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About Glyn and Liz

Writer Liz wainwright and Independent Researcher Glyn Wainwright

Autoimmunity and T2D

My anecdotal experience and studies have shown me thIs:-

Glycoproteins are important on cell surfaces (extracellular matrix) they are anchored by dolichols and form an important part of the communication between tissue and immune system, with recognisable sequences of sugars deliberately assembled for the matrix. This is structural sugars in the body assembled by enzymes in the normal cellular machinery.

Glycation damaged proteins (AGE). These are exposed proteins who randomly become attached to a mono-sugar (usually glucose but recently increasingly fructose) attaching to lysine by the maillard reaction).

In cooking at oven temps this is a desirable and flavoursome reaction at some speed.

In diabetics this is a very slow (decades at body temp) degradation of lipid receptor mechanisms, elastins and collagens.

Auto-immunes and T2D

The body has a clean-up immune response to random AGE mono-sugar attack, which is overwhelmed as we age and develop T2D (over decades). The suagr damage effect is present in many tissues showing a strong immune response (arthritis, eczema) which often respond well to carbohydrate restriction and increased dietary use of ‘essential fatty acids’.

Low-Cholesterol and Violent Behaviours

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References
58.Lester D. Serum cholesterol levels and suicide: a meta-
analysis. Suicide Life Threat Behav 2002; 32: 333-46.
59. Edgar PF, Hooper AJ, Poa NR, Burnett JR. Violent behavior
associated with hypocholesterolemia due to a novel APOB
gene mutation. Mol Psychiatry 2007; 12: 258-63.
60. Lalovic A, Levy E, Luheshi G, et al. Cholesterol content in
brains of suicide completers. Int J Neuropsychopharmacol
2007; 10: 159-66.
61. Muldoon MF, Manuck SB, Mendelsohn AB, Kaplan JR, Belle
SH. Cholesterol reduction and non-illness mortality: meta-
analysis of randomised clinical trials. BMJ 2001; 322: 11-5.
62. Baigent C, Keech A, Kearney PM, et al.; Cholesterol
Treatment Trialists’ (CTT) Collaborators. Efficacy and safety
of cholesterol-lowering treatment: prospective meta-
analysis of data from 90,056 participants in 14
randomised trials of statins. Lancet 2005; 366: 1267-78.
63. Golomb BA, Kane T, Dimsdale JE. Severe irritability
associated with statin cholesterol-lowering drugs. QJM

2004; 97: 229-35

Cholesterol & Insulin

diabetes [9]. The underlying mechanisms of the
potential adverse effects of statins on carbohydrate
homeostasis are complex [10] and might be related
to the lipophilicity of the statin [11]. Indeed,
retrospective analysis of the West of Scotland
Coronary Prevention Study (WOSCOPS) revealed
that 5 years of treatment with pravastatin reduced
diabetes incidence by 30% [12]. The authors
suggested that although lowering of trigliceride
levels could have influenced diabetes incidence,
other mechanisms such as anti-inflammatory action
might have been involved; however, in the
multivariate Cox model, baseline total cholesterol
did not predict the development of diabetes [12].
Furthermore, pravastatin did not decrease diabetes
incidence in the LIPID trial which included glucose-
intolerant patients [13]. On the other hand, in the
JUPITER trial (Justification for the Use of Statins in
Prevention: an Intervention Trial Evaluating
Rosuvastatin), which studied apparently healthy
persons without hyperlipidemia but with elevated
high-sensitivity C-reactive protein levels [14], the
risk of diabetes was increased by a factor of 1.25
[95% confidence interval (CI), 1.05 to 1.51] among
individuals receiving rosuvastatin 20 mg daily with
respect to placebo. Strikingly, among persons
assigned to rosuvastatin, the median low density
lipoprotein (LDL) cholesterol level at 12 months was

55 mg per deciliter [interquartile range, 44 to 72
(1.1 to 1.9)].
It is intriguing that salutary lifestyle measures,
which might exert their beneficial action through
an anti-inflammatory mechanism without a strong
cholesterol-lowering effect, beyond reducing
cardiovascular events and total mortality, reduce
also the risk of diabetes and other chronic
degenerative diseases. This fact may represent
a ‘justification’ not to use a drug in low-risk primary
prevention populations: lowering cholesterol at the
expense of increasing diabetes might be counter-

productive over the long-term.

References
9. Sukhija R, Prayaga S, Marashdeh M, et al. Effect of statins
on fasting plasma glucose in diabetic and nondiabetic
patients. J Investig Med 2009; 57: 495-9.
10. Szendroedi J, Anderwald C, Krssak M, et al. Effects of high-
dose simvastatin therapy on glucose metabolism and
ectopic lipid deposition in nonobese type 2 diabetic
patients. Diabetes Care 2009; 32: 209-14.
11. Ishikawa M, Okajima F, Inoue N, et al. Distinct effects of
pravastatin, atorvastatin, and simvastatin on insulin
secretion from a beta-cell line, MIN6 cells. J Atheroscler
Thromb 2006; 13: 329-35.
12. Freeman DJ, Norrie J, Sattar N, et al. Pravastatin and the
development of diabetes mellitus: evidence for
a protective treatment effect in the West of Scotland
Coronary Prevention Study. Circulation 2001; 103: 357-62.
13. K
eech A, Colquhoun D, Best J, et al.; LIPID Study Group.
Secondary prevention of cardiovascular events with long-
term pravastatin in patients with diabetes or impaired
fasting glucose: results from the LIPID trial. Diabetes Care
2003; 26: 2713-21.
14. Ridker PM, Danielson E, Fonseca FA, et al.; JUPITER Study
Group. Rosuvastatin to prevent vascular events in men
and women with elevated C-reactive protein. N Engl J Med
2008; 359: 2195-207.

