Coming Shortly
OK after a sarcastic post I should do some more serious stuff.
I have one as yet uncompleted which I was going to call “Good Science, Bad Science” but I think it’s going to turn into a series, I keep turning up more relevant stuff
Then I was going to do one about my current theories, but again several people have turned up several more papers I need to re-read and dig into their references.
See, the beauty of a theory, as opposed to a dogma, is that it changes in the face of new evidence, whereas a dogma alters, ignores or statistically manipulates the evidence to fit. Commonplace in the dietary field. People can make an entire career from inhaling the dogma at an early age and regurgitating it until they retire (or die of a heart attack).
One thing I thought of doing was listing some authorities’ papers in chronological order: it stands out that those doing Real Science change their views significantly over time. Simin Liu is one such, I have high hopes for him now he’s a professor. Frank Hu was another who nearly grasped things, then turned away at the last moment in favour of lipophobia.
Here he is finally “coming out”, aided and abetted by Ron Krauss (so no surprise there then)
Patty W Siri-Tarino, Qi Sun, Frank B Hu and Ronald M Krauss
Theoretically only the absract is available FOC but I found the pdf here
and I’m now off to read it (I have caffeine and nicotine so will probably be able to comprehend it (grins))
then I’ll hit this one again
Gluttony, sloth and the metabolic syndrome: a roadmap to lipotoxicity
I don’t altogether agree with it, they’ve put several carts before the horses IMO, but there’s some good stuff in there to be cross-fertilised with the good stuff I’m currently delving into on a couple more blogs
and
Another Fat Dietician
They really shouldn’t let them out in public looking like that, let alone on TV. Actually, maybe they should so long as they wear a label
“Eat like me, look like me!”
Unlike some she seemed fairly sensible though.
Here’s one who isn’t fat, but I bet her patients are.
She was on yet another disappointing diet programme recently, and I dug up this pdf
She nearly gets a lot of things, but this demonstrates where she is completely and utterly misguided
The healthier option
is increasingly the
profitable option
Well that’s the entire problem, what’s profitable is replacing nutritious foods like healthy saturated fats with cheap fillers like wheat and Omega 6 seed oils, and sugar in the UK/HFCS in the US.
Also in the media
Despite fewer visits to gyms and a love of high-fat foods, people in the 1960s were slimmer simply because they were more active, the government says.
Er no, I think it was BECAUSE of the high fat foods displacing all those carbs.
Obesity rise on death certificates, researchers say
Diabetes danger of South Asian youngsters
Healthier lifestyles ‘may add more years of bad health’
and an absolute doozie
Snack stand-off: Banana v KitKat
As is par for the course, carb content was not even mentioned, oh except for this
Also helps regulate blood sugar levels and slowly release energy.
A banana??? Yeah it will regulate your BG like putting a brick on your accelerator will regulate your speed. My BG goes up if I look at one for too long. This is not uncommon, they must be one of the most regularly avoided fruits by sensible diabetics. Pity because they were one of my favourites – plantains too.
Yet a standard “diabetic breakfast” is a banana in a bowl of oatmeal.
Doctors ‘failing to give correct cholesterol targets’
Yet more oversimplified crap. NO mention of HDL at all, let alone trigs, both more significant danger factors than LDL alone. Ah but they get improved, often radically, on a low carb diet so better to ignore them and concentrate on the one number that is most likely (though far from certain) to improve on a low fat diet.
Also no mention of the fact that the majority of the population (ie. women) respond far less even than men to TChol or LDL lowering in terms of actual disease risk.
No that isn’t a dietician, that’s someone with Cushing’s
A Short History of Nutritional Science
An excellent series of papers by Kenneth J Carpenter
He takes the story from the 18th Century up to 1985. On the one hand it’s a pity he stopped there, on the other if he’d continued he would have needed another ten parts and still only have covered half the subject.
One major point that stands out is how often in previous history “science” has rushed blindly off down a blind alley and had to backtrack. The post-Keys low fat mania is not a new phenomenon.
They don’t necessarily guillotine “savants” any more but they can still make them lose their jobs (or try to, see an earlier post on Dr. Anna Dhalqvist.)
The leading German organic chemist of the time, Justus Liebig, now comes into the picture. He too had become interested in the subject of “animal chemistry,” and wrote that Dumas must be wrong because it was well known that pigs would fatten when fed on potatoes that were rich in starch, but contained only a negligible level of fat. This meant that animals must be able to convert carbohydrates to fat even though the conversion required “reduction” rather than oxidation.
