(The Conversation – Karl Zimmerer) One day last March I talked with Juliana and Elisa, a mother and daughter who farmed just outside the city of Huánuco, Peru. Although they had only one acre of land in this mountainous landscape, they grew dozens of local varieties of potatoes and corn, along with other crops. And they knew each of their varieties by a common name – mostly in their Quechua language.
Potatoes are native to the Andes, and over 4,000 varieties are grown there now. They come in numerous shapes, sizes and colors – red, yellow, purple, striped and spotted. A colorful mound of them resembles the bold, burnished colors of locally woven shawls.
Farmers near the city of Huánuco continue to grow many species and varieties of food plants in their fields and gardens in this mountainous landscape. Karl Zimmerer, CC BY-ND
This wide array of types is an example of agrobiodiversity – a genetic legacy created by natural selection interacting with cultural practices over thousands of years. Today, however, agrobiodiversity is declining in many countries. In Mexico farmers are cultivating only 20 percent of the corn types that were grown there in 1930. Chinese farmers are producing only 10 percent of 10,000 varieties of wheat that were recorded there in 1949. More than 95 percent of known apple varieties that existed in the United States in 1900 are no longer cultivated.
According to Bioversity International, an international research and policy organization, just three crops – rice, wheat and maize – provide more than half of plant-derived calories consumed worldwide. This is a problem because our diets are heavy in calories, sugar and saturated fat and low in fruits and vegetables.
But there also are bright spots, such as Andean potatoes. In a recent article, Stef de Haan of the International Center for Tropical Agriculture and I call for a major effort to strengthen agrobiodiversity for the future. Consuming many different species and varieties provides a diet that offers many unique tastes and a wide selection of nutrients that humans need to thrive. It also can help ensure more stable food systems and the needed variety of desirable genetic traits, such as hardiness.
Wealthy nations have less-diverse diets
Generally, agrobiodiversity is significantly lower in wealthy nations, where the industrial food system pushes toward genetic uniformity. For example, federal agriculture policy in the United States tends to favor raising large crops of corn and soybeans, which are big business. Crop subsidies, federal renewable fuel targets and many other factors reinforce this focus on a few commodity crops.
In turn, this system drives production and consumption of inexpensive, low-quality food based on a simplified diet. The lack of diversity of fruit and vegetables in the American diet has contributed to a national public health crisis that is concentrated among socioeconomically disadvantaged groups. Low agrobiodiversity also makes U.S. agriculture more vulnerable to pests, diseases and climate change.
Agrobiodiversity is a set of genetic resources in food and agriculture. FAO
To connect these conditions to agrobiodiversity, consider potatoes. Although the United States has 10 times more people than Peru, only about 150 varieties of potato are sold here. Six varieties account for three-quarters of our national potato harvest. They dominate because they produce high yields under optimal conditions and are easy to store, transport and process – especially into french fries and potato chips. Federal policies have helped these varieties become established by reducing the cost of irrigation.
Ironically, rich agrobiodiversity in many low- and medium-income nations supports more standardized and genetically uniform breeding industries in wealthy nations. U.S. and European scientists and seed companies have used the diversity of Andean potatoes and their relatives to create commercial varieties that are the roots of modern industrial agriculture.
How change can promote agrobiodiversity
To protect and increase agrobiodiversity, we have to know how to value it in a rapidly changing world. In the GeoSynthESES Lab that I lead at Penn State, we are developing an ambitious new framework to analyze whether and how agrobiodiversity can continue to be produced and consumed in the future.
Thanks to our fieldwork in Peru and other countries, we’re finding that certain global dynamics, such as urbanization and migration, can be compatible with agrobiodiversity production and consumption. For example, Elisa and Juliana live within a few miles of the Huánuco urban area, and they both work jobs in the city. Their “traditional” farming and eating patterns blend with their part-time farming.
Such changes can even support the innovative use of local food varieties, but only under the right conditions. Farmers must have sufficient land and water. They have to continue preferring these food flavors and tastes. Vibrant local markets for these foods make producing them economically viable.
Heirloom apples, Stroud Farmers Market, Gloucestershire, England. Barry W******, CC BY
Together with collaborators working in Huánuco, our lab is assessing ways in which global trends could undercut agrobiodiversity in Peru. One concern is local adoption of “improved varieties” of both potatoes and corn that are being created by national and international breeding programs and private seed companies.
Under favorable conditions, these types provide high yields and potentially good sales income. But the seeds can be expensive by local standards, and growing them requires more inputs, such as fungicides and irrigation. Farmers who use them are less resilient if it’s a bad growing year or if cash is low. For these reasons more than one-half of the potato and maize seed being grown by the Huánuco farmers still comes from local sources such as nearby markets, neighbors, and family members.
So far, farmers in Huánuco and elsewhere in Peru prefer to growth both their traditional crops and new ones if possible. But discussions of new initiatives to extend the reach of such “improved varieties” reflect how these challenges will continue to evolve.
