Catawba College Environmental Summit for High School Students
February 17th, 2020
Three leading organizations - the Center for the Environment at Catawba College, Rocky Mountain Institute, and the Environmental Working Group - are partnering to provide an opportunity for young environmental leaders to learn, create, share, interact, grow, connect, and build relationships. You know you have unique talents and particular interests; at Redesigning Our Future, you will learn the skills needed to use your passions to create a sustainable world.
Cholesterol Lipid Hypothesis Part II
January 13, 2020
The hypothesis: cholesterol and lipoproteins like LDL are inherently good and necessary unless they become unbalanced either through genetics or lifestyle choices.
From last week: It turns out that the carrier lipoproteins like LDL and HDL cholesterol are an ancient part of our innate immune system that have an important function in fighting infection. We have always used these lipoproteins to clear infectious material before they can do damage.
Remember that the carrier lipoprotein cars are known as chylomicrons, VLDL, IDL, LDL, and HDL. They have a primary role to carry fats/energy around the body. While they serve the fat carrying primary role dutifully, these same little cars float around in your blood stream looking for disturbed infectious particles or pathogens to throw in their trunk in order to transport them back for elimination in the liver. (Harris et. al. 1993) (Vreugdenhil et. al. 2003)
Cholesterol Lipid Hypotheses
January 6, 2020
Part 1
Is cholesterol the problem? Or just a response to the bodies inflammation, dysbiosis and/or infectious issues? Why do we need cholesterol? Is the cholesterol you eat the issue or the type that your body makes? Is it the genetic mutations related to lipoprotein receptors that clear cholesterol? Or a mix of all of the above? We will look at these questions and others over the course of this article set.
Coronary artery disease or atherosclerosis is the medical name given to the disease that leads to a heart attack. What is atherosclerosis?
Physical Therapy with Dave - a new random series
February 17th, 2020
Why Exercise?
If you exercise regularly, ask yourself why you do so?
Common answers, will be:
1) It feels good
2) It is a habit
3) It is part of my healthy lifestyle
4) My doctor tells me I need to exercise
If you are in this camp, keep up the good work, regardless of your reason!
Snacking and Motility
January 13th, 2020
Is snacking a good idea? The simple answer is NO!
There are many reasons as to the why for this NO answer.
Snacking is the process of frequently eating small volumes of food stuffs to alleviate hunger or emotional symptoms or for the very, very few among us that have low blood sugar issues.
Why is snacking a problem?
Cholesterol Lipid Hypothesis Part III
January 20, 2020
So far, I have put forth some hypotheses that are controversial and raise questions about the American College of Cardiology guidelines.This is fine with me because this is about stimulating a conversation about disease etiology and treatment. Readers are never encouraged to go against their physician's recommendations. The choice to change a current therapeutic regimen is solely between the patient and their provider and frankly is likely predicated on how much damage has occurred over one's current lifetime coupled with genetic risk and the ability to alter lifestyle risk factors effectively.
I believe that pharmacotherapy, i.e. statin drugs, are likely necessary for patients
This week: Wheezing in young children
January 27, 2020
I am taking a one week pause on the cardiology story to refine the next tricky section.
Winter is here and we are seeing an increased volume of children with viral related wheezing disorders. Bronchiolitis, a term that means inflammation of the bronchioles, is a viral associated illness that causes significant lung inflammation in children under the age of three years old. It is one of the leading causes of hospitalization in this age group.
This illness is usually benign and self limited as the cough and wheezing fade away over a few days to a week without intervention. However, it can also be scary as some children will present with cough, fever, wheezing and further respiratory compromise over time. Some high risk individuals need to be aware of this disease, including: premature or low birth weight newborns, children with immune system defects, cardiac disease, chronic lung disease and/or severe neurological disease.
Fructose FYI
January 27th, 2020
Fruit sugar, fructose, in its natural whole food form is generally very safe to consume in moderate quantities. Fructose is metabolized only in the liver and thus needs to be consumed in moderation. The human body is genetically predisposed to making fat in the liver from fructose or converting it to glucose for further storage as triglyceride fat peripherally. This is a great adaptation if you are planning to fatten up to survive the winter!
Cholesterol Lipid Hypothesis Part IV - Endothelial Dysfunction
February 3, 2020
How does an artery clog?
Let us recap a little at this time.
1) Cholesterol and lipoproteins are significant and necessary for pathology to develop but not the only player in heart disease and atherosclerosis. I believe that inflammation is the root cause of the problem driving the lipid imbalance and plaque formation.
2) Lipoproteins are produced and recycled every day in order to deliver energy to tissues around the body via triglycerides and are a part of the ancient innate immune system.
Breastfeeding
February 4th, 2020
Breastfeeding is best! This is a truth that is undisputed.
I have been preaching this belief for as long as I have been writing. It is only a discussion for those that are capable of nursing. Recently, I received some feedback about discussing alternatives for mothers that would like to breastfeed but are unable to do so. Formula that is mass produced is an obvious second rate alternative. Therefore, we will skip discussing it for now. Let us look at donor breastmilk as I see it following the research.
First off, the data is quite pathetic on the use and risks of donor breast milk in term healthy newborns.
Second, The AAP, American Academy of Pediatrics takes a strong stance without good data for term infants.
Third, this leaves us guessing overall at risk and benefit.
