With 1 being more healthful than 2, which is in turn more healthful than 3. So, you take a 1 and add a bit of 2 to it, and you’ve converted it to a 3. Which, to my way of thinking, doesn’t make a lot of sense.

Then we get to the real problem.

GROUP 4. Ultra-processed Foods

Ultra-processed foods, such as soft drinks, sweet or savoury packaged snacks, reconstituted meat products and pre-prepared frozen dishes, are not modified foods but formulations made mostly or entirely from substances derived from foods and additives, with little if any intact Group 1 food.

Ingredients of these formulations usually include those also used in processed foods, such as sugars, oils, fats or salt. But ultra-processed products also include other sources of energy and nutrients not normally used in culinary preparations. Some of these are directly extracted from foods, such as casein, lactose, whey and gluten. Many are derived from further processing of food constituents, such as hydrogenated or interesterified oils, hydrolysed proteins, soya protein isolate, maltodextrin, invert sugar and high-fructose corn syrup.

Additives in ultra-processed foods include some also used in processed foods, such as preservatives, antioxidants and stabilizers. Classes of additives found only in ultra-processed products include those used to imitate or enhance the sensory qualities of foods or to disguise unpalatable aspects of the final product. These additives include dyes and other colours, colour stabilizers; flavours, flavour enhancers, non-sugar sweeteners; and processing aids such as carbonating, firming, bulking and anti-bulking, de-foaming, anti-caking and glazing agents, emulsifiers, sequestrants and humectants.

A multitude of sequences of processes is used to combine the usually many ingredients and to create the final product (hence ‘ultra-processed’). The processes include several with no domestic equivalents, such as hydrogenation and hydrolysation, extrusion and moulding, and pre-processing for frying.

The overall purpose of ultra-processing is to create branded, convenient (durable, ready to consume), attractive (hyper-palatable) and highly profitable (low-cost ingredients) food products designed to displace all other food groups. Ultra-processed food products are usually packaged attractively and marketed intensively. [My bold]

So, Group 4 foods are what we usually think of as snack foods. But not always.

Here’s an example from the Morning Brew, one of my favorite newsletters. About once every week or so, the writers will list the ingredients of a familiar food, which the readers are then supposed to name. A couple of day ago, here was the list of ingredients of a well known food. See if you can guess what it is. (Answer at the bottom of this section. No peeking.

Tomatoes (Tomato Puree, Water), Water, Enriched Wheat Flour (Wheat Flour, Malted Barley Flour, Niacin, Reduced Iron, Thiamine Mononitrate [Vitamin B1], Riboflavin [Vitamin B2], Folic Acid), Beef, Crackermeal (Enriched Wheat Flour [Bleached Wheat Flour, Niacin, Reduced Iron, Thiamine Mononitrate, Riboflavin, Folic Acid], May Contain Guar Gum), LESS THAN 2% OF: High Fructose Corn Syrup, Salt, Textured Vegetable Protein (Soy Flour, Soy Protein Concentrate, Caramel Color), Modified Corn Starch, Soybean Oil, Bleached Wheat Flour, Carrots, Dehydrated Onion, Caramel Color, Flavorings, Enzyme Modified Cheese (Cheddar Cheese [Pasteurized Milk, Cultures, Salt, Enzymes], Cream, Water, Salt, Sodium Phosphate, Xanthan Gum, Carotenal [Color]). CONTAINS: MILK, SOY, WHEAT

As any fool can see, this ‘food’ is loaded with all kinds of ingredients you would never find in a home kitchen, so it would definitely be considered as a Group 4 food by NOVA. Yet it would not be considered a junk food by almost anyone. I tried to guess what it was and came sort of close. As it turns out, I had actually eaten this product. Who knew?

Have you ever wondered why it is that ice cream that contains milk, cream, sugar, eggs, and salt (and maybe a bit of vanilla) always costs vastly more than ice cream with a list of ingredients longer than your arm? You would think that adding all those extras to the basic ingredients would make it more expensive, not less. But the multi-ingredient foods are always less expensive.

Which is why on average we get 80+ percent of our calories from processed or ultra-processed foods. They are cheaper, more shelf stable, and have added flavors that make them tastier, or more addictive, to use a loaded word.

