The Arrow #98

Hello everyone.

Greetings from Dallas.

This may be a short Arrow as I am in the throes of getting moved to Substack.

Uh, actually, I am moved to Substack. Didn’t know it would happen so fast. It will take some time to work out the kinks, because it’s a totally new platform for me. It has gobbled up a lot of my day, so it will be a short Arrow.

I didn't realize how much effort it was going to take to get everything switched. I've got to say, ConvertKit has come through like a champ. I am totally appreciative. But it is still taking longer than I anticipated. Basically because I am sort of a tech idiot, so it takes me forever to do anything on my own.

I've got my tech guy helping me, but there is stuff I have to do myself. Stuff like fiddling with the Substack template, so it will resemble what I'm sending out now. As always, there is more involved than I anticipated. [The bride interjects: ever the optimist!]

Plus, this just happens to be one of those times where a handful of projects I've had on the back burner have suddenly sprung to life and everyone is demanding first this then that.

First, I'll deal with a few emails. Since a number of people wrote asking the same question, I won't quote anyone specifically. I mentioned that I used a  specific kind of cherry extract , which was recommended to me by a reader, to sooth my golf aches and pains. I gave it a try, and it worked. I use this instead of Advil or any other NSAID simply because I don't like taking drugs of any kind. Anyway, had a handful of people asking me about the appropriate dosage.

The bottle label reads

As a dietary supplement, take 1 capsule daily with 8-12 oz of water or as directed by your healthcare professional.

Here is how this healthcare professional takes it. I throw two or three back with a meal or a fatty snack. I take them with some water or other liquid, but I don't hew to the 8-12 oz. Which is a stupid recommendation, anyway.

The substances in cherries that reduce inflammation are carotenoids, flavonoids, lycopenes, and a bunch of other similar compounds I've probably never heard of. Problem with all these ingredients is that they are almost all fat soluble. In other words, they need fat to be fully absorbed.

If you take them on an empty stomach with 8-12 oz of water as the label recommends, you won't get much absorption. So take them with a meal, especially a fatty meal. Or a fatty snack.

The other isn't really a question. It was more of a comment. A bunch of people wrote to tell me how much fun they had fiddling with the  AI link  I posted. One person wrote to tell me how creeped out she was with some of the stuff she got back.

I had kind of forgotten about it until I got these emails. So I went back and fiddled with it a bit. Ended up discovering a great use for it. The new theme for my blog is set up for a feature image, which is a large image that takes up a pretty good chunk of the first page of the blog post. I always have trouble finding pictures that are congruent with the subject of a particular post. If the post is about a person or event, it's kind of a no brainer, but if it's about something like, for example, widespread medical ignorance about a specific topic, it's tough to find a "feature image" that works.

I've been slowly and ponderously going through my blog trying to fix broken links and add feature images. It's been drudgery and a slow go. I get some of them fixed...except for the feature image. This past week I got a notice that I had a handful of broken links. When I went to the specific blog post--the subject of which is the widespread ignorance of many physicians about diet and nutrition--and took a look, I realized I didn't have a feature image. How does one find an appropriate image about medical ignorance? Especially one with no royalty fees required?

Suddenly, I remembered the AI site I had written about last week. I pulled it up and quickly entered "stupid doctors in the style of Modigliani." Bingo! The perfect picture came up, so I used it.  Here's the link . Let me know what you think.

For some reason, just for grins, I tried "halloween in the style of Bosch" and came up with this.

Is that cool or what? Now I'm busy working on my Christmas cards. [The bride cautions: not in the style of H Bosch… please!]

From the Mailbag…

Got an email of the sort that really pisses me off. Here is is in its entirety.

Why do you need to comment on politics?!   It takes away your credibility in my mind.  Really!  The election was fair.  There was no irregularities which would have changed the outcome.  Are you a trump supporter?   He is a cheat and a liar and has no redeeming qualities at all.  Stick to your science please.  Chris Krebs said election was fair and very much so.  Who are you to comment to all your followers about this.  Anyway.