Shifting diets
We also are analyzing local impacts of the global spread of inexpensive, low-quality industrial foods. Juliana, Elisa and their Huánuco neighbors increasingly depend on staples such as rice and sugar and on heavy use of cooking oil. Many of them still grow high-agrobiodiversity crops, but on a smaller scale, and these crops play a shrinking role in their diets. It is important to counter this trend by revaluing these nutritious foods, both for human health and for the environmental benefits that agrobiodiversity brings.
On the positive side, middle-class Peruvians are embracing agrobiodiverse foods sold through markets and food fairs, such as the huge annual Mistura food festival in Lima. Internationally renowned elite restaurants and celebrity chefs are potentially important, nontraditional allies. It is crucial to find ways in which Elisa, Juliana and other producers of agrobiodiverse foods can earn rewards from these new markets.
There also is growing interest in agrobiodiversity in the United States. Potato farmers here in central Pennsylvania and across the Northeast are reviving more than 100 local varieties that until recently had been considered lost. In the Southwest, research groups recently uncovered evidence of the ancient “Four Corners Potato,” the first known wild potato in North America, which was used some 10,000 years ago. DNA from this species could provide genes to make modern potato strains more resistant to drought and disease.
Global shifts of urbanization, migration, markets and climate can potentially be compatible with agrobiodiversity, but other powerful forces are undermining it. The imperatives of producing food at lower cost and higher yield clash with efforts to raise high-quality food and protect the environment. The future of agrobiodiversity hangs in the balance.
Close-up side view of a young surgeon frowning with her hands holding her head
(NaturalBlaze by Heather Callaghan) And so it begins… A healthcare system has literally fired 50 employees – in one fell swoop – over a draconian flu jab policy. They can’t fire us all if we stand up, right? That might be the inner wishful thinking of those who refuse vaccinations while working in the healthcare system.
A Minnesota-based health system has fired about 50 employees who refused to get a flu shot.
Essentia Health announced last month that employees would be required to get vaccinated for influenza unless they received a religious or medical exemption.
The system claimed that it was trying to “keep patients from getting sick at its 15 hospitals and 75 clinics in Minnesota, Idaho, North Dakota and Wisconsin.”
Essentia says 99 percent of the company’s 13,900 eligible employees had gotten the shot, received an exemption or were getting an exemption by the Monday deadline.
The United Steelworkers filed an injunction to try to delay the policy, but a federal judge denied the request. Minnesota Public Radio reports at least two other unions are filing grievances on behalf of workers who lost their jobs.
How do you know when something is truly for the benefit of the people? Why, when you are forced to choose it or lose your entire livelihood, of course!
We’d like to point out that we have heard from workers in other healthcare systems who are being forced to get shots or either lose their jobs or wear masks for over four months of the year. Please remember that it is not just nurses and doctors who are being coerced, but support assistance workers and other department workers in the hospital systems.
We hope that all the unions fighting any healthcare systems using these seriously violating policies go all the way and win back basic rights for these employees.
(ProPublica) This story was co-published with NPR’s Shots blog.
Two years ago, Margaret O’Neill brought her 5-year-old daughter to Children’s Hospital Colorado because the band of tissue that connected her tongue to the floor of her mouth was too tight. The condition literally called being “tongue-tied,” made it hard for the girl to make “th” sounds.
It’s a common problem with a simple fix: an outpatient procedure to snip the tissue.
During a pre-operative visit, the surgeon offered to throw in a surprising perk. Should we pierce her ears while she’s under?
O’Neill’s first thought was that her daughter seemed a bit young to have her ears pierced. Her second: Why was a surgeon offering to do this? Wasn’t that something done free at the mall with the purchase of a starter set of earrings?
“That’s so funny,” O’Neill recalled saying. “I didn’t think you did ear piercings.”
The surgeon, Peggy Kelley, told her it could be a nice thing for a child, O’Neill said. All she had to do is bring earrings on the day of the operation. O’Neill agreed, assuming it would be free.
Her daughter emerged from surgery with her tongue newly freed and a pair of small gold stars in her ears.
Only months later did O’Neill discover her cost for this extracurricular work: $1,877.86 for “operating room services” related to the ear piercing — a fee her insurer was unwilling to pay.
At first, O’Neill assumed the bill was a mistake. Her daughter hadn’t needed her ears pierced, and O’Neill would never have agreed to it if she’d known the cost. She complained in phone calls and in writing.
The hospital wouldn’t budge. In fact, O’Neill said it dug in, telling her to pay up or it would send the bill to collections. The situation was “absurd,” she said.
“There are a lot of things we’d pay extra for a doctor to do,” she said. “This is not one of them.”
Kelley and the hospital declined to comment to ProPublica about the ear piercing.
Surgical ear piercings are rare, according to the Health Care Cost Institute, a nonprofit that maintains a database of commercial health insurance claims. The institute could only find a few dozen possible cases a year in its vast cache of billing data. But O’Neill’s case is a vivid example of health care waste known as overuse.
Into this category fall things like unnecessary tests, higher-than-needed levels of care or surgeries that have proven ineffective.
Wasteful use of medical care has “become so normalized that I don’t think people in the system see it,” said Dr. Vikas Saini, president of The Lown Institute, a Boston think tank focused on making health care more effective, affordable and just. “We need more serious studies of what these practices are.”