I’ve now learned that flavorings, both artificial and natural, have much more to do with taste than I thought. And are designed to make us keep eating. For example, vanilla flavoring makes things sweeter. Consequently, it’s added to all kinds of foods. The manufacturers know that sweetness makes people want to eat more.

People in the food business are like people in every business: they want to increase their revenue and improve their bottom line. But they are limited in how they can do it. They can depend on population growth (the slow track). They can try to take business from their competitors (tough to do). Or they can try to get their own customers to eat more. And, if it comes by way of their customers becoming obese and diabetic, well, so be it.

Food technologists know well how to encourage people to eat more by making foods denser and by adding a bunch of flavors, emulsifiers, and other ingredients not found in a typical home kitchen.

Take a look at the ingredients of a Lean Cuisine entrée as listed in the book.

Here’s the ingredients list for the Lean Cuisine Grilled Chicken and Vegetables: ‘cooked rigatoni pasta (water, durum wheat semolina, wheat gluten), water, cooked seasoned chicken (white meat chicken, water, soy protein isolate, modified corn and tapioca starches, corn maltodextrin, salt, sodium phosphate, seasoning), tomatoes in juice (contain citric acid [acidulant], calcium chloride), yellow zucchini, broccoli, carrots, parmesan and romano cheeses (from milk), modified corn starch, onions, cider vinegar, tomato paste, salt, sugar, garlic purée, soy oil, olive oil, brown sugar, yeast extract, basil, oregano, potassium chloride, flavour, spices.’

Where the author really came through for me in this book was in his descriptions of what these ubiquitous ingredients are used for by the manufacturers.

For example

Two of the most ubiquitous, and thus the most studied, emulsifiers are carboxymethylcellulose and polysorbate 80. Polysorbate 80, also known as polyoxyethylene sorbitan mono-oleate or E433, is an entirely synthetic emulsifier. It’s found in lots of kosher pickles, ice cream, aerosols of whipping cream, toothpaste, moisturising cream, shampoo and hair dye. Carboxymethylcellulose – also known as cellulose gum or E466 to you and me – was invented during World War 1. It’s a polymer made from alkalised plant sugars with a chemical process that uses chloroacetic acid. You’ll find it in lots of thick and gloopy UPF products – it stops them separating. Things like Tesco Brownie Flavour Milk, Costa Caramel Latte and Müller’s cookie dough flavour milkshake. It’s also found in a roll-on deodorant brand called Rexona, eye drops, and even a brand of micro-enema called Norgalax. You can buy it online in big bags if you are into molecular gastronomy or diarrhoea.

The book is loaded with these kinds of explanations that I found most enlightening.

But on the negative side, the author is a real Kevin Hall fanboi, which I found not to my taste. He also disparaged the whole idea of insulin resistance and the carbohydrate-insulin hypothesis, which comes, I’m sure, from his Kevin Hall worship. And he denigrates Gary Taubes, which I found unseemly.

Also on the negative side—for me, at least—was his chapter on how UPFs were racist in that they were mostly consumed by less affluent people. Which those who are kind of racists themselves always identify as people of color. And, along the same lines, there was the obligatory chapter on how UPFs were hastening climate change. You can well imagine my thoughts on that.

All in all, the book’s positives outweigh its negatives. I learned a lot and got a ton of resources in the bibliography to seek out and learn more from the source.

The info in the book has made me a vastly more careful label reader. Before reading it—I’m kind of ashamed to admit—my label reading didn’t get much beyond simply looking at the carb and protein content. It was actually better than that. I did look to see the seed oil content as well, but my eyes just kind of glazed over at all the flavorings, gums, emulsifiers, etc. No longer, however.

If I were to make my own categories of processed foods, I would stratify foods both by the number of additives and the degree of structural damage done to the food. In other words, in my view sugar beets would be less processed than table sugar (sucrose), which would be less processed than powdered sugar.

I would figure out a way to assess the impact by type and amount of all these food additives to the incretin response. As I’ve discussed multiple times in The Arrow, the incretin response determines the insulin response. Which, in turn, is a good measure of overall metabolic health.

Here is a short video of a segment of a talk I gave on the incretin response. Those of you who have been readers for a while have seen it a time or two. I’m posting it for the newbies.

If you have no idea what the incretin response is, take a look at the video, because I’ll be bringing it up again in a section a bit later.