Obviously, this guy—it was a male, or at least a typical male name—is on the left side of the political spectrum. His email brings to mind something I’ve heard said many times. Those on the right believe those on the left to be misguided, while those on the left believe those on the right to be evil.

But what really gets to me is the notion that my political leanings, which, as I’ve written countless times, are somewhere between heterodox liberal and heterodox conservative—and that encompasses a large span—matter vis a vis my nutritional or medical opinions.

I’ve never destroyed a friendship or a relationship of any kind for that matter over politics or religion. I am totally politically opposed to many artists of one kind or another, but that doesn’t keep me from reading their works, marveling at their paintings, or paying to see their movies. Politics is an opinion, not a measurement of innate intelligence or goodness or artistic merit.

Eugene Wigner, who received the Nobel Prize in physics, said of John von Neumann

I have known a great many intelligent people in my life. I knew Planck, von Laue and Heisenberg. Paul Dirac was my brother in law; Leo Szilard and Edward Teller have been among my closest friends; and Albert Einstein was a good friend, too. But none of them had a mind as quick and acute as Jansci von Neumann. I have often remarked this in the presence of those men and no one ever disputed me… Perhaps the consciousness of animals is more shadowy than ours and perhaps their perceptions are always dreamlike. On the opposite side, whenever I talked with the sharpest intellect whom I have known – with von Neumann – I always had the impression that only he was fully awake, that I was halfway in a dream.

By all accounts, von Neumann was kind of a right wing crank politically. Would von Neumann have lost all scientific credibility in the mind of my correspondent because of politics?

Don’t get me wrong. I’m not comparing myself to Jansci von Neumann. Not even Einstein would do that. But my point is many smart people—people with something interesting or cogent to say—are all over the place politically. Their politics should have nothing to do with their scientific credibility.

There is only one sentence in the email above that isn’t itself worthy of doubt. And that one is: Are you a Trump supporter? Which simply asks a question. But even that one reeks of malice, though the words themselves don’t.

Take this sentence, for example: “He [Trump] is a cheat and a liar and has no redeeming qualities at all.”

Really? None? As I’ve written before, Trump is like the rest of us. He has his good points, and he has his bad points. A couple of days ago, the Wall Street Journal—certainly no fan (read their opinion pages on him if you don’t believe me)—had this to say about Trump

Every serious memoir to emerge from the last administration has revealed the existence of, in essence, two Donald Trumps. One is funny, perceptive, charming and has an instinctive rapport with ordinary people. This Trump loves his family and country and fiercely guards the interests of those close to him. The other Trump is erratic, vengeful, detached from principle, deeply narcissistic and capable of shocking acts of betrayal. Most people see one or the other, generally according to their politics, but both are the complicated reality that is Donald J. Trump.

In other words, both good and bad. Just like the rest of us.

While I’m at it, I would love it if my correspondent would name a president in recent history who did not lie through his teeth. C’mon man, let’s hear who this highly principled individual is. Our current president? Any one in recent memory?

You might say, well, the other presidents didn’t lie as much. All I can say to that is: Falsus in uno, falsus in omnibus.

At this point, you’re probably thinking I’m a Trump fanboy, but that’s not remotely the case. I had no idea what he would do when he got elected, and I was pleasantly surprised when he governed like a moderate Republican. He cut taxes, got rid of onerous regulations, and was anti-war. But I hated his constant name calling and fighting with the press. But, then, again, he had the entirety of the press against him and all the while was dealing with the Russian collusion hoax, foisted on us all by the FBI, to cover its own misdeeds. Contending with that, if you knew yourself to be innocent and that it was a setup, would put anyone’s nerves on edge. It would certainly make me want to fight back.

Where he lost me was with the Covid lockdown mandates. After having stood up to most everyone in the government and following his own gut, he totally went wobbly with Fauci, Birx, and Redfield. He allowed them to crater the economy that had boomed since his election and inflict financial hardship on God only knows how many Americans. He threw tons of money at the pharmaceutical industry to come up with a vaccine that, if it worked at all, worked for a short period of time and ended up perhaps creating an entire new diagnostic code: SADS.

