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Gary L. Engstrom's avatar

I think a big part of the problem is that we, as citizens of our country, are chronically afraid for two reasons. First, we as citizens of our country are basically chronically ill, and it seems no one knows why. Example: I asked AI the cause of diabetes, and followed the bunny trail and landed on chronic alcohol use. Apparently we don't know the cause of diabetes. But one guy fed a high fructose diet to all possible laboratory animals and they all developed symptoms of diabetes. We cannot test this with humans because that would be unethical. If we know something is harmful to animals we cannot do the same test with humans and if we have only tested animals these findings cannot be extrapolated to humans.

And then there is hypertension -- you end up with the same rabbit hole. We really don't know the cause. I'm quite sure it is not a deficiency in ACE inhibitors, beta-blockers, or calcium channel blockers.

When my blood pressure started to become a bit wacky, I asked my doctor if my potassium might be low. He replied, "No, we measured that and you'r okay." I replied, "But that's serum potassium, not cellular potassium." He got defensive. So, I started supplementing by sprinkling just a small bit of potassium chloride on my food once per day and my blood pressure leveled out.

I told this to a friend who had just been diagnosed with hypertension 150/80. He did what I did and came back down to 120/70 within three months. Another friend was on a bata blocker as a treatment for hypertension, which slows down one's metabolism, by the way, and she was gaining weight. I told her my story and she quit the bata blocker, lost weight and her hypertension is settling down. The official opinion as to why bata blockers cause weight gain? They don't know.

I looked up some studies on supplementation with potassium and the doses they were giving were enough to choke a horse, and had "mixed results." My guess is that if you consume too much potassium your body works so hard to get rid of the surplus and overdoes things.

The second reason people are chronically afraid, is that they have lost trust in authorities. Oh, I just demonstrated that. So, they turn to the opinions of crackpots.

Gary Taubes's avatar

The reasons for our chronic anxiety, such as it is, is a longer discussion. I also think the media plays an enormous role because chemicals in the environment or toxic cell phones in our pockets are always good stories.

As for your potassium-blood pressure connection, that's been discussed often. I more or less got into writing about nutrition because a researcher who thought potassium played the critical role leaked an article to Science about a related dietary trial. Here's a debate discussing the current state of the evidence: https://www.medscape.com/viewarticle/999805?form=fpf

Gary L. Engstrom's avatar

If the kidneys are unable to remove sodium from the blood stream, then the potassium would not make that much difference, I would think. Potassium worked for me because I was not suffering full blown hypertension.

David Brown's avatar

Typcally, health writers, who write about nutritional controversies, opinion check. W. Edwards Deming quote: "In God we trust, all others bring data."

I suggest those who read this comment do a "high blood pressure adipose tissue arachidonic acid" web search in AI Mode.

Gary L. Engstrom's avatar

You wrote: “I suggest those who read this comment do a "high blood pressure adipose tissue arachidonic acid" web search in AI Mode.”

I suggest that you make the same search, replacing “adipose tissue arachidonic acid” with:

Excessive alcohol

Excessive fructose

Chronic hyperglycemia

Excessive omega 6

Dietary deficiency in potassium

And you get to the same place.

So, it is complicated.

And then do a web search for: “What is the root cause of hypertension?”

You get: “…excessive sodium intake, lack of physical activity, smoking, and obesity, which strain the cardiovascular system. Chronic stress, aging, genetics, and underlying conditions like diabetes or kidney disease also contribute to stiffening or narrowing arteries, forcing the heart to work harder.”

None of the above five items are included, and this general statement …excessive sodium…. Is all that our attending physicians seem to know.

These five listed items, are the result of our modern American lifestyle of consuming nutritionally light, calorie dense substances, and is the root of our hypertension epidemic — 48% of adults being hypertensive.

So, then do a web search on: Do Americans tend to be deficient in dietary potassium?

“Yes, most Americans are deficient in dietary potassium, with studies suggesting that over 98% of US adults fail to meet the recommended daily intake. Potassium is recognized as a "nutrient of concern" because low intake is linked to high blood pressure, and many people do not eat enough potassium-rich plants.”

