Weird Medicine: The Podcast - 373 - Medical Journalism Stinks

Episode Date: September 7, 2019

Well, not all of it is bad, but this one, on diet sodas and mortality meets all the criteria for poorly researched clickbait. A "very special" episode wherein a news story is subjected to critical thinking. More, including the new Gecho Loopsynth V2 from gechologic.com.   stuff.doctorsteve.com (for all your online shopping needs!) simplyherbals.net (Dr Scott’s nasal rinse is here!) noom.doctorsteve.com (lose weight, gain you-know-what) tweakedaudio.com offer code “FLUID” (best CS anywhere) premium.doctorsteve.com (all this can be yours!) Buy Every WM Podcast on a Thumb Drive!     Learn more about your ad choices. Visit podcastchoices.com/adchoices

You're listening to Weird Medicine with Dr. Steve on the Riotcast Network, riotcast.com. I need to touch it. You know, ho, ho, he ho. In the garretid. I've got diphtheria crushing my esophagus. I've got Tobolabovir, dripping from my nose. I've got the leprosy of the heart valve, exacerbating my impetable woes. I want to take my brain now, blasted with the wave, and all over my nose. ultrasonic, ecographic, and a pulsating shave, I want a magic mill all my ailments, the health equivalent of Citizen Kane, and if I don't get it now in the tablet, I think I'm doomed, then I'll have to go insane. I want a requiem for my disease, so I'm Beijing, Dr. Steve. It's weird medicine, the first and still only uncensored medical show in the history of broadcast radio, now a podcast. I'm Dr. Steve, and this is a show for people who never

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All right. Please don't forget, stuff. dot, doctor steve.com. Stuff. Dot, Dr. Steve.com for all your online shopping needs. And we've got some, most of the things that we've talked about on this show we have on stuff. Dr. Steve.com as far as products and health care things that you can buy, including my peripheral neuropathy cocktail, which, you know, I'm not selling it. I'm just letting you know what worked for me.

And I've got some new information about that, maybe for next, I may actually have this genetic thing. apparently it's more common than I thought, this weird mutation that causes, wow, peripheral neuropathy, ataxia, general weakness, all the things that your old pal has, and never learned about this one in medical school. So one of my colleagues turned me on to it. So I'm going to try some things. If it works out, I'll let you know. Anyway, but I mean, I'm fine.

It's just a lifestyle thing. It makes it a little bit harder for me to type 140. 40 words a minute or to, you know, shred my synth man with some meaty synth leads. But anyway, don't forget tweakeda audio.com for if you're going to listen to those meaty synth leads, offer code fluid will get you 33% off the best earbuds for the money and the best customer service anywhere. Also, check out Dr. Scott's site at simplyerbils.net. I'm still rocking the weight loss. I'm telling you, Noom is the greatest thing I've ever tried. If you want to attain your ideal body weight with me, go to Noom.doctrsteve.com. It's N-O-O-O-M dot Dr.

Steve.com. You get two free weeks where you can just try it. If you don't like it to hell with it, then just delete it. It's an app, and it's not a diet. It's not a diet. That's the cool thing. It's a psychology app. It actually helps you in other aspects of your life. as well, at least it did me. So Noom.com, two free weeks and 20% off. If you decide to do it, you only have to do it for three months. It's not a lifelong thing like Weight Watchers and no points and all that, BS. So it's the only thing I've ever found been successful and I've tried everything.

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I'll send you a thumb drive, 32 gig thumb drive with about 16 gigs of content on there. as up-to-date as when you buy it. And, you know, sometimes there's some extra crap in there because I forget to delete some things. Or you can go to premium.com for $1.99. You can get archives for the whole show. You just download them yourself. You can pick and choose what you want.