So, no, I’m not a fanboy. But I also don’t think he’s the devil incarnate.

While Trump is under discussion, here is an interesting take on him if you haven’t seen it. An “honest liar.” Pretty well put.

Justin Hart @justin_hart

Wow. Chapelle explains why Trump is so popular with many. I’ve never heard it told this way before.

The Bride’s Newest Book: C’est Arrivé

Eye of the Storm, Book 2 in the Caddo Bend saga is now available on Amazon in both paperback and e-book formats. (It’s even FREE for all those who subscribe to Kindle Unlimited.) Those who’ve read the first book (and she thanks you kindly) are surely eagerly awaiting the next installment. Those who haven’t yet, well, there’s still time! Once again, I must bow before her industry. And she’s made me swear a blood oath that we’ll get PP2.0 out next.

Flu Vaccine, Alzheimer’s, and the Adherer Effect

I just read Peter Attia’s latest post about research showing that getting the flu shot every year is associated with a decreased incidence of Alzheimer’s.

Peter is a friend of mine, and we agree on most everything other than statins. And now maybe this. Although he comes across in his post as a little tepid about the flu shot as compared to how adamant he is on the idea of LDL lowering to prevent heart disease.

He leads with a nice summary of how the two parts of the immune system work.

Apart from preventing severe disease and complications from influenza infection, flu vaccination is hypothesized to promote broader changes in the immune system, which in turn impacts AD pathogenesis. The immune system is generally conceptualized as two branches: innate immunity, with which we are born, and adaptive immunity, a system in which specialized cells develop “memory” of previous diseases, leading to faster and more specific reactions to pathogens in the future. While vaccination has traditionally been associated with activating adaptive immune responses for a target disease, vaccines have more recently been recognized for their ability to impact innate immunity and induce non-specific protection against a broad range of pathogens – part of a phenomenon known as “trained immunity.” In addition to increasing the body’s ability to resist infection, these innate immune system changes may lower the risk for chronic inflammation and decrease neuroinflammation.

The only argument I would have is with the very first sentence. As we’ll see in a bit, even the CDC’s own data show the flu vaccine to be ineffective.

Peter goes on to discuss how the immune system can reduce the burden of overall inflammation, which does affect the brain, and perhaps can reduce the potential for developing Alzheimer’s. A disorder, I’m sure, everyone would like to avoid.

The paper he discusses is a retrospective study with a large number of subjects. Researchers compared the rate of Alzheimer’s in those who religiously took the flu vaccine annually with those who didn’t. And discovered that

seniors who received at least one flu vaccine were 40% less likely than their non-vaccinated peers to develop AD in the 4-year follow-up period. A total of 5.1% of the vaccinated subjects and 8.5% of the non-vaccinated subjects were diagnosed with AD during the follow-up, corresponding to a relative risk (RR) of 0.6 (95% CI: 0.59-0.6) and an absolute risk reduction (ARR) of 3.4% (95% CI: 3.3 -3.5%) for flu vaccination.

Seems impressive until you realize that a) it’s an observational study, not a randomized trial, and b) there is the adherer effect to take into account.

The adherer effect?

Over forty years ago, the New England Journal of Medicine published a study about clofibrate, a pre-statin cholesterol-lowering drug, and 5-year all-cause mortality. This was a randomized, double-blind, placebo-controlled study designed to see if those subjects taking clofibrate would have greater 5-year survival than those who took a placebo instead.

When the codes were broken at the end of the study and the data tabulated, it turned out that those 20 percent of those subjects taking clofibrate had died within five years, while 20.9 percent of those taking placebo died over the same time period.

But the researchers looked a little deeper into the data and discovered that those subjects who took at least 80 percent of their clofibrate medications had a substantially better five year mortality than those subjects who didn’t take their clofibrate regularly. Those faithful takers had a 15 percent mortality whereas those less adherent suffered a 24 percent mortality. A substantial difference in anyone’s playbook.

So, the data implied that clofibrate was a lifesaver. At least in this group of subjects.

Clofibrate for everyone!

