Friday, July 30, 2010

Cartoons Before Movies

The movie was listed to start at 115PM.

Natasha and I sat there patiently, suffering commercials and appeals to buy overpriced soda and popcorn for about 10 minutes.

THEN, 115PM arrives.

Where after Natasha and I suffered another 30 F@#*ING minutes watching MORE commercials, interspersed with previews.

The movie finally starts at 145PM.

Can somebody in the industry answer me this one simple question;

"Why in Spike Spiegel's name do they NOT show Bugs Bunny cartoons anymore before the movie?"

Does anybody in the cinema industry realize how much of a competitive advantage they would have over their peers if they'd just bleeping get rid of the advertisements and throw up some old school Bugs Bunny?

Oh, wait, that's right. I forget. I'm THINKING. Foolish me thinking of the customer first and somehow trying to improve a product.

And BTW, it was Carmike theaters I had to suffer this waste of time with. If you ever want to see a movie at a Carmike theater, just show up 30 minutes last and the movie should about be ready to start.

Thursday, July 29, 2010

The Adventures of Captain Capitalism and the Elusive Fairburn Agate

Today the motorcycle was grumpy and needed some tender loving care. Then after it was unresponsive I just beat it into submission and now we are on agreeable terms. After spending 3 hours on regreasing the rear axle and having a stern talking with the motorcycle, I ended up going out on an agate hunt with the lovely Natasha (who is the one taking the pictures so it's kind of hard to get pictures of her to satisfy all of you guys who want more pictures of her and less of me).

Regardless the hunt was successful as I inevitably found a fairburn agate!....of course it's puny...and of course it's worth about a whopping $15...and I think we spent that much in gas just to get to the agate bed...but I was victorious none the less!


Pay attention kids. Chicks dig men who can find Fairburn Agates!



You can barely see the fairburn pattern. But it's there!
Shit Slingers III (The Early Years Part 4 by Polish Avenger)

Polish Avenger – A software-engineering undergraduate sentenced to 25 years because his friend was shot dead during a burglary they were committing. In Arizona, if a burglar gets killed, the accomplices can get 25-year sentences.

Before I introduce you to Magnum (our alpha male-slinger) we’ll address a question submitted by Leigh about the behavioral mindset of those who fling poo: Do people only do it “inside”?

I’m sure formal psychological studies exist on this, although I haven’t personally read any. From stories by readers about befouled public areas (the fitting room scene made me choke with laughter!), it seems more common than we would like to think about.
At SMU [a supermaximum prison] an entire wing is dedicated to the criminally insane, and they’re among the highest percentage of those who sling “recreationally,” as opposed to malicious carpet bombing. I suspect that there’s a perverse delight in breaking such a basic hygiene and social taboo.

As a child, I recall being in a classy hotel’s men room and being seized with an incontrollable urge to dispense about a quart of liquid soap using the squirt nozzle. It flowed like amber lava down the marble counter and pooled on the floor. When the deed was done, I fetched my dad who was waiting outside.
I pointed at the mess, and exclaimed, “Look what someone did!”
He replied, “Some people are pigs!”
And indeed, I had a primal and animalistic joy at what I’d done. But I was about 7 at the time and grew out of that phase.

So yes, insofar as slinging is just being messy and/or leaving poo behind for someone else, that trait is definitely seen both inside and out. To cross the next line and deliberately hose someone down with it, however, appears to be of a darker mindset.
Anyone out there know of a conflict being resolved with Dookie Uzis? As far as I know, slinging on someone is generally confined to prison as a specialized form of assault. Most of the “tough guys” I know would have much rather gone the standard routes of beating and stabbing; only when those weren’t possible did they turn to the brown arts.

Two further points of interest – one, Leigh mentioned a giant pant-load in a ladies room. Yes, it seems likely that females share the sling gene. Later in my biohazard career, I met with similar horrors – we’ll get to those in a future post!
Two, Shaun’s description of poop-smeared darts. Those things are terrible! With nothing more than a rolled-up piece of writing paper, a sharpened paper clip or staple, and a pencil eraser, you can build a lovely little blowgun and totally screw up someone’s life.

I’m glad I don’t live in supermax anymore.

Our next few posts will chronicle the infamous Magnum – a real legend, this one!

Click here for Shit Slingers II.

Our friends inside appreciate your comments.

Post comments and questions for Polish Avenger below or email them to writeinside@hotmail.com To post a comment if you do not have a Google/Blogger account, just select anonymous for your identity.

Shaun Attwood

Wednesday, July 28, 2010

Heh, Heh

Santa Claus, the Tooth Fairy, and Keynesianism.

How's that labor market kids
?

The Captain's Continued Adventures

The Captain continues his South Dakota adventures with the bagging of two peaks (Medicine and Copper Mountains) and panning for gold!

I originally struck out on my own...



but soon had followers. Kids are interesting things. I'm amazed how their parents do not know what's cool anymore. I go fossil hunting, agate hunting, mountain climbing, motorcycle riding and ironically wherever I go, kids inevitably follow and start interrogating me about what I'm doing. Without fail they then run to their mother and ask, "MOM! MOM! MOM! Can we PLEEEEEEEASE go panning for gold?"

Sure enough mom, who forgot what it was like to be a child, says, "No, we're going to church and then summer school and then we're going to the library where you can read a good book."



In any case, the young future adventurer above was curious about how one pans for gold. Your Captain was successful in that he found TWO puny specks of gold. I am now officially rich.

This is Medicine Peak.



This is Copper Peak


Reverse order here.



More to come on my "boring" vacation in a "boring, fly-over" state.
Second Book Review for Hard Time

By Stephen Rodgers at The Week In

A justice system where police lock people away without trial
while they build a case against them, a prison regime where
inmates are fed rancid food with dead rats and where gangs
decide who lives and dies. A Third World setting for John
Grisham’s latest blockbuster perhaps? No, this is the true story
of Widnes born Shaun Attwood after he falls foul of the law in
the state of Arizona in America, land of the free!

Shaun was in Bristol recently when he spoke to students from
Sir Bernard Lovell School in Oldland Common as part of a tour
to warn of the dangers of drug use, something he has thrown
his weight into since returning from his ordeal at the hands of
the notorious Sheriff Joe Arpaio’s Maricopa County Jail system.
During his 26 month stay ‘at Sheriff Joe’s pleasure’ he started
‘Jon’s Jail Journal’ and his blogs began to lift the lid on the
conditions inside the jail where inmates are forced to wear pink
underwear, women work on chain gangs and more is spent on
feeding the dogs than the prisoners.

Shaun Attwood moved to Phoenix in the 1990’s and quickly
found success as a stockbroker. A fan of the rave scene which
was taking off just as he left Manchester, he set about bringing
it to Arizona. Success led to money, friends and inevitably
drugs – both using and supplying. The hedonistic lifestyle came
to an abrupt end in 2002 when a SWAT team broke the door
down and he found himself on remand in Maricopa Jail with a
$750,000 cash bond and all his assets seized. The nightmare
was only just beginning as Shaun was to find himself
submerged in a world where all normal rules of society are
turned on their head. Rival gangs vied for control, crystal meth
was more freely available than it was outside, slops and mouldy
bread were the staple diet and falling foul of house rules could
result in anything from a beating to death. Sheriff Joe Arpaio’s
jails had the highest death rate in the US.

For the next 26 months, ‘English Shaun’ had to navigate the
various gang protocols, keep off drugs and remain sane in an
inferno while suffering postponement after postponement of
court hearings and a doubling of his bond. With a State
Prosecutor out to make a name for herself but little hard
evidence, the twists and turns in the legal process keep adding
to the sense of hopelessness of Shaun’s ‘Through the Looking
Glass’ world. The story is skillfully told through first person
accounts and letters written to his fiancée and his family back in
England and often, just when you think things can’t get any worse,
they invariably do.

