Maggie's Portrait

Maggie's spirit will live forever in this beautiful portrait by Kellie Straw. It brought me to tears yesterday when I saw it for the first time. Please visit her website at http://www.strawdogart.com/. She can also do a portrait of your best friend! I miss Maggie terribly, but having this painting of her will bring me some comfort. Thank you Kellie!

A Few Of My Favorite Things...

What brings me joy?

It's a good thing to think about what you have in life and give thanks for the simple pleasures.

I am thankful.

In no particular order, here are a few things that bring me joy:



Dogs (here with Maggie)

Sushi

The pigeon stretch (try it..it feels amazing)

Toes in Sand

Travel

The Beach

Laughing

Music (with Elvis)

Art

Friends

Coffee

Campfires

The After Workout High

Baths

What brings you joy?

Pride

This weekend was Long Beach Pride. The festival is the second largest event in the city behind the Grand Prix.

It's always a good time with great energy.

This year, Shawdee, Caroline and I rode our bikes to watch the fun.

Here are some pictures from the day:

The Coronary Heart Disease Epidemic: Possible Culprits Part I

In the last post, I reviewed two studies that suggested heart attacks were rare in the U.K. until the 1920s -1930s. In this post, I'll be discussing some of the diet and lifestyle factors that preceded and associated with the coronary heart disease epidemic in the U.K and U.S. I've cherry picked factors that I believe could have played a causal role. Many things changed during that time period, and I don't want to give the impression that I have "the answer". I'm simply presenting ideas for thought and discussion.

First on the list: sugar. Here's a graph of refined sugar consumption in the U.K. from 1815 to 1955, from the book The Saccharine Disease, by Dr. T. L. Cleave. Sugar consumption increased dramatically in the U.K. over this time period, reaching near-modern levels by the turn of the century, and continuing to increase after that except during the wars: Here's a graph of total sweetener consumption in the U.S. from 1909 to 2005 (source: USDA food supply database). Between 1909 and 1922, sweetener consumption increased by 40%:

If we assume a 10 to 20 year lag period, sugar is well placed to play a role in the CHD epidemic. Sugar is easy to pick on. Diets high in refined sugar tend to promote obesity due to overeating.  An excess causes a number of detrimental changes in animal models and human subjects that are partially dependent on the development of obesity, including fatty liver, the metabolic syndrome, and small, oxidized low-density lipoprotein particles (LDL). Small and oxidized LDL associate strongly with cardiovascular disease risk and may be involved in causing it. These effects seem to be partly attributable to the fructose portion of sugar, which is 50% of table sugar (sucrose), about 50% of most naturally sweet foods, and 55% of the most common form of high-fructose corn syrup. That explains why starches, which break down into glucose (another type of sugar), don't have the same negative effects as table sugar and HFCS.

Hydrogenated fat is the next suspect. I don't have any graphs to present, because no one has systematically tracked hydrogenated fat consumption in the U.S. or U.K. to my knowledge. However, it was first marketed in the U.S. by Procter & Gamble under the brand name Crisco in 1911. Crisco stands for "crystallized cottonseed oil", and involves taking an industrial waste oil (from cotton seeds) and chemically treating it using high temperature, a nickel catalyst and hydrogen gas (see this post for more information). Hydrogenated fats for human consumption hit markets in the U.K. around 1920. Here's what Dr. Robert Finlayson had to say about margarine in his paper "Ischaemic Heart Disease, Aortic Aneurysms, and Atherosclerosis in the City of London, 1868-1982":

...between 1909-13 and 1924-28, margarine consumption showed the highest percentage increase, whilst that of eggs only increased slightly and that of butter remained unchanged. Between 1928 and 1934, margarine consumption fell by one-third, while butter consumption increased by 57 percent: and increase that coincided with a fall of 48 percent in its price. Subsequently, margarine sales have burgeoned, and if one is correct in stating that the coronary heart disease epidemic started in the second decade of this century, then the concept of hydrogenated margarines as an important aetiological factor, so strongly advocated by Martin, may merit more consideration than hitherto.

Partially hydrogenated oils contain trans fat, which is truly new to the human diet, with the exception of small amounts found in ruminant fats including butter. But for the most part, natural trans fats are not the same as industrial trans fats, and in fact some of them, such as conjugated linoleic acid (CLA), may be beneficial. To my knowledge, no one has discovered health benefits of industrial trans fats. To the contrary, compared to butter, they shrink LDL size. They also inhibit enzymes that the body uses to make a diverse class of signaling compounds known as eicosanoids. Trans fat consumption associates very strongly with the risk of heart attack in observational studies. Which is ironic, because hydrogenated fats were originally marketed as a healthier alternative to animal fats. The Center for Science in the Public Interest shamed McDonald's into switching the beef tallow in their deep friers for hydrogenated vegetable fats in the 1990s. In 2009, even the staunchest opponents of animal fats have to admit that they're healthier than hydrogenated fat.
The rise of cigarettes was a major change that probably contributed massively to the CHD epidemic. They were introduced just after the turn of the century in the U.S. and U.K., and rapidly became fashionable (source):
If you look at the second to last graph from the previous post, you can see that there's a striking correspondence between cigarette consumption and CHD deaths in the U.K. In fact, if you moved the line representing cigarette consumption to the right by about 20 years, it would overlap almost perfectly with CHD deaths. The risk of heart attack is so strongly associated with smoking in observational studies that even I believe it probably represents a causal relationship. There's no doubt in my mind that smoking cigarettes contributes to the risk of heart attack and various other health problems.

