Sunday, October 28, 2007


Obviously, excess food intake is the major cause but the body does not always store excess calories as fat. What makes it do so? One contributory cause is suggested below. It is a book review. I cannot keep up even with the journal literature, however, so I had no time to read the book. I therefore delegated the review job to my friend "Ken", who does not have any formal science education but is nonetheless a perceptive reader:

The Potbelly Syndrome - Book review

A health book by Russell Farris and Per Marin, M.D., Ph.D.

I am not a medical man and so I review this book as a layman. It can be very illuminating for an acute observer from another discipline to take an overview of research outside his field, especially if he has an invested interest in the object of that research; the necessity for micro research of a macro subject can often blur the big picture.

Russell Farris is a meticulous observer and researcher of a medical condition that affects him directly. He has been wise enough to enlist the aid of a qualified specialist in the field to overview his conclusions.

Farris' expertise in artificial intelligence is obvious in the flow-chart style of analysis he brings to his research and it makes following his train of logic very easy for the layman and professional alike.

He sets out to show by cause, effect, and process, how it is possible for untreated infections from middle-path germs to lead to obesity and all of its associated problems; arthritis, hypertension, type 2 diabetes, arterial occlusion, stroke, cardiovascular disease etc.

The author tells us that middle-path germs cannot kill us and we cannot kill them so we carry them to our graves; they (the germs) have a vested interest in allowing us to survive in order to keep them fed and comfortable and introduce them to our friends. In order to keep us infected but still breathing, they force us to raise our cortisol levels high enough to weaken us, but not high enough to kill us right away. This is the start of the cortisol loop; a balancing act between immune cell response and infection maintenance.

Every infection triggers an "Acute Phase Response (APR)" whereby immune cells leap into action to destroy the invaders. The immune cells are highly toxic and the ensuing battle leaves dead cells strewn across the battlefield. These cells form pus in the tissues which, when located in the arteries, can slowly narrow the channels of blood flow. Cholesterol shows a large presence in such arteries and has been blamed for the subsequent occlusion when it may be a result rather than a cause.

The thing that intrigued me throughout this book was that my previously held assumptions were being turned on their heads. The first was that germs cause inflammation. Farris tells me that it is the bodies own immune system that actually causes the inflammation that doctors prescribe anti-inflammatory medication for. Both of these mechanisms, i.e. inflammation and medication, increase cortisol levels, and excess cortisol is a major cause of hypertension.

Like an iterating loop in a computer program, Farris demonstrates how cortisol loops can affect our body's chemistry adversely in the process of protecting us from infection.

A brief look at a cortisol-loop flowchart will help to clarify Farris' contention. The following diagram is reproduced exactly from the book. The highlighting is the authors and is referenced in the text.

Having identified excess cortisol as the catalyst for many ills, Farris faces the enigma of cortisol testing and finds that because of natural diurnal fluctuations in cortisol levels (i.e. high in the morning with a peak after lunch and a low tail off towards evening) a single sample is simply insufficient to deduce overall levels. A flattened diurnal curve will go unobserved yet will produce excess levels of cortisol.

Apparently, one of the major causes of chronic illness is from the middle-path germ chlamydophila (Chlamydia) pneumoniae (CPN) which infects between 40 and 70 percent of all adults in the USA and has been linked to more than forty diseases and conditions. When an immune cell eats a CPN germ it becomes infected thus the cells that protect us from most germs keep themselves and us infected year after year. They are very difficult to eradicate permanently but, because they are not perceived to be life-threatening in themselves it is easier to ignore them.

Common germs like CPN seldom cause life-threatening illnesses in healthy people but many of them raise our cortisol levels.

One of the most disturbing aspects of this book is my slowly evolving realisation of how ineffectual medical diagnosis by GPs can be, and, to be fair, what an impossible position we put them in when we ask for a diagnosis. To properly test for all of the aberrations in the human body in a ten minute consultation is expecting the impossible. A thorough cortisol level test alone requires an extended stay in a regulated environment with constant round-the-clock testing and monitoring - intensive care for a non-life-threatening condition?

It is also apparent that medical fallacies abound in the literature which is offered to our GP's. Diet and cholesterol levels have long been blamed for heart attacks and as a consequence we are constantly being advised to reduce our intake of them and saturated fats. A quote from one coronary heart disease commentator (George V. Mann) is worth repeating:

The diet-heart hypothesis has been repeatedly shown to be wrong, and yet, for complicated reasons of pride, profit and prejudice, the hypothesis continues to be exploited by scientists, fund-raising enterprises, food companies and even governmental agencies. The public is being deceived by the greatest health scam of the century.

The scope of this extraordinary book is much deeper than the brief extracts I have chosen to highlight. The medical references, suggested reading and contextual clinical trial results that accompany the text would keep a more diligent reviewer busy for years and I have checked none of them. If the referenced material is accurately sampled and appropriately utilised, I am convinced that the logic behind Farris' conclusions is impressive and very worthy of serious consideration.

The author offers a few suggestions for counteracting the insidious effects of potbelly syndrome but none are particularly effective or life-changing. You might also take into account that medical fallacies proliferate because of the astounding complexity of all biological systems and offering simplistic explanations of the mechanisms for the observed behaviour, no matter how logical and attractive, could be fraught with esoteric errors.

Farris' book is eminently readable and thought provoking. It has the potential to change medical thinking but I doubt that it will because of the understandably slow uptake of new ideas by nervous doctors who only feel safe if they follow the procedures which have been advocated by generations of doctors before them. I applaud their conservative structure but suggest that we, the patients, take control of our own health and assist in the training of our doctors by understanding our own ill health and suggesting tests that seem relevant to us.


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].


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