Probably the most significant effect of Hard Time, is that you
have to keep reminding yourself this is not Shaun Attwood’s
first novel, it’s his auto biography! Neither is this a simple story
of injustice, the false imprisonment of an innocent man. Shaun
makes no attempt to disguise the fact he had been heavily
involved in the supply of drugs during his time in Arizona.
Whether that justifies being held in a remand system while
police and prosecutors force witnesses to testify against him is
another matter. Especially as it becomes clear that the vast
majority of Shaun’s inmates are being held using similar tactics.

If there is a happy ending to the story, it is of a man who has
confronted his own version of hell and come away stronger for
the experience. At the denouement of his case he tells the
judge that Mahatma Gandhi once said that the law should be
used to change men’s hearts. Shaun Attwood’s heart is
certainly in a good place now. The jury is still out on Sheriff Joe
Arpaio. A harrowing tale nevertheless.

Hard Time is on sale from next week (Thursday 5th August). It
can be pre-ordered at most bookshops or at Amazon.

Link to the review.

Hard Time is now on sale at the Book Depository.

I'm doing a reading with the author of Try Me, Farah Damji, in London on 23 August · 18:30 - 20:00 at:
The Gallery Stoke Newington Library
Stoke Newington Church Street, London N16, 0JS

Tuesday, July 27, 2010

What Does Shiller Know!

Oh, now he's just being a meanie, negative stick in the mud.

Enjoy the decline!
Question Time with Warrior

Warrior - Serving fourteen years for kidnapping and aggravated assault. Half Hispanic and Scottish-Irish with family still in Mexico. Brought up by a family steeped in drug commerce. He writes some of the best prison-fight stories on the Internet.

Here’s what I have to say on the comments following what I wrote about the death of Grit.

I’m not saying that Grit went out like some “hero.” I don’t know where that word entered the equation, but he did live that gangster lifestyle and exited in that manner by choice.
My heart goes out for those that loved him. He was a likeable individual. However, addiction wasn’t the sole factor that contributed to his overdose. A combination of institutionalization, decades of criminal behavior, a lack of education and trade skills were some of the factors among many that led him to further abuse himself with drugs and his eventual overdose.
I’m not knocking Grit, but there does come a time when we all need to grow up and recognise our duty and responsibility. The reality of that gangster lifestyle is life in prison or death, whichever comes first. Ask any lifer. On every yard there are lifers using dope as self-medication to escape the reality of having to spend the rest of their lives in prison, and they will die in here. It must be difficult for outsiders to fathom the magnitude of that cold hard reality.
I’ve spoke to countless old timers who have spent 20+ years in prison. If they were to be released, they say they’d get a gun and rob because that’s all they know. Prison has not given them any other skills or the education they need to function outside. During my 10 years, I’ve been asked to help countless prisoners to quit doing drugs and I have yet to see more than two succeed, but despite that ratio, I’m still willing to help anyone to try.
The reality is that only a small portion of men in prison change, an even smaller portion don’t use or clean up, an even smaller portion become proactive about their own rehabilitation and education, and sadly even less stay out. This is especially true in Arizona, and more than likely elsewhere. Even though prison is not about rehabilitation, it is up to us to figure out how much self worth we have and what we need to do to earn back and keep our freedom.
We all try to beat the system in our own way. It’s our choice as to how.

Click here for the previous Question Time

Click here for Warrior’s previous blog, including links to some of his best prison stories.

Post comments and questions for Warrior below or email them to writeinside@hotmail.com  To post a comment if you do not have a Google/Blogger account, just select anonymous for your identity.

Shaun Attwood

Sunday, July 25, 2010

The Captain's Ascent of the Mighty Crow Peak

Greetings all Cappy Capites.

This is from South Dakota where it's obviously such a "boring" place to live because, well, it's neither the east NOR the west coasts and they don't have ANY professional sports teams. And come to think of it, I don't think I've even seen ONE Lexus dealership here.

Why would anybody want to live here?

Below are some pictures of me with the buffalo, and some other pictures of me and Natasha climbing Crow Peak.

You will enjoy them.

Enjoyment is mandatory.








This one we did not think through all the way on account Natasha aligned the camera directly with the sun. The sun is bright.


The Warden (by Guest Blogger Timothy Earl)

Timothy Earl is 42, single, in joint legal and physical custody of two, and writes as Ravenswood Jack from 7200 feet above sea level in a valley between the arms of the Rocky Mountains in Wyoming.

I was glad to be meeting Duane – the warden at Wyoming State penitentiary – within a month of my shackled arrival. For weeks, I’d been in double-bunked solitary confinement. The meeting signalled my release into the general population after the evaluation period. I was on my ass in a chair outside Duane’s orange office with some stranger, waiting in line to talk to him like everyone else.

When my turn came, the officer standing nearby took off my cuffs. I’d watched him un-cuff, wait for, and re-cuff two or three before me. It was an astonishing treat to be so trusted with my hands in the presence of the warden. There were administrative workers, not security people, everywhere.

Duane was smiling. He had rolled up short sleeves, and was armed. I was aware without any threat from him that he was capable of kicking my ass. There was no insincerity in his way of looking right into my eyes through his glasses. He was deep-chested, shorter than I, shaved, and wore a heavy watch. His collar was unbuttoned, maybe even one button too low. He was in his early 60's, and in good shape. His handshake was really something.

I was at eye level, both feet on floor, seated across a big 1970's desk with the things he wanted me to think about facing me, and the things he wanted to think about facing him.
“Tim? Do you go by Tim?”
“Yes, sir. I'm Tim.”
“Tim you seem like a pretty nice kid, pretty easy to get along with, right? I got your letter. I'm glad you're here. Don't turn out to be a heavy, Tim. Just don't. I'll send you right back where you came from. Ok?”
“Ok! And thank you.”
“All right now. They'll get you back over there, and you'll be out on the yard getting set up soon. Ok?”
“Ok. Bye, Duane.”
“Bye, Tim.”

Duane had started there in the mid 70's. All of the staff were important to him. Think of it this way: your cuffs are off, you're brand new there, and if Duane can't be alone in his office with you without handcuffs, you can't really expect to be placed in medium security like I was hoping to be. Duane was man enough to face thousands of convicts alone in his office without handcuffs. I didn't want to stand out, and I didn't.

He never forgot my name. Although I was a convict, he treated me like I was a person named Tim who was in a lot of trouble, and his presence gave me the feeling that things would be okay, and that the security people around me had a reasonable man to answer to.

Welcome to the Wyoming State Penitentiary. I'm Timothy Earl, inmate 15642. Maybe you'd better let me show you around:
http://wyomingstatepenitentiary.blogspot.com/

Post comments and questions below or email them to writeinside@hotmail.com To post a comment if you do not have a Google/Blogger account, just select anonymous for your identity.

Shaun Attwood

Community Security Bank of New Prague

Honest to Pete.

I was there all of 4 months ago pitching my independent underwriting service.

Bachelor Object Migration

Allow me to explain to you girls the concept of Bachelor Object Migration or BOM.

You see, BOM, is based on the principle that any new object entering a bachelor's life musn't be rushed or accelerated into that bachelor's life. That it has to be acclimated, going through various stages, before it find it's rightful place in the bachelor pad. This can range from any object be it a car or something as simple as food, but again, key is to take your time and make sure that object is neither rushed, nor hurried into the bachelor life.