That was around 1840. That knowledge appears to have gone (temporarily) missing 120 or so years later.
Here’s one I didn’t know, from 1910
Babcock challenged him to feed breeding heifers ingredients all from a single cereal grain, and to compare the result with a diet made up from mixed cereals.
Hart agreed and, with a group of colleagues, used sixteen 6-mo-old heifers and constructed three rations each based entirely on either corn, oat or wheat products, and balancing the proportions of ground grain, gluten and straw to obtain the same energy value and proximate analysis. A fourth ration was a mix of the other three. The trial was begun in 1906 and continued for two full reproductive periods; the results are summarized in Table 3 . The heifers receiving the all-wheat ration quickly lost condition and performed extremely badly, with none of their calves surviving and two of the cows also dying before the end of the trial. In contrast, the corn-fed heifers maintained their condition and had healthy, strong calves, with the results from the other treatments being intermediate
Results are here
There are obvious parallels with wheat-fed people.
It is interesting in view of the importance of their discoveries that McCollum’s young colleagues at Yale told him that he was foolish to accept a position in which he would be working in nutrition since, “the subject was already worked out, with nothing remaining to be discovered!”
This was in 1910, and in 1945 Oxford University likewise decided to disband its Nutrition group. Sadly typical of the attitudes of some still working in the field. “Now we know everything we can go home” – yet current dietary recommendations appear to be achieving seriously minor improvements in some individuals while being central in the “epidemics” of metabolic diseases such as obesity and cardiovascular disease, including Type 2, in the rest of us.
If You Are Squeamish Look Away Now
Whatever bug was offending my guts returned.
My FBG was 5.8 (106) and post breakfast 7.5 (135). Afternoon was 5.8 (106), the same again before dinner and still the same after my meal. Which proves that venison casserole with mushrooms and peppers and masses of purple sprouting broccoli is good stuff.
That night I generated enough gas to power a small town, and the following morning I took a dump so massive that by the time I’d finished I could see small climbing parties roped together ascending the foothills while tiny skiers were slaloming down from the peaks.
Finally that seems to have rid my body of the offending virus/bacteria, my BG dropped rapidly back to normal.
I checked my labs, which my excellent GP had printed out and dropped off for me when she visited my mother, and the bloodcounts looked slightly off – like the BG numbers indicative of an infection.
Despite this I STILL maintain that my health has been better than many others this winter, and significantly better than it used to was, despite my “unhealthy” diet. My immune system seems to catch the infections early and blat them before they become more than minorly irritating: this was an exception.
Since then I discovered yet another hospital not far away was closed to visitors due to Winter Vomiting Bug/norovirus, and a couple of neighbours were also afflicted. One had to take time off work which she almost never does.
21st Century Metabolism
Sometime in the last century, metabolic research went off on a wild goose chase following Ancel Keys.
What I call 21st Century research is actually returning to stuff that was known in the past (check out William Banting – no relation to the Banting that discovered insulin – and compare with Robert Atkins, for example).
Recent work has concentrated on the Eeeeevils of Saturated Fat and the benefits of Healthy Whole Grains, and burning off the excess carbs with high levels of cardio. Is it working? well look at the statistics for metabolic diseases, all related to insulin resistance.
21st Century Metabolism largely looks back to the diet and types of exercise we evolved to handle, and which worked for several millennia without causing “epidemics” of diabetes and other cardiovascular diseases and obesity, or the rising levels of “sports injury” (apparently even the Wii is resonsible for some injuries).
Everyone has their own specific take on the details, but the Big Picture is satisfyingly consistent: reduced carb input, especially avoiding grains and particularly wheat, avoidance of excessive Omega 6 seed oils, increase of Omega 3, preferably animal-based, and a decent balance between healthy saturated and monounsaturated fats, and replacement of that endless jogging with heavy lifting, preferably to failure, and high impact interval training, and more low level exercise like walking. (Best started with professional advice, except for the walking, to avoid joint and connective tissue problems, especially common in diabetes).
Both sides of this equation balance one another out and produce major improvements in health not only for ill people but already healthy ones. Even people who make 20th Century Metabolism work don’t do that well by comparison.
