Coronavirus

[ZeApelido]

I think you're completely missing the point of the chart that I included as a global environmental context of the problem of refined sugar. Single ingredients have been both demonized and lionized by the media and by big food, and its the global change in diet and liefstyle that generates risks for the major diseases (Especially the big four diseases of aging that are breaking the bank – coronary artery disease/stroke, cancers, type II diabetes/obesity, or diaobesity as it's called, and neurodegenerative disorders, particularly Alzheimer's disease).

If you would actually look carefully at the chart you will see that our ancient environment could only supply sugar and carbs in the form of fruits and vegetables (and perhaps a very small amount of honey, wine and few ancient grains that were not common in hunter gatherer groups). So I agree with you if you are suggesting that you have to see the big picture of all those changes. I would disagree with you however if you're suggesting that refined sugars are not a huge part of that big picture alteration.

The other issue that you're leaving out is microbiome alteration associated with sugary foods. There's lots of evidence that microbiome tilt in a pro-inflammatory direction with increased Intestinal permeability (leaky gut) is a direct consequence of both sugary diets as well as artificial sweeteners..

I definitely think refined sugars are part of the problem.

We still don't know to what extent so-called healthy diet patterns (Paleolithic or perhaps Mediterranean or other diet but with minimal processed carbs and minimal dairy) are healthy due to their effect on the microbiome, and to what extent they are healthy simply because direct effects on our metabolism. I'm sure it's a mix. But it is pretty hard to separate out those factors both experimentally and mechanistically. In any case, in the quantities that we are consuming sugar, the evidence as my senior physician colleague dkp_Duke emphasizes, is simply overwhelming that those dietary patterns, including perhaps most especially the consumption of high fructose corn syrup in sodas and in other foods, is a proven risk factor for type II diabetes and obesity. There simply a pretty straight line between those issues. If you are seeking to deny or minimize that I would suggest you seek a career as a publicist for Big Food. They'd be very appreciative.

Risk factors and causal mechanisms are 2 different levels of significance. There's common sense and there's being overdramatic. If I had to tell someone how to get healthier, the first things I would suggest is

1) No liquid calories (especially sugar)
2) Eat more whole - grained / less processed food
3) Move around more

This is different from saying sugar is poison. Eat fruits and veggies, and a bit of sugar in some of your foods isn't going to bother you much.

As for endurance athletes, you need to look up gluconeogenesis. Glycogen and fat stores are quickly turned into glucose which is quickly metabolized into ATP. Even with the blood glucose of 100, that's not enough to supply much physical activity without this hepatic mechanism. So the idea that athletes need to load up on sugar directly is metabolically/scientifically misinformed.

Yes I know about gluconeogenesis. As you know fat stores conversion into ATP is rate limited (so actually not quick enough) thus the preferential use of glycogen anaerobic and aerobically at higher intensities of exercise. Respectfully it is well established in literature the benefit of sugar consumption during races 1 hr and longer.

 

[bkp_duke]

Lol I definitely don't disagree that sugars / artificial sweeteners / fat don't promote additional food consumption.

But if you think like Lustig that sugar is poisoning you via excess fructose the liver can't handle...

Artificial sweeteners aren't doing that.

The point is it's way more complex than Lustig makes it seem.

You obviously didn't listen / view even a single one of the videos that I linked. He doesn't say it's simple, but he lays out the evidence very well.

You are very much in a minority here, and are literally arguing against a trained endocrinologist (ya know, the people that TREAT diabetes). EVERY time I could get my patients to eliminate sugared or artificial sweetened drinks from their diets, they lost weight and their diabetes at minimum improved. EVERY, SINGLE, TIME.

I didn't say the liver "cannot handle" it. The liver is the only substantially regenerative organ in the body. No one goes into liver failure from fructose intake. They can from fat deposition, but even that is not that common. What I did say was Fructose is processed VERY differently from Glucose. Glucose is transported (via the GLUT4 transporter) into muscles for direct usage. Fructose transport is far lower in skeletal muscle, and instead is primarily transported into the liver and fat cells.

You can burn Glucose for fuel, directly. Fructose, your body has to make a lot of changes to it and most of those usually involve the liver processing it.

Fructose also doesn't promote the release of Ghrelin from the brain (the hormone that makes you feel full). Glucose does, and fats and proteins do much more. Literally, this is the definition of "empty calories" - Fructose doesn't fill you up at all, and makes you store the energy.

 

[bkp_duke]

Oh, and we LOVE Fructose because it is far far sweeter tasting that Glucose. It's one mechanism that the corporate farmers use to make their foods more addictive.

Fructose - Wikipedia

 

[bkp_duke]

This is different from saying sugar is poison. Eat fruits and veggies, and a bit of sugar in some of your foods isn't going to bother you much.

Not the same. Not even remotely the same.

Fruits = complex carbohydrates. Your body has to digest them and you rarely get a substantive blood sugar spike from consumption of them. You literally have to break the carbohydrates apart into simple sugars before they can be used.