The mystery food made of the ingredients listed above is Chef Boyardee Beef Ravioli.

The Arrow is a reader-supported publication. I put a great deal of effort into missive and hope what I share is of value to you. If so, please sign up as a paid subscriber. I just went to Costco a few days ago, and the price of The Arrow is less than one Costco hotdog per week. And it is much more nourishing. Thanks in advance.

Okay, I’m going to provide you with some nourishment now.

You Shouldn’t Always Trust Your Doctor

Bari Weiss’s The Free Press is one of my favorite Substack reads. I’ve had a paid subscription forever, and I’m rarely ever disappointed. Bari, whom I don’t know personally, was a far-left radical in college and ended up on the staff of the New York Times, where far-left radicals with a flair for the pen often find themselves. Despite her far-left ways, she realized that she was in an echo chamber, and that anyone who didn’t keep the echo echoing got in trouble. Since she was an independent thinker, she realized she had to get out of the bubble and quit the job that every leftist journalist dreams of. And she fled to Substack.

She started exposing herself to other opinions and got more or less red pilled. And began producing one helluva Substack newsletter. She hires a lot of writers and has a diversity of opinion that I find thought provoking.

All this is by way of working up to the terrific piece from a couple of days ago I want to excerpt to the max. It, unfortunately, is behind a paywall, or I would just link the whole thing for you. As it is, I’ll give you an overview with generous excerpts.

The piece was written by Dr. Casey Means, a Stanford-trained physician, about her mother’s close encounter with the medical profession before her death. I could have written this article myself, but not because of the death of my mother. I’ve just been around the medical profession long enough to know the truth about it.

The article, which is really a chapter in a book the author has written, starts off with her 71 year-old mother experiencing some deep abdominal pain and shortness of breath while on a hike. She saw her doctor, who examined her and ordered a number of diagnostic procedures. When these came back to her doctor, he/she texted the results to the patient: stage 4 pancreatic cancer.

When I read this, I was astounded. What kind of doctor would text something like that to a patient? Granted, it’s unpleasant to deliver news like that to a patient, but it’s part of the job description. I mean, my God, the patient could be in an important meeting or who knows where, and that message comes through in a text!?!? As a physician, you want the patient there in front of you when you deliver that kind of news, so you can answer questions, offer options, discuss a strategy or simply offer comfort. But through a text…?

Right after the diagnosis, a medical team out of Stanford and Palo Alto Medical Foundation jumped to action, recommending a laundry list of surgeries and procedures—biopsies, blood transfusions, and a liver stent. In most cases, the patient would have agreed to these procedures, and the meeting would wrap up quickly. These recommendations were coming from some of the most prestigious institutions in the world, after all.

But based on my experience in medicine, I started asking questions. I learned that these procedures had about a 33 percent chance of extending her life a few more months at most, a 33 percent chance of shortening her life span, and a 33 percent chance of not impacting her life span (yet keeping her away from the family). In all cases, the invasive route would mean that my mom would need to sit in a hospital room alone, because of Covid-19 protocols, and potentially longer if the surgery had complications, as they often do with immunocompromised cancer patients. 

Additionally, her cancer was causing her liver to fail by the day and her body to destroy its red blood cells, making the prognosis numbers even worse, potentially complicating her recommended procedures, and making her dependent on every-other-day, multi-hour blood transfusions in the hospital, despite being so weak she could barely leave her bed. We were amid Covid lockdowns, and we also knew that she would be forced to check in for the hospital procedures alone and might not come out. My mom made it clear to the oncologist that she was not afraid of her rapidly impending death, but she wanted to minimize unnecessary pain or nausea in her final days.

Despite telling her oncologist that she just wanted to die pain free, she and her family were shamed for not pulling out all the stops.

The doctor was not consciously trying to recommend a suboptimal procedure, but I knew the invasive route would generate hundreds of thousands of dollars for the hospital, and this doctor’s pay was tied to booking these procedures.

I confirmed with the oncologist: “You are recommending an invasive diagnostic procedure that would under no scenario extend her life more than a couple of months and risk my mom dying alone in a hospital room? Even though we are certain that this is stage 4 pancreatic cancer based on the CA 19-9 blood test and CT scan, and that she has liver failure and almost no red blood cells left?”