For a crash course in the concepts, I recently found an excellent site
which I thoroughly recommend.
That was their blog, here’s their website
and if you want to see if it works, check out Jill Coleman
As a taster, read this post
When I first read the Lyon Diet-Heart Study I thought it was an important piece of work which gave pretty unequivocal results, but I also wondered how much better it would work if they’d removed most of the grains, some of the fruit and added more healthy saturated fats.
Like many of my thoughts this was totally unoriginal, Staffan Lindeberg got there before me.
Not All Bad News
My brain is rebooting quite satisfactorily whenever the sun comes out. The trouble is it doesn’t STAY out: a few dull days and
<zzzzz>
<thunk>
Still, the neighbours’ snowdrops are coming out now and some of the churchyards are bursting into a carpet of white. I have a bunch of crocus corsicus in flower and some of the birds have started to sing again, including a skylark in the back field.
Thinking about it though, since I started controlling my BG I haven’t caught a cold. Well not a proper one, I get the odd snuffle, sneeze and cough and then it goes away without developing further, unlike what has been occurring with some of my friends and neghbours. Also I have avoided the flu for several years.
I did have some sort of digestive upset, it started with pains which appeared to be in my kidneys, first on the right and then worse on the left. Since I was due for tests my GP ran kidney function, and a PSA: both came back normal though the kidney numbers were a bit towards the lower end.
As usually happens, the culprit was not revealed until after I visited the doctor: I developed a pain in the left upper quadrant (unusual as most of my digestive symptoms occur on the right, where I had my cholecystectomy, the old fashioned kind where they open you up like a letterbox from navel to ribcage and delve in with both hands, which may have left some adhesions) which was followed by a case of Johnny Cash Disease (a burning ring of fire).
At that time one of the local hospitals was closed due to Winter Vomiting Virus. We went to the one that wasn’t closed but there’s no guarantee I didn’t pick something up while there.
I now suspect the pains were in the region of my kidneys. This seems to have cleared up now.
I suspect it was some kind of infection because my FBG went up for no apparent reason, and my post-breakfast numbers were also high, coming back to normal later in the day. This is often characteristic of an infection and sometimes occurs before any other noticeable symptoms.
I’m now halfway back on track, I’ve been walking a lot often carrying heavy shopping and going the long way round – and meeting other people doing exactly the same thing. Next jobs are to do some lifting with the boxes in the garage, and return to gardening.
Another significant thing which is new this year, since I started adding more healthy saturated fats like butter and especially cheese, is that my knuckles have survived even the prolonged cold period without drying out and cracking. I blame the better sources of fat and the contents including Vitamin D3 and probably K2 – this has been observed by many others.
Usually I get through between a tube and a tub of Lotil each winter healing the damn things up. This year I used it once – I got a kind of jagged paper cut, probably from ice when clearing snow off the car, which first became infected (I applied a couple of smears of antibiotic ointment) then refused to seal properly. I think I used the Lotil twice.
Would that everyone else had been so fortunate this winter, strangely after the weather improved was when everyone became ill.
My 105 year old neighbour was rushed into hospital after a fall, but fortunately the injury was fairly trivial, just to her scalp which produced a frightening amount of blood. BTDT, once I caught my head on the car’s tailgate – the cut was so small it didn’t even need a plaster, but the amount of blood that poured down my face made me look like I’d gone six rounds with a velociraptor. You wouldn’t believe that a scalp could contain more blood than the whole of the rest of the body, but so it appears.
My 83 year old neighbour with diabetes and leukemia was also rushed in with a kidney infection (hmmm, about the same time my kidneys were playing up), and a few other local characters have also been hospitalised.
Mostly they are in their eighties and nineties and previously active (there’s a BIG hint there, it’s well worth finding out what such people eat and do to maintain such good health for so long). Sadly a friend’s mother just died from cancer – she was younger than me. 😦
The snow’s back today but at least the sun is shining so I think I have the energy for another post.
Hiatus
It’s all Alan’s fault!
He wrote an excellent post on lipids and statins which contained some excellent references.
The references contained further excellent references, which I followed up, along with a whole bunch of papers I’d already downloaded from Hyperlipid, Whole Health Source and elsewhere.
When I got to the stage where I was hitting the same references several times from different directions, I decided my job was done.
Then I upgraded Firefox and lost the sodding lot! Again!