The first stage of BOM is the contemplation stage. In this stage life tells the bachelor, subtly, that he needs something. For example boxer shorts. Life, over the course of time, wears down the bachelor's boxer shorts to the point they have holes, are thread bare and are about to lose all function. And as the bachelor does laundry or goes to the bathroom he notices this in his boxer shorts and comes up with a great epiphany;

"I think I might have to get some new boxer shorts this year."

Now understand that was just the contemplation stage. The bachelor is sensing a need and is contemplating filling it. But it will not manifest itself into action until the Need Stage.

The need stage is where the bachelor obviously needs this object. His boxer shorts are in disrepair, he has NO food in the fridge, or is in desperate need of some kind of surgery. But the key defining trait of this stage is where the bachelor realizes he "needs" it, typically notated when the bachelor says to himself;

"Wow, I need to get some new boxer shorts."

Then comes the procrastination stage.

Yes, he "needs" it, but would he really be a bachelor if he immediate ran out and got it? That's what girls do. That's what married folk do. They have a need and then they call their spouse and tell them to "pick it up on the way home." Whereas the bachelor has the skills of procrastination. Bachelors are gifted creatures, able to find quick fixes to needs. The bachelor may cut his long pajamas, made of the same boxer material and convert them into boxers. The bachelor may just suffer with the now shredded boxers perhaps hemming them with a bit duct tape. The bachelor, though in desperate need of food will simply go to the bar or substitute it with a substitute food such as beer or whiskey. It is these skills that a bachelor makes.

Sadly, however, even the most gifted bachelors have to inevitably break down and go and buy the objects the need for survival. This is a low point in the bachelor's life in that they now have to "do" something that is outside of work, video games, drinking, scoring with chicks and play. They have to do a "chore" and you can tell when they are at this stage as they are usually depressed. Head hung low and not smiling. Regardless, they man up, grab a pen, and put together a "To Do List." This is the "To Do List" Stage of BOM.

Understand the to do list will not just be that one item. Here the bachelor embarks one what is the closest he will come to life planning. And aside from "get new boxer shorts" he will list other things so as not to make his life sound so dull;

1. Get new boxer shorts
2. Buy Ferrari
3. Take over Goldman Sachs by borrowing TARP money
4. Date Jennifer Aniston
5. Fly F-16 Fighter plane
6. Retire in the Bahama's with a harem of honeys managed by Jennifer Aniston
7. Have weekly bikini wrestling to decide who gets to date me that week

With the completed to do list in hand we now move onto the "purchase stage."

The purchase stage is where the bachelor is willing and able to buy the object. He has psychologically prepared himself and admitted that it is just a fact of life he needs new boxer shorts, and is the only thing holding him back from achieving his other objectives on his to do list. However, the purchase stage is regulated by one thing; "the right turn."

The bachelor is an efficient creature you must understand. Expending minimal amounts of effort for maximum gain. Ergo when purchasing items, the bachelor will only purchase the items if the store is on the right side of the road thereby requiring a right turn and thereby avoiding a left turn. If you need gas, yes, the "closest" gas station may be a mile away, but if it's on the left side of the road, this requires a left turn. A turn that can last 14 days. Many bachelors as we speak are still stuck behind some SUV driving soccer mom, who hasn't realized the green arrow means go. Ergo, even if the closest gas station is a mile away, because it is on the left side of the road, the bachelor will drive the next 50 miles on fumes to the closest gas station on the RIGHT side of the road. The same applies to boxer shorts or any other purchase that is necessary. The bachelor will not engage in the purchase stage unless the store is on the right side of the road (British bachelors engage in the opposite practice).

The bachelor enters the store, returns with the purchase in hand, throws it into the car which starts our next stage; the "Leave It in the Car Stage."

Satisfied he has done the majority of the work, the bachelor now has no guilt or psychological pressure to continue completing the chore. As far as the bachelor is concerned, he has completed his task and can now go about his bachelor activities. Notice the "To Do List" said, "Get boxer shorts." Not "wear new boxer shorts." Triumphantly he returns to his home, smug look on his face, goes into the house, opens a beer and promptly plays Call of Duty 5.

The leave it in the car stage can last anywhere from a week to a year depending on the object. If the object was say, ice cream, and it is December in Minnesota, that ice cream can stay in the trunk of the car, and thus the "leave it in the car stage," for at least 3 months. Sometimes the psychological trauma of having to run an errand and buy something is so devastating, the bachelor purges the experience completely from his mind, forgetting he purchased an object and it is in the car. Not until the bachelor has a date and is forced to clean out the car does he discover object, at which time he heralds great efficiency because it "saved" him the trip to the store he through he still had to take.

Regardless, the boxers, now nothing but strings inevitably prompt the bachelor to bring the object from the car into the house. This is a relatively short lived stage known as the "move it into the house" stage. However, the house is nothing more than a really big, immobile car. And like the car the object can stay in the house without ever really being used. Typically it begins this stage by starting on the desk or the floor, a large flat area the bachelor usually tosses stuff for general assortment later, only to be disturbed by the biennial bachelor pad cleaning. This is an important part of the process as the new object or objects, must become acclimated to all the other objects in the bachelor pad. From there it advances to the floor that it's supposed to be on. For example my dresser, and thus the boxers, are on the 2nd floor, requiring a simple toss of the boxers up the flight of stairs where they land near the vicinity of the dresser. As long as they're in the vicinity of where they're supposed to be, in the bachelor's mind that's "put away." Typically females, be they moms, sisters, friends or femme fatales, will protest it is "not put away" "lying there on the floor." This requires the bachelor to explain to them the concept of "put away good enough," which usually results in rolling eyes.

With order now in the bachelor household, now begins the unpacking/assembling stage. Some objects such as boxers you unpack. Others, such as entertainment systems you assemble. Again, here you do not want to rush them, unless they are related to the entertainment system or consist of electronics. But for the most part there is no need to unpack them right away. I mean, come on, you WENT to the store, you PURCHASED them, you brought them back HOME, you brought them INTO THE HOUSE, you PUT THEM AWAY GOOD ENOUGH, and now you have to rush and unpack? Be a bachelor, leave them in their original wrapping.

And finally comes the use stage. After a long and difficult struggle to acquire, transport and put away good enough the objects, now comes the time to actually use them. In total the whole BOM process can take anywhere from 1 week to 1 year, but now the bachelor finally gets to enjoy using the objects. Of course, criticism is laid upon us, primarily by those of the female persuasion, that this is nothing more than procrastination. However, they do not realize the merits of BOM. First, the order and balance of the bachelor pad was not disturbed by rushing in new objects. Who knows what chaos would have ensued if those boxer shorts were haphazardly purchased the day of need and worn the very next? The house could have collapsed or caught on fire. The orderly, deliberate process of BOM prevent that from occurring. Second, the bachelor expended the minimum amount of effort to bring objects into the house. Following the right turn principle and efficient space management through the use of his car, the bachelor has freed up additional time to be spent on video games and football...I mean his "girlfriend." Third, the bachelor maintains order in his household as the BOM process ensures all objects are put away good enough where they belong. And finally, the bachelor ensures a frugal lifestyle, purchasing only what he needs and not racking up credit card bills that he'll inevitably ask daddy to pay for. It are these benefits that make BOM an essential part of bachelorhood management and a vital tool for bachelors everywhere.