All right, very good. So I'm going to fade up this new music bed. Check this app. So most of you who listen to the show know that I am a fan of electronic music and synthesizers. And going way back to seeing Rick Wakeman on stage when I was a college student. They were just all that stuff he had and just the technical skill is amazing. And then I was a fan of Keith Emerson, which, by the way, if you are who are who, Likewise, a fan of Keith Emerson.

You can go to the Mug store. I know that my wife won't even go in. Okay, so I get it. She'll go with me to Asheville. It's in Asheville, North Carolina. Very cool town. Highly recommended. And she'll go to Asheville with me,

and she'll even drive to the Mogue store, but she'll sit outside in the car and will not go in. It's like, it's not, well, anyway. But in there, They have some classic synthesizers, and if they still have it, they had Keith Emerson's touring synthesizer. And he had one of the earliest analog preset systems where he could patch the thing up, have three or four patches, and then switch between them. You know, now we have flash memory and programmable ROM memory that will memorize patches that we have. Back then, there was no such thing.

This was an analog synthesizer. There's no presets. You'd just dial stuff in. And so he would have to, like I said, use patch cables and patch each module to make a pathway for sound to go through. And then he had this big giant switch, and it would just switch the cables so that the synthesizer was seeing different routings. and that way he could change sounds. I always wondered how he did it because he would do different sounds, but he had this big modular Moog synthesizer,

and I never saw him actually twiddling any knobs, except every once in a while he'd hit the filter cut off to make a cool sound. But anyway, you can touch that. If you're so minded, you can play Tarkas on it, which is what I did, because that's what kind of a nerd I am. But it was cool to say that I have at least played the first few notes of Tarkas on Keith Emerson's actual synthesizer on which he played Tarkas many, many times, so it's pretty cool. Anyway, that's on Broadway Street in Asheville, North Carolina.

If you're in the area, you should go by. It's pretty cool. What I'm fiddling with here is a gecko loop sense. My friend Mario in Ireland makes these things. He is what you call one of them geniuses. And this thing is infinitely programmable little music-making computer. And it has different sensors on the outside. So, like, if I can bring up the counterpoint just by placing my finger over one of these sensors,

not actually even touching it. Here, listen. Now, I brought a bunch of... I'm just playing one of the... programs on this thing and it's got a million of them and uh if you're smart you can do your own it's in the ad for him in any way but check out gecko loopsynth or uh geckologic.com and he has a all kinds of cool just fun things if you've got a friend who is into music and you don't want to spend a crap load of money on them but you want to get them something

you know they don't have this guy has got the stuff and um uh and uh Anyway, I'm just really proud of him being able to make a living doing this. And he used me as voiceover for one of his recent ads, so you can look for the Gecko-Loop Synth version 2. And then there's this weird thing where we're hunting aliens. It's bizarre. It's the goofiest thing you've ever seen, actually. And I didn't do as good a job as I could have

if I had kind of had a little better grasp of what he was going for. But it was still fun to do. And because of that, because he doesn't pay money for doing things for him, but you get paid in synthesizers. I have serial number zero zero one of the Gecko loop synth version two. So anyway, so if you're interested, check that out anyway. I just thought you guys would find that mildly interesting. All right. Back to medicine.

I have some things I want to talk to you about that are pretty significant. Number one, the vaping industry is taking a big hit right now because there was a report of some lung-related deaths that were attributed to people vaping. I need a lot more information before I can wax eloquent on this, so I'm hoping by next show I'll have a full review of the literature on this. I just want to say that as I have said from day one, I have never said that vaping was bad. As a transition from smoking to complete cessation of everything, it may be a reasonable alternative. However, there's a lot of, there's not really a word for it, disregulation. some regulation but some not not very good regulation and these things are basically medical devices

that are delivering a Medicare or a drug nicotine that's known to be habit-forming and then all these adulterants that are in there different juices and flavorings and stuff like that that really we're not intended to put in our lungs I mean, what's supposed to go in our lungs is air. So I've always contended that I can't say they're bad, but I can't recommend it.