“Yes, that is what we’re recommending,” the doctor replied.

This was all taking place in California during all the Covid nonsense, so both the daughter-doctor and her mother knew that once she entered the hospital she’d be alone and probably die alone. The author of the piece doesn’t get into how much of a role that played in the decision, but I’m sure it weighed heavily on all involved.

The author flirted briefly with the idea of maybe exploring what the surgical options might be that could perhaps relieve the pain and give her mom a few more months of life.

Then she remembered.

During residency, one of my best friends was a cancer surgeon. In the meeting with my mom’s doctors, words my friend spoke years before rang in my head: If you walk through the doors of this surgical oncology department, you are going to get an operation, whether you need it or not.

I remember speaking to this friend after work when she was visibly shaken after watching a patient insidiously coerced into a surgery that wasn’t necessary. Frequently, she suggested patients with terminal cancer be put on palliative care, which prioritizes the patient’s comfort and peace in their final days. The senior doctors generally shot this down. She told me her attending surgeon would “lose his mind” for suggesting anything other than surgery to a patient. If a patient said they wanted to decline a surgical intervention, the department leaders would force them to sign “against medical advice” paperwork and be left with fewer resources to seek palliative care or less invasive treatment options.

She goes on to say—and I agree with her—that no one signs up for this in medical school. Everyone pretty much wants to be a doctor to help people. Sure, the income and prestige are nice, but there are much, much easier ways to get those without going through the nightmare of a medical education and training.

She goes on to discuss how doctors end up feeling trapped, which is why suicide is so high in the medical profession. More so now, I’m sure, than when I started in practice. Back then most doctors had their own practices and were in control. Today, most are cogs in a corporate system and are pushed to do more procedures and gin the bills. At least if they want to earn any kind of decent salary. The whole issue of RVUs (revenue value units—the way a lot of doctors get paid) is something I should write about some day. It’s awful.

A few days before her death (she lived for 13 days after diagnosis), the daughter’s mother asked to be taken to the site where she was to be buried, which was a beautiful cemetery in the pines overlooking the Pacific Ocean. The entire family took her to the spot, stayed there for a while, and had multiple group hugs.

While there she lost consciousness and died two days later surrounded by her family.

Unfortunately, the entire medical edifice is designed to make money only if you are sick. Which seems almost predatory. But that’s just how the system works. Numerous times I’ve had people in both private and public forums ask me why doctors don’t do more preventative medicine. Why we don’t try to keep people healthy instead of only treating them when they’re sick.

I always give the same answer.

I’ve been in medical practice for many, many years, and I have never had anyone come into my office to see me saying, Doc, I feel so great right now that I just want to keep on feeling this way forever. Tell me what I have to do to keep feeling like this?

There is no money in preventative medicine. There is only money in taking care of sick people. If the medical system were an enzyme, I would call it substrate driven.

The doctor-daughter goes on, and this is the part I could write. I just don’t have the mistreated mother to give it emphasis.

Most health advice ends with a disclaimer to “consult your doctor.”

I have a different conclusion: when it comes to preventing and managing chronic disease, you should not trust the medical system. This might sound pessimistic or even frightening, but understanding the incentives of our medical system and why it does not deserve our benefit of the doubt is the first step to becoming an empowered patient.

I hear you asking this question: Hasn’t our system produced medical miracles over the past hundred years? Hasn’t life expectancy almost doubled during that time? Medicine is complicated—why should we question a system that has worked so well?

Life expectancy has increased primarily because of sanitation practices and infectious disease mitigation measures; because of emergency surgery techniques for acute and life-threatening conditions, like an inflamed appendix or trauma; and because of antibiotics to reverse life-threatening infections. In short, almost every “health miracle” we can point to is a cure for an acute issue (i.e., a problem that would kill you imminently if left unresolved). Economically, acute conditions aren’t great in our modern system, because the patient is quickly cured and no longer a customer.

Starting in the 1960s, the medical system has taken the trust engendered by these acute innovations and used it to ask patients not to question its authority on chronic diseases, which can last a lifetime and thus are more profitable.

But the medicalization of chronic disease in the past fifty years has been an abject failure. Today, we’ve siloed diseases and have a treatment for everything:

• High cholesterol? See a cardiologist for a statin.