Experts estimate the U.S. health care system wastes $765 billion annually — about a quarter of all the money that’s spent. Of that, an estimated $210 billion goes to unnecessary or needlessly expensive care, according to a 2012 report by the National Academy of Medicine.
We also reported how drug companies make oversize eyedrops and vials of cancer drugs, forcing patients to pay for medication they are unable to use. In response, a group of U.S. senators introduced a bill this month to reduce what they called “colossal and completely preventable waste.”
But any discussion of waste needs to look how health care dollars are thrown away on procedures and care that patients don’t need — and how hard it is to stop it.
Just ask Christina Arenas.
Arenas, 34, has a history of noncancerous cysts in her breasts so last summer when her gynecologist found some lumps in her breast and sent her for an ultrasound to rule out cancer, she wasn’t worried.
But on the day of scan, the sonographer started the ultrasound, then stopped to consult a radiologist. They told her she needed a mammogram before the ultrasound could be done.
Arenas, an attorney who is married to a doctor, told them she didn’t want a mammogram. She didn’t want to be exposed to the radiation, or pay for the procedure. But sitting on the table in a hospital gown, she didn’t have much leverage to negotiate.
Christina Arenas of Washington, D.C., went to the doctor for a breast ultrasound but said she was required to get more imaging tests than she needed, including the mammogram on her computer.(Allison Shelley for ProPublica)
So, she agreed to a mammogram, followed by an ultrasound. The findings: no cancer. As Arenas suspected, she had cysts, fluid-filled sacs that are common in women her age.
The radiologist told her to come back in two weeks so they could drain the cysts with a needle, guided by yet another ultrasound. But when she returned she got two ultrasounds: one before the procedure and another as part of it.
The radiologist then sent the fluid from the cysts to pathology to test it for cancer. That test confirmed — again — that there wasn’t any cancer. Her insurance whittled the bills down to $2,361, most of which she had to pay herself because of her insurance plan.
Arenas didn’t like paying for something she didn’t think she needed and resented the loss of control. “It was just kind of, ‘Take it or leave it.’ The whole thing. You had no choice as to your own care.”
Arenas, sure she’d been given care she didn’t need, discussed it with one of her husband’s friends who is a gynecologist. She learned the process could have been more simple and affordable.
Arenas complained to The George Washington Medical Faculty Associates, the large Washington, D.C., doctor group that provided her treatment. Her request to have the bill reduced was denied. Then bill collectors got involved, so she demanded a refund and threatened legal action.
She said she never got to speak to anyone. Her demand was routed to an attorney, who declined her request because there was “no inappropriate care.” She also complained to her insurance company and the Washington, D.C., attorney general’s office, but they declined to help reduce the bill.
Overtreatment related to mammograms is a common problem. The national cost of false-positive tests and overdiagnosed breast cancer is estimated at $4 billion a year, according to a 2015 study in Health Affairs. Some of this is fueled by anxious patients, some by doctors who know that missing a cancer diagnosis can be grounds for a medical malpractice lawsuit. But advocates, patients and even some doctors note the screenings can also be a cash cow for physicians and hospitals.
With Arenas’ permission, we shared her case with experts, including Dr. Barbara Levy, vice president of health policy for the American College of Obstetricians and Gynecologists and three radiologists.
Levy said there’s a standard way to treat a suspected breast cyst that’s efficient and cost-effective. If the lump is large, as in Arenas’ case, a doctor should first use a needle to try and drain it. If the fluid is clear and the lump goes away there’s no cause for concern or extra testing. If the fluid is bloody or can’t be drained, or the mass is solid, then medical imaging tests can determine if it’s cancerous.
However, doctors often choose to order imaging tests rather than drain apparent cysts, Levy said. “We’re so afraid the next one might be cancer even though the last 10 weren’t,” she said. “So, we overtest.”
Levy and the radiologists agreed that at least some of Arenas’ care seemed excessive. But their opinions varied, which shows why it can be difficult to reduce unnecessary care. Standards are often open-ended, so they allow for a wide range of practices and doctors have autonomy to take the route they think is best for patients.
The American College of Radiology recommends an ultrasound for a 32-year-old — Arenas’ age at the time of the procedure — with an unidentified breast mass. Mammograms are also an option, but “most benign lesions in young women are not visualized by mammography,” the guidelines state.
Arenas reviews her medical bills. Experts called the care to treat her breast cysts “excessive.” (Allison Shelley for ProPublica)
Dr. Phillip Shaffer, a radiologist who’s practiced for decades in Columbus, Ohio, said he didn’t think Arenas needed the mammogram. “I wouldn’t do it,” he said. “If I did an ultrasound and saw cysts, I’d say you have cysts. In 32-year-olds the mammogram does almost nothing.”
Dr. Jay Baker, chair of the American College of Radiology breast imaging communications committee, agreed that the ultrasound alone would have “almost certainly” identified the cyst. But, he said, maybe something about the lumps concerned Arenas’ radiologist, so a mammogram was ordered.