I do not drink alcohol, I eat a diet low in fructose, glucose and omega 6, so that leaves potassium, a few sprinkles a day did the job. So, yes, I looked at the data.

David Brown's avatar

I wasn't able to get to the same place using the web searches you suggested. Adipose tissue arachidonic acid is a slow accumulation problem that stems from years of consuming excessive amounts of linoleic acid and or preformed arachidonic acid. It appears to be a reliable biometric for monitoring changes in metabolic status. Many different nutrient deficiencies or excesses can modulate eicosanoid production affecting inflammation, endocannabinoid tone, and immune system activity. However, none of them track as closely with metabolic syndrome as does adipose tissue arachidonic acid.

Gary L. Engstrom's avatar

Arachidonic acid is an essential fatty acid and it is important to get enough, but also too much is bad. A typical "J" curve and essential to hit the "sweet spot." One of the problems is that when we demonize a molecule like this people avoid its sources altogether -- swinging too far to the other side. Modern techniques of producing eggs and beef make the problem worse as grain-fed beef is higher in arachidonic acid and lower in omega 6, whereas grass-fed beef has a more balanced ratio. Same with industrial eggs vs pastured.

I consume quite a bit of eggs, dairy fat, and beef, all from quality sources and at age 82 am in excellent health. My blood pressure is at 120/60.

The problem with AA is not AA itself, but its metabolites, which are inflammatory. So, rather than excessive AA, perhaps it is the lack of anti-inflammatory capacity due to an overall inflammatory diet high in the items I have listed in my previous response.

David Brown's avatar

Actually, arachidonic acid is an essential fatty acid for felines but not for humans and canines who have the ability to elongate and desaturate both linoleic and linolenic acid as needed.

You must have meant to write "lower in omega-3".

You are wise to consume animal products that presumably have a good balance of omega-3s and 6s. That said, you might find this interesting: "The Yakutian horses, which fed on cereals enriched with nutrients preserved by natural cold (green cryo-fodder), accumulated significant amounts of 18:2n-6 and 18:3n-3, the total content of which in cereals was 75% of the total FA content. We found differences in the distribution of these two FAs in different tissues of the horses. Thus, liver was rich in 18:2n-6, while muscle and adipose tissues accumulated mainly 18:3n-3. Such a distribution may indicate different roles of these FAs in the metabolism of the horses. According to FA content, meat of the Yakutian horses is a valuable dietary product. https://www.mdpi.com/2218-273X/10/2/315#References

Further comment by Siberian Federal University researcher Olesia Makhmutova. “The dietary value of the Yakutian horse meat is very high precisely due to the ideal balance of polyunsaturated omega-3 and omega-6 acids, 1:1 ratio of these acids is ideal for us, but civilization is steadily shifting the balance towards the predominance of omega-6 due to the dominance of vegetable oils, cheap pork and fast food in our daily diet. We also need omega-6 acids, but in combination with the omega-3 partners, which are found mainly in fatty fish. The horse meat we tested is also very good, especially for child nutrition and the diet of people suffering from cardiovascular diseases. If the population of Yakutia starts consuming mass-market products, which are now imported abundantly into the republic, and makes a choice in favor of, let us say, semi-finished pork products, this may drastically affect people's health. This is just the case when you should not change a time-tested balanced diet." https://www.sfu-kras.ru/en/news/23160 As you noted, part of the problem is lack of anti-inflammatory capacity. Unfortunately, that problem cannot be effectively addressed by increasing omega-3s and micronutrients intake. Read this article and you'll see what I mean. https://pmc.ncbi.nlm.nih.gov/articles/PMC2875212/

Gary L. Engstrom's avatar

I agree, increasing omega 3 is not the answer without decreasing omega 6.

Jack Gallagher's avatar

Excellent prose, as always. The article re-run from the year 2000 shows that your reporting stands the test of time.