• High fasting glucose? See an endocrinologist for metformin.

• ADHD? See a neurologist for Adderall.

• Depressed? See a psychologist for a selective serotonin reuptake inhibitor (SSRI).

• Can’t sleep? See a sleep specialist for Ambien.

• Pain? See a pain specialist for an opioid.

• PCOS? See an ob-gyn for clomiphene.

• Erectile dysfunction? See a urologist for Viagra.

• Overweight? See an obesity specialist for Wegovy.

• Sinus infections? See an ENT for an antibiotic or surgery.

But what nobody talks about—what I think many doctors don’t even realize—is that the rates of most of these conditions are going up at the exact time we are spending trillions of dollars to “treat them.”

Chronic conditions are the financial lifeblood of the medico-pharmaceutical industry. Your bad lifestyle habits—which are the driving force behind most chronic diseases—are their bread and butter.

In my view, you are much better off trying to manage your chronic diseases with appropriate lifestyle changes, pain in the butt though they may be to stick with. But they’ll pay you multiple dividends in the end and keep your doctor and Big Pharma’s hands off your wallet.

I have not read this doctor’s book, but if it’s anywhere near as valuable as this heavily excerpted chapter, then it’s well worth the read. You can find it in the link to the piece at the top and here. I’ll let Bari and team get the pittance of an Amazon affiliate payment. They deserve it for featuring such an important article.

Speaking of chronic diseases…

A New Book On Diabetes

Don’t touch that remote. I’m going to talk a bit about Gary Taubes’s new book Rethinking Diabetes. I’ve got to tell you, the book is about much more than diabetes.

I want to start out by telling you about a friend of mine. His name is Richard Bernstein, Dick to his friends. He is a physician with type 1 diabetes. I know personally two other physicians who have type 1 diabetes, so there are probably a lot of them out there.

Dick is different. Dick will be 90 years old this year and is still going strong. Dick is doubtless the oldest person in history with an adolescent diagnosis of type 1 diabetes. No one with type 1 lives that long.

What is Dick’s secret?

Before I tell you, let me give you a little history.

Dick was diagnosed with type 1 diabetes when he was 12 years old. He began taking insulin shots to control his condition, which he managed to control well enough to get him through engineering school. He got married to an emergency room physician, and one day, she came home and told him about the wonderful new piece of equipment they had just received in her ER.

It was a glucometer.

And it was about the size of an espresso machine, but it could get an immediate glucose reading from a drop of blood. This was a huge advance, because people coming into an emergency room unconscious is a fairly regular occurrence. Before the glucometer, the doc on duty would instantly assume insulin shock, start an IV, and push a bunch of glucose. If the patient immediately responded, then the doc knew that was the problem. Which is life threatening.

If the patient did not respond, then the search started for the cause of the loss of consciousness, which could be ketoacidosis from the lack of insulin.

With a glucometer handy, the doc can get a blood sugar reading in seconds and know to rule out either insulin shock or diabetic ketoacidosis.

When Dick discovered such a machine existed, he began badgering the supplier for one. He told me it cost him about $600 at that time. (And that was a big cash outlay half a century ago.) Now they are tiny, handheld, and can be bought for almost nothing.

Once he got it in his hands, Dick began experimenting with it on himself. He kept meticulous records of everything he ate measured to the gram, how high it sent his blood sugar, and how much insulin it took to bring it down. He created a method to keep his own blood sugar under tight control and actually published it under the title The Glucograf Method of Normalizing Blood Sugar. He gave us a copy years ago; I think it is out of print now.

He tried to get a paper published in a medical journal, but was told he wasn’t a physician or researcher, so he wasn’t really qualified to publish a scientific article.

So he said okay, and went to med school in middle age. Got out and started a practice treating diabetics.

He is thin and fit. He does strength training and keeps his blood sugar controlled with a low-carb diet and minimal insulin.

MD and I have been with him at dinners when he almost unnoticeably will test a food—he’s always on the lookout for hidden carbs in everything—and, if necessary, will give himself an insulin injection right through his dress shirt and undershirt. If you’re not watching closely, you’ll miss it.

He is living proof that someone with a chronic disease can live a long, long time by taking meticulous care of himself. But it takes effort and knowledge. By years of practice, Dick has been able to make all his self-care automatic and truly effortless. And he’s been rewarded with a long, long, active life.

