From: sbharris@ix.netcom.com (Steve Harris  sbharris@ROMAN9.netcom.com)
Newsgroups: alt.impeach.bush,alt.politics.bush,alt.politics.usa.republican,
	soc.veterans,sci.med
Subject: Re: American health care best? No...Most expensive? Yes...Ranked 12th
Date: 29 Jun 2004 15:30:09 -0700
Message-ID: <79cf0a8.0406291430.1737be4e@posting.google.com>

bluefins2005@yahoo.com (Blue Sea) wrote in message
news:<61a8bd38.0406281115.38c0f6ed@posting.google.com>...
> According to study of UN on health care issues, US came in 17th, below
> many advanced countries such as Canada, France, etc...
> "Sid9" <sid9@bellsouth.net> wrote in message
> news:<2TMDc.944$qG.457@bignews3.bellsouth.net>...
> > June 28, 2004
> > OP-ED COLUMNIST
> > A Second Opinion
> > By BOB HERBERT
> >
> > In an article a few years ago in The Journal of the American Medical
> > Association, Dr. Barbara Starfield of the Johns Hopkins School of Medicine
> > took a look at the overall health of the American people, and compared
> > conditions here to those in other industrialized countries.
> >
> > What she found was disturbing.
> >
> > "The fact is that the U.S. population does not have anywhere near the best
> > health in the world," she wrote. "Of 13 countries in a recent comparison,
> > the United States ranks an average of 12th (second from the bottom) for 16
> > available health indicators."
> >
> > She said the U.S. came in 13th, dead last, in terms of low birth weight
> > percentages; 13th for neonatal mortality and infant mortality over all; 13th
> > for years of potential life lost (excluding external causes); 11th for life
> > expectancy at the age of 1 for females and 12th for males; and 10th for life
> > expectancy at the age of 15 for females and 12th for males.
> > She noted in the article that more than 40 million Americans lacked health
> > insurance (the figure is about 43 million now) and she described the state
> > of Americans' health as "relatively poor."
> > "U.S. children are particularly disadvantaged," she said, adding, "But even


COMMENT:

We've been over and over this kind of mis-applied criticism in this
forum.

For one thing, infant mortality figures are very hard to cross
compare, since a country can drastically affect its infant mortality
rate by classifying the very most premature infants (for example,
below 1 kg) as either "live-births" or miscarriages.

Adult life expectancy is easier to compare, but it should be
recognized that total life expectancy in counties it's not a simple
matter of how good the medical system is. It's also heavily influenced
by cultural factors like crime, youth violence, drug addiction rates
(including tobacco and alcohol) etc.

If you take the US states which have the best life expectancy, like
Hawaii, Minnasota, South Dakota, and Utah, you find that they compare
very well with those of Japan in Iceland. They are as good as anywhere
in the world-- yet there is nothing special about the US health care
system present in these states. For example, male life expectancy at
birth in Hawaii is 75.4 and for females it's 81.4.  For Utah men it's
74.9 and for Minnisota women it's 80.8. These are due to cultural
factors completely independent of doctors, hospitals and even
insurance plans. And so they are also in Japan and Iceland, too, no
doubt. In fact, I have little doubt that the Hawaii beats all the
other states in the US in lifespan is due in part to the Japanese
Americans who live there. It's not that Hawaiian doctors or hospitals
are amazing.

What drags things down in the US are places like Washington DC where
males at birth can expect only 61.8 years and women 73.3. That gives
an average of 67.5-- piss poor. Next is Louisiana at 72.7 and
Mississippi at 72.6.

Now the people who blame the medical system for crack babies and gang
shootings in Washington DC, have a real problem. What they are
demanding is magic medicine, Star Trek medicine. There aren't fixes
for kids shot in the head and babies left in dumpsters. Not medical
fixes, anyway.

But those are the underlying assumptions of this kind of criticism. It
says, essentially, that US medicine may be good enough for Utahns and
Hawaiians and Minnestotans to live as long as anybody in the world,
but it's not good enough to allow people in Washington DC to do it,
even with them trying like mad to kill themselves.

Well, that's true. But what of it?