Smoking is a powerful factor, but it doesn't explain everything. How is it that the Kitavans of Papua New Guinea, more than 3/4 of whom smoke cigarettes, have an undetectable incidence of heart attack and stroke? Why do the French and the Japanese, who smoke like chimneys (at least until recently), have the two lowest heart attack death rates of all the affluent nations? There's clearly another factor involved that trumps cigarette smoke. 

I Am Inspired

By YOU!!!!

Really.

I put together more profiles of people today for AmericanLifeToday.com and am inspired by your story. Everything. All of it. Thank you.

Please be sure to submit your 5 answers today if you haven't already.

Look at you!

You're incredible!

Finish What You Started

I had this idea last fall about introducing you to your fellow Americans by asking each person 5 questions about their life. I launched www.AmericanLifeToday.com on January 1st, 2009 with the idea of profiling a person each day of the year, for the entire year.

That was my hope.

I am not one to quit, so I will continue to search for people to introduce you to. It's simple to participate and I hope you do.

Answer the questions below and submit your answers to AmericanLifeToday@gmail.com Please incude a picture. If you know of someone that we should meet, plase forward this post to a friend on the button below. Thank you so much! I can't wait to learn more about you.

Name:
Age:
Sign:
I grew up in:
I currently live in:
Occupation:
You can find me:
You will never find me:
Your website or Charity you are passionate about:

1.) Who or what Inspires you?
2.) What would you want to change about yourself?
3.) What is your most prized possession?
4.) Who has been the most influential person in your life? Why?
5.) How do you want to be remembered?

The Coronary Heart Disease Epidemic

Few people alive today are old enough to remember the beginning of the coronary heart disease (CHD) epidemic in the 1920s and 1930s, when physicians in the U.S. and U.K. began sounding alarm bells that an uncommon disease was rapidly becoming the leading cause of death. By the 1950s, their predictions had come true. A decade later, a new generation of physicians replaced their predecessors and began to doubt that heart attacks had ever been uncommon. Gradually, the idea that the disease was once uncommon faded from the public consciousness, and heart attacks were seen as an eternal plague of humankind, avoided only by dying of something else first.

According to U.S. National Vital Statistics records beginning in 1900, CHD was rarely given as the cause of death by physicians until after 1930. The following graph is from The Great Cholesterol Con, by Anthony Colpo.


The relevant line for CHD deaths begins in the lower left-hand part of the graph. Other types of heart disease, such as heart failure due to cardiomyopathy, were fairly common and well recognized at the time. These data are highly susceptible to bias because they depend on the physician's perception of the cause of death, and are not adjusted for the mean age of the population. In other words, if a diagnosis of CHD wasn't "popular" in 1920, its prevalence could have been underestimated. The invention of new technologies such as the electrocardiogram facilitated diagnosis. Changes in diagnostic criteria also affected the data; you can see them as discontinuities in 1948, 1968 and 1979. For these reasons, the trend above isn't a serious challenge to the idea that CHD has always been a common cause of death in humans who reach a certain age.

This idea was weakened in 1951 with the publication of a paper in the Lancet medical journal titled "Recent History of Coronary Disease", by Dr. Jerry N. Morris. Dr. Morris sifted through the autopsy records of London Hospital and recorded the frequency of coronary thrombosis (artery blockage in the heart) and myocardial infarction (MI; loss of oxygen to the heart muscle) over the period 1907-1949. MI is the technical term for a heart attack, and it can be caused by coronary thrombosis. Europe has a long history of autopsy study, and London Hospital had a long-standing policy of routine autopsies during which they kept detailed records of the state of the heart and coronary arteries. Here's what he found:

The dashed line is the relevant one. This is a massive increase in the prevalence of CHD death that cannot be explained by changes in average lifespan. Although the average lifespan increased considerably over that time period, most of the increase was due to reduced infant mortality. The graph only includes autopsies performed on people 35-70 years old. Life expectancy at age 35 changed by less than 10 years over the same time period. The other possible source of bias is in the diagnosis. Physicians may have been less likely to search for signs of MI when the diagnosis was not "popular". Morris addresses this in the paper:

The first possibility, of course, is that the increase is not real but merely reflects better post-mortem diagnosis. This is an unlikely explanation. There is abundant evidence throughout the forty years that the department was fully aware of the relation of infarction to thrombosis, of myocardial fibrosis to gradual occlusion, and of the topical pathology of ostial stenosis and infarction from embolism, as indeed were many pathologists last century... But what makes figures like these important is that, unlike other series of this kind, they are based on the routine examination at necropsy of the myocardium and of the coronary arteries over the whole period. Moreover Prof. H. M. Turnbull, director of the department, was making a special case of atheroma and arterial disease in general during 1907-1914 (Turnbull 1915). The possibility that cases were overlooked is therefore small, and the earlier material is as likely to be reliable as the later.