Around the same time my brain imploded, partly through an overdose of biochemistry and partly because my SAD (aka hibernation) caught up with me.
This is one of those annoying conditions, some years it’s relatively mild, sometimes it starts up around September or even August when the daylength becomes noticeably shorter. Sometimes it responds to tweaking my venlafaxine dose upwards, sometimes downwards. Sometimes I can give my neurotransmitters enough of a kicking that they reset, other times I more or less have to wait for February.
This year (OK last year) I was optimistic that BG control and supplemental Vitamin D3 was keeping it at bay, I kept functional until half way through November then crashed and burned. The snow didn’t help any – we had deep long lasting snow from mid December until a few days ago. It came as little consolation that I was not the only person to be affected – or the only species: until the snows finished them off I still had roses, cosmos, nicotianas and other summer flowers in bloom, and a viburnum which shouldn’t flower until May burst into blossom. Even my car died (flat battery). I know just how it felt.
Now in addition to catching up on this blog (and the others I’ve not been reading) I have about three months gardening to do in a couple of weeks before the spring bulbs start to flower.
Long term this was not such a bad thing: since I wasn’t doing much, and had been driving downtown rather than walking in order to take mother, it’s served to give me a data point as to the effect of exercise (or rather lack of it) on my last test results.
A1c went up from my usual 5.6 to 5.8. HDL stayed at 1.4 (55) but LDL went up from 2.4 (94) to 2.6 (101) and trigs went up from 0.7 (62) to 1.4 (124)
Apart from the lack of exercise I had one or two meals which blew my BG – one in the sort of pub where the food would be considered really excellent by any dietician had me at 9.7 (175). I don’t normally eat in places where I can’t select my own menu, but this was another experiment demonstrating that my numbers are controlled rather than cured, and the effect of a “Healthy” Diet can undo the good rather quickly.
Add in some excess 85% chocolate and probably overdoing the fruit a bit – a long strawberry season and some excellent russets and coxes were probably also part of my downfall.
For my last tests I trialled dropping my statin. Depending which labs you look at my HDL either went up to 1.5 (59) or dropped to 1.2 (47), my LDL shot up to 4.0 (156) and my trigs to 1.3 (115) so the statin obviously has some benefits for me and I restarted it.
So I now have numbers for diet plus exercise plus statin, diet and exercise alone and diet and statin alone, all of which were a major improvement on the high carb low fat diet I was previously put on, with or without the statin. So no surprise there then.
This year’s resolution – to beat last year’s numbers.
Gout
This is yet another condition “associated” with diabetes, principally Type 2, and insulin resistance in general.
Curiously if you look at almost any website on the subject you will find little controversy. Most doctors will agree on treatment and will NOT be telling you to “eat more liver and kidneys to stabilise your purine level”, they will almost certainly tell you to avoid food containing high levels of purines. Strange that the same logic does not apply to diabetes.
A useful resource I was pointed to by Quentin, writer of a most entertaining book (and currently in hospital undergoing radiation therapy, having survived not only diabetes but leukemia and another form of cancer for far longer than anyone expected): apparently Dalmations have a genetic inability to process purines, and it would appear from this most comprehensive list that they also suffer from owners who feed them things like Endive.
Seriously though, this is one of the best available sources for purine content.
Excess dietary purines are only one factor though: other things can affect purine metabolism and increase uric acid, one such being fructose. Some people demonstrate chronically high uric acid levels without ever developing gout. Medications such as diuretics may also affect purine metabolism or uric acid clearance.
Update on mother: it turned out NOT to be gout after all but an infection in her toe, as we first suspected. Fortunately we can generally get a GP out quickly when required: she is now on antibiotics and recovering well (and has had her steroids increased again) so kidney is back on the menu! Curiously the last times she had gout attacks it was after eating rhubarb: probably some combination of the fructose and oxalic acid set it off, and she was put on allopurinol which along with the food avoidance had served to keep her gout-free for a long time.
One potential way of identifying gout in its initial stages is that one or more joints become red and swollen and hot to the touch. Unfortunately as we have discovered this may also be a symptom of a bacterial infection! The later stages where more joints are affected and crystals of urate emerge through the skin are more easily identified, by which time the pain is appalling.
IMO it’s important to get this diagnosed as soon as possible as it may come on very quickly and it needs to be differentiated from similar arthritic conditions including pseudogout, and as we now know from infections which in old folks and others with reduced circulation can rapidly turn to cellulitis.