Good or Bad Lipid Profiles

The 2013 Nobel Prize for Medicine raised expectations of a parallel discussion of extra-cellular lipid circulation in The Lipid Cycle. A better understanding of the health problems caused by disruption to The Lipid Cycle has been blocked for over 40 years by incorrect use of the chemical term ‘cholesterol’ as an inaccurate surrogate when referring to Lipid profiles. This singular error has caused decades of misunderstanding and inappropriate treatments in medicine.

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The Lipid Cycle

The build up of damage to the LDL class of lipids is on the supply side of lipid circulation in the blood has erroneously been referred to as ‘Bad Cholesterol’.

Understand this means it should have better been called ‘Bad-LDL’.

Undamaged or healthy ‘Good-LDL’ on the supply side delivers fatty nutrients to organs and tissue in a controlled manner (receptor-mediated endocytosis). Bad-LDL remains in the blood until scavenged into adipose tissue.

image

The HDL lipid class operate on the return side of the lipid cycle and is depleted when LDL is damaged.

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The High Cholesterol Paradox

This summary of my conference presentation explains Lipid Cycle Damage. In my essay, linked from here, there is a relatively easy to read account. It contains supporting academic references for professionals to follow.

Link

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Thank you Dr Verner Wheelock for the extensive critique of the reports . The Cochrane reports analysis was heroic and well structured. We had a huge debate about them at the time on THINCS (www.thincs.org).

For my part I shy away from statistical analysis which doesn’t include ‘All Cause Mortality’ figures. The reason being that failure to look at all the non-cardio deaths and drop-outs from trials cleans and amplifies the apparent benefits of Statins. This means we can never know the Numbers Needed to Harm NNH side of the medication.

My first ever review paper (G Wainwright et al., 2009) looking at the clinical impact of cholesterol lowering in all non-cardiovascular organs, was seminal in that it pointed up a fundamental flaw in the whole statin concept i.e. Cholesterol is vital and inhibiting its production is destined to create a wide and varied set of Adverse Events in statin users in the longer term.  That is why ‘all cause mortality’ data is not made available (caveat emptor).

In our second review paper(Seneff et al., 2011)  we became aware of the fact that LDL/HDL ratios were associated with LDL consumption by organs and not production by the liver. The whole LDL argument had been inverted.  If LDL is damaged by glycation,  LDL goes up and HDL falls.  The liver’s glycated-LDL is unused and the corresponding HDL return to the liver does not happen.

LDL HDL Cycles

How such a fundamental part of the lipid nutrition cycle could be missed is hard to understand. Obsession with statins and statin finance has done immense harm to cardio-medicine and I believe we are seeing the start of a major NICE scandal as the BMA object to the guidance.

G Wainwright, L Mascitelli, and M Goldstein (2009). Cholesterol-lowering therapy and cell membranes. Stable plaque at the expense of unstable membranes? Arch. Med. Sci. 5, 289–295.

Seneff, S., Wainwright, G., and Mascitelli, L. (2011). Is the metabolic syndrome caused by a high fructose, and relatively low fat, low cholesterol diet? Arch Med Sci 7, 8–20.

109. Cochrane Collaboration Evaluates Statins for Primary Prevention of Heart Disease | Verner’s Views

Link

The treatment and placebo groups’ mortality lines should be independent: a trend in one should have no consequential influence on the other. However:

  • All 4 lines are essentially identical for 1.6 years.
  • Then there is a departure — by both lines at the same time.

The fact that both lines — treatment and placebo — depart at the same time is important. Why should the treatment suddenly become beneficial at exactly the same time as non-treatment becomes detrimental?

The average line of both treatment and non-treatment groups follows a ‘natural’ mortality curve; any natural survival curve would have its slope increasing downward. (i.e. becoming more negative.)

Both treatment and placebo lines follow this natural curve for 1.6 years. Then both diverge. The placebo group shows this slope change increasing (negative) at a faster rate than all other lines. But, surely, it should follow the natural mortality curve. Why doesn’t it?

The slope of the treatment group is nearly constant from 1.8 years onward. It’s not a curve at all, but an almost straight line — and it shouldn’t be. What it says is that old people die at the same rate as younger ones. And life isn’t like that.

Is this evidence that the data of the 4S trial were not handled in an honest manner? Were deaths occurring in the treatment group assigned to the placebo group? Is this why the two curves, which should be independent, are apparently related? Or is there a mistake somewhere? Is there an error in logic?

Statins: Saviours of Mankind or Expensive Scam?

Link

The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines.

•They present major evidence for low-carbohydrate diets as first approach for diabetes.
Such diets reliably reduce high blood glucose, the most salient feature of diabetes.

Benefits do not require weight loss although nothing is better for weight reduction.

Carbohydrate-restricted diets reduce or eliminate medication.

There are no side effects comparable to those seen in intensive treatment with drugs.
Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman
EC, Accurso A, Frasetto L, McFarlane S, Nielsen JV, Krarup T, Gower BA, Saslow L, Roth KS, Vernon MC, Volek JS, Wilshire GB, Dahlqvist A, Sundberg R, Childers A, Morrison K, Manninen AH, Dashti H, Wood RJ, Wortman J, Worm N, Dietary Carbohydrate restriction as the first approach in diabetes
management. Critical review and evidence base, Nutrition  (2014), doi: 10.1016/j.nut.2014.06.011.

You can’t get funding very easily for lifestyle trials because there is no profit to be made. Or is there? Medical Insurance and NHS costs would be reduced dramatically – so there is a cost reduction motive for funding!

Dietary Carbohydrate restriction as the first approach in diabetes management