Contrary to my normal practice where I respond to replies after quoting them,
this
time I make my response first.
I am frankly amazed that Chuck and Moose are unable to put two and two together
and come to the logical conclusions reached by Dr Esselstyn and Dr Prendergast
who are practicing doctors.
And I will point out that reliance solely on peer-reviewed published material
has them
fall into the exact same blinkered trap that outfits such as the Heart
Foundation in
both New Zealand and Australia have fallen in to and I have little doubt
contributes to
their pathetic rate of success in reducing CVD (Coronary Heart Disease) and
stroke
in these countries. Prendergast and Ignarro level a very similar accusation at
USA
hospitals and medical professionals.
Keeping this as brief as I can.
Dr Esselstyn points out in his book on page 41 "And nitric oxide, as I have
noted, is
absolutely essential ..
read the rest here..
http://www.brianswale.com/zuikoholics/2013/L-arginine-1500-90%25.jpg
"Using the Nobel Prize for discovering the messenger effect of nitric oxide
(NO) in
such a way as to seem as though it is also an endorsement of the L-A treatment
is
unethical", is bullcrap.
Without L-arginine, nitric oxide WOULD NOT EXIST in the bloodstream, because it
is created there by L-arginine by feeding the enzyme which scientists call
"nitric oxide
synthase".
Further, as the scan of pages 42 & 43 reveals, if ADMA (asymmetric
di-methyl-arginine) is present, it competes with L-arginine for access to
nitric oxide
synthase, and the more it succeeds the less NO is produced.
There is another enzyme called DDAH = di-methyl-arginine
di-methyl-amino-hydrolase, which will destroy ADMA and thus restore the
production
of NO, *but* the major cardiovascular risk factors plus oxidative stress from
foods
that generate free radicals impair the ability of DDAH to destroy ADMA.
Esselstyn chose to protect the L-arginine -> nitric oxide synthase -> NO
mechanism
by keeping free radicals OUT of his recommended (vegan) diet. Was it successful?
Certainly it was in his first trial where he aided about 20 ( I forget the
exact number
but it was about 20) terminally ill CVD patients stay on a vegan diet. At the
formal
end of that study, 12 years later, not one of those people had worsened CVD and
at
least one was shown by CAT scan to have had the CVD reversed.
Prendergast was faced with sure premature death when in his 30's he was shown
to
have severe arterial disease (equivalent to what an 80-year-old 'Murrican'
could be
expected to have) in the arteries in and around his stomach. So he chose to
(with the
advice of Dr J Clarke) augment his supply of L-arginine, and as he told me in
an
e-mail, did not modify his diet. As a result of this L-arginine
supplementation,
somewhere around 8 - 10 years later two CAT scans showed that his abdomen was
totally clear of arterial disease and so were his cardiac arteries.
At the same time he adopted this course of action for himself, he, as
endocrinologist
for diabetics, placed them on the same supplementation.
Pay attention here please Moose.
Diabetics in his region of California typically get CVD at the rate of 35%, so
typically
he ended up referring that 35% of his patients to cardiac surgeons etc.
The volume of his referrals up to that point in time kept 3 cardiologists in
business.
Over a period of ?16? years he put 5,000 ( five thousand) diabetic patients on
L-arginine supplementation.
NONE of them ( as far as he has been able to ascertain) had CVD worsen, if they
had it and most would well have had their arterial health improved as a result.
Hence because his patients were no longer at risk of CVD and presenting with
such,
forthwith none were referred to the three cardiologists.
These three closed their practices and moved elsewhere.
Due to this wonderful achievement, the USA Diabetics Association awarded him
with
their "Father of the Year" prize. of which he is justly proud.
It could well be that "peripheral arterial disease" which seems to be medical
jargon
for arterial disease of the legs (and perhaps arms), does not respond to
L-arginine
supplementation. It could well be that such cases need segregation.
But it is very clear that arterial diseases in the cardiac arteries (supplying
the heart)
and carotid arteries ( supplying the brain) do respond. These two afflictions
cause
typically around 35% of all premature deaths in the "Western culture"
societies, AND
many more who are affected but not killed outright suffer crippling incapacity
at huge
cost to society.
Adopting the so-called "Mediterranean diet" goes some way to maintaining NO
supply, since its use reduces the 35% above by about 25% to 26% premature
mortality. But is that good enough? I don't think so.
Look at the mortality figures for your country in this database; I have set it
for the
USA but you can easily change countries. ( see that the combined death rate in
the
USA is 28.17%, no doubt reduced from the 35% of elsewhere due to the enormous
amount of and expensive heart surgery carried out there).
http://www.worldlifeexpectancy.com/country-health-profile/united-states
Medical authorities which rely solely on refereed papers and ignore the
evidence of
such as Drs Prendergast and Esselstyn are stupid.
I rest my case. Back to doing my tax ...
Chuck and Moose wrote
>
> What Moose said. What Brian knows full well but fails to tell us is that,
> of all the physicians he has mentioned as recommending L-arginine for the
> treatment of CVD, only Dr. John P. Cooke
> <http://www.methodisthealth.com/john-p-cooke-md-phd> has ever conducted
> ANY peer-reviewed clinical research on the use of L-arginine. In 2002 Dr.