Cholesterol Lipid Hypothesis Part V - Endothelial Dysfunction
February 10, 2020
How does an artery clog?
Recap: In an obese person, we have a scenario where a fat cell has been stuffed by dietary sugar excess and the cell membrane is damaged by oxidized free fatty acids, FFA, making it an immune reactive adipocyte that is releasing pro-inflammtory chemicals systemically. As the lipoproteins increase in the blood stream to compensate for the excess FFA and LPS, a concentration gradient forms allowing a small dense LDL particle to slip into the heart vessel wall where it can be oxidized and engulfed by a professional macrophage forming a foam cell. If the foam cell is not appropriately cleared because of the chronic systemic inflammatory lipid onslaught, you have the nidus for an inflamed area that has invaded in the artery wall.
Coronavirus
February 10th, 2020
The new and emerging coronavirus concern from Wuhan, China is not likely to play a big part in the United States because of our rigorous infection control measures in the hospital settings. Worldwide, previous outbreaks of novel viral related diseases like SARS and MERS spread more rapidly and farther because of poor medical provider infection control measures in the countries of origin.
The coronavirus is in the same family as the common cold but packs a serious punch killing at a rate of 4% for the very elderly or infirmed patient. We need to take this virus very seriously. Those at risk, for now, seem to be isolated to travelers to China. The quarantine period post travel appears to be about 14 days before you can be sure that you are not infected.
Cholesterol Lipid Hypothesis Part VI
February 17, 2020
I hope that over the last five weeks, I have sufficiently laid the case for heart disease as a complex disorder that is far from just a cholesterol issue. It may be worth a reread in its entirety before reading todays missive on the to do list. I think that the issue at hand is primarily a dysfunctional relationship between host genetics, inflammatory lifestyle choices and time.
As I think about my father's and my heart disease risk factors, I immediately think about my two minions and how I can prevent these issues from coming to life in them as they are genetically 50% of me.
Turning back to Dr. Mark Houston, I think that his approach makes the most sense for my family and my patients.
EDC'c and Immune Function
December 30th, 2019
If you have an allergic phenotype, a tendency toward allergic diseases like allergic rhinitis, asthma and eczema, then you really want to avoid endocrine disrupting chemicals, EDC's. The allergic phenotype immunologically is known as a TH2 or T helper cell type 2 polarized immune state. This means that at baseline your immune system releases chemicals that promote the release of cells like eosinophils and mast cells which in turn release chemicals like histamine that cause our nasty symptoms of sneezing, wheezing and itching.
Cardiology #1
December 30, 2019
The new year is upon us and as I promised here is the new and updated cardiovascular disease story. This article series may be the most important series that I will and have tackled as it is the leading cause of death in this country and is entirely preventable with smart prevention oriented choices that begin at birth! Our children are the future.
After three decades of research and a 15-hour deep dive into the world of lipids and cholesterol with Dr. Peter Attia via his excellent podcast "Drive", it is time to update the cholesterol cardiovascular disease story as it exists in 2019/20.
Open Letter
December 23rd, 2019
After discussing the patient doctor care relationship topic with a few people, it was recommended that it be shared here. Here it is:
Open letter to parents and patients:
Over the past few years, I have noted with dismay the statements people make in the doctor's office or in other locations related to doctors and care providers. What I am about to say is not about my hurt feelings or just my general complaining. Rather, I am hoping that this passage will give everyone a better understanding of patient care, work load and time constraints that exist today.
Baby Food
December 23rd, 2019
Baby food remains contaminated! So says a new published report from the Healthy Babies Bright Futures Non profit group. They state: "The problem, uncovered nearly a decade ago, is far from solved. New tests of 168 baby foods commissioned by Healthy Babies Bright Futures (HBBF) found toxic heavy metals in 95 percent of containers tested. One in four baby foods contained all four metals assessed by our testing lab-arsenic, lead, cadmium, and mercury.
Update on Measles
December 16th, 2019
Measles will erase some immune memory.
As measles cases continue to climb worldwide, a group out of the Netherlands has shown that the measles virus can hijack the immune system of sick individuals wiping out it's memory to other pathogens. This is not a good thing as this makes the individual susceptible to these infections all over again potentially raising risk of a bad outcome.
Dr. Mina, lead author on the study in the Journal Science this year, noted that between 11 and 73% of the circulating antibodies that protect against diseases are lost post natural measles infection.
Great books to give for Christmas!
December 16th, 2019
Christmas Books
For Teens:
1) Extreme Ownership - Jocko Willink
2) Anything You Want - Derek Sivers
3) The Seven Habits of Highly Effective Teens - Sean Covey
4) Make Your Bed - Admiral William McRaven
5) The Daily Stoic - Ryan Holiday
6) Priciples - Ray Dalio
7) The Millionaire Next Door - Thomas Stanley
8) Tuesday's with Morie - Mitch Albom
This is the beginning of Year 10!
December 16, 2019
It is very exciting to think of all the things that will come to pass in 2020 for our collective learning and health outcomes. Last year, I promised a new updated story on cardiovascular disease and risk all the way back to childhood. Alas, it did not get finished in time. Too many other projects got in the way and 2020 will be the year of the CVD risk discussion. The multi article discussion is being looked at by a few brilliant cardiology friends for completeness and correctness.
This year, I hope to tackle autoimmune disease, allergic disease and metabolism further and deeper as the research keeps mounting.