And I don't know that it's good or at least neutral. It doesn't have to be good. It doesn't have to be good for you. We do kind of demand that it's at least neutral or if it's bad for you, we know what the badness is so that you can choose to do it despite the fact that's bad. cigarettes. We know cigarette smoking isn't good for you. As a matter of fact, for a lot of people, not everybody, but a lot of people, it's cigarette smoking can be harmful. And for a fraction of those people can be catastrophically harmful. But you're aware of that. The warning is on the

label. It says specifically this stuff can cause cancer, heart disease, increase your risk for stroke. And remember I always talk about our goal is not to not die. because we're going to die. But I'd like to die on my own terms if I can. And barring that, I'd like to at least reduce my risk of dying when I don't want, when I'm not ready. Of course, when I'm ever going to be ready. My dad was 86. He said, hell, I'm not ready.

He always hated it when people say, well, he lived a long life. He'd say, shut up. You know, it doesn't seem that long when you're 86 and you're here. That's always people younger than that that say that crap. But anyway, I digress, as is my want to do. I would like to mitigate my risk of dying in a horrible way. So I'd like for my face not to be dissected away with head and neck cancer. So, you know, I did eventually quit smoking.

And I try to be at least aware if I'm eaten at the Y that there's no HPV there because I was too old to get the HPV vaccine, those sorts of things. you know, I'd prefer not to die of colon cancer or lung cancer, so I get my screening test done. So if I do get it, I can get it diagnosed early and get it treated. And so, therefore, I think if your goal is to mitigate your risk, you've got to quit smoking. I say at the end of every show. If you can do that with a vape pen that you use briefly to get you to quitting, it's probably fine. But we don't know the long-term effects of inhaling these giant clouds of vapor into our lungs.

I mean, I see people blowing these things out. It does look kind of cool, except a lot of the folks that are doing it are a bit affectatious. And so, you know, my kids and I kind of make fun of them. You know, I'm going to take a toot off my vape pen man. And it looks like a clarinet with all these things coming off of it. And this giant, you know, room-filling cloud. As an ex-smoker, I know that feels good. when you do that.

There's something about that. Getting that big old drag of smoke and taking it deep into your lungs and blowing it back out again. There was something, I mean, you know, I'm not stupid. I'm probably in some things I am, but I'm relatively educated. And yet, even after I had my MD, I was smoking like a fool. And, you know, I was smoking two before I hit the showers. I had burn marks on the head of my penis from flicking cigarettes between my legs sitting on the pot in the morning, you know, because if you do that an infinite number of times, well, if you do it an infinite number of times, you'll have an infinite number of burns on your dick. But if you do it, you know, every day, day in, day out.

And so let me see how many drags you get off a smoke? I don't know. 20 or 30. And so that's 60 every day, 60 times 365, whatever that is. You're going to burn your dick every once in a while. Let's ask Alexa what that is. I'm curious. Alexa, what is 60 times 365?

60 times 365 is 21,900. Yeah. So you flick 21,000 times between your legs. there's going to be an ember that's not going to go where you want it to. And so, and that's always fun to explain. No, honey, it's not herpes. It's a cigarette burn. So just stop it.

Just stop it. Seriously. I think that was either how Anthony or Jim Norton quit. One of them said to the other one, oh, why don't you just quit? And then that was enough to make him quit. There's a study that shows if physicians, We'll just, all providers, doesn't have to just be a physician, will tell their patients to quit smoking 5% of them will do it just based on that.

That's 95% won't. So it's not a very effective technique, but it doesn't cost anything either. Well, it costs the office visit, but you were paying for that anyway. So definitely, let's quit smoking. You know what? Let's quit vaping, too. And they said the risk is increased and people who are dabbing. Does that mean that these cannabis vape pens are also an issue?