None of the radiologists consulted by ProPublica could explain why two ultrasounds on the return visit would be necessary. According to Arenas’ medical records, the practice told one reviewer that two were done to make sure the cysts hadn’t changed.
Shaffer didn’t buy it. “They just billed her twice for one thing,” he said.
Levy, the gynecologist, said it’s “excessive” to do two ultrasounds. And, she said, there was no need to send clear fluid to pathology.
Arenas offered to waive her privacy rights so the practice that provided her treatment could speak to ProPublica. Officials from the practice declined to comment. Her medical records show that in response to reviews by her insurance company and the attorney general’s office, her doctors said the care was appropriate.
Since then she has her cysts drained without images in her gynecologist’s office for about $350. But Arenas said on two occasions she’s used a needle at home to do it herself. (Doctors do not recommend this approach.) She admits it was an extreme choice, but at the time she worried she would be subjected to more unnecessary tests.
“I was taken advantage of because I was a captive audience,” she said.
In a brick-and-glass office park just outside Roanoke, Virginia, Missy Conley and Jeanne Woodward have battled on behalf of hundreds of patients who believe they’ve been overtreated or overcharged. The two work for Medliminal, a company that challenges erroneous and inflated medical bills on behalf of consumers in exchange for a share of the savings.
The two women excitedly one-up each other with their favorite outrages. How about the two cases involving unnecessary pregnancy tests? One of the patients was 82 —decades past her childbearing years. The other involved a younger woman who no longer had a uterus.
Another case involved an uninsured man who fell off his mountain bike and hurt his shoulder. The first responders pressured him to take an air ambulance to a hospital when it would have been faster for his friends to drive him. He got charged $44,000 for the whirlybird. Such unexpectedly pricey flights — and the aggressive billing that comes with them — have been featured in stories by NPR, The New York Times and The Atlantic.
Medliminal gets dozens of calls a week from consumers who are fed up with the medical system.
Woodward, a nurse and certified medical auditor, regularly sees patients billed for unnecessary lab tests. A man with diabetes may only need his glucose measured, but the doctor may order a bundle of 14 unnecessary tests, she said. The extra tests inflate the tab.
If there’s a billing dispute it can take months of phone calls and emails to get a case resolved, said Conley, who gained an insider’s knowledge during years working for insurance companies.
Patients fighting bills on their own often give up and pay the bill or let it go to collections, she said. “The whole system is broken,” Conley said.
Saini, president of The Lown Institute, said profit is a major driver of overuse.
“Providers are getting constant messages from superiors or partners to maximize revenue,” Saini said. “In this system we have, that’s not a crime. That’s business as usual.”
Patients aren’t true health care consumers because they typically can’t shop by price and they often don’t have control over the care they receive, Saini said. The medical evidence may support multiple paths for providing care, but patients are unable to tell what is or is not discretionary, he said. Time pressure adds urgency, which makes it difficult to discuss or research various options.
“It’s sort of this perfect storm where no one is really evil but the net effect is predatory,” Saini said.
Once the service or treatment is provided, the bill is on its way, with little forgiveness.
In 2015, Dr. Dong Chang, the director of the medical intensive care unit at Harbor-UCLA Medical Center, a public hospital in Los Angeles, decided to see whether the care being delivered in his ICU was appropriate.
Resources were scarce in his ICU, and he suspected it might be possible to manage them better. So, he and his colleagues reviewed the records of all the patients in the unit over the course of a year to see whether the patients might have been either too sick, or too healthy, to benefit from intensive care.
The results shocked them. They determined the care may not have been beneficial to more than half of the patients. “ICU care is inefficient, devoting substantial resources to patients less likely to benefit,” their study, published in the February edition of JAMA Internal Medicine, concluded.
Dr. Dong Chang, director of the medical intensive care unit at Harbor-UCLA Medical Center, has found that many patients are too sick or too healthy to benefit from intensive care. (Jenna Schoenefeld for ProPublica)
Chang and his team also reviewed the use of intensive care at 94 hospitals in two states, Maryland and Washington, focusing on four common conditions that can lead to treatment in an intensive care unit.
They found wide variation in the types of patients hospitals determined needed intensive care. One hospital put 16 percent of patients with diabetic ketoacidosis, a serious condition that can result in a coma, in intensive care, while another hospital did so with 81 percent of such patients. The range for patients with pulmonary embolisms was from 5 percent to 44 percent and for those with congestive heart failure, it was 4 percent to 49 percent.
Chang attributes the difference to doctors using intensive care based on their habits, hunches or training. Profit, he said, may also be a motive, but it didn’t appear to be a driving force.
“We really don’t have good standards and a good discussion going on about who should receive ICU care,” Chang said.
The unnecessary intensive care can also be harmful. The study found intensive care patients underwent more invasive procedures, like the insertion of catheters, including central lines, which carry the risk of infection. Overuse of the ICU is bad for patients who don’t need it, Chang said. Survival rates were also no better at the hospitals that used intensive care the most.
Reducing unneeded intensive care stays would save big money. Intensive care costs about $10,000 for a typical stay and accounts for 4 percent of national health care expenditures, according to research cited by Chang’s team.
