Friday, June 29, 2007


Since diabetes is a seriously life threatening disorder, it is reasonable enough to expect that those who have only a mild form of it might die sooner too -- but I am not convinced that the study below shows that. We are informed that 65% of the deaths from heart attacks in their sample (218 out of 298 people) were diabetics of all sorts -- including those with only some symptoms of diabetes. But the major group within those deaths would have been those with fully-blown diabetes, leaving very small numbers for those with only some symptoms of diabetes -- numbers that seem too small to permit much in the way of generalizations.

And the results found were rather contradictory anyway. It was found that those with "impaired fasting glucose" were more likely to die of heart disease but those with "impaired glucose tolerance" were not. So pick whichever one of those you like to conclude that pre-diabetic symptoms are or are not likely to lead to a heart attack! The conclusions of the paper are certainly more sweeeping and confident than the small numbers plus that inconsistency in results would warrant. Just another silly epidemiological study, I am afraid. If I had any pre-diabetic symptoms, I would certainly not let that study add to my worries. Fortunately, when I did have a glucose tolerance test a few years ago, my body was very well-behaved about it

Risk of Cardiovascular and All-Cause Mortality in Individuals With Diabetes Mellitus, Impaired Fasting Glucose, and Impaired Glucose Tolerance. The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab)

Elizabeth L.M. Barr et al.

Background--Diabetes mellitus increases the risk of cardiovascular disease (CVD) and all-cause mortality. The relationship between milder elevations of blood glucose and mortality is less clear. This study investigated whether impaired fasting glucose and impaired glucose tolerance, as well as diabetes mellitus, increase the risk of all-cause and CVD mortality.

Methods and Results--In 1999 to 2000, glucose tolerance status was determined in 10 428 participants of the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). After a median follow-up of 5.2 years, 298 deaths occurred (88 CVD deaths). Compared with those with normal glucose tolerance, the adjusted all-cause mortality hazard ratios (HRs) and 95% confidence intervals (CIs) for known diabetes mellitus and newly diagnosed diabetes mellitus were 2.3 (1.6 to 3.2) and 1.3 (0.9 to 2.0), respectively. The risk of death was also increased in those with impaired fasting glucose (HR 1.6, 95% CI 1.0 to 2.4) and impaired glucose tolerance (HR 1.5, 95% CI 1.1 to 2.0). Sixty-five percent of all those who died of CVD had known diabetes mellitus, newly diagnosed diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance at baseline. Known diabetes mellitus (HR 2.6, 95% CI 1.4 to 4.7) and impaired fasting glucose (HR 2.5, 95% CI 1.2 to 5.1) were independent predictors for CVD mortality after adjustment for age, sex, and other traditional CVD risk factors, but impaired glucose tolerance was not (HR 1.2, 95% CI 0.7 to 2.2).

Conclusions--This study emphasizes the strong association between abnormal glucose metabolism and mortality, and it suggests that this condition contributes to a large number of CVD deaths in the general population. CVD prevention may be warranted in people with all categories of abnormal glucose metabolism.

Circulation 2007, June 18, 2007

The perks and pitfalls of pride

Pride has perplexed philosophers and theologians for centuries, and it is a paradoxical emotion. Pride based on personal excellence is encouraged, but too much pride can easily tip the balance toward vanity, haughtiness and selflove. Scientists have also been perplexed by this complex emotion, because it is so unlike socalled primary emotions, those felt as a first response to a situation, like fear and disgust.

Psychologists have been exploring pride's origins and purpose, and whether pride is as universal as, say, joy or anger.

In the June issue of the research journal Current Directions in Psychological Science, Jessica Tracy of the University of British Columbia in Vancouver and Richard Robins of the University of California, Davis review several recent studies on the nature and function of pride.

In one experiment, researchers used photographs of models with varying facial expressions and body language, asking subjects to identify the nonverbal signs of pride.

They found what they called a prototypic prideful look, which was recognized by children as young as four and people of many different cultures, including members of an isolated, preliterate tribe in Burkina Faso, West Africa.

So pride seems to be universal, they said, but that still leaves the questions: What is it? What is its purpose? To explore this, Tracy and Robins first asked people to come up with words that they associated with pride. They found that either people link pride to such achievementoriented ideas as accomplishment and confidence"authentic" pride -- or to self-aggrandizement, arrogance and conceit -- "hubristic" pride.

People who tend to feel authentic pride were more likely to score high on tests of extroversion, agreeablen, genuine selfesteem and conscientiousness, the pair found; but people who tend to feel hubristic pride were narcissistic and prone to shame. Further, they found that people who felt positive, achievementoriented feelings of pride viewed hard work as the key to success in life, whereas hubristic people tended to view success as predetermined, due to their stable abilities.

Tracy and Robins argue that the primitive precursors of pride probably motivated our ancestors to act in altruistic and communitarian ways, for the good of the tribe. The physical display of pride both reinforced such behavior and signaled to the group that this person was worthy of respect. So individual pride, at least the good kind, contributed in important ways to the survival of the community.

But what about pride's dark side? Tracy and Robins speculate that hubris might have been a social "short cut," a way of tricking others into paying respect when it was not warranted. Those who could not earn respect the oldfashioned way figured out how to look and act accomplished in order to gain status. Social cheaters puffed themselves up because deep down they did not have what it took to succeed. Whatever respect they got would have been fleeting, of course, as it is today.



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


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