Is there any life left in the cholesterol hypothesis (a.k.a. the lipid hypothesis)? Is there anything left for serious scientists to cling to or is time for its mouldering corpse to end up on the trash heap of medical history, alongside lobotomy, bloodletting and the theory of the four humors? I was asked this question by a reader of this blog recently, and as it happens, a systematic review was recently published in Evidence Based Medicine (my favorite medical journal, mainly because it is edited by the brilliant Dr. Carl Heneghan) that definitively answers this question, so I thought it would be interesting to go through what the evidence says together.

As many readers will be aware, the cholesterol hypothesis is the idea that cardiovascular disease is caused by high levels of cholesterol in the blood stream. The hypothesis harks back to the early part of the twentieth century, when a Russian researcher named Nikolai Anitschkow fed a cholesterol rich diet to rabbits and found that they developed atherosclerosis (hardening of the arteries, the process which in the long run leads to cardiovascular disease). Of course, rabbits and humans are very different species, with very different dietary preferences. Rabbits, being herbivores, normally have very little cholesterol in their diets, while humans, being omnivores, generally consume quite a bit of cholesterol. Regardless, the data was suggestive, and led to the hypothesis being formulated.

In the 1940's and 1950's an American researcher named Ancel Keys carried out a number of studies which supposedly showed a correlation between cholesterol intake and heart disease in humans. The most famous of these was the "Seven Countries Study", which was an observational study carried out in, as the name implies, seven different countries, and which found that people in countries with a high intake of saturated fat had high blood levels of cholesterol, and were much more likely to develop heart disease than people in countries with a low intake of saturated fat. This lead to the hypothesis that saturated fat intake leads to high blood cholesterol levels which leads to atherosclerosis which leads to cardiovascular disease and premature death.

As we've discussed before, observational studies cannot draw any conclusions about causation, they can only show correlation. And there is also a question why these seven specific countries were chosen (the reader will be aware that there are in fact closer to two hundred countries) - they certainly weren't chosen at random. If the populations in a study aren't chosen at random, that creates a significant risk of cherry picking of data (and makes it impossible for the researchers carrying out a study to refute that accusation).

In spite of these limitations, the cholesterol hypothesis became heavily hyped, leading to official dietary recommendations around the world, which are still very much unchanged, that recommend low intakes of saturated fat and cholesterol, and of foods rich in these substances, such as red meat.

N-acetylcysteine (NAC) has a long history of use as a first-aid remedy for acetaminophen poisoning. Emergency room physicians will administer it in cases when you've taken an overdose of Tylenol or other acetaminophen products. The way it neutralizes the toxic effects of the drug is by recharging glutathione, thereby preventing liver damage.

Interestingly, NAC may also be useful against COVID-19, as explained by pulmonologist Dr. Roger Seheult in the MedCram lecture [below]. By raising glutathione, it helps combat oxidative stress, which is a main factor in the cytokine storm associated with COVID-19.

A recent literature analysis¹ linked glutathione deficiency to COVID-19 disease severity, leading the author to conclude that NAC may be useful both for prevention and treatment. NAC may also combat the abnormal blood clotting seen in many cases, and helps loosen thick mucus in the lungs.

In a retrospective study of patients tested for COVID-19, researchers at the University of Chicago Medicine found an association between vitamin D deficiency and the likelihood of becoming infected with the coronavirus.

"Vitamin D is important to the function of the immune system and vitamin D supplements have previously been shown to lower the risk of viral respiratory tract infections," said David Meltzer, MD, PhD, Chief of Hospital Medicine at UChicago Medicine and lead author of the study. "Our statistical analysis suggests this may be true for the COVID-19 infection."

The research team looked at 489 UChicago Medicine patients whose vitamin D level was measured within a year before being tested for COVID-19. Patients who had vitamin D deficiency (< 20ng/ml) that was not treated were almost twice as likely to test positive for the COVID-19 coronavirus compared to patients who had sufficient levels of the vitamin.

A scientist has warned that overuse of alcohol-based hand sanitising gel could lead to certain bacteria adapting to survive the product and could create new superbugs that could threaten public health.

Andrew Kemp, head of Scientific Advisory Board on the British Institute of Cleaning Science, said it has not yet been proven that alcohol-based hand sanitising gels could kill the virus that causes Covid-19 on skin.

But an over-reliance on the disinfecting product could mean certain bugs will learn how to survive them and instead thrive on residual sugars and proteins on a person's hands.

Instead, he said there should be more emphasis on washing hands with soap and water, which the World Health Organisation also recognises as the most effective way to protect oneself against infection.

The Doctors for Disaster Preparedness¹ lecture [below], given August 16, 2020 in Las Vegas, Nevada, features Dr. Lee Merritt, an orthopedic spinal surgeon with a medical practice in Logan, Iowa.²

In her presentation, she discusses how geopolitical power can be swayed in the absence of an identifiable army or declared war. She talks about the cognitive dissonance we're currently facing, when what we're told no longer corresponds with known facts or logical thinking.

And she reviews how medical technocrats — the so-called medical experts and political leaders who have turned the world upside-down in response to COVID-19 — have been 100% wrong about everything they've been telling us.

Results from two early-phase Russian non-randomised vaccine trials (Sputnik V) in a total of 76 people are published today in The Lancet, finding that two formulations of a two-part vaccine have a good safety profile with no serious adverse events detected over 42 days, and induce antibody responses in all participants within 21 days.

Secondary outcomes (planned outcome measures that are not as important as the primary outcome measure, but are still of interest in evaluating the effect of an intervention [1]) from the trial also suggest the vaccines also produce a T cell response within 28 days.