If the hospitals in Maryland and Washington with the highest rates of intensive care use had behaved more like those with lower use, it would save around $137 million, the study estimated. That’s the savings for fewer than 100 hospitals in two states. There are about 4,000 hospitals nationwide, suggesting that reducing unnecessary intensive care use could save billions of dollars a year.
Chang hesitated to call the overuse of intensive care “wasted” health care spending. He said the medical literature calls it “non-beneficial” care, which is maybe a nicer way of saying the same thing.
For O’Neill, her dispute of the fee for her daughter’s ear piercing was a trip into the hell of medical billing.
O’Neill is an attorney, so she knows how to weed through fine print. But it took her untold hours and phone calls to the hospital and her insurance company to root out the issue. The hospital had initially billed her insurer for the $1,877.86 for “operating room services” related to the ear piercing. The company rightly rejected payment for the cosmetic procedure. So, the hospital billed the family, according to her medical and billing records and correspondence.
The surgeon billed the family an additional $110, which O’Neill paid.
The operative report describes the piercing in obscure technical terms: “The bilateral lobules were prepped with betadine and a 18 gauge was used to pierce the left lobule in the planned position …”
O’Neill said she got nowhere in several conversations with the manager of the hospital’s team that deals with payments directly from consumers. Then in mid-July, O’Neill wrote a letter to the manager explaining that they were at an impasse and urged the hospital to cancel the bill.
In early August, ProPublica contacted the hospital and surgeon to inquire about the ear piercing. The hospital spokeswoman replied in an email that, generally speaking, ear piercings during surgery are rare and only done at the request of a family. (The medical records say O’Neill requested the ear piercing.) It would not result in a separate operating room charge, she wrote.
The spokeswoman’s explanation didn’t jibe with the hospital’s bill, which even listed the billing code for ear piercing. She declined to discuss O’Neill’s case or explain the discrepancy.
In mid-August, the self-pay manager sent O’Neill a letter saying, “the remaining balance of $1,877.86” would be removed “as a one-time courtesy adjustment.”
The manager added that the hospital hadn’t done anything wrong. The account was “correctly documented, coded, charged and billed according to industry standards,” she wrote.
And that’s just the problem. The hospital’s $1,877 bill for the ear piercing was within industry standards.
As for O’Neill, she and her daughter had to endure one additional insult. The surgeon’s piercing of one ear was off-kilter so it had to be redone. This time O’Neill had it done at the mall, for about 30 bucks.
(Dr. Mercola) In the health paradox of the year, 52-year-old cardiologist John Warner, president of the American Heart Association (AHA), recently suffered a heart attack in the middle of a health conference.1,2 In a statement, the association reported Warner was in stable condition after having a stent placed to open a blocked artery. Part of Warner’s speech at the Scientific Sessions conference in Anaheim, California, centered around his own family’s struggle with heart disease.
“After my son was born and we were introducing him to his extended family, I realized something very disturbing: There were no old men on either side of my family. None. All the branches of our family tree cut short by cardiovascular disease,” Warner said in his speech.3
“Together we can make sure old men and old women are regulars at family reunions, that people live long enough and healthy enough to enjoy walks and fishing trips with their grandchildren and maybe even their great-grandchildren. In other words, I look forward to a future where … children grow up surrounded by so many healthy, beloved, elderly relatives that they couldn’t imagine life any other way.”
The AHA’s CEO, Nancy Brown, said in a statement:4 “John wanted to reinforce that this incident underscores the important message that he left us with in his presidential address … that much progress has been made, but much remains to be done.”
Many AHA Recommendations Worsen Heart Health
In all likelihood, Warner followed AHA recommendations, many of which are actually recipes for heart disease disaster. Of the foods scientifically proven to cause heart disease and clogged arteries, excess sugar and industrially processed omega-6 vegetable oils, found in nearly all processed foods, compete for space at the top the list. And what kinds of foods does the AHA recommend to protect your heart?
Not only does it support ample grain consumption, it also recommends eating harmful fats such as canola, corn, soybean and sunflower oil.5 “Blends or combinations of these oils, often sold under the name ‘vegetable oil,’ and cooking sprays made from these oils are also good choices,” the AHA says. Meanwhile, the association still insists saturated fats are to be avoided.
Just this past summer the AHA shocked health experts around the world by sending out a worldwide advisory6 saying saturated fats such as butter and coconut oil should be avoided to cut your risk of heart disease, and that replacing these fats with margarine and vegetable oil might cut your heart disease risk by as much as 30 percent. Overall, the AHA recommends limiting your daily saturated fat intake to 6 percent of daily calories or less.7
This is as backward as it gets, and if Warner was following this long-outdated advice, it’s no wonder he suffered a heart attack. In fact, it is to be expected. As noted by American science writer Gary Taubes in his extensive rebuttal to the AHA’s advisory,8 with this document, the AHA reveals its longstanding prejudice — and the method by which it reaches its flawed conclusions.