Jonathan Christie's avatar

The 1980 Dietary Goals for the United States ushered in the low-fat diet and the diabesity epidemic, yet few see cause and effect despite plausible mechanism(s) and the natural experiment of the low-carb diet reversing the damage so widespread by now that most everyone knows an example. Why don't the diabesics see the black swan for what it is? Could it be our childhoods - the tooth fairy, Father Christmas, our various religions - so damage our perceptions that we can't see the real demons?

Gary Taubes's avatar

One of my learning experiences over the years with these kinds of paradigm clashes is that both sides invariably have an explanation for every observation, and, when taken individually, those explanations kinda sorta make sense. So mainstream nutritionists now tend to blame the ob-db epidemic on ultra-processed foods, which made us eat too much and they see the timing with dietary guidelines as only a coincidence.

Mark Tokarski's avatar

Perhaps tangential, but my favorite magazine over time, even as my own opinions have spanned the known universe, is National Review, William F. Buckley Jr.'s baby. It is still alive and kicking. To this day, they maintain some distance and a sense of humor about things. Back in the 1970s there was a scare about a certain sugar substitute being used in soft drinks, since (in massive doses) it had been known to cause cancer in rats, NR suggested that we continue to use it, and feed it to our pet rats, and then "watch the little bastards die, real slow."

Tardigrade's avatar

Coming of age in 60s and 70s, I watched in real time two examples of scientific paradigms being overturned: warm-blooded dinosaurs* and continental drift. This left me with an appreciation of scientific skepticism and suspicious of established dogmas, and consequently receptive to the ideas in Good Calories, Bad Calories.

Science today has a lot of problems, not least among them distortions caused by funding, dogma/career protection, and politics. Partly as a result, and despite the perceptive admonitions of Richard Feynman, there seems to be an inadequate appreciation of complex systems, ambiguity, gray areas, and the principle of always considering "What if I'm wrong?"

That's why the science writers I appreciate most are Gary Taubes and Peter Dobromylskyj, who tend not to jump to conclusions and are willing to at least acknowledge the flip side of things.

* Decades later, I was delighted to volunteer on a Wyoming dig with Robert Bakker, author of The Dinosaur Heresies.

Gary Taubes's avatar

Paradigms will be overturned if the evidence is sufficiently compelling and the resistance sufficiently weak. The problem is that the latter is as important as the former. In the nutrition world, for instance, there was no competing paradigm of nutrition and chronic disease to prevent the nutrition world from embracing the idea that dietary fat caused heart disease. Once that idea filled the vaccuum,though, it had to be rejected and replaced by whatever the right theory is. That has always been a much harder job. And in fields large as nutrition, it may be functionally impossible. Too much noise being generated every day by the research community for any meaningful signals to be noticed and change the way people think.

Roel Pieterman's avatar

Great piece! A classic case is chloramphenicol. At present PFAS is a likely candidate. The EU, champion of the precautionary principle, is proposing regulations based on the premisse that all the many varieties of PFAS are all equaly hazardous. Note that the WHO IARC using a hazard approach in stead of a risk assessement, deemed chlysosaat likely carcinogenic and triggered billion dollar Law suites in the USA. Meanwhile no regulatory agency in the world has endorsed this judgement. To find out more on that nefarious issue read the analyses by the Risk Monger of what hè call the ‘predatorts’.

Gary Taubes's avatar

Thanks, Roel. I like the term, predatorts. Pretty much captures it.

IARC used the same approach with red and processed meats.... a story in and of itself.

Tardigrade's avatar

Hey Gary. I'm still reading, but wanted to point out that the three paragraphs starting with "I also learned that these controversies had similar characteristics. They existed because the available methods—experimental or observational—were incapable of providing unambiguous evidence..." have what appears to be some copy/paste duplication.

Gary Taubes's avatar

Thanks. FIxed on line. I also got Kahneman's first name wrong (not Richard, but Daniel) which is a bit more embarrassing.