Dr. Morris's study was followed by another similar one published in 1985 in the journal Medical History, titled "Ischaemic Heart Disease, Aortic Aneurysms, and Atherosclerosis in the City of London, 1868-1982", conducted by Dr. Robert Finlayson. This study, in my opinion, is the coup de grace. Finlayson systematically scrutinized autopsy reports from St. Bartholemew's hospital, which had conducted routine and detailed cardiac autopsies since 1868, and applied modern diagnostic criteria to the records. He also compared the records from St. Bartholemew's to those from the city mortuary. Here's what he found:

The solid line is MI mortality. Striking, isn't it? The other lines are tobacco and cigarette consumption. These data are not age-adjusted, but if you look at the raw data tables provided in the paper, some of which are grouped by age, it's clear that average lifespan doesn't explain much of the change. Heart attacks are largely an occurrence of the last 80 years.

What caused the epidemic? Both Drs. Morris and Finlayson also collected data on the prevalence of atherosclerosis (plaques in the arteries) over the same time period. Dr. Morris concluded that the prevalence of severe atherosclerosis had decreased by about 50% (although mild atherosclerosis such as fatty streaks had increased), while Dr. Finlayson found that it had remained approximately the same:


He found the same trend in females. This casts doubt on the idea that coronary atherosclerosis is sufficient in and of itself to cause heart attacks, although modern studies have found a strong association between advanced atherosclerosis and the risk of heart attack on an individual level. Heart attacks are caused by several factors, one of which is atherosclerosis.  

What changes in diet and lifestyle associated with the explosion of MI in the U.K. and U.S. after 1920? Dr. Finlayson has given us a hint in the graph above: cigarette consumption increased dramatically over the same time period, and closely paralleled MI mortality. Smoking cigarettes is very strongly associated with heart attacks in observational studies. Animal studies also support the theory. While I believe cigarettes are an important factor, I do not believe they are the only cause of the MI epidemic. Dr. Finlayson touched on a few other factors in the text of the paper, and of course I have my own two cents to add. I'll discuss that next time.

Life and Coffee

I love coffee.

I drink it everyday.

I was never one to go out for coffee until recently. Dave and I would chat about drinking coffee and how we thought that we could change the world after 3+ cups. Or, more along the lines of how brilliant and creative we are after 3 cups. I am sold. Why not?



So, after 3 hours sitting here in the same spot, my mind started wandering to the people that came into the store rather than what I came in here for...

Actually, I wanted to get out of my head and I did just that. I crawled into the heads of everyone else.

People hang out here all day. I had no idea. This is all new to me. It makes me feel smart to hang out at a bookstore, so why not? Feeling smart with a caffeine buzz is not a bad thing, well...until later. We won't talk about that now.

It's like an airport. People coming and going, wandering, sitting, reading, staring, thinking, drinking, eating.

Living.



Found out a refill is only 50 cents. It's why I am here for 3 hours. And to stay out of the house. Yes, I still have Maggie's beds all over, food and bowl still out. Being away gets my mind off of it for a little while at least.

Students, retirees, mothers, kids, me. We're all here.



This blog isn't much of anything but to say I am "being."

I am here.

I am aware.

Home Away From Home

I want to start off by saying that I continue to miss Maggie everyday. She will forever be in my heart. The past week I went to my home away from home (Chico, CA) to help mourn her loss. It was a nice to have a change of scenery for a few days.

I love it there.
I went to college there.
My college room mates and best friends live there.
It's home to me.

I tried to take it slow and not do much. I did for the most part. It was relaxing to see everyone and doing simple things that I enjoy. Since I arrived during the week, everyone was working so I met them in different places to share their life with them.

I did spend moments alone in the park (trying to avoid snakes)but I had no idea about the other fun activities that were in store for me.

I walked with Rose and Jake, went to Hannah's (John and Heide's daughter)softball game, and had the privilege to attend a "clothes party" at someones house with Heide. I was oblivious to this "secret club."

Women gathering in a home, watching a clothes paring demonstration, being served wine, and once it's completed...off come their clothes! It was a flurry of half naked women grabbing articles of clothing...shoving and pushing, screaming at each other, falling on the floor. Pure chaos!! Well, sort of.

They didn't appreciate me being there not partaking in the wine, taking pictures and not stripping, but I had an entertaining time watching all of the fun. To protect the innocent, only photos before the strip down will be included.

Here are some pictures to give you an idea of the excitement. :)

Presenting the clothes...

Starting the wine and cheese fest...

Heide and Connie with their game plan...

Hannah (on left) and friend at their softball game

Up to bat (with dad coaching in background)

Jake running in the park

Jake

Enjoying Bidwell Park

Bear Hole

NOT enjoying a new friend I almost stepped on:

I am so thankful that they are in my life and that I can go visit them on a moments notice. Until next time...