Saturday, July 24, 2010

Fat storage in pancreas and in insulin-sensitive tissues in pathogenesis of type 2 diabetes

Fat storage in pancreas and in insulin-sensitive tissues in pathogenesis of type 2 diabetes

Obesity is associated with increased storage of lipids in nonadipose tissues like skeletal muscle, liver, and pancreatic b cells. These lipids constitute a continuous source of long-chain fatty acyl CoA (LC-CoA) and derived metabolites like diacylglycerol and ceramide, acting as signalling molecules on protein kinases activities (in particular, the family of PKCs), ion channel, gene expression, and protein acylation. In skeletal muscle, the increase in LC-CoA and diacylglycerol translocates and activates specific protein kinase C (PKC) isoforms, which will phosphorylate IRS-1 on serine, preventing its phosphorylation on tyrosine and association with PI3 kinase. This interrupts the insulin signalling pathway leading to the stimulation of glucose transport. In pancreatic b cells, short-term excess of fatty acids or LC-CoA activates PKC and also directly stimulates insulin exocytosis. Longterm exposure to free fatty acids (FFA) leads to an increased basal and blunted glucose-stimulated insulin secretion by affecting gene expression, increase in KATP channel activity, and uncoupling of the mitochondria. In addition, the saturated FFA palmitate increases cell death by apoptosis via increase in ceramide synthesis.
{...} 
In obesity, a situation of excess supply and/or decreased oxidation, fatty acid not only accumulate in adipose cells but also in other tissues like skeletal muscle, liver, and pancreatic b cells. Triglycerides are not harmful as such, but are precursors of signalling molecules like LC-CoA, diacylglycerol, ceramides, acting directly or indirectly in skeletal muscle on insulin signalling and glucose uptake, and in pancreatic b cells, on insulin secretion and cell viability. 

Going to leave this one just "out there" except to say that it ties in with a lot of the other research/studies I've been posting about lately.
I was a bit taken aback by the title on a recent blog post by Dr. William Davis at his Heart Scan Blog
Why doesn't your doctor try to CURE diabetes?

Dr. Davis paints the medical profession with a rather broad unflattering brush.   Are there docs out there who are more concerned about profit over your health?  Yes.  Are there doctor-drones who reflexively reach for the prescription pad?  Again, yes.   But I believe that most doctors -- and I know several since before they became docs -- do care about their patients and dole out advice based on what they believe to be the best course of action.

Certainly the statement that "Adult diabetes is the one chronic disease that nobody cares to cure" goes more than a bit over the top!

Davis goes on to say that most docs don't think it can be cured, and that is probably true.  The old school re: type 2 would be based on when the disease was more rare and probably not detected until progressed significantly to the point of beta-cell impairment.  But nowadays, with earlier onset and screening, it really can be reversed and "cured" by ..... drum roll please ..... eating less and moving more!  Reducing fat stores below the max fill line (caloric deficit) and exercise work in conjunction to reduce insulin resistance.  I believe successful early intervention can indeed cure the disease.

Dr. Davis goes on to describe a scenario whereby you present at the doctor's office with a FBG of 156 and an HbA1c of 7.1%.  The doc puts you on metformin and the ADA diet.  Now this scenario is presented as if this is some uncaring robo-doc basically going with the flow recommending a course of action with  no track record towards improving patient health.  He also presumes there is no prior treatment history here.  I would venture to guess that most of those who get the diabetes diagnosis from their docs have previously been diagnosed (formally or cautioned) as pre-diabetic and counseled to lose weight .. perhaps on multiple occasions.  IOW, this isn't the first attempt at intervention in the progression of the disease and the patient has failed to make the appropriate lifestyle changes.

OK, so we could argue until we're blue in the face what diet is preferable for weight loss, but there's such a high correlation between obesity and T2 that some have taken to calling it diabesity, and there is ample evidence that just modest weight loss alone can cure it.  LC advocates would blame the doctor for recommending a "failed" low fat diet, but they would be ignoring the fact that many people fail to lose weight on low carb diets as well (and/or fail to maintain it).

If my doctor counsels me to lose weight and I come back 6 months later weighing the same or more, whose fault is that?  The doctor can't hold our hands and can only take our word for it that we tried to lose weight but couldn't or how hard we really tried (vs. compliance was not so hot).    Given the deleterious impacts of glycylation, the doc is doing the responsible thing to lower HbA1C as rapidly as possible with the metformin.  If a patient has not demonstrated an ability to reverse their insulin resistance through lifestyle change, the doc has no choice but to resort to pharmaceutical intervention.

There is emerging evidence that early intervention with metformin is more effective.  In other words, use metformin to attain glycemic control in the early stages and there will be LESS of a need for other medications down the line (or their need will be postponed).  So could it be that the doctors are trying to cure diabetes after all?  Metformin may reverse the condition more rapidly in the short run, and if patients adhere to a reducing diet (even that of the ADA), their diabetes can be cured.  

But Davis will infer no such positive motive on his colleagues.  He presumes that patients will gain 10-15lbs a year on the ADA diet, thereby inferring that in prescribing the diet the doctors intend for their patients to do so.  Huh?!   There are obese/overweight people with serious health issues due to their weight and even those don't "scare them straight" to adhere to a weight loss plan.  I am not condemning or criticizing those people -- I was one although w/o the serious health issues.  But Davis ignores the reality that losing and MAINTAINING weight is both difficult and rare for any number of reasons not related to the composition of one's diet.  The ADA formula of counting calories is a little too low in fat and protein for my tastes, but I hardly see recommending a reducing diet -- any reducing diet -- as irresponsible.  Certainly since weight loss has been shown to reverse (aka "cure") T2, especially if caught early, this advice is what Martha would call a "good thing".

I continue to be concerned over whether LC diets that either do not produce weight loss and/or are not consistently complied with present a significant improvement over a HCLF diet.  BOTH elevated glucose and NEFA/FFA produce deleterious results, and it is the NEFA that contributes to insulin resistance.  LC can lower 24 hr AUC glucose, but if IR persists you haven't "cured" a thing -- only masking a down-line symptom in the progression of a disease.  Metformin, OTOH, increases insulin sensitivity and reduces gluconeogenesis. Perhaps early NEFA lowering pharmaceutical intervention is an avenue to pursue  (metformin's action on lipolysis is inconclusive, it lowers NEFA in some while having no effect in others).

I would agree that all too often patients request a pill and/or doctors reach for the prescription pad to solve medical conditions.  But in progressive lifestyle diseases like this, by the time it gets to the point of diagnosis, lifestyle changes alone may be either too slow or ineffective.  The boat has sailed.  But pharmaceutical intervention need not be for all eternity.  It may well be that just as chemo "cures" cancer by killing off the cells, early intervention to lower circulating glucose and NEFA may well "cure" diabetes provided the IR inducing lifestyle (diet and inactivity) is altered and modest weight loss achieved.

What does it mean to be "cured" of diabetes?  That would be normal basal insulin levels, normal fasting glucose and NEFA's and a normal insulin response to carbohydrate.   If a low carber can't eat a bowl of rice without blood sugar going out of control, I contend their diabetes is not cured but rather controlled.

Friday, July 23, 2010

In South Dakota

This is your captain speaking;

I'm in South Dakota for a month long vacation on account if I worked any more, that would put me in a higher income tax bracket. And since I'm going Galt, well, you know. Time, leisure, labor thing and all.

Postings will be less frequent than normal.

Thursday, July 22, 2010

Ask not What Alan Can Do for You

Given inflation occurring and the dollar tanking and the Fed a-printing, I thought this little simple primer on inflation and currency would help explain some of the phenomena going on out there.

I love The Economist, but sometimes they get it wrong.

Inflation is a very simple thing. You needn't make it more complicated than it already is, because it's not complicated at all, for all inflation is, is a function of two very simple things;

1. How much stuff an economy produces (GDP)
2. How much money its government prints (the Money Supply, or from hence on MS).