Steve Harris

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: Low-Glycemic Better Than Low-Fat Diet
Date: 8 Jun 2005 13:00:17 -0700
Message-ID: <1118260817.591857.78210@z14g2000cwz.googlegroups.com>

Yes.  Note that life expectancy in the US by state is a wide scatter,
going from Hawaii where life expectancy is similar to Sweden and
Iceland, down to Louisianna and Mississippi, where it's down about the
same as Chile and Costa Rica. These differences are due to fundanmental
socioeconomic problems which medical technology *per se* cannot deal
with. If the problem was medical technolgy per se, Hawaii and Utah
would be just as unhealthy as the rest of the US. They aren't.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: whole grain wheat
Date: 8 Jun 2005 20:29:18 -0700
Message-ID: <1118287758.632380.111890@g49g2000cwa.googlegroups.com>

>>For the so-called "staff of life" it is missing some very important
nutrients. And this is whole grain wheat, refined white flour is
virtually bereft of any nutrienst useful to humans. <<


COMMENT:

As is white rice and white rice flour.  This does not prevent the
Japanese from having the world's best life expectancies, as they mix
all that white rice with a bunch of other stuff, whenever they eat it.

Why this same principle should not work as well with white wheat flour
is not obvious. Probably it does, as you point out for the
Mediterraneans. I think the overall epidemiology suggests that it
hardly matters what carbohydrate you use, so long as you consume it
adequate with protein and fat. And that your overal diet has enough
vitamins (which can be from other sources entirely), minerals, and
adequate w-3 and w-6 EFAs.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: whole grain wheat
Date: 9 Jun 2005 10:54:22 -0700
Message-ID: <1118339662.685574.55460@g43g2000cwa.googlegroups.com>

>>The mediterraneans and the japanese do not eat huge amounts of sugars.
They eat moderate amounts of pasta and/or rice. They eat a lot of fresh
whole-food foods with minimal processing. They eat entirely adequate
amounts of healthy fats (fish fats, olive oil, etc). The live closer to
the soil with little extra food processing other than just cooking the
fresh foods. These foods are filling and full of real nutrition. <<

COMMENT

I don't know where the hell you get these ideas, but it's not from
being in the Mediterranean.

The sweetest breakfast I ever had was as a houseguest on the island of
Majorca IN the Mediterranean, where my hosts ate a collection of the
lightest, thinnest pastries you ever saw, for breakfast. With juice.
Nor were they the oily sweet pastries of the Greeks. There were just
plain honey glaze and flour, so far as I could tell. This was not
tourist stuff, but what they ate every day.  Other meals did indeed
include a lot of seafood (little fried octupi and lots of shrimp) but
as for "processing," I have no idea what you mean. Food that is cut up
and cooked and fried with spices and other stuff is "processed."

On the continent, the breakfasts tend to center about pastry (that's
why this is called a "continental breakfast" don't you know). The idea
that continental pastry is somehow a lot different than what you get in
the US, is bullshit.

The lowest carb breakfasts I've ever had while traveling came in
England and Scotland, where the standard fare at bed and breakfasts is
bacon, eggs, butter, clotted cream, and maybe fruit or shortbread.
Served by widows of men who'd probably been killed by similar
breakfasts. This is heart disease country. There's no particular "food
paradox" when it comes to the first meal of the day, unless you think
high glucose load meals cause vascular disease.  Then there is.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: whole grain wheat
Date: 9 Jun 2005 19:16:55 -0700
Message-ID: <1118369815.043812.270750@z14g2000cwz.googlegroups.com>

>>High glucose meals causes vascular disease. By direct damage from high
blood glucose levels, and the chronic depletion of vitamins,
specifically the B vitamins and vitamin c, which are essential to
vascular health. <<

COMMENT

I suppose that would explain the many animal models of atherosclerosis
caused by giving the animals high blood sugars chronically (aka
diabetic or streptozotocin treated rats).  Not.

It DOESN'T work. You can give rats or rabbits or dogs or monkeys
atherosclerosis by modifying their dietary fat and cholesterol.  If
there's any model where this has been done to these animals by screwing
around with their dietary glucose loads and dietary carbs, please
enlighten us.  Yes, elevated blood sugars surely contribute to the
human problem in frank diabetics.  But most human vascular disease
doesn't occur in frank diabetics. It does however, occur to humans with
LDL > 100, and heart disease is rare in cultures where LDL is low.