Compare his situation to that of the average person with type 1 diabetes.

Most go to a diabetologist after their diagnosis and get put on a hefty dose of insulin and are told to make sure to keep their carb intake up so they don’t go into insulin shock. If your blood sugar goes too low or you start to feel drowsy, eat a donut or drink a soft drink. Or take glucose tablets. Most people end up treating their insulin with carbohydrates instead of the opposite, which is what Dick has done for 60 years.

Gary’s book, which talks about Dick, describes how we went off the rails in terms of diabetes treatment. And what to do to get back on the rails.

But he discusses a lot more than that. He delves deeply into the anti-saturated-fat nonsense. He describes insulin resistance and how to deal with it. And does it all by discussing the historical underpinnings.

If you’ve got diabetes, you should read his book. If you have any chronic disease you should read his book. If you want an understanding on how to avoid chronic disease, you should read his book.

Gary wrote an essay in Time magazine about some of his research and wrote an insightful Q&A for Nina Teicholz’s substack composed of questions he would like people to ask him. These will give you a nice overview of what the book is all about.

I can’t recommend it enough.

Another UPF Or Wegovy In a Bag

The comments in last week’s Arrow were loaded with fodder for this week’s arrow. One of the commenters recommended I watch a video by Nick Norwitz on d-allulose and weight loss.

I usually try to stay abreast of Nick’s videos, but somehow this one slipped by me.

In the video, Nick discusses a mouse study on the sugar d-allulose and GLP-1. As we all know by now, GLP-1 receptors are what the new injectable weight loss drugs Ozempic, Wegovy, Mounjaro, and Zepbound all activate. If consuming d-allulose could generate the production of GLP-1, it could activate its own receptors and perhaps bring about the same weight loss without the side effects.

Before we get into what it does, let’s go over what d-allulose is. It is a natural sugar found in small amounts in Kiwi fruit, wheat, figs, raisins, maple syrup and molasses. When consumed by humans, 70 percent is absorbed. Of that absorbed, most is lost in the urine. Most papers show that only one tenth of the consumed d-allulose is counted as caloric intake. A teaspoon of pure sugar is 4 grams of carb, so a teaspoon of allulose is 0.4 grams of carb.

It tastes mildly sweet to most people, but based on many comments I saw as I researched it, there are allulose super tasters out there who can’t stand the taste of it.

But it works well in baking and cooking, so many keto and low-carb dieters have started using it as a sweetener.

Now let’s take a look at the paper Nick discusses in his video. As I say, it is a mouse paper, and we don’t know if the outcome in mice will be the same as it is in humans.

Nick does a nice job in explaining all the parameters tested on these mice. The researchers took blood from the portal vein, which is the large blood vessel that the GI tract circulation feeds into that ends up going directly to the liver. The liver then deals with any toxins and partitions all the nutrients as needed.

Measuring the blood in the portal vein shows that the GLP-1 is released in the gut in response to the dietary allulose intake.

The paper is chock full of graphs of all kinds. I’ll put a copy in my Dropbox here, so you can look at them all at your leisure.

Let’s just look at two.

Here is the increase in GLP-1 after consuming the allulose. The line at the top with the red circles is the allulose driven GLP-1. The line on the bottom is the saline solution.

This one shows the weight loss. It’s a little confusing because the line goes up. That’s because rodents continue to gain weight all their lives. As you can see, though, the gain is less on the red line, which is the allulose diet.

Other graphs show that the mice don’t eat as much when they get the allulose, which pretty much happens when people get semaglutide.

So, allulose does act as oral Wegovy in mice. But it does so at a pretty hefty dose. The mice were getting 3 grams per kilogram weight. Which means a 150 pound person would need to consume 210 grams of it to get an equivalent dose. 201 grams is a little over 7 ounces, so it’s quite a dose.

Nick does make the point that rodent metabolism is different than human, and that we probably wouldn’t need that much. But how much would we need? 100 grams? 50 grams? And could we choke down that much without a problem? And what else might that do?

Who knows?

Well, I looked around and found a video by a big guy who is keto adapted and who consumed 50 grams on camera and measured both glucose and ketones before consuming it and at 30 minutes, one hour, and two hours after.

