Conflict of Interest

The U.S. National Cholesterol Education Program (NCEP) is a government organization that educates physicians and the general public about the "dangers" of elevated cholesterol. They have a panel that creates official guidelines for the reduction of cardiovascular disease risk. They contain target cholesterol levels, and the usual recommendations to eat less saturated fat and cholesterol, and lose weight.

They recommend keeping LDL below 100 mg/dL, which would place tens of millions of Americans on statins.

I was reading Dr. John Briffa's blog today and he linked to a government web page disclosing NCEP panel members' conflicts of interest. It's fairly common in academic circles to require conflict of interest statements, so a skeptical audience can decide whether or not they think someone is biased. The 9-member NECP panel was happy to indulge us:

Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca; he has received research grants from Merck, Abbott, and Glaxo Smith Kline.

Dr. Cleeman has no financial relationships to disclose.

Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer, and EHC (Merck); she has received unrestricted institutional grants for Continuing Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca, and Bristol-Myers Squibb Medical Imaging; she has received a research grant from Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical, and Biosite.

Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Esperion, and Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and Novartis.

Dr. Clark has received honoraria for educational presentations from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has received grant/research support from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer.

Dr. Hunninghake has received honoraria for consulting and speakers bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for consulting from Kos; he has received research grants from AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and Pfizer.

Dr. Pasternak has served as a speaker for Pfizer, Merck, Merck/Schering-Plough, Takeda, Kos, BMS-Sanofi, and Novartis; he has served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer Health Solutions, Johnson & Johnson-Merck, and AstraZeneca.

Dr. Smith has received institutional research support from Merck; he has stock in Medtronic and Johnson & Johnson.

Dr. Stone has received honoraria for educational lectures from Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant.

Every company in bold is a statin manufacturer. This is outrageous! These are the people setting official government blood cholesterol target values for the entire country! Eight out of nine of them should be dismissed immediately, and replaced by people who can do a better job of pretending to be impartial!

Eating Down the Food Chain

Europe once teemed with large mammals, including species of elephant, lion, tiger, bear, moose and bison.

America was also home to a number of huge and unusual animals: mammoths, dire wolves, lions, giant sloths and others.

The same goes for Australia, where giant kangaroos, huge wombats and marsupial 'lions' once roamed.

What do these extinctions have in common? They all occurred around when humans arrived. The idea that humans caused them is hotly debated, because they also sometimes coincided with climactic and vegetation changes. However, I believe the fact that these extinctions occurred on several different continents about when humans arrived points to an anthropogenic explanation.

A recent archaeological study from the island of Tasmania off the coast of Australia supports the idea that humans were behind the Australian extinctions. Many large animals went extinct around the time when humans arrived in Australia, but that time also coincided with a change in climate. What the new study shows is that the same large animals survived for another 5,000 years in Tasmania... until humans arrived there from the mainland. Then they promptly went extinct. That time period didn't correspond to a major climate change, so it's hard to explain it away.

It's a harsh reality that our big brains and remarkable adaptability give us the power to be exceptionally destructive to the environment. We're good at finding the most productive niches available, and exploiting them until they implode. Jared Diamond wrote an excellent book on the subject called Collapse, which details how nearly every major civilization collapse throughout history was caused at least in part by environmental damage. It's been a hallmark of human history since the beginning.

I don't think it will take much to convince you that the trend has accelerated in modern times. Ocean life, our major source of nutrient-rich wild food, has already been severely depleted. The current extinction rate is estimated to be over 1,000 times the baseline, pre-modern level, and rising.

Humans have always been top-level predators. We kill and eat nutrient-dense prey that is often much larger than we are. But today, the extinction of such walking meat lockers has caused us to eat down the food chain. We're turning to jellyfish and sea cucumbers and... gasp... lobsters!

While it's true that we've probably always eaten things like shellfish and insects, I find it disturbing that we've depleted the oceans to the point where we can no longer sustainably eat formerly abundant carnivorous fish like tuna. We need to make a concerted effort to preserve these species because extinction is permanent.

I don't want to live in a future where the only thing on the menu is bacteria patties, the other other other other white meat.

Saharan Hunter-Gatherers Unearthed

The media recently covered an archaeological discovery in Niger that caught my attention. In the middle of the Sahara desert, researchers found a hunter-gatherer burial site containing over 200 graves ranging from about 10,000 to 4,500 years old. During this period, the region was lush and productive.

There were two groups: the Kiffian, who were powerful hunters and fishermen, and the Tenerian, who were smaller pastoralists (herders) and fishermen.

Individuals at the Kiffian sites averaged over 6 feet tall, with some reaching 6' 8". They were powerfully muscled, and found with the remains of elephants, giraffes, pythons, giant perch and other large game.

Not that you have to be Conan the Barbarian to kill an elephant. Forest pygmies traditionally hunt elephants, and there's a picutre in Nutrition and Physical Degeneration to prove it. They use stealth, agility and an intimate knowledge of their prey to make up for their small size and primitive weapons.

Both the Kiffians and the Tenerians had excellent dental development and health. Take a look at some of the pictures. Those are the teeth of a wild Homo sapiens. Straight, free of decay and with plenty of room for the wisdom teeth. They must have had good dentists.

Both cultures also showed a high level of intelligence and empathy. They were found with decorated pottery shards and their bodies were arranged in imaginative and empathetic ways. A man was buried sitting on a tortoise shell. A mother was buried with her two children. Here's the picture. I can't say it better than the LA Times:

Among the Tenerian graves was a heart-rending burial tableaux [SIC!!]: A young woman was lying on her side. Pollen under her body suggested that she was placed on a bed of flowers. Lying on their sides facing her were two young children, their fingers interlocked with hers, leaving a tangle of bones.

Haha, I couldn't let the spelling error slide, it should be 'tableau'. Hey, I'm half French, give me a break.

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Fit at 70

In my professional life, I study neurodegenerative disease, the mechanisms of aging, and what the two have in common. I was reading through a textbook on aging a few months ago, and I came across an interesting series of graphs.

The first graph showed the average cardiorespiratory endurance of Americans at different ages. It peaks around 30 and goes downhill from there. But the author of this chapter was very intelligent; he knew that averages sometimes conceal meaningful information. The second graph showed two lines: one representing a man who was sedentary, and the other representing a man who exercised regularly for his entire life. The data were from real individuals. The endurance of the first man basically tracked the national average as he aged. The endurance of the second man remained relatively stable from early adulthood until the age of 70, after which it declined noticeably.

We aren't taking care of ourselves for nothing, ladies and gentlemen. We're doing it because the stakes are high. Just look at Jack LaLanne, the fitness buff. He's been working out regularly and eating a whole foods diet since before I was born, and he's still pumping iron every day at 93.