>>Heart disease country is in India among the vegetarian Hindus who have
triple the incidence of heart disease of their meat eating neighbors, the
Indian Muslim. This is referred to as the Indian Paradox. <<

COMMENT:

There's no paradox about it. You know about that favorite Hindu food
clarified butter, called ghee? Full of saturated fat, transfat,
oxidized cholesterol.  I can't think of a food better designed to give
you atherosclerosis, and it has NOTHING to do with carbohydrates. Nada.


If these Hindus were vegan, now THAT would be a paradox. Ghee is no
paradox. Ghee will kill you.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: whole grain wheat
Date: 10 Jun 2005 16:08:44 -0700
Message-ID: <1118444924.172593.9530@z14g2000cwz.googlegroups.com>

> I suppose that would explain the many animal models of atherosclerosis
> caused by giving the animals high blood sugars chronically (aka
> diabetic or streptozotocin treated rats).  Not.

>>You mean the studies that fed animal source fats to normally vegetarian
animals? Pretty sad science, if you ask me. <<


Rats are not "normally vegetarian". They are omnivores.  And
atherosclerosis has been induced in dogs, which are carnivores and
normally very resistant to it,by feeding them hydrgenated coconut oil
and cholesterol.  Feeding a little safflower oil along with this,
prevents the problem.

>>We are not talking about rats ir rabbits or dogs or monkeys, we are
talking about humans. <<

In whom the mechanisms for production of atherosclerosis are hardly
likely to be much different. Yes, meat eating animals are more
resistant to production of atherosclerosis. But humans are (apparently)
not good carnivores. At least, we don't do well on a high aggricultural
meat or dairy fat diet.

> There's no paradox about it. You know about that favorite Hindu food
> clarified butter, called ghee? Full of saturated fat, transfat,
> oxidized cholesterol.  I can't think of a food better designed to give
> you atherosclerosis, and it has NOTHING to do with carbohydrates. Nada.

>>That's is just plain ridiculous.

Why?  Because you don't want to believe it?

Int J Cardiol. 1996 Oct 25;56(3):289-98; discussion 299-300.

Association of trans fatty acids (vegetable ghee) and clarified butter
(Indian ghee) intake with higher risk of coronary artery disease in rural
and urban populations with low fat consumption.

Singh RB, Niaz MA, Ghosh S, Beegom R, Rastogi V, Sharma JP, Dube GK.

Heart Research Laboratory, Medical Hospital and Research Centre,
Moradabad, India.

These cross-sectional surveys included 1769 rural (894 men and 875 women)
and 1806 urban (904 men and 902 women) randomly selected subjects between
25-64 years of age from Moradabad in North India. The total prevalence of
coronary artery disease based on clinical history and electrocardiogram
was significantly higher in urban compared to rural men (11.0 vs. 3.9%)
and women (6.9 vs. 2.6%), respectively. Food consumption patterns showed
that important differences in relation to coronary artery disease were
higher intake of total visible fat, milk and milk products, meat, eggs,
sugar and jaggery in urban compared to rural subjects. Prevalence of
coronary artery disease in relation to visible fat intake showed a higher
prevalence rate with higher visible fat intake in both sexes and the
trend was significant for total prevalence rates both for rural and urban
men and women. Subgroup analysis among urban (694 men and 694 women) and
rural (442 men and 435 women) subjects consuming moderate to high fat
diets showed that subjects eating trans fatty acids plus clarified butter
or those consuming clarified butter as total visible fat had a
significantly higher prevalence of coronary artery disease compared to
those consuming clarified butter plus vegetable oils in both rural (9.8,
7.1 vs. 3.0%) and urban (16.2, 13.5 vs. 11.0%) men as well as in rural
(9.2, 4.5 vs. 1.5%) and urban (10.7, 8.8 vs. 6.4%) women. Univariate and
multivariate regression analysis with adjustment for age showed that
sedentariness in women, body mass index in urban men and women, milk and
clarified butter plus trans fatty acids in both rural and urban in both
sexes were significantly associated with coronary artery disease. It is
possible that lower intake of total visible fat (20 g/day), decreased
intake of milk, increased physical activity and cessation of smoking may
benefit some populations in the prevention of coronary artery disease.