Sugar/HFCS = pure simple sugar. With the serving sizes we consume in the US, you literally overload the ability of the body to immediately process these, unless you are an Olympic athlete in the middle of a competition. Since they cannot be used for fuel, even the glucose gets processed into fat.

 

[dfwatt]

This is different from saying sugar is poison. Eat fruits and veggies, and a bit of sugar in some of your foods isn't going to bother you much.

That was my original point, which you seem to have now claimed as your idea. IT IS TOTALLY DIFFERENT TO GET SUGARS FROM FRUITS AND VEGETABLES VERSUS HIGH FRUCTOSE CORN SYRUP!!!!

 

[jerry33]

Fructose also doesn't promote the release of Ghrelin from the brain (the hormone that makes you feel full). Glucose does, and fats and proteins do much more. Literally, this is the definition of "empty calories" - Fructose doesn't fill you up at all, and makes you store the energy.

Ah. That explains why eating a cookie (I make these myself with fresh milled wheat, so they're not all bad) makes me feel full. Thanks for the explanation.

 

[dfwatt]

Clinically an idiot is someone with the mentation of a 2 year old. Imbeciles are up to the mental ability of a 7 year old. Morons are up to the mental ability of a 12 year old.

Edit: as an example my wife always calls me an idiot just to be clinically correct.

Damn, I wish I had all this impressive technical information before I started releasing my groundbreaking products (Idiot Spray and Moron Spray I/II). I had it all backwards! Strongest product (Moron Spray II) should have been called Idiot Spray! First product should have been called Moron Spray. You really have completely f---- up my product line with all this new information.

But what is the age of a Moran?

Damn! Fortunately, I have large private stash of Idiot Spray that I can use on myself in just these circumstances. My wife thinks I need to use daily anyway. Women!

 

[madodel]

Maybe I missed it with all this discussion on fructose versus glucose, but any comments on why Dexamethasone would decrease deaths other than normal steroidal actions of reducing immune reactions? Life-saving coronavirus drug 'major breakthrough'

 

[bkp_duke]

Maybe I missed it with all this discussion on fructose versus glucose, but any comments on why Dexamethasone would decrease deaths other than normal steroidal actions of reducing immune reactions? Life-saving coronavirus drug 'major breakthrough'

Most likely, the anti-inflammatory aspect in the lung tissue. Slows that down, which prevents fluid accumulation, and thereby death by pneumonia.

We don't know currently, but I would like to see the timeline of effectiveness on this. I would bet it's not very effective in the very latest stages (i.e. intubation and you are already severely inflammed). It also might not be effective early on in the disease, as the immunosuppresent aspect of Dex could have more negative effects than the anti-inflammatory action. Just supposition on my part, would like to see that data teased out more so clinicians know what is the best scenario to give it to COVID-19 patients.

EDIT - this is not an uncommon treatment for severe pneumonia. It's been used a good while in other intensive care patients with out of control inflammatory responses that do more harm than good. The key is balance with Dex - too much and you suppress the immune system and prevent it from mounting a proper response to the virus.

 

[30seconds]

Hadn't checked in here for a while.

Nice to see that we aren't talking about how CV fears / death rates/ hospitalizations are overblown.

But it may be time to start a Splenda vs. Corn Syrup thread

 

[AlanSubie4Life]

Hadn't checked in here for a while.

You haven't missed much. Pandemic is over now, so there's nothing to talk about.

 

[N5329K]

Most likely, the anti-inflammatory aspect in the lung tissue. Slows that down, which prevents fluid accumulation, and thereby death by pneumonia.

We don't know currently, but I would like to see the timeline of effectiveness on this. I would bet it's not very effective in the very latest stages (i.e. intubation and you are already severely inflammed). It also might not be effective early on in the disease, as the immunosuppresent aspect of Dex could have more negative effects than the anti-inflammatory action. Just supposition on my part, would like to see that data teased out more so clinicians know what is the best scenario to give it to COVID-19 patients.

EDIT - this is not an uncommon treatment for severe pneumonia. It's been used a good while in other intensive care patients with out of control inflammatory responses that do more harm than good. The key is balance with Dex - too much and you suppress the immune system and prevent it from mounting a proper response to the virus.

Apparently, it is not at all effective in preventing death in patients not on supportive therapies (those who are doing relatively well), slightly advantageous for those receiving low-intensity oxygen treatment via cannula or CPAP, and most effective for intubated patients.
Go figure.

Robin

 

[SageBrush]

Clinically an idiot is someone with the mentation of a 2 year old. Imbeciles are up to the mental ability of a 7 year old. Morons are up to the mental ability of a 12 year old.

Edit: as an example my wife always calls me an idiot just to be clinically correct.

Fair enough, idiot it is for trump. Goes well with the trumper tantrums.