You see, the amount of money floating around in an economy REALLY technically doesn't matter. For what truly determines the wealth and standards of living of a nation is the amount of stuff it can produce. Print off all the money you want, so each American has a trillion dollars, that doesn't increase the amount of X-Box's, milk, cars, chocolate, food, jewelry, etc., that we produce. So while you may be excited once you get your trillion dollars, you'll soon realize that ultimately we're not a cent richer as a nation because no corresponding increase in the amount of stuff occured. Alas, we'd just have hyper inflation and the same standards of living.

Now, you'd think this simple truth would have been learned long ago. Ahhh, but never underestimate the power of what I call "The Essence of Socialism;"

You can get something for nothing.

For history is just full of idiots thinking you can get something for nothing, especially by just boosting the money supply. All the way from the ancient Roman Empire in 218AD to just a decade ago in Yugoslavia did idiots who believed in the essence of socialism think their problems would be solved by boosting the money supply.

But please don't think former communist countries and empires long ago are the only ones guilty of such stupidity. Look at America's most stupid decade, the 1970's.

With GDP and MS growth like this;
(Note- "Average MS growth is the average annualized growth rate of the M1, M2 and M3 money supply measures)

How couldn't inflation occur?

Well, OK, to the untrained eye this tells you nothing because GDP growth and inflation are volatile and erratic. So let's "simplify it up a notch" (got your spice weasel?) and take a 5 year rolling average;



Ahhh, the picture becomes much more apparent. For how couldn't there be inflation in the 70's? You had a money supply growing at an average rate of roughly 9% a year while the economy was only able to produce more stuff at 3% a year.

You may want to chalk up the heady inflationary days to "oil shocks" and "oil embargoes." I chalk it up to stupid politicians, stupid monetary policy and the Baby Boomers who were finally being shepherded out of their parents basement and into the working world to start their job protesting the Vietnam war (surprisingly "protesting the Vietnam War" doesn't contribute to GDP).

Now, notice, rough logic would dictate that if we increase the money supply by 9%, but the economy only grows by 3%, then we should roughly have 6% inflation. ie- the difference between economic growth and money supply growth should give us our inflation rate.

Only one way to tell.

The yellow line is the difference between economic growth (5 yr trailing) and money supply growth (5 yr trailing)


When superimposed on the 5 yr trailing inflation rate;


Well, shucks howdy! Look at that! As far as economics go, that's a perfect fit!

But notice the tail end there, where the difference between the money supply growth and GDP exceeds that of inflation. This is where it gets interesting.
Normally such a divergence would suggest higher prices and thus inflation, yet inflation has remained stubbornly low...or has it?

For you see, the CPI, which is represented by that red line, only includes the prices of consumables. It does NOT include two major asset categories;

Stocks

and

Housing

Notice the increase in the difference between MS and GDP occured in late 1999 and early 2000. Depsite the stock market crash, it was usurped by the housing market where prices have continued to skyrocket.

With everybody's money in housing and stocks, it doesn't show up in the CPI measure, but that doesn't mean there isn't inflation. So while the CPI and official inflation has remain relatively tame, stock prices

and property

hasn't.

Alas, inflation has been with us this entire time, it's just we don't complain about it when the price of our stocks and homes go up.

Now enter in this most recent uptick in inflation.

Here, it is largely due to an increase in oil prices and people are now looking to their central bankers to slay inflation. A sort of "Leftist Syndrome" where people expect somebody else to solve their problems. But I'm not just talking sociology majors that want the government to create jobs so they can do something with their worthless degrees or spoiled brat trust fund babies who expect everything to be taken care of by daddy. We're talking the people at The Economist and the economics profession in general who are in knee-jerk reaction mode;

"Oh, there's inflation? Slay it Greenspan!"

But as a capitalist and a despiser of all things lazy and leftist, need I remind you of the very important lesson we learned above? That inflation is a two-sided equation. It's not just how much money is slushing around in the economy, but how many goods and services we as a nation produce. Notice the relationship between labor productivity and inflation.

A nearly perfect negative relationship, showing that as productivity goes down, inflation goes up (note the chronic deterioration from the mid 60's to the early 80's. Yes, pot, supplanted by cocaine while listening to Jim Moronson may not be good for labor productivity.)

Alas, the fighting of inflation is not solely the responsibility of central banks and central bankers, but by the workers of a country. The central bankers will control the money supply, you the worker, must produce a corresponding amount of goods and services that give reason for such a money supply to exist in the first place.

Thus, fellow countrymen, I say ask not what your central banker can do for you, but what you can do for your central banker.

Now get off your lazy asses and start contributing to GDP!
My First Book Review

This review of Hard Time at City AM went out today.

BY ZOE STRIMPEL

REAL-LIFE Sherriff Joe Arpaio, lord of the Maricopa County Jail system in Arizona, is known (to his detractors) as the Angel of Death. He brags about spending less money feeding the inmates than the prison dogs; he makes everyone wear pink underpants and women are put on chain gangs. Look at his website – www.mcso.org – and you’ll get a sense of this man’s fervour for punishment.

His prison, then, is not the kind of environment a successful day trader from a happy family in Widnes is suited to. Yet this most dreadful of US prisons is just where Englishman Shaun Attwood wound up after a SWAT team busted him for money laundering and drug dealing at his Scottsdale Arizona apartment, where he lived a double life as dotcom millionaire and raver.

Hard Time is the gripping account of Attwood’s time among lethal gangsters, including the Aryan Brotherhood, and of living in fear amid sewage and cockroaches. At first, he is in shock – then he slowly adapts, learning how to avoid violence and garner some peace and quiet. Having only read books on finance before, he submerges himself in literature, psychology and philosophy in a quest to understand his past. He begins to write letters home, his first one with a golf pencil he sharpened on a cell wall. These became a blog attracting world-wide acclaim; they’re harrowing, horrifying and often funny.

Hard Time begins with Attwood’s arrest in the middle of the night and proceeds through his two years in jail prior to his sentencing to nine-and-a-half years in prison (he was released after six). It’s shocking, but readers will be cheered to know that for Attwood, the ending is happy, as he’s now back in the UK and free, spending his time giving talks on the perils of drugs.

Link to the review.

Link to the sewage blog.

Hard Time is now also on sale at the Book Depository.

I'm also doing a reading with the author of Try Me, Farah Damji, in London on 23 August · 18:30 - 20:00 at:

The Gallery Stoke Newington Library
Stoke Newington Church Street, London N16, 0JS

Facebook page for the reading.

Wednesday, July 21, 2010

The Hispanic Scholarship Fund

From CFACT. I like in particular how the woman says, "you have to major in the right degree."

Perhaps our Latino brothers and sisters, some of whom I presume do not have the luxury of majoring in sociology, know something their upper-middle income liberal-arts-majoring white counterparts do not.

Honest to God

How in god's name do idiots like this get jobs?

The sky is red, water is dry, night is day.
The Costs of Youth (by Shane)

Shane - After being denied psychiatric medication by ValueOptions, Shane turned to illegal drugs financed by burglaries. For stealing a few hundred dollars worth of goods, he was sentenced by Judge Ron Reinstein to eleven years. Shane is the author of the blog Persevering Prison Pages.

All in black, I was dressed in an authentic U.S. Army trench coat tailored to my short stature and jungle warfare combat boots. Even though I still had a dimpled baby face, I was trying to portray myself as much older. I was already well on my way down the path of self-destruction. Drugs and petty crimes were common things, and more serious crimes like burglary, auto theft and dealing drugs were becoming more frequent. Although still just a scared kid, I’d grown more and more jaded and distrustful of others, as well as only concerned about myself. I was on my own.