> Cooke wrote "The Cardiovascular Cure" wherein he recommends dietary and
> exercise regimens and also the use of L-arginine as a dietary supplement.
>
> But Dr. Cooke did not stop doing research on L-arginine in 2002. He and
> others continued research on longer term supplementation and discovered
> that long term supplementation had adverse effects. For example:
> <http://jama.jamanetwork.com/article.aspx?articleid=202136> I pointed this
> out to Dr. Cooke in a personal email to him and asked if he was still
> recommending the use of L-arginine and got this response.
> -----------------------------------------------------------------------
> Yes, the book needs to be updated to take into account the new data, one
> of which papers is mine(the one from Stanford published in Circulation in
> 2007, showing no benefit and potential vascular harm from chronic use of
> Arginine in patients with Peripheral arterial disease. Accordingly I no
> longer recommend l-Arginine supplementation for heart and vessel health.
> ------------------------------------------------------------------------
> Brian would do better to pay less attention to L-arginine peddlers and
> more attention to those who do clinical research such as Dr. Christopher
> Gardner mentioned below. He's quite believable when he admits that his 25
> years of vegetarianism is contra-indicated by his own recent research.
>
> Chuck Norcutt
>
>
> On 9/7/2013 2:12 AM, Moose wrote:
> On 9/6/2013 2:10 PM, Brian Swale wrote:
> Moose wrote about what I wrote
> .........
> Michael C. Johnston seems to have just taken a broad-based look at the
> range of diet books without going into important science.
>
> Agreed. I only linked to it because it is such a good summary of the range
> of firmly held, 'correct' ideas about diet. In the world of nutrition
> science, the main difference seems to be that the professionals don't have
> best selling books. I like the video I linked to in part because
> Christopher Gardner does not take himself too seriously as some sort of
> expert who knows all the answers.
>
> I watched about 20% of the video
> http://www.youtube.com/watch?v=eREuZEdMAVo
> ie, 16 minutes of the total 1 hour 16 minutes, and it seemed that what he
> is on about is obesity and weight-loss.
>
> Impatience ... It's at minute 23 that he starts showing the effects of the
> different diets on cardiovascular blood chemistry risk factors. From then
> on, it's a mixture of stuff about losing weight and the effect of diet on
> health and well being. Only an hour long, before a question period. You
> forced me to watch it again - but I'm not sorry.
>
> If you watch the whole thing, I expect you will find it hard to support a
> high carb diet for the majority of people. That is what you proposed in
> your post, and one of the things in it with which I disagree. Gardner is
> too smart to explore the possibility in public, but there is the
> possibility that high carb diets, as recommended by the
> medical/nutritional establishment, have contributed to the large increase
> in incidence of diabetes. Can't likely be proven, but the differences in
> response to a high carb diet by people with different insulin responses,
> near the end of the video, is suggestive.
>
> Those are irrelevant to what interests me, which is the total obliteration
> of the leading cause of premature death in the Western World; vascular
> disease, caused by atherosclerosis and arterosclerosis. Currently,
> somewhere around 35% of premature deaths are cause by heart attacks and
> strokes, and nearly all are preventable; BUT most of the health advisers
> seem to think these are not avoidable. Through knowledge of biochemistry
> relating to artery health, these premature deaths ARE avoidable, and if a
> person has arterial disease already, this can be reversed.
>
> The problem is that there are many conflicting opinions about how to
> stop/reverse the course of the disease. Many are from important
> authorities who simply disagree.
>
> Please look at this 10 minute video; the voice is that of Dr Joe
> Prendergast.
>
> http://www.youtube.com/watch?v=BDqLcblMyIY
>
> Well, that was a fairly slick piece of promotion, almost completely
> lacking in anything substantive. I am not quite the uninformed tyro you
> might assume. When Dr. Myer Friedman was recruiting subjects for a 10 year
> study of cardiovascular disease, he showed us what was then the most
> famous slide in cardiology, the first slide showing a ruptured plaque and
> the resulting clot that had killed the patient.
>
> As the video says, up until an assistant of Dr. Friedman's found it,
> everyone assumed that plaque buildup eventually slowed blood flow to
> dangerous levels. What no one knew until then was the actual cause of the
> acute infarction. It doesn't really go with a very slow restriction, but
> no one had a cause of the sudden event.
>
> So I've known about one of the great revelations of the video for well
> over 20 years. I did qualify for that study, which required NO evidence
> whatsoever of CV disease. I still had no signs at the end of my
> participation ten years later.
>
> Dr. Friedman had followed up on his famous book, "Type A Behavior and Your
> Heart" by conducting a series of increasingly ambitious studies of the
> effect of time urgency and unwarranted, chronic anger on the course of CV
> disease.
>
> His immediate prior, five year, study tracked the lives of two groups of
> people who had just had a first heart attack. It was stopped early, based
> on ethical grounds. The results were so statistically strong that it was
> considered unethical not to offer the results to the control group, who
> were dying off much faster.