 

[SageBrush]

Maybe I missed it with all this discussion on fructose versus glucose, but any comments on why Dexamethasone would decrease deaths other than normal steroidal actions of reducing immune reactions? Life-saving coronavirus drug 'major breakthrough'

That, whatever it means.

With widespread use we'll get to see if chronic Covid-19 and/or late re-emergence are side-effects

 

[kbM3]

I'd like to see a direct source on that attribution. 15%Of the United States infected with Covid 19 is a literally crazy and wildly optimistic number, given that this is higher than NYS overall. If he did say that, add it to the evidence that Osterholm is losing his mind, as he also said recently when appearing on MSNBC as a consultant epidemiologist that "masks make no difference". And anyone arguing for those flu-like IFR numbers looks more and more like a fringe right wing COVID19 max-denier.

Osterholm’s 5%-15% already infected range in the U.S. came from a podcast about 3 weeks ago. In his more recent podcasts he’s stated 5%.

maybe he was giving credence early on to the Stanford and Los Angeles serological studies?

 

[dfwatt]

Most likely, the anti-inflammatory aspect in the lung tissue. Slows that down, which prevents fluid accumulation, and thereby death by pneumonia.

We don't know currently, but I would like to see the timeline of effectiveness on this. I would bet it's not very effective in the very latest stages (i.e. intubation and you are already severely inflammed). It also might not be effective early on in the disease, as the immunosuppresent aspect of Dex could have more negative effects than the anti-inflammatory action. Just supposition on my part, would like to see that data teased out more so clinicians know what is the best scenario to give it to COVID-19 patients.

EDIT - this is not an uncommon treatment for severe pneumonia. It's been used a good while in other intensive care patients with out of control inflammatory responses that do more harm than good. The key is balance with Dex - too much and you suppress the immune system and prevent it from mounting a proper response to the virus.

I still can't find a paper in a UK Journal that gives us any real data about this - have you got anything?. It would be really interesting to see SOFA scores and cytokine levels and other lab values in these patients that may have shown benefit vs in patients that showed no benefit. Would help folks parameterize when to use dexamethasone.

 

[dfwatt]

Osterholm’s 5%-15% already infected range in the U.S. came from a podcast about 3 weeks ago. In his more recent podcasts he’s stated 5%.

maybe he was giving credence early on to the Stanford and Los Angeles serological studies?

Whatever the explanation it's evidence that he's really lost his critical thinking (as the Stanford study was a disaster) or perhaps that he was somebody who was motivated to minimize covid-19 IFR for other reasons. 5% infected in USA looks realistic. 15% is nuts.

 

[dfwatt]

Apparently, it is not at all effective in preventing death in patients not on supportive therapies (those who are doing relatively well), slightly advantageous for those receiving low-intensity oxygen treatment via cannula or CPAP, and most effective for intubated patients.
Go figure.

Robin

Actually I think it fits and it's not totally counterintuitive. There seem to be a lot of ways to die from covid-19. One-way is from clotting / coagulopathy - that would be strokes/heart attack or perhaps extensive microangiopathy/ small vessel disease in the lung. Another is kidney failure. A third might be pneumonia and a fourth might be sepsis (which you might think of as a situation where pro-inflammatory cytokines start to functionally derail a whole lot of organs). These of course are not mutually exclusive and severely ill patients might present with at least one but often two or more of these manifestations. But perhaps dexamethasone helps in the subset of patients that are becoming septic, but wouldn't be helpful for patients with kidney failure, Mis and CVAs. Sepsis is often times associated with severe pneumonia. But as BKP_duke has already mentioned the problem of course is not suppressing antiviral immune activity while you are preventing collateral damage so to speak from the immune system.

 

[Causalien]

I believe they are specced to filter 95% of particles 0.3um in size because this the most difficult size to filter. They have much higher than 95% efficiency for both smaller and larger particles.
View attachment 552231
N95 Respirators and Surgical Masks | | Blogs | CDC

I think this is mostly early anti-mask propaganda. There are plenty of YouTube videos for health professionals showing how to fit an N95. The only adjustments are the size, position, position of straps and the nose wire!

The KN95 masks I bought on eBay seem to fit pretty well. When I breath in it feels and looks like the air is going through the filter material. When I exhale some of the air definitely goes around the filter. I doubt they fit as well as a molded N95 though.
View attachment 552235

I use Alpha Pro Tech's N95 surgical mask.

Their masks have metal wire all around the seal so you can tighten the seal to your liking. I've been wondering why other masks only have a nose wire making it not fit everyone perfectly.

Disclaimer: Used to own their stock but have sold all of them.

 

[N5329K]

I still can't find a paper in a UK Journal that gives us any real data about this - have you got anything?. It would be really interesting to see SOFA scores and cytokine levels and other lab values in these patients that may have shown benefit vs in patients that showed no benefit. Would help folks parameterize when to use dexamethasone.

Some data here, starting at 3:21:

Robin