PMID: 8910075 [PubMed - indexed for MEDLINE]

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: whole grain wheat
Date: 12 Jun 2005 21:10:13 -0700
Message-ID: <1118635813.280707.292610@g47g2000cwa.googlegroups.com>

>>High glucose meals causes vascular disease. By direct damage from high
blood glucose levels, and the chronic depletion of vitamins,
specifically the B vitamins and vitamin c, which are essential to
vascular health. <<

COMMENT:

Really?  And what is your evidence for this?  There really are no
sufficiently long intervention trial with low glycemic index to show
they have any effect on coronary disease.  The epidemiology is not with
you here, either, as most of the Asian world which has low coronary
rates, also eats a lot of rice starch.

Finally, we all know that diabetics die of heart disease more often
than diabetes per se. But if the glucose itself is damaging their
coronaries, and not high blood pressure or cholesterol, then it would
be far more important to control glucose in diabetics to prevent future
heart attack, than it is blood pressure or cholesterol. But this is NOT
what studies find. Cholesterol and blood pressure control are each more
important, in the meta-analysis of available prospective studies.  This
doesn't look too good for your hypothesis that you have the most
important causal factor nailed.

1. Am J Med. 2001 Dec 1;111(8):633-42.

Comment in:
    ACP J Club. 2002 Jul-Aug;137(1):3.
    J Fam Pract. 2002 Apr;51(4):306.

The effect of interventions to prevent cardiovascular disease in patients
with type 2 diabetes mellitus.

Huang ES, Meigs JB, Singer DE.

General Medicine Division, University of Chicago, Chicago, Illinois
60637, USA.

PURPOSE: Cardiovascular complications account for over 50% of mortality
among patients with type 2 diabetes mellitus. We quantify the
cardiovascular benefit of lowering cholesterol, blood pressure, and
glucose levels in these patients.  METHODS: We conducted a meta-analysis
of randomized controlled trials in type 2 diabetes or diabetes subgroups,
comparing the cardiovascular effects of intensive medication control of
risk factor levels in standard therapy or placebo. We identified trials
by searching MEDLINE (1966 to 2000) and review articles. Treatment
details, patient characteristics, and outcome events were obtained using
a specified protocol. Data were pooled using fixed-effects models.
RESULTS: Seven serum cholesterol-lowering trials, six blood
pressure-lowering trials, and five blood glucose-lowering trials met
eligibility criteria. For aggregate cardiac events (coronary heart
disease death and nonfatal myocardial infarction), cholesterol lowering
[rate ratio (RR) = 0.75; 95% confidence interval (CI): 0.61 to 0.93) and
blood pressure lowering (RR = 0.73; 95% CI: 0.57 to 0.94) produced large,
significant effects, whereas intensive glucose lowering reduced events
without reaching statistical significance (RR = 0.87; 95% CI: 0.74 to
1.01). We observed this pattern for all individual cardiovascular
outcomes. For cholesterol-lowering and blood pressure-lowering therapy,
69 to 300 person-years of treatment were needed to prevent one
cardiovascular event. CONCLUSION: The evidence from these clinical trials
demonstrates that lipid and blood pressure lowering in patients with type
2 diabetes is associated with substantial cardiovascular benefits.
Intensive glucose lowering is essential for the prevention of
microvascular disease, but improvements in cholesterol and blood pressure
levels are central to reducing cardiovascular disease in these patients.

Publication Types:
    Meta-Analysis

PMID: 11755507 [PubMed - indexed for MEDLINE]


2. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD004467.

Low glycaemic index diets for coronary heart disease.

Kelly S, Frost G, Whittaker V, Summerbell C.