If in any doubt get a second opinion: I now realise I had two attacks in the past, both only in one thumb joint, which my doctor failed to identify even when the tophi (a mix of pus and crsytallised uric acid) burst through the skin. He assured me it was a “trivial skin infection”. Fortunately our local crew are far more competent.
Yet another condition whose incidence can be reduced by tight BG control and especially reducing insulin resistance.
This Is What I’m Talking About
Yesterday I got up around 11. Breakfast was a couple of oatcakes buttered and stuffed with smoked salmon, with a large handful of salad and a couple of olives: the balance of high protein, moderate fat and low carbs works well at breakfast.
Aftetr recaffeinating myself and reading a few papers I made a dash down to the bank and a couple of shops (I cheated and went half way by car), made a bunch of phone calls and assembled some new disks into caddies, then put a couple of old disks into new caddies and then into the fridge.
DON’T LAUGH! This was recommended by a disk recovery expert to try prior to using his extremely expensive services. One was a Seagate whose bearing was overheating (not uncommon, I don’t know if more recent ones have overcome this). Curiously the other was a Samsung: these were previously reliable. I’m not sure if there isn’t a problem with the PSU to the external drive box. The problem is that I backed up most of the Seagate onto the Samsung. And although most of the content is backups I need to pull off the stuff that isn’t and put it onto a Hitachi.
I can’t stress enough the importance of BACKUPS. Got that? Backup your backups, it could happen to you! I like disks in external E-SATA/USB enclosures because they will go on any computer and can also be used for transferring files faster than over the network, and keeping backup copies.
Anyway by then mother was pining to go out, so we went for a drive around looking at the autumn colours in the trees and hedges and the fresh green of the growing crops.
I didn’t want to spend too long as I had a big delivery coming tomorrow and needed to clear some space in the garage and chuck a load of empty boxes (recycling day). As we turned into the lane I saw the delivery truck: they’d arrived a day early and wanted to know if they could tip straightaway.
They helped me shift some stuff, mainly empty boxes, and had coffee while I swept the dead spiders and other crud out of the garage. Then I had another oatcake slathered with butter and topped with Wensleydale. This was the first thing I’d eaten since breakfast – it was now after 3 pm. Then we set to work and unloaded several tonnes of boxes. I never even broke sweat, and without testing I could tell my BG was unaffected.
I now have all my books and magazines out of store, and a bunch of nice heavy boxes for lifting. I like lifting, you can do a lot of work in a short time and it is beneficial to muscle development and reducing insulin resistance, and for some reason it’s much easier when there’s an end result rather than when it’s exercise for its own sake. I need something like this to do as the garden has gone crazy and refused to shut down – I have roses still in flower, cosmos about six feet tall still covered in bloom, candytuft springing up everywhere and leaves on many of the bushes I’m waiting to drop before I prune them and renovate the flower beds underneath. Also I haven’t been walking as much as I usually do due to mother’s age and infirmity – she can no longer come and I get paranoid about leaving her for too long.
We ate about six pm – steak and kidney pie without the pie – mother casseroled a pig’s kidney, a bunch of steak, carrots, onions and peppers served with lashings of purple sprouting and followed by a few strawberries. Oh I also had a small slice of brown bread – I try to avoid wheat but she gets all paranoid – and washed it down with some Bordeaux. Followed by a square of 85% chocolate and more coffee.
After a while I went and crashed out for a couple of hours, then worked into the night mainly watching TV programmes I’d recorded – including a sort of restrospective concert by Georgie Fame featuring such luminaries as Guy Barker, Alan Skidmore and Rico Rodriguez, and another concert by Van The Man (Morrison) featuring Georgie Fame – and running backups.
Around Midnight I had another meal similar to breakfast, then around 2 am mother got up unable to sleep with a pain in her toe, which I helped her soak in a bowl of water. Initially I thought it may be repairs from the podiatrist but she soaked the bandage off which caused some relief, and this morning it was obviously an attack of gout.
We risked the kidneys because she hadn’t had gout for about a year. Obviously not a good plan: pity because I’m very fond of kidneys. and liver, but don’t want to annoy her by scoffing them in front of her.
After that I had yet another oatcake with a big hunk of Emmental and went back to bed.
So that’s around 30 carbs from the oatcakes, maybe 20 from the bread, plus whatever was in the veggies and strawberries and chocolate (not a lot in the latter).