>
> At that time, his protocol, which is entirely based on behavior
> modification, was the single, most effective treatment for reducing
> subsequent mortality of survivors of first heart attacks.
>
> The study I was lucky enough to be a treatment subject in was a ten year
> study of people between the ages of 45 and 65 at the beginning who had no
> detectable CVD. It was going well, i.e. my group was having fewer heart
> attacks and dying off more slowly, (we got periodic progress reports) when
> statins came on the scene.
>
> It wasn't that they were more effective, or even whether they were
> effective at all. The problem was that the sample size wasn't large enough
> to statistically separate any effect from statins from the effects of the
> research protocol. So the study was never published. Unfortunate, as I
> believe it would be a major treatment had the study been publishable. More
> info here. <http://www.youtube.com/watch?v=wxMopJ_eb3c>
>
> Research starting in 1840 has shown endlessly that morbidity and mortality
> are closely linked with social status. The facts aren't in doubt. The
> question was always what the actual physiological causes behind this are.
> Research carried out by Robert Sapolsky on the metabolisms of apes in
> Africa shows the vast difference between dominant males and submissive
> males, and its health effects/implications. Friedman's research and theory
> is similar, in that it posits metabolic and physiologic effects of long
> term chronic, as opposed to occasional acute, 'fight or flight' bodily
> chemistry, as caused by certain common behavior patterns
>
> I bring all this up to point out that not all prominent, expert
> investigators of CVD believe that the chemical magic bullet approach is
> even a useful path. And not all research points that way.
>
> As Chuck has pointed out, using the Nobel Prize for discovering the
> messenger effect of nitric oxide in such a way as to seem as though it is
> also an endorsement of the L-A treatment is unethical, to my mind. It
> isn't stated directly, but clearly implied, in the video. And didn't Dr.
> Prendergast later drop that treatment, over concerns about side effects?
> Was this video made before that? If not, it's simply blatant
> misrepresentation today.
>
> As to the claim of making no referrals to hospitals, I believe that is
> either another misrepresentation, as presented in the video, in neglecting
> to say it's only no CV related referrals, or a good reason to pull his
> license to practice medicine. My mother had diabetes, and I was her
> primary support through her final years. Her primary care physician was an
> endocrinologist, very highly regarded, and he sent her to the hospital
> several times, none CV related. Diabetes, especially in the elderly, is a
> serious disease, with many effects/symptoms, a number of which may require
> hospitalization. People, especially the elderly, not uncommonly require
> hospital treatment for other causes, as well.
>
> He is either a liar, in the video, or an incompetent physician, if he has
> treated thousands of patients without a single hospital referral in 15
> years.
>
> All of that aside, I believe, as someone with more than usual lay
> knowledge, that the causes of CVD are too varied, complex and interactive
> to be fully understood to date. I also strongly suspect that ingestion of
> large amounts of a single chemical is not likely to be a simple cure for
> everybody, or even a majority.
>
> There is also the problem of placebo effect and Physician effects. The
> promise of cure from a treatment and the effect of physician personality,
> especially empathy and compassion and/or an aura of authority, on clinical
> outcomes is quite powerful, and one of the reasons for double blind
> studies, rather than anecdotal evidence, which is what the video story is,
> at bottom.
>
> Sorry if this rains on your parade, but I believe my knowledge and
> experience make my opinions in the matter the equal of yours. I doubt that
> Dr Prendergast is a huckster, per se, but it seems to me that the video
> puts him in that light.
>
> A. Skeptical Moose
....................
> Brian would do better to pay less attention to L-arginine peddlers and
> more attention to those who do clinical research such as Dr. Christopher
> Gardner mentioned below. He's quite believable when he admits that his 25
> years of vegetarianism is contra-indicated by his own recent research. He
> certainly looks healthy, and not like he needs to diet, anyway. And if
> he's not insulin resistant (and I'm betting he isn't), it's not a big deal
> for him.
>
> I think the chagrin may be more for what he's advocated to those for whom
> it may not be the best course.
>
> Running in the circles I do, I know various degrees of
> veggie-vegan-macrobiotic, etc., as well as many who are in various stages
> of avoiding sugars, gluten, red meat, cows milk, etc. etc. in various
> combinations.
>
> Some Vs seem very healthy and happy, others I want to capture for a month
> and feed something like a modified Atkins. I think it would do marvelous
> things to their physical and mental health. It's weird to be eating with a
> couple of vegans, one happy and apparently healthy, the other semi
> cadaverous (to my eye), sallow, etc. and chronically depressed - and
> neither of them seems to notice a difference.
>
> It strikes me that a great deal of obsession about what to and not to eat
> is inherently political. Some seems spiritual, but I think much of that is
> political, too, at bottom. (Does the term psycho-political make sense
> here?) I have also known people with serious celiac disease, obviously
> real allergies and/or other unpleasant reactions to various foods.
>
> I, for example, react quite differently to large quantities of alcohol
> than others I've had occasion to be with when they were seriously
> inebriated.
>
> Dietary Moose
Brian Swale
--
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