Tardigrade's avatar

Apropos of almost nothing, here is a very thoughtful essay about calories and hyperpalatability.

https://davebarry.substack.com/p/holiday-diet-tips

Timothy Carey's avatar

Another fabulous article Gary. Thanks loads. The extra article added at the end was like a wicked dessert after a sumptuous main course. I think your mother's wisdom is profound. Without a doubt some people have horrendous things to contend with. I genuinely don't know how they get out of bed in the morning. For many of us though, most of the time, our lives are pretty good. We don't have to be on the watch for marauding tribes from over the hill or savage hungry animals. Yet our heightened vigilance and state of awareness lingers.

Your writing is such a great reminder of why it's so important to get it right when we're engaged in scientific endeavours. I completely agree with your position that we should be raising rather than lowering our standards. I loved your reference to the "science of things that aren't so". It reminded me of a quote from Phil Runkel's terrific tome "People as Living Things". Phil was referring to the more specific topic of psychiatric disorders but the idea of standards and what we regard as a strong signal are relevant. He suggested, "If you go looking for a particular clustering of symptoms (There! There’s one! There! There’s another!) you are bound to find that the instances you have picked out as being the looked-for clustering are all very like the clustering you were looking for. "

Jonathan Christie's avatar

"Those of us who believe in ESP, for instance, do so because we have anecdotal evidence that it does exist, despite the decades of scientific experiments that suggest it does not." This seems to imply you're and ESP believer 'cos of anecdotal evidence - if that's right, I'd love to know what it is! My mother was 2,500 miles away when I got sick, she was disquieted and called - proves nothing of course but these things are far more compelling when they happen to you!

Gary Taubes's avatar

No, I'm not an ESP believer. One of the observations Francis Bacon made is that you always have to ask about background. He told a story about an atheist (or agnostic?) who goes into a church and the pastor shows him a painting of five sailors who survived a shipwreck, because, the pastor says, they believed in God. And the atheist says, what about all the sailors on that ship who believed in God, but didn't survive the shipwreck? How do you explain them? When I hear your anecdote, I think of my mother, the lay expert on anxiety, who would have called me daily if she was acting on her subliminal anxieties that I was doing poorly. So maybe your mother just got lucky? Or you forgot all the times she called with a sense of disquiet and you were fine. How do we tell if this was really ESP? Do a randomized controlled trial.... an experiment.

David Brown's avatar

So as not to disapoint you Gary, I did this web search: "Does adipose tissue arachidonic acid correlate with brain cancer?"

Perplexity AI Summary Response: Current evidence links obesity, altered systemic lipid metabolism, and AA‑dependent eicosanoid signaling to glioma biology, but no study has cleanly answered whether “more arachidonic acid in adipose tissue = higher brain‑cancer risk.” The relationship is best viewed as mechanistically plausible and indirectly supported (through obesity, inflammation, and AA‑rich environments that favor glioma growth) rather than as a quantified, proven epidemiologic correlation at this time."

Next, I asked, "Is there a quantified, proven correlation between preformed arachidonic acid intake and adipose tissue arachidonic acid?"

Perplexity AI Response: Available human data do not show a clear, quantified, and consistently proven correlation between usual preformed arachidonic acid (AA) intake and AA levels in adipose tissue. Within normal dietary ranges, inter‑individual metabolic variation appears to explain adipose AA much more than reported AA intake itself.

Available human data; Below is my human studies wish list. When I ask if these study designs have ever been used in an experimental setting, the AI response is typically "No".

1) Vegetarian omega-3 supplementation weight loss trial in which linoleic acid intake is restricted to 3% of energy or less

2) Vegan omega-3 supplementation weight loss trial in which linoleic acid intake is restricted to 3% of energy or less

3) Human omnivore omega-3 supplementation weight loss trial in which preformed arachidonic acid is restricted and linoleic acid intake is lowered to 3% energy or less

4) Human onnivore GLP-1 receptor agonist/omega-3 supplementation weight loss trial in which preformed arachidonic acid is restricted and linoleic acid intake is lowered to 3% energy or less

5) Human omnivore trial in which preformed arachidonic acid intake is deliberately restricted, and linoleic acid intake is reduced to 3% of energy or less in conjunction with omega-3 supplementation to quiet an over-activated endocannabinoid system