The point of this? On my original high carb moderate fat diet I would have needed to carb up for such unexpected exertion. On the dietician’s low fat high carb diet I would have had to carb up before, during and after and would still have been knackered due to the rapid rises and drops in BG and the ensuing insulin resistance. On what I’m eating now it hardly phased me at all.
Here are some samples of what else I’ve eaten this week: my breakfasts are basically similar but include other fish (and other brands of smoked salmon) or bacon, or sometimes lamb chops, with some combination of salad usually including watercress and often also olives and/or toasted sunfolower seeds.
Evening meals have included (unsmoked) salmon with spinach, stir fry including crab with bacon, coloured peppers, garlic, lime juice and quinoa, and chili con carne made from base ingredients which which I risked a small helping of rice.
Nocturnal meals have included prawn curry with cashew nuts, chillies, ginger and more garlic, chicken fried in coconut oil and encrusted with coconut powder, ground almonds and sesame seeds (and garlic!).
Snacks have included . . . well I don’t need to snack very often but sometimes have an oatcake with some form of cheese, or goat cheese with blueberries, or nuts, or 85% chocolate in a low dose.
I try to ring the changes so I’m eating a lot of different stuff (there’s a pheasant in the freezer and due to mother’s gout tonight will probably be something relatively bland) and to be honest I dont find it at all difficult to eat anatomically correct portions of carbs, fat, protein and assorted veggies such that my BG excursions are minimised, my lipids are normalised and my energy levels stay up.
Here’s Patti’s take on the same dietary issues.
In The Media Again
I just watched a couple of TV programmes I’d recorded earlier. Both of them almost “got it” but turned away at the last moment.
One was Dispatches which looked at the sugar and salt content of breakfast cereals, but shied away from pointing out the dangers in the cereal content. One sad thing was looking at some of the kids and thinking “wheat face!”
The second was Who Made Me Fat?
Now Channel 4 is fairly competent, but BBC3 is aimed at the sort of audience who needs an instruction manual for an on/off switch but knows the imtimate details of the “lifestyle” of every celebrity. Despite that it took a half decent swipe at the food industry, and pissed off one or two politicians (and several security guards). The Olympics, sponsored by McDonalds, Coca-Cola and Cadburys???
Both programmes rightly slammed sugar, but also fats – and didn’t address other carbs at all, so Conventional Wisdom is still alive and well. George McGovern was right to make Ancel Keys the world’s most successful grain salesman.
One things that emerged from the latter was the truly horrendous Sugar Bureau. Apparently the RDA for sugar is 60g, plus 30g of unrefined sugar already concealed in foods like fruit. Say what??? that’s 45g of fructose alone, I’m pushing it to eat 90g total carbs! The presenter added up her sugar consumption on her low fat diet and found it was over 160g – that’s right, 80g of fructose on top of 80g glucose. Now add her healthy breakfast cereal and brown rice and you start to see why there’s an epidemic of obesity which is worsening as people avoid fats. Something my mother bought the other day had an RDA of 70g for sugar and 230g for total carbs, I’ve seen higher but seldom lower on other packets
Not a few of her interviewees correctly pointed out that extra sugar is added to foods because it’s a cheap bulking agent and replaces more expensive ingredients. Sadly they didn’t take the next logical step of realising this also applies to wheat.
You may think the ongoing saga of the sacking of Drugs Adviser Professor David Nutt, followed by the resignation of Les King, has nothing to do with diet, or diabetes, but I think it is directly relevant: he was sacked because he went up against dogma with facts and information, much as what happens to doctors and researchers who do the same in the dietary field. When cannabis was declassified I said at the time that it was a temporary move designed to induce tokers to be less careful so the Police could build information and make a lot of arrests later when it was reclassified again. Was I wrong? Don’t assume when this lot of eejits are voted out and the other lot of eejits are voted in that any of this will change – except that the Food Industry will probably be given even more carte blanche to increase their profits at the expense of our health. Which makes me ponder whose profit margin is greater, a heroin dealer or a wheat pusher.
And finally . . . some good news.
If they’d used an even better diet they’d almost certainly have gotten even better results. Here’s how to find what that diet is
The original paper is here
Oops, no it’s not, that’s a different paper.
Subscription only, but you can read the summary.
The Hypocritic Oath 
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