What statins do

Sama Hoole

@SamaHoole

A statin does not remove cholesterol. It switches off an enzyme near the top of a pathway, and cholesterol is only one of the things that pathway makes. Here is the rest of the list. Coenzyme Q10, which your mitochondria use to turn food into ATP. Muscle levels fall by 20 to 35 per cent. Dolichols, which the cell uses to attach sugars to its own proteins. Heme A, part of the last enzyme in the respiratory chain. Prenylated proteins, which the pancreas needs in order to release insulin. Selenoproteins, including the glutathione peroxidases that handle oxidative stress. Squalene, and downstream of it the vitamin D your skin makes from sunlight. And cholesterol itself, raw material for testosterone, oestrogen, cortisol, bile acids and every cell membrane you own. One enzyme, seven outputs, and the drug is named after one of them. Now the label, which concedes more than the marketing does. 28 February 2012: the FDA adds raised blood sugar and type 2 diabetes to the label of every statin sold in America. 2010: the Lancet meta-analysis of thirteen trials behind that decision found a 9 per cent rise in new diabetes. 28 February 2012: the same announcement adds memory loss and confusion. 28 February 2012: and quietly drops routine liver monitoring, on the grounds that serious liver injury is rare, unpredictable, and was not being caught by the monitoring anyway. August 2001: Bayer pulls Baycol from every market on earth except Japan. Thirty-one American deaths from rhabdomyolysis on the FDA's desk, later linked to around a hundred. Fatal cases reported at forty times the rate of the other statins. Lipitor went on to become the biggest selling drug in human history. Over 130 billion dollars. The two tissues that burn the most CoQ10 are heart and skeletal muscle. Which is why the man with the aching legs and the fresh diabetes diagnosis gets told his cholesterol is beautifully controlled. It is. That was the only thing anyone measured.

 

Omnivores

 

Sama Hoole

@SamaHoole

A pig is an omnivore. Whenever somebody tells you humans are omnivores, ask them to put the pig on the table next to us and go through it feature by feature, because the pig is what the word actually describes. The pig has a long gut with a genuine large intestine and caecum where microbes ferment fibrous material into short chain fatty acids it absorbs and uses. Yours does almost none of that. The pig will eat acorns, roots, tubers, grain, windfall fruit, carrion, eggs, insects and the occasional unlucky bird, and it will thrive on any mix of them, because that is what omnivore means. Not tolerates. Thrives. Bears are the same story. Raccoons. They have the plumbing for a genuinely mixed diet and it is not a compromise for them. A wild boar rooting through a beech wood in October is not making do. That is an animal operating exactly to specification. Now run us through it. No fermentation chamber worth the name. No cellulase. A caecum reduced to a decorative worm. Stomach acid at a pH that sits with the scavengers rather than the browsers. A gut around 40 percent smaller than a primate our size ought to be carrying. And a gallbladder for hitting large fatty loads, which the grazers deleted entirely. Omnivore is a description of dietary equipment, not a description of dietary willingness. I can drink diesel. That does not make me a tractor. We eat plants the way a dog eats grass. Occasionally, opportunistically, and never as the thing keeping us upright. The pig is the omnivore. We are the thing the pig would be terrified of if it could think straight.

Biosphere 2

 

Sama Hoole

@SamaHoole

Eight people sealed themselves in a glass dome to prove humanity could feed itself on plants, and spent two years starving in front of the world's press. Biosphere 2 cost a hundred and fifty million dollars. Three acres of Arizona desert under sealed glass, eight crew, door shut on 26 September 1991, nothing in or out for two years. The farm inside was worked intensively and by any agronomic measure it was superb, out-producing the most efficient smallholder farming on earth by a wide margin. It produced 83 per cent of what they needed. Which left Roy Walford, the crew doctor, in a sealed box with seven hungry colleagues and his own life's work. Walford was a UCLA pathologist who had spent thirty years arguing that severe calorie restriction extends lifespan. He had doubled it in mice. And here was reality handing him his own hypothesis with the door welded shut. So he called it a health programme. The menu became vegetables, half a glass of goat's milk a day, and meat or fish about once a week. The men lost close to a fifth of their body weight, the women about a tenth. And the markers Walford cared about behaved impeccably: blood pressure, glucose, cholesterol and triglycerides all down at least twenty per cent, into ranges any doctor would frame. He published it in PNAS in 1992. The bloodwork was magnificent. The people were falling apart. Jane Poynter wrote the book afterwards. Fatigue, depression, mental fog, and a preoccupation with food that ate the entire interior life of the crew. They stole from each other. They split into two factions that stopped speaking. The ecological research the building had been constructed for was largely abandoned by people who no longer had the headroom for anything past the next meal. The ants and cockroaches, by contrast, were thriving. The air was leaving too. Oxygen started at 20.9 per cent and kept dropping and nobody knew where it was going. Columbia eventually worked it out: the concrete was quietly eating it. So oxygen had to be pumped in from outside, which is an interesting result for a sealed world. Walford's verdict on the mutiny is the whole thing in one sentence. He said afterwards that any other physician aboard would have panicked and declared they were starving, but that he knew they were on a programme of health enhancement. He knew. Seven other people, visibly wasting, were simply mistaken. He came out in 1993, developed ALS, blamed the conditions inside, and died in 2004 aged 79 after years on 1,600 calories a day in pursuit of a longer life. The mice got double. He did not make it to average for an American professor. Every argument you have heard this decade was already in that building. Grow it locally. Take the animals out. Eat less. Watch the numbers improve. Eight of the most motivated humans alive, handed three acres of the best-managed farmland on the planet and no meat, could not feed themselves. The press reported the fighting as a personality clash.

Brian Cates - Political Columnist & Pundit

@drawandstrike

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1h

He went to his grave still convinced he was right. Think about that.

Sama Hoole

@SamaHoole

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1h

That's human nature in a sentence. We don't just defend ideas; we defend identities.

Sama Hoole

@SamaHoole

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3h

Hunger changes people remarkably quickly. It's not just the body that suffers; mood, judgement and morale take a hit too.