Fortunately the researchers dug even deeper. They decided to look at the group of 2,600+ subjects who had been randomized into the placebo group. Remember that the none of the subjects in either group knew whether they were getting clofibrate or a placebo, so that wouldn’t have affected their behavior. As it turned out, and as you would expect, both groups had adherers and non-adherers.

Upon analysis, the researchers discovered that in the placebo group, those who faithfully took their pills, the mortality rate was 15.1 percent, which is essentially the same as those in the clofibrate group. The non-adherers had a mortality rate of 28.3 percent, which wasn’t that much different as those non-adherers in the clofibrate group.

What made the biggest difference in survival wasn’t the drug, it was the adherence to the drug regimen prescribed.

People who take their prescribed medications regularly are a different breed of cats than those who take them haphazardly. The are doubtless more focused on their health than the non-adherent. They probably watch their diet more, exercise more, and, in general, take better care of themselves. Which, if the case, would make more of them live longer.

About 30 years later in 2009 a study appeared in Circulation showing those who were more adherent to statin prescriptions had lower death rates from even accidents than those who were less adherent.

Which, if you think about it, makes sense. People who are less adherent are probably less risk averse. If you are afraid of dying from heart disease, and you believe statins will prevent heart disease, then you’ll take your statins like clockwork. If, on the other hand, you are not as risk averse, then you’re more likely to take your meds haphazardly. And to take more risks in general.

Those who take more risks are likely to have more accidents. Which is what the Circulation study demonstrated.

How does this play into the flu vaccine scenario?

Who gets the flu vaccine every year? Careful people who are concerned with their health (and believe the flu vaccine works). The study mentioned in Peter’s post reported that there was even a dose-response effect in those who did and those who did not develop Alzheimer’s. In other words, those who took more flu shots over the four year observation period were less likely to get Alzheimer’s than those who took fewer shots. Which, of course, makes sense since the every-year-folks are probably more likely to be more health conscious than those who take a flu shot on an occasional basis.

And they doubtless have other more healthful habits that end up with their experiencing less chronic inflammation, which is one of the suspected causes of Alzheimer’s.

I’m not sure it’s the flu shot that does it. I would say a history of regular flu shots is a marker for a more health-conscious person.

The flu shots themselves are more or less worthless. Igor Chudov writes of a study presented to the CDC about the effectiveness of the flu vaccine.

The presentation prepared by and for CDC, compiled by Jessie Chung et al., shows data on the performance of “the influenza vaccine” in the 2021-2022 season. The study uses a “test-negative design” and is not a randomized trial. (James Lyons-Weiler and Justin Hart discussed many times how CDC prefers this method to hide the underperformance of vaccines). But even that method could not hide the utter ineffectiveness of the flu vaccine. [Links in the original]

The graphic above is from the same article and shows even some negative effectiveness in older people.

So, basically flu shots are worthless, yet those who take them are less likely to develop Alzheimer’s. When I ran a search through the medical literature a year or so ago, I found a handful of papers that looked at the difference between those vaccinated with the influenza vaccine and those who weren’t. The data showed that those who got the flu shots got the flu less than those who didn’t, but got more viral upper respiratory infections than those who didn’t take the flu shots.

Remember, the way vaccines are tested is by waiting to see if those study subjects who got the vaccine get fewer cases of the flu than those who don’t. Unlike other drugs, they are not tested to look for long-term adverse effects.

So, all in all, if the flu vaccines are worthless at preventing the flu, then it’s probably the adherer effect that is reducing the rates of Alzheimer’s in those who are regular customers of the flu shots and not the shots themselves.

We Love Our Heart

Don’t forget the We Love Our Heart conference is coming up this weekend. They even made me a little graphic to post about it.

Many great speakers you don’t want to miss. You can click here to find out more about it. Hope to see you there.

That’s about it for today. Sorry for the abbreviated version. I’ll do better next week even though it is Thanksgiving, and I’ll be out of town.

Sorry if there are any screw ups in the formatting here. I’m still learning the system.

Keep in good cheer, and I’ll see you next Thursday.!

Don’t forget our sponsors Dry Farm Wines, HLTH Code, and Precision Health Reports.