School of Health and Social Care, University of Teesside, Middlesbrough,
TS1 3BA, UK. S.kelly@tees.ac.uk

BACKGROUND: The glycaemic index (GI) is a physiological measure of the
ability of a carbohydrate to affect blood glucose. Interest is growing in
the low GI carbohydrate concept for the clinical management of people at
risk of, or with established coronary heart disease. There is a need to
review the current evidence from controlled trials in this area.
OBJECTIVES: The primary objective is to review the current evidence from
RCTs that assess the relationship between the consumption of low
glycaemic index diets and the effects on coronary heart disease and on
risk factors for coronary heart disease. SEARCH STRATEGY: We searched
CENTRAL (Issue 4, 2003), MEDLINE (1966 to 2003), EMBASE (1980 to 2003)
and CINAHL (1982 to 2003). We also contacted experts in the field.
SELECTION CRITERIA: We selected randomised controlled trials that
assessed the effects of low glycaemic index diets, over a minimum of 4
weeks, on coronary heart disease (CHD) and risk factors. Participants
included were adults who carry at least one major risk factor for
coronary heart disease such as abnormal lipids, diabetes or being
overweight. DATA COLLECTION AND ANALYSIS: Two of our research team
independently assessed trial quality and extracted data. Authors of the
included studies were contacted for additional information when this was
appropriate.  MAIN RESULTS: Fifteen randomised controlled trials met the
inclusion criteria.  No studies found reported the effect of low
glycaemic index diets on CHD mortality or CHD events and morbidity. All
fifteen included studies report the effect of low glycaemic index diets
on major risk factors for CHD.  Meta-analysis detected limited and weak
evidence of a relationship between low glycaemic index diets and slightly
lower total cholesterol, compared with higher glycaemic index diets.
There is also limited and weak evidence of a small reduction in HbA1c
after 12 weeks on low glycaemic index diets but not at 4 to 5 weeks.
There is no evidence that low glycaemic index diets have an effect on LDL
cholesterol or HDL cholesterol, triglycerides, fasting glucose or fasting
insulin levels.  REVIEWERS' CONCLUSIONS: The evidence from randomised
controlled trials showing that low glycaemic index diets reduces coronary
heart disease and CHD risk factors is weak. Many of the trials identified
were short-term, of poor quality and conducted on small sample sizes.
There is a need for well designed, adequately powered, randomised
controlled studies, of greater than 12 weeks duration to assess the
effects of low glycaemic index diets for CHD.

Publication Types:
    Meta-Analysis
    Review

PMID: 15495112 [PubMed - indexed for MEDLINE]

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: whole grain wheat
Date: 13 Jun 2005 09:21:09 -0700
Message-ID: <1118679668.962128.294320@z14g2000cwz.googlegroups.com>

They don't disclose it in the abstract, but it really doesn't matter.
If high sugar is the PRIME causal thing, the association because blood
sugar and heart disease should be closer than the association between
other cholesterol and hypertension and heart disese. Which it is. And
closer than the association between these factors and high blood sugar.
Which it is, because with medication we now have the power to control
them independently.

I'm not saying high blood sugar doesn't contribute to artery damage.
But NOTHING in the literature I know of suggests that it is the primary
mechanism. Not epidemology, not intervention trials. And the fact that
controlling glucoses in diabetics doesn't even do as much for risk of a
second vascular event as controlling their pressures and cholesterols,
is strong evidence against little varations in non-diabetics being the
cause of of the scourge of heart disease in developed countries.
Especially since the variations in cholesterol and blood pressure which
go along with this scourge, ARE quite substantial.

SBH

From: Steve Harris <sbharris@ix.netcom.com>
Newsgroups: sci.med.nutrition
Subject: Re: Atkins/GI/GL question...
Date: 14 Jun 2005 08:52:29 -0700
Message-ID: <1118764349.446719.21030@z14g2000cwz.googlegroups.com>

>>Am I correct in thinking that Atkins is on the extreme side because he
didn't work in terms of actual 'glycaemic load' as opposed to 'glycaemic
index': he rules out or restricts some things -- on the basis of their GI
-- that maybe should be allowed because in practice *they actually have a
low GL*? <<


COMMENT:

Glycemic load is amount of carbohydrate per serving multiplied by the
glycemic index of that carbohydrate.  It's a better index for what a
serving of something will do to your blood sugar if you eat it alone.
For example, carrots have a high glycemic index but a low glycemic
load because they don't have that much carbohydrate per serving.

Atkins DID pay attention to total grams of carbohydrate per serving,
which means his recommendations tend to track glycemic *load* better
than index. Simply because load varies much more than index from food
to food. But Atkins didn't particularly track either one.

SBH