In short, the AHA simply excluded any and all contrary evidence. After this methodical cherry-picking, they were left with just four clinical trials published in the 1960s and early ‘70s — the eras when the low-fat myth was born and grew to take hold. The problem is nutritional science has made significant strides since then, and a number of significant studies have firmly disproven the hypothesis that saturated fat causes heart disease, finding no association whatsoever.
In related news, the AHA recently issued new guidelines on blood pressure,9 moving the goal post for heart health yet again. Now you’re considered hypertensive if your blood pressure is above 130 over 80. Previous guidelines started hypertension at 140 over 90. This means an estimated 30 million Americans will qualify for the designation of having high blood pressure, and of those, an estimated 1 in 5 are likely to receive the recommendation to take blood pressure medication.
Flawed Fat Recommendations Have Been Followed With Disastrous Consequences
Since the 1950s, when vegetable oils began being promoted over saturated fats like butter, Americans have dutifully followed this advice, dramatically increasing consumption of vegetable oil. Soybean oil, for example, has risen by 600 percent while butter, tallow and lard consumption has been halved. We’ve also dramatically increased sugar consumption, which has also been implicated as a primary contributor to heart disease and other chronic health problems.10
While following this advice, Americans have gotten fatter and sicker. Heart disease rates have not improved even though people have been following the AHA’s “heart healthy diet.” Common sense tells us if the AHA’s advice hasn’t worked in the last 65 years, it’s not likely to start working now. Modern research is just now starting to reveal what actually happens at the molecular level when you consume vegetable oil and margarine, and it’s not good.
For example, Dr. Sanjoy Ghosh,11 a biologist at the University of British Columbia, has shown your mitochondria cannot easily use polyunsaturated fatty acids (PUFAs) for fuel due to the fats’ unique molecular structure. Other researchers have shown the PUFA linoleic acid hinders mitochondrial function and can even cause cell death.12
PUFAs are also not readily stored in subcutaneous fat. Instead, PUFAs tend to get deposited in your liver, where they contribute to fatty liver disease, and in your arteries, where they contribute to atherosclerosis.
According to Frances Sladek,13 Ph.D., a toxicologist and professor of cell biology at UC Riverside, PUFAs behave like a toxin that builds up in tissues because your body cannot easily rid itself of it. Making matters worse, when vegetable oils like sunflower oil and corn oil are heated, cancer-causing chemicals like cyclic aldehydes are also produced.14
Other research confirms such findings by linking fried foods to an increased risk of death. For example, eating fried potatoes more than twice a week has been shown to double a person’s risk of death compared to never eating fried potatoes.15 Animal and human research has also found vegetable oils promote:
According to Dr. Cate Shanahan,21 a family physician and author of “Deep Nutrition: Why Your Genes Need Traditional Food,” the idea that PUFAs are healthier than saturated fats falls flat when you enter the field of biochemistry, because it’s “biochemically implausible.” In other words, the molecular structure of PUFA is such that it’s far more prone to react with oxygen, and these reactions disrupt cellular activity and cause inflammation.22 Oxidative stress and inflammation, in turn, are hallmarks not only of heart disease and heart attacks but of most chronic diseases.23,24
“[T]he folks at the AHA claim saturated fat is pro-inflammatory and causes arterial plaque and heart attacks — but there is no biochemically plausible explanation for their argument,” she told me in an emailed rebuttal to the AHA advisory.“Saturated fat is very stable, and will not react with oxygen the way PUFA fat does, not until the fundamental laws of the universe are altered.
Our bodies do need some PUFA fat, but we need it to come from food like walnuts and salmon or gently processed (as in cold pressed, unrefined) oils like flax and artisanal grapeseed, not from vegetable oils because these are refined, bleached and deodorized, and the PUFA fats are molecularly mangled into toxins our body cannot use.”
Open Letter to AHA President
In an open letter to AHA president Warner, Dr. William Davis, a New York cardiologist and author of The New York Times best seller “Wheat Belly, Lose the Wheat, Lose the Weight, and Find Your Path Back to Health,” writes, in part:
“If you ignore the nonsense that AHA policy dictates, you can absolutely gain control over cardiovascular risk. But you will NOT find the answers in any AHA policy. I learned these lessons practicing as an interventional cardiologist, then abandoning this ridiculous way of managing coronary disease to devote my efforts to early detection and prevention.
So, I thought I would articulate some of these thoughts in an open letter to Dr. Warner as he recovers from his procedure … Dr. Warner — … There are a number of reasons why someone like you — deeply-entrenched in the conventional world of heart disease management and what passes for prevention — highlights the miserable failure that the modern coronary care paradigm represents:
1) We are trapped by the outdated but profitable lipid hypothesis … 2) We know from abundant data that small oxidation- and glycation-prone LDL particles are highly atherogenic … are potent triggers of the inflammation cascade … and are triggered to abundant degrees in some genotypes upon consumption of the amylopectin A of grains …
[Y]es, the food that the American Heart Association advises to fill the diet with — and sugars … I am hoping that, now that this disease has touched you personally, your eyes will be opened to the corrupt and absurd policies of conventional coronary care and the American Heart Association.”