Because now that breaks my heart. I got to tell you. So I hope that that's not the case. I'm hoping it's that they'll find out it's just the juice that they use and the nicotine vape pens and not the cannabis or CBD vape pens. But the jury's still out on that. So I'll get you some more information on that next time. Now, this next thing I want to talk to you about is how medical journalism sucks, for the most part, not always, but it sucks pretty bad.

And some of the things I read are just this clickbait. And so this is one of those. And it's not exactly clickbait because there is something here, but the way that it's sensationalized and misreported in the, in the, in the, in the, in the, in the, in the, journalistic literature is mind-boggling. So what I'd like to do is just read you this. And then I'll just express my horror at some of the things that are said. So here we go. This is from the sun.

And it says, sweet and sour. Just two Diet Coke's a day increases your risk of deadly heart attack or stroke by 50%. That is terrifying. 50%. Well, I have to stop drinking. them right now. Okay, so then they have a sub-headline. Just two diet drinks a day raises the risk of dying young by a quarter.

A major study revealed. No, wait a minute. They just said in the headline, two Diet Coke's a day increases your risk of deadly heart attack or stroke by 50%. Then the next line it says, just two diet drinks a day raises the risk of dying young by a quarter, a major study reveals. Well, maybe there's a difference between. The whole population and the young population, where they don't say that, so this sucks already.

I got this far into it, one sentence in, and I realized there was some malarkey going on. It says, lovers of Diet Coke and Pepsi Max. Oh, see, now they had to use the brand names because there's lots of other diet drinks out there, not just Coke and Pepsi. See their chances of being killed by a heart attack or stroke rocket by more than half compared to those who avoid. this stuff. Now, they have a picture of what looks like a soda. Can't tell if it's diet soda or not. My microscopic gas spectroscopy vision is not functioning today.

It says two fizzy drinks a day, even if they are diet versions, increases your risk of dying young by a quarter, experts have warned. Okay, so we're going back and forth between this 25. percent and 50 percent number. And then experts said the important, and they put important in quotes, European findings involving more than 450,000 people were, quote, unquote, concerning. Well, no shit. And then they put the period outside the quotation mark, which drives me crazy as a journalism

major. Okay, maybe that's a European thing. They urge Brits to ditch soft drinks and switch to water. No problem with that. No problem with that whatsoever. The World Health Organization research found the dangers from guzzling. Of course, see, you have to conjure up this image of people guzzling, artificially sweetened pop, not just sipping it or drinking it, but they have to be guzzling it. We're up to three times greater than regular sugary drinks.

Well, now we're talking 300% of something. So they're throwing out all these times things, and none of this really makes any sense. So now it says, okay, so the next headline is diet drinks worse. It suggests switching to sugar-free products such as Diet Pepsi or Luca Zade Zero. What the hell is that? Could be equally bad for health, if not worse. Motion detected at the front door. Oh, well, thank you, Alexa.

Let's just take a look and see what we can see. I like those commercials when they go, hey, you better not. You better not do it. Put it down, buddy. Let's see. This is the problem is it takes so long to get to it that they're already gone. Okay, well, thank you very much. Okay, it suggests switching to sugar-free products such as Diet Pepsi or Luca Zade Zero could be equally bad for health, if not worse.

Study was carried out by the International Agency for Research on Cancer in France, which is a part of the WHO. Now, first thing, the agency for research on cancer, now it starts to make me wonder if they were looking for something else with this study, because we've talked about this on the show. A good study is one that has a defined endpoint, not a fishing expedition, where you go and you say, well, let's look at people who use a spartame and people who do. don't and then let's just see what we see so and then you look at heart disease you look at stroke you look at cancer prostate enlargement sexual dysfunction and then you find something in there because you're likely to find something it may even be statistically significant but then you have to then control that study you have to do it again controlling just for those variables so that you've got a cohort of people that are matched with a cohort of another cohort of people so that the only variable is that

one thing to the best of your ability i know with people that's really hard to do and then you look and you do a prospective trial where you're watching them over time not retrospective where you're looking at