Stepping through the door of a small pet shop next door to the pool hall I was supposed to meet Tom at, I moved immediately to the pen that held six small puppies. They excitedly yipped, yelped and bounced around as soon as I approached. I’d always wanted a puppy and loved to visit them anytime I had time to drop into a pet store.

Picking up the smallest one, obviously the runt of the litter, I cradled him in my arms and scratched behind his floppy brown ears. The baby cocker spaniel nuzzled into my arms and I kissed the top of his head. I wanted to take him home. Setting him gently back into the pen with his siblings, a deep hurt brought tears to my eyes. I had no home.

As I reached down to pet the puppies, Tom walked past the store’s front window, heading for the pool hall. Jaws clenching and releasing, the muscles in his pockmarked face made him look angry, but I knew that wasn’t the case. He was just high on crystal meth or “tweaking” as we called it. He’d been awake for a few days.

Waiting a minute or two, I slipped out of the store, and walked next door to the pool hall. As I entered, Tom was at a table near the restrooms. He saw me, and motioned for me to go into the restroom. Nervous, I put my hands in my coat pocket to make me appear bigger and more dangerous.

Entering the small, dirty restroom, I checked the two stalls to ensure that nobody was inside. As I finished, Tom entered and locked the door behind him.
“What’s up youngster?” he asked, forcing a smile on his face that made him look more devious than cordial.
“Yeah, you got your end?” I said, and waited for him to produce the cash before I’d even shown him the dope.
“Slow down, kid. I gotta see what I’m gettin’ first.” He stepped towards me, his hand out, palm up.
Stepping forward and removing my hands from my pockets, I said, “That’s not how this works, and you know that. I’m outta here. Get the fuck outta my way.”
Instantly his demeanor changed and out came a crumpled wad of cash from his pocket. “Hey, I was just playin’, youngster. Here.”
I took his cash in my sweaty palm, counted it out and stuffed it into my front pants pocket. I reached into my coat pocket, and pulled out a plastic baggie full of bootleg crystal meth known as “crank.” “Steve told me to tell you it’s an eight ball. Exactly 3½ grams. He said he’ll cut you off if you complain it’s light, so don’t even try it.” I tossed it to him, and started to leave.
As I unlocked the door, Tom opened the baggie, and headed into the first stall.
Passing the pet shop, I glanced over at the puppies. I wanted to buy one, but I continued to walk. I never got a puppy. I gave Steve his money, and for payment, I got to sleep in his car that night.

I did many things as a kid that were wrong and stupid. I was trying to survive on my own, and be an adult.

Recently, I’ve watched Arizona’s legislators and Governor Brewer callously and irresponsibly gut state-funded programs that provide help to kids in need. Programs that were severely lacking or nonexistent when I was a kid. I could have benefited from those programs in the 80’s. These programs being cut and done away with will have terrible repercussions on Arizona’s young people, and increase the likelihood that they’ll end up in prison. Prisons, jails and mental hospitals are full of adults who could have been spared this life if they’d had help as kids. So are cemeteries! How can somebody in good conscience make those cuts?

Click here for Shane’s own blog

Click here for the first blog about Shane at Jon's Jail Journal

Some of Shane's Prison Stories:
What Comes Around
Convict Justice
Fighting For No Good Reason

Our friends inside appreciate your comments

Post comments for Shane below or email them to writeinside@hotmail.com To post a comment if you do not have a Google/Blogger account, just select anonymous for your identity

Shaun Attwood

Monday, July 19, 2010

The Great MBA Bubble

First it was the Dotcom Bubble.

Then it was the Housing Bubble.

And now it is the Education or "MBA" Bubble.

I predicted the previous two and I'm sure as I am typing here I will have reliably predicted the third.

The reason why is that in addition to my awesome economic mind and insight I also moonlight as a tutor on the side. Business is a-BOOMIN' because as the recession hits, the talking heads tell everybody "education is a recession-proof asset" and since the US is awash with liberal arts undergrads the natural next step is to get your MBA. Combine that with an incredibly efficient private sector and there is no limit to the fly-by-night, online, MBA schools sprouting up all over the internet and BAM!!! I got a small little clientele of MBA students that need tutoring.

Now for those of us who went to business school, this will be no surprise. But for those of you who never went to business school or are some how "impressed" somebody has an "MBA" let me explain to you right now that MBA's are worthless.

Matter of fact, they're worse than worthless. They're damaging. One only needs to ask who was at the helm of all the banks during the housing bubble and subsequent crash?

MBA's.

Who was peddling IPO shares in soon-to-be-worthless Dotcoms???

MBA's.

YOu look at pretty much every major economic catastrophe and the leaders that drove the economy there, you will see them honeycombed with MBA's.

Now, maybe back in the day, say, the 1950's, and MBA would have carried some weight. The individual went beyond his or her degree in accounting and decided to study business at a higher level. The insights gained from this would give you TANGIBLE SKILLS that would give you an edge over your competitors. The problem though is that over time and as more and more MBA's flooded the market, the MBA lost its potency. Additionally since business is common sense (no matter WHAT "they" tell you) you have to constantly re-create the MBA to somehow seem that it is on the "cutting edge" of "business science" when in reality common sense can only be sliced, diced and re-taught in so many ways.

The result was that the MBA didn't morph into this super degree where you learn tangible skills that will make you a more productive employee and turn you into a leader. It rather turned into a "stamp of approval" that simply showed employers you were a conformist. You would jump through hoops. You were perfectly fine going through the mendacity of a 2 year degree in common sense while acting like it was some kind of "professional venture." It is the fact you could tolerate such an inane and stupid process that made MBA's sought after - they were non-thinking automotons and THIS is what employers of today really want. They don't want leaders or innovators, they want conformists.

Alas, I get enraged when I sit there with my students and see just what tripe and utter garbage these schools are teaching. Chapter upon chapter is written on simple concepts that only need a paragraph to be explained, only for the sole purpose to make the "LEadership and Management" book look like an authoritative 559 page tome instead of the 3 page pamphlet it could easily be condensed into. The forcing of students to take what is essentially the same class 3 times (leadership in education, educational leadership, theories on managing leadership in education) to fill an MBA program and generate more tuition while teaching them nothing new. And do not get me started about how they teach obsolete, worthless, economic theories that NO ONE IN THEIR RIGHT MINDS WOULD EVER USE. DCF, EVA, "Porter's Five Forces Model."

But today, one took the cake. Abso-freaking-lutely took the cake.

I was going over an essay one of my students wrote for flow, content, etc., on account that in addition to being an excellent salsa dancer and fossil hunter extraordinaire, I am an outstanding author. I made some changes, reworded some sentences, but nothing dramatic. I gave it back to him, pointed out a couple things and he said,

"Oh, I can't have contractions in my papers."

Confused, originally because I thought he was talking about pregnancy-related "contractions," I said, "What do you mean you can't have contractions?"

He said, "Well this sentence here. You changed it to read, "the company shouldn't invest in this project because the NPV is negative."

I said, "yeah, so?"

"Well, "shouldn't" is a contraction. You combined "should" with "not." And they told us in our professional writing course to NEVER use contractions."

I sat dumbfounded and my blood pressure increased even further.

The MBA industry, has become SO VOID OF NEW IDEAS, REAL, TANGIBLE SKILLS TO TEACH THAT THE BEST, THE ABSOLUTE BEST THING THEY CAN COME UP WITH IS TO ELIMINATE THE BLEEPING USE OF CONTRACTIONS????