The Magic Pill Myth Needs to End
Davis goes on to note that heart disease is a multifactorial problem that cannot be solved with a pill.
“Thinking that a statin drug … [is] sufficient to prevent coronary events is absurd and overly-simplistic, like thinking that taking Aricept for dementia will stop the disease — of course, it does no such thing,” he writes, adding, “There are no drugs to ‘treat’ many of the contributors to coronary atherogenesis.But there are many non-drug strategies to identify, then correct, such causes.”
Nondrug prevention strategies suggested by Davis include:
•Avoiding any and all dietary factors that provoke insulin resistance, glycation and formation of small, dense LDL particles. Importantly, this would include avoiding the harmful fats recommended by the AHA such as margarine and processed vegetable oils, and keeping your total daily fructose consumption below 25 grams per day.
•Optimizing your vitamin D level.
•Optimizing your omega-3 fat intake: An omega-3 index of 10 percent or greater is associated with “dramatic reduction in cardiovascular events,” Davis notes. Indeed, a 2010 analysis25 found that while diets higher in omega-6 fats (found in ample amounts in vegetable oils) and lower in omega-3s increased the risk of nonfatal myocardial infarction and death from heart disease by 13 percent; a mixed diet of both omega-3 and omega-6 fats reduced these risks by 22 percent.
Meanwhile, the AHA recommends higher intakes of omega-6, saying26 “Aggregate data from randomized trials, case-control and cohort studies, and long-term animal feeding experiments indicate that the consumption of at least 5 percent to 10 percent of energy from omega-6 PUFAs reduces the risk of coronary heart disease relative to lower intakes.
The data also suggest that higher intakes appear to be safe and may be even more beneficial.”This statement runs counter to a large body of research suggesting the converse — specifically, that reducing omega-6 fats and increasing omega-3 is better for your heart.
•Addressing your thyroid function.
•Optimizing your gut microbiome to address dysbiosis caused by excess sugar, chlorinated and fluoridated water, and exposure to antibiotics, pesticides and common heartburn drugs.
Stent Placement No Better Than Placebo
Research also does not support the routine procedure of coronary artery angioplasty and stent placement. In fact, recent research suggests up to 50 percent of all stent placements may be unnecessary.27 Moreover, the effectiveness of this procedure is right on par with placebo. In a recent study published in The Lancet, researchers from Imperial College London investigated the difference between patients who had received a stent for stable angina and those who underwent a placebo intervention.28
In the short video above, lead author and interventional cardiologist Dr. Rasha Al-Lamee, describes the study and its results. Two hundred participants with severe single vessel blockage were recruited from five sites across the U.K.29 During the initial six weeks, all patients underwent an exercise test followed by intensive medical treatment.
At that point, they were randomly assigned to two groups. The first underwent a percutaneous intervention (PCI) during which coronary angioplasty was performed and a stent was placed. The second group also underwent a PCI procedure with an angiogram but without a balloon angioplasty or stent placement.30
For the following six weeks, neither the patient nor the physician knew if the patient received the stent. At the conclusion of the six weeks, patients again underwent an exercise test and were questioned about their symptoms. The researchers found both groups experienced nearly identical improvements in exercise tolerance and no difference in reported improvements of their symptoms.31 From the data, Al-Lamee commented:32
“Surprisingly, even though the stents improved blood supply, they didn’t provide more relief of symptoms compared to drug treatments, at least in this patient group. It seems that the link between opening a narrowing coronary artery and improving symptoms is not as simple as everyone had hoped.”
In this interview, Dr. Thomas Cowan, family physician, founding member of the Weston A. Price Foundation and author of “Human Heart, Cosmic Heart: A Doctor’s Quest to Understand, Treat and Prevent Cardiovascular Disease,” reveals how your heart and circulatory system works. This understanding may go a long way toward changing the way you understand heart disease.
He makes a strong case for heart disease being rooted in mitochondrial dysfunction and believes plaque formation alone cannot explain a heart attack.”[Conventionally], it’s all about the plaque,” Cowan says. “My point in the book is that it’s NOT about the plaque.” The conventional view is that your heart functions like a pump — a pressure propulsion system caused by the muscular contraction of the ventricles.
Cowan explains that your heart is actually better described as a hydraulic ram — a vortex-creating machine — where the primary mover of blood is the interaction occurring between the negatively charged vessel walls and the positively charged water in your blood. Importantly, the following three natural energies result in a separation of charges that improve blood flow:
1. Sunlight charges up your blood vessels, which increases the flow of blood. When the sun’s rays penetrate your skin, it causes a massive increase of nitric oxide that acts as a vasodilator. As much as 60 percent of your blood can be shunted to the surface of your skin through the action of nitric oxide.
This helps absorb solar radiation, which then causes the water in your blood to capture the energy and become structured. This is a key component for a healthy heart. The ideal is to be exposed to the sun while grounding, meaning walking barefoot. This forms a biological circuit that makes it work even better.
2.Negative ions from the Earth, also known as earthing or grounding. This also charges up your blood vessels, creates a separation of charges, creates more positive ions and allows the blood to flow upward, against gravity.
3.The field effect or touch from another living being, such as laying on of hands.