The new paper reports the findings from two small phase 1/2 trials lasting 42 days - one studying a frozen formulation of the vaccine, and another involving a lyophilised (freeze-dried) formulation of the vaccine. The frozen formulation is envisaged for large-scale use using existing global supply chains for vaccines, while the freeze-dried formulation was developed for hard-to-reach regions as it is more stable and can be stored at 2-8 degrees centigrade.

Since 1900, there's been a dramatic 74% decline in mortality rates in developed countries, largely due to a marked decrease in deaths from infectious diseases. How much of this decline was due to vaccines? The history and data provide clear answers that matter greatly in today's debate about vaccines as the race to find a vaccine for COVID-19 pushes us towards a vaccine that might be mandated for everyone.

Since 1900, the mortality rate in America and other first-world countries has declined by roughly 74%, creating a dramatic improvement in quality of life and life expectancy for Americans.

The simple question: "How did this happen?"

Why did the mortality rate decline so precipitously? If you listen to vaccine promoters, the answer is simple: vaccines saved us. What's crazy about this narrative is how easy it is to disprove, the data is hiding in plain sight. The fact that this easily-proven-false narrative persists, however, tells us a lot about the world we live in, and I hope will encourage parents to reconsider the veracity of many of the narratives they've been fed about vaccines, and do their own primary research.

1970, Dr. Edward H. Kass

Standing before his colleagues on October 19, 1970, Harvard's Dr. Edward H. Kass gave a speech to the annual meeting of the Infectious Diseases Society of America that would likely get him run out of this same profession today. At the time, Dr. Kass was actually the President of the organization, which made the things he had to say about vaccines and their impact on the reduction in American mortality rates even more shocking, at least by today's standards. Forty-eight years after Dr. Kass' speech, vaccines have taken on a mythological status in many corners of our world, hyped up by the people who benefit the most from their use. Of course vaccines saved the world. Of course every child should get every vaccine. If you don't vaccinate, you will enable the return of deadly childhood diseases. If you don't vaccinate, your child will die. If you question vaccines, even a little, you're an "anti-vaxxer" who should be shunned and dismissed!

But what if most of the history about the role vaccines played in declining mortality isn't even true?

After claims of double infections added to the prevailing anxiety around Covid-19, Russian scientists say it's not possible to be sick twice from the virus if you have no comorbidities, such as allergies, diabetes, and obesity.

As reported by business daily Kommersant, researchers at the private DNKOM laboratory examined 1,512 people from the Russian cities of Moscow, Ryazan, Kursk, and Nizhnevartovsk, and concluded that, after 74 days of observation, there is no chance of most people becoming sick again from Covid-19.

The study showed that a second infection could only affect patients with underlying issues, such as allergies, diabetes, autoimmune diseases, and obesity. In addition, people who take significant doses of anti-inflammatory drugs may also be re-infected by Covid-19, as the medicines suppress immunoresistance.

When you visit your doctor, you might assume that the treatment they prescribe has solid evidence to back it up. But you'd be wrong. Only one in ten medical treatments are supported by high-quality evidence, our latest research shows.

The analysis, which is published in the Journal of Clinical Epidemiology, included 154 Cochrane systematic reviews published between 2015 and 2019. Only 15 (9.9%) had high-quality evidence according to the gold-standard method for determining whether they provide high or low-quality evidence, called GRADE (grading of recommendations, assessment, development and evaluation). Among these, only two had statistically significant results - meaning that the results were unlikely to have arisen due to random error - and were believed by the review authors to be useful in clinical practice. Using the same system, 37% had moderate, 31% had low, and 22% had very low-quality evidence.

The GRADE system looks at things like risk of bias. For example, studies that are "blinded" - in which patients don't know whether they are getting the actual treatment or a placebo - offer higher-quality evidence than "unblinded" studies. Blinding is important because people who know what treatment they are getting can experience greater placebo effects than those who do not know what treatment they are getting.

You generally take more medications as you get older. The doctor prescribes a statin to lower cholesterol, a steroid spray for allergies, a proton pump inhibitor for reflux, and a painkiller for the knee that's still sore after that running injury a few years back. But too many medications, sometimes referred to as polypharmacy, can become a problem — the more medicines you take, the greater the chances one medication will have a negative interaction with another and cause a serious adverse effect.

At some point, you and your doctor may need to ask a fundamental question: Do you need all of these medications?

"It's always a little bit of detective work to figure out where the medications came from — who prescribed them and when," says Gregory Ouellet, MD, MHS, a geriatrician at Yale Medicine's Dorothy Adler Geriatric Assessment Center.

Adverse drug events, or unexpected medical problems that occur during treatment with a drug or other therapy, cause 1.3 million emergency department (ED) visits in the United States each year and about 350,000 hospitalizations, according to the Centers for Disease Control and Prevention (CDC).

These medical events are most common among older people — those over 65 are nearly seven times more likely than younger people to be admitted to the hospital after an ED visit, and most of the time that visit is due to a negative drug interaction. "It only takes one unnecessary medication or a negative drug combination to cause a serious problem," says Karen Jubanyik, MD, an emergency medicine specialist.

In many cases, you may not need all the medications you're taking, says Marcia Mecca, MD, a Yale geriatrician who directs a "de-prescribing" program at the Veterans Affairs (VA) Connecticut Healthcare System in West Haven called IMPROVE (Initiative to Minimize Pharmaceutical Risk in Older Veterans Polypharmacy Clinic). The clinic's sole purpose is to eliminate unnecessary medications and help avoid emergency room visits for patients who are 65 or older, have multiple chronic conditions, and take 10 or more medicines a day.

"We look at people's medication lists carefully — especially if they have a new concern, are having trouble with their memory, or are at risk for falling," Dr. Mecca says. It's a process that involves listening to the patient and learning about what they want and expect from a given medication, she says.