But then, I calm down, I chant my Galt-Buddha chant, I tell myself,

"Let go of the caring
Let go of the caring
Go Galt Go Galt
Society is collapsing
You cannot stop it
Your life is finite
Relax and enjoy the decline
Let go of the caring
Let go of the caring."

My new-found-econ-Buddha-Galt-philosophy set aside, it still amazed me. This school charges $27,000 for an MBA. My alma-mater, the Carlson School of Management charges last I heard $78,000. And I can only imagine what the Ivy League is charging for their progressively worthless MBA programs. All for what?

To learn not to use contractions?

The ramifications of this are of course going to be severe on several levels.

One, the simple fact MBA students are flooding the market. GMAT test takers (the pre-MBA qualification test) broke a record in 2009 at 263,000 test takers, no doubt to be dwarfed by 2010 numbers.

With this many MBA's and the simply law of supply (which these MBA's should know about) the value of an MBA is going to drop. Furthermore, since employers don't hire MBA's because of their uniqueness or innovation, but rather their conformance, MBA's are nothing more than a commodity in that "conformity" is simply that - a commodity. Any yes-man will do. So even though idealistic MBA students are thinking a job is just right around the corner upon graduation, unless the employment situation in the economic picks up (which my super awesome economic powers know it won't) they're still going to face a flooded market and nowhere near the salary-commanding ability they thought they'd have.

This will only worsen hundreds of thousands of people's personal finances. As they fork over money for what is progressively becoming a worthless degree, they will end up in debt with no better or at best, marginally better income earning potential.

Certainly this will hurt the individuals pursuing their MBA's, but don't think there isn't a cost to employers. Pursuing conformance over performance, ass-kissers over ass-kickers, employers will feel really good about themselves because their underlings have been programmed to be yesmen, but will experience no real tangible benefits from employing them. No real leadership or innovation will come out of this latest generation of MBA's. No real ground-breaking products or ideas will come from them. Worse still, knowing it is more important to be nice than right, these MBA's will simply shut up if there's any trouble at the firm knowing not to rock the boat. This yes-man disease will essentially corrupt the private sector forcing the private sector to become more like Goldman Sachs where bribing government officials and rent seeking replace innovation and ass-kicking.

The natural consequence to hiring people who tell you what you want to hear and not the truth or what you need to hear is that these firms will inevitably diverge so much from reality they will go out of business. We saw it with the Dotcoms, we saw it with the housing bubble, and we saw it with the auto industry. Firms that play nice instead of right, will pay the consequence (until the government bails you out). They will not be in business. They will not be able to employ people. They will not be able to produce a profit ever again. And they certainly won't be hiring any MBA's.

But hey, at least nobody used any contractions.

The Price You Paid for Feminism

and all of its marxist, entitlement-mentality bliss.

The Progression of Insulin Resistance

Vascular function, insulin resistance and fatty acids  (I'll blog on the vascular focus of this paper shortly, but this post is focusing on the bolded statements in the abstract).


Abstract
Over the past 10 years it has become clear that intact vascular function, especially at the level of the endothelium {cells lining the blood vessels}, is paramount in the prevention or delay of cardiovascular disease. It has also become clear that insulin itself, in addition to its metabolic actions, directly effects vascular endothelium and smooth muscle.  Insulin, at normal physiologic concentrations, causes changes in skeletal muscle blood flow in healthy, insulin-sensitive subjects. Insulin’s effect on the endothelium is mediated through its own receptor and insulin signalling pathways, resulting in the increased release of nitric oxide. Insulin’s vascular actions are impaired in insulin-resistant conditions such as obesity, Type II (non-insulin-dependent) diabetes mellitus and hypertension, which could contribute to the excessive rates of cardiovascular disease in these groups.  Insulin-resistant states of obesity and Type II diabetes show a multitude of metabolic abnormalities that could cause vascular dysfunction. Non-esterified fatty acid levels increase long before hyperglycaemia becomes present. Raised non-esterified fatty acids impair insulin’s effect on glucose uptake in skeletal muscle and the vascular endothelium and thus could have detrimental effects on the vasculature, leading to premature cardiovascular disease.
If it is true that NEFA levels rise before blood glucose becomes elevated, then perhaps a screening for pre-pre-diabetes should involve measurement of this blood biomarker?  

What causes elevated NEFA?  It's largely not dietary fats as these are mostly transported as chylomicrons, although there's some indication that in an obese person more FFA's escape re-esterification in the fat cells.  However NEFA levels are largely regulated by their release from adipose tissue in the ever-present FFA/Triglyceride cycling.   The release of NEFA is policed by the inhibitory action of insulin, and this role of insulin has been described as protective.

So if elevated NEFA is the first symptom in the cascade, and an indication of impaired insulin inhibitory action on fat stores, then is the progression of IR proposed by Taubes totally wrong?  Taubes contends that peripheral tissues develop IR first followed by organs and finally adipose tissue.  This statement in this article would indicate that it's the other way around.  Elevated NEFA would indicate some degree of insulin resistance of the fat cells.  Insulin is not largely involved in storing fat, it is involved in its release.  But what causes this?  Hmmmm.... over-stuffed fat cells perhaps?  As circulating NEFA's rise these induce insulin resistance skeletal muscle and perhaps the liver as well so that it pumps out too much glucose.  

It seems more and more apparent to me that carbohydrate consumption per se has relatively little to do with the development of IR.  It naturally occurs in certain phases of life (puberty, aging) but most of us are able to compensate for mild IR by increasing insulin production.  To be fair, it's not dietary fat that necessarily causes it either, although there's still the question of higher IMCL just from eating a higher fat diet and the potential for IMCL derived diacylglycerol and/or ceramides to induce IR in skeletal muscle cells.   Using our insulin does not appear to cause us to become resistant to it.  Indeed the opposite seems to be closer to the truth as low carbers are advised to "carb up" for several days prior to taking an oral glucose tolerance test so as to restore their insulin responses to as normal as possible.

I propose that the fat accumulation leads to elevated NEFA leads to peripheral IR and other deleterious effects on the liver and pancreas.  Only  chronic carbohydrate overfeeding seems to contribute to increases in fat mass, but net fat accumulation will still largely be contributed by dietary fat.  IOW fat accumulation leads to IR leads to hyperinsulinemia.   Fat accumulation is, in the end, dictated by energy balance.


Atkins Autopsy

Every now and then I'm reminded of something that kind of bugs me about LC diet promoters.  There simply aren't many long term low carbers in our general population (as a percent).  So when I see these long term meta studies looking at correlations between various biomarkers and CVD, for example, I wonder how this translates to someone who follows a low carb diet for the long run.  Real life examples ... people who may have yo-yo'd a bit with LC as well.  Do the low fasting trigs of a low carber correlate with reduced CVD?  But I hold no illusions that some meta study will be done following thousands of low carbers.  (Still, I can dream)

In the absence of that, the next best thing would be for prominent "leaders" in the field to share their personal experience/results.  So it's always bothered me a little bit that Dr. Atkins didn't leave instructions for an autopsy to be made public.  After all, what better vindication of low carbing can one imagine than Atkins possessing clean arteries (or at least arteries similar to those of others)?  This would have definitively been Dr. Atkins last laugh at the medical establishment.  I can only be left to wonder that either Dr. A didn't practice what he preached, or he had misgivings regarding its impact on his CV system.  

No ... I'm not a Dr.A died of a heart attack conspiracy theorist.  But I do think that there is/was value in prominent long term low carbers sharing their actual "results".

Sunday, July 18, 2010

Recession Medicine

Exercise to lose weight and reduce lipotoxicity!

Thanks to reader Cody for finding a study I had come across previously regarding IMCL/IMTG.  Actually the study linked to was an update, but there's a secondary lesson, I believe, to be had from the results.  Since this was a study in older folks, there's a sub-message here:  it's never too late!


We previously reported an “athlete’s paradox” in which endurance-trained athletes, who possess a high oxidative capacity and enhanced insulin sensitivity, also have higher intramyocellular lipid (IMCL) content.
The purpose of this study was to determine whether moderate exercise training would increase IMCL, oxidative capacity of muscle, and insulin sensitivity in previously sedentary overweight to obese, insulin- resistant, older subjects. Twenty-five older (66.4 0.8 yr) obese (BMI 30.3 0.7 kg/m2) men (n 9) and women (n 16) completed a 16-wk moderate but progressive exercise training program.  
Body weight and fat mass modestly but significantly (P 0.01) decreased. Insulin sensitivity, measured using the euglycemic hyperinsulinemic clamp, was increased (21%, P 0.02), with modest improvements (7%, P 0.04) in aerobic fitness (V˙ O2peak). Histochemical analyses of IMCL (Oil Red O staining), oxidative capacity [succinate dehydrogenase activity (SDH)], glycogen content, capillary density, and fiber type were performed on skeletal muscle biopsies.  Exercise training increased IMCL by 21%. In contrast, diacylglycerol and ceramide, measured by mass spectroscopy, were decreased (n 13; 29% and 24%, respectively, P 0.05) with exercise training.   SDH (19%), glycogen content (15%), capillary density (7%), and the percentage of type I slow oxidative fibers (from 50.8 to 55.7%), all P 0.05, were increased after exercise.
In summary, these results extend the athlete’s paradox by demonstrating that chronic exercise in overweight to obese older adults improves insulin sensitivity in conjunction with favorable alterations in lipid partitioning and an enhanced oxidative capacity within muscle. Therefore, several key deleterious effects of aging and/or obesity on the metabolic profile of skeletal muscle can be reversed with only moderate increases in physical activity.
Here's a link to the preliminary work I believe I was looking for (from the references in the above paper):
Skeletal Muscle Lipid Content and Insulin Resistance: Evidence for a Paradox in Endurance-Trained Athletes

So I've blogged a bit about lipid accumulation in non-adipose tissue, lipotoxicity and insulin resistance.  IMCL seems to correlate with IR, but the "athlete's paradox" is that insulin sensitivity accompanies increases in IMCL in athletes.  Therefore IMCL cannot be "toxic" in and of itself.  In this study we see that exercise decreases diacylglycerol and ceramide levels at the same time as IMCL's increase.  The negative effects of IMCL appear to be correlated to the build-up of metabolites rather than the stored triglycerides themselves and/or the turnover of  IMCL -- it's a secondary storage tank in the obese, but perhaps more like a gas tank for the athlete.  Perhaps ceramide is the sole culprit, insulin sensitivity, oxidative capacity and IMTG all increased by around 20%.  Ceramide and DAG both decreased, but only ceramide decreases correlated with insulin sensitivity improvements.

But ... in reading the originally referenced article, something else jumped out at me.  They took 25, mainly weight stable, obese, older (avg age ~66), sedentary people and, near as I can tell, did not change their diet.  One can presume most of these were eating a SAD before and after.  The participants were simply put on a moderate exercise regime.  The exercise was 45 min cardio (moderate by heart rate and/or perceived exertion), 4-5X/week -- mostly walking or stationary cycling.  You know ... the type of exercise often poo pooed in the low carb community that can only, according to Taubes, make you hungrier and cause you to eat more.  The subjects actually averaged 3.5X/week for the 16 weeks of the study.  

The result?:   In 4 months an average loss of almost 3-3/4 lbs of fat mass.  If continued for a year, this would translate into an average of 11 pounds in a year.  Not too shabby when compared to the weight losses reported by Shai et.al., but more importantly this counters to oft-repeated claim that you can't lose weight by exercise alone.  

And health-wise?  Insulin sensitivity improved >20%  (even as IMCL increased), as ceramide and diacylglycerol decreased.  IOW, whatever the cause of the IR, exercise alone improved this state.  

So exercise CAN improve health independent of diet. 

Standing Up (Part 1 by Warrior)

Warrior - Serving fourteen years for kidnapping and aggravated assault. Half Hispanic and Scottish-Irish with family still in Mexico. Brought up by a family steeped in drug commerce. He writes some of the best prison-fight stories on the Internet.

It was mid June 2003, 110 degrees outside, and my fifth hour locked in an outside holding cage at Central Unit. My sunburnt body had turned crimson. A sergeant had placed me there to “cool off.” I was determined not to break down. With no water or shade, I willed my body not to either.

My eyes were exhausted from squinting out the sun. Heat-warped air was raging off the concrete, but from 40 yards away, I still managed to recognize a brown uniform coming in my direction. The officer had something in hand, but I couldn’t tell what. He was about 5’8”, mid twenties, his brownish-blond hair cut short. His eyes were behind Oakley sunglasses. Though boyish in face, his posture displayed that of a seasoned officer. Confidence is key in prison for inmates and staff, even if you have to fake it.

Leaning over, displaying my prison-inked arms through the handcuff slot, I gave the officer a look as scorching as the sun.
He approached with a Styrofoam cup of water, reached out and offered it to me. “Here’s some water for ya.”
“Nah. I’m cool,” I replied with an aggressive calm.
“You don’t want any water?”
“Fuck you! Fuck your water! And fuck your sergeant!”
“So you don’t want this water, huh?”
“No, and you’ll see why.”
“What are you gonna do? Go off? You’ll just end up in the hole.”
I snickered at him for assuming I was the temper-tantrum type. “You’re going to see how persuasive I can be to 200 prisoners,” I said, mad that I’d displayed some of my hand, which I put down to the sun getting at me.
I must have struck a chord with the officer as his expression and tone changed. “Look, man, if I could pull you out of here I would. The serg wants you here. He’s a piece of shit, I agree. If I had my way, I’d pull you out, but I’m just a C.O. He’s a sergeant. I got to follow orders.”
“You fuckin’ pathetic loser. I didn’t ask you for a fuckin’ explanation. Fuckin’ get lost, and don’t come back unless you’re to pull me out,” I stated dismissively.
Angry and offended, he turned and walked away.

Forty-five minutes went by. The same officer returned with another to escort me back to my cell. My body was blistering red, my mouth parched as if I’d swallowed a bucket of sand, and the muscles around my eyes aching from squinting. I was relieved they’d come to let me out, but determined not to show it. I pulled my jumpsuit back over my shoulders, as I had it half way rolled down to my waist. I turned around and cuffed up.
Their hands clenched my biceps with a grip that meant, “Make the wrong move, and you’re hitting the floor, face first.”
They manoeuvred me towards my housing unit at their own stop-and-go pace – a tight squeeze to stop, a loose one to go. We walked 30 yards, and turned right until we were facing the control room and traditional sliding steel door. One officer waved for the door to be opened, and the female in the control room activated it.
In the control tower was a familiar silhouette. With his arms crossed and a stern look, it was the sergeant that had locked me outside in 110-degree heat. I gave him an equally level stare that said, “This isn’t over.”
The two officers noticed, and nudged me forward.

Our friends inside appreciate your comments.

Links to more prison stories by Warrior:
Warrior v Big E.
Rapist on the Yard
Bucket of Blood
Central Unit

Post comments and questions for Warrior below or email them to writeinside@hotmail.com To post a comment if you do not have a Google/Blogger account, just select anonymous for your identity.

Shaun Attwood