A Healthy Heart Is the Result of a Healthy Lifestyle
As noted by Cowan, “The best thing is to be, more or less, with shorts or naked on the beach, with the saltwater, which acts as an electrical conductor, holding hands with somebody you love. That’s how you structure the water [in your blood vessels].” Sun exposure, grounding and skin-to-skin contact are three heart disease prevention strategies that, ideally, everyone should be doing, and it doesn’t get a whole lot easier or less expensive than this.
That said, your heart health is really dependent on your diet — what you eat and when you eat. In my view, the best treatment for heart disease is to work your way up to an intermittent fasting schedule where you’re fasting for 20 hours a day. When you do eat, make sure you eat real food, and consider a cyclical ketogenic diet, high in healthy fats, low in net carbs with moderate protein.
Once you’re comfortable with this intermittent fasting schedule, start doing a monthly five-day water fast. This really is the most powerful metabolic intervention I know of, and I feel it’s one of the healthiest things I now do for my own health. Senescent cells, which have stopped replicating, play a distinct role in aging and disease. Once replication stops, these cells need to be removed from your body, or else they start clogging it up, causing severe inflammation and immune dysfunction.
Fasting very effectively gets rid of senescent cells — a process known as autophagy. Fasting also stimulates the production of stem cells, which help with regeneration and healing.
While a five-day fast may sound intimidating, if you’re used to 20-hour daily intermittent fasting for a month before starting your five-day fast, then the hunger that typically strikes on the second day of fasting is dramatically reduced and will typically not be at all bothersome. Fasting is also a powerful remedy for insulin resistance, which is a major underlying factor of heart disease.
Last but not least, the following exercise, which requires only two to three minutes, three times a day, is a super-simple way to boost your heart health. It prompts your body to release nitric oxide, which will help relax your blood vessels and improve your blood pressure.
(Independent) Not all robots will take over human jobs. My colleagues and I have just unveiled a prototype care robot that we hope could take on some of the more mundane work of looking after elderly and disabled people and those with conditions such as dementia.
This would leave human carers free to focus on the more personal parts of the job. The robot could also do things humans don’t have time to do now, like keeping a constant check on whether someone is safe and well, while allowing them to keep their privacy.
Our robot, named Stevie, is designed to look a bit (but not too much) like a human, with arms and a head but also wheels. This is because we need it to exist alongside people and perform tasks that may otherwise be done by a human. Giving the robot these features help people realise that they can speak to it and perhaps ask it to do things for them.
Stevie can perform some of its jobs autonomously, for example reminding users to take medication. Other tasks are designed to involve human interaction. For example, if a room sensor detects a user may have fallen over, a human operator can take control of the robot, use it to investigate the event and contact the emergency services if necessary.
Stevie can also help users stay socially connected. For example, the screens in the head can facilitate a Skype call, eliminating the challenges many users face using telephones. Stevie can also regulate room temperatures and light levels, tasks that help to keep the occupant comfortable, and reduce possible fall hazards.
None of this will mean we won’t need human carers anymore. Stevie won’t be able to wash or dress people, for example. Instead, we’re trying to develop technology that helps and complements human care. We want to combine human empathy, compassion, and decision-making with the efficiency, reliability and continuous operation of robotics.
One day, we might might be able to develop care robots that can help with more physical tasks, such as helping users out of bed. But these jobs carry much greater risks to user safety and we’ll need to do a lot more work to make this happen.
Stevie would provide benefits to carers as well as elderly or disabled users. The job of a professional care assistant is incredibly demanding, often involving long, unsocial hours in workplaces that are frequently understaffed. As a result, the industry suffers from extremely low job satisfaction. In the US, more than 35 per cent of care assistants leave their jobs every year. By taking on some of the more routine, mundane work, robots could free carers to spend more time engaging with residents.
Of course, not everyone who is getting older or has a disability may need a robot. And there is already a range of affordable smart technology that can help people by controlling appliances with voice commands or notifying caregivers in the event of a fall or accident.
Smarter than smart
But for many people, this type of technology is still extremely limited. For example, how can someone with hearing problems use a conventional smart hub such as the Amazon Echo, a device that communicates exclusively through audio signals? What happens if someone falls and they are unable to press an emergency call button on a wearable device?
Stevie overcomes these problems because it can communicate in multiple ways. It can talk, make gestures, and show facial expressions and display text on its screen. In this way, it follows the principles of universal design, because it is designed to adapt to the needs of the greatest possible number of users, not just the able majority.
We hope to have a version of Stevie ready to sell within two years. We still need to refine the design, decide on and develop new features and make sure it complies with major regulations. All this needs to be guided by extensive user testing so we are planning a range of pilots in Ireland, the UK and the US starting in summer 2018. This will help us achieve a major milestone on the road to developing robots that really do make our lives easier.
Global shifts of urbanization, migration, markets and climate can potentially be compatible with agrobiodiversity, but other powerful forces are undermining it. The imperatives of producing food at lower cost and higher yield clash with efforts to raise high-quality food and protect the environment. The future of agrobiodiversity hangs in the balance.
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