He said he had tried 100 grams before and had some GI distress. With the 50 grams he tried on camera, he didn’t have any problems.

His blood results were pretty amazing.

His blood sugar didn’t really change much over the two hours. But his ketone levels actually went up. He was at 0.4 before drinking the allulose mixed with water. At 30 mins they were 0.5, at one hour, they were 0.6, and at two hours, they were 0.7.

This tells me a lot. I always wonder what the incretin effect is in experiments like these. But it’s really impossible to measure as there are no home test kits like there are for glucose and ketones. Published experiments have shown that the combination of fat and carb blunts the blood sugar response, which everyone—including me before I pondered it—thinks is a great thing. But it does so because it sends the incretin GIP through the roof, which also sends insulin through the roof. Not a good thing at all.

The n=1 study the guy in the video did is enlightening because his ketones went up. Which tells me the allulose didn’t really generate an incretin response. Otherwise his insulin would have gone up and his ketones would have vanished. In his case, the ketones went up, so I’m pretty sure there was not an incretin effect. Which makes the allulose even more attractive as a sweetener.

Most people probably won’t show many ketones in their blood unless they’ve been sticking to a ketogenic diet. The ketones would not work as a proxy for the incretin response if you don’t have any circulating to begin with.

I became so intrigued with allulose that I actually bought some.

MD spent some time looking at brands and prices and came up with the one she thought had the best value. Since allulose is found in such small quantities naturally, all the commercial stuff is made using fructose that’s been turned to allulose by enzymatic digestion it appears. So it really would be considered a Group 4 food in the NOVA UPF classification. Some of the brands say they’re made in China. I would avoid those. Here is the link for the one we bought, which I should get tomorrow. I’ll report on it in a future Arrow.

If it works as represented, I think it would be a nice sweetener for a birthday cake and frosting. Or an occasional treat here and there. But I wouldn’t recommend eating it (or really any sweetener) all the time.

Why?

First, if we don’t absorb it, we probably haven’t had a lot of it in our past, so we haven’t adapted to it evolutionarily. And we don’t know what the consequences of eating a lot of it over a number of months or years might be.

Also, our taste buds for sweets are actually receptors. Just like insulin receptors, they can become blunted. And when they are blunted, it takes more and more sweetness to stimulate them.

If you eat normal foods, the sweet receptors become re-sensitized and even foods you normally think of as not particularly sweet actually taste a little sweet.

Plus, if allulose works like sugar in cooking and baking, which apparently it does, there will be the temptation to use it to make low-carb junk food. Cookies, brownies, cakes, pastries, all that stuff. Which is okay now and again, but not a steady diet of it.

Remember the almost 90-year-old Dick Bernstein. Make the effort to control your lifestyle and you should live a long, long time.

Okay, I’ve kind of overdone it today, because I wanted to make sure there was enough material to help people improve their lives left over after my Covid rant. This is doubtless the longest Arrow ever. And the latest as a consequence.

Links of Interest

• AI discovers that not every fingerprint is unique.

• New study shows Paxlovid does not reduce risk for long Covid.

• Scientists, who have a keen grasp of the obvious, have found that “braver” birds are better at invading new environments.

• How to bypass internet annoyances such as popups, paywalls and those loathsome overlays. What moron came up with overlays anyway?

• Ten facts about Americans and alcohol consumption.

• A high-sugar diet is bad news for humans, leading to diabetes, obesity and even cancer. Yet fruit bats survive and even thrive by eating up to twice their body weight in sugary fruit every day. How do they do it? It’s all in the genes.

• BBC more or less admits it is pretty lax in its authentication process.

• Use video of the 4,000 year-old recipe for Babylonian lamb and beet dish for a New Year’s feast.

Not a lot this week as this thing has gone on long enough.

Video Of the Week

I had a handful of videos this week for the VOTW, and I was trying to decide which one to use when the winner crossed my desk out of nowhere. MD found it and sent it my way.

It is the perfect video for our discussion of lifestyle changes. This lady has put in a lot of work to be able to do what she does on video for the first time. What she does is not all that easy for anyone her age, much less her weight. It’s at a CrossFit facility, and folks at those are always incredibly supportive. I don’t know this woman at all, but I am proud of her. Her video made me misty eyed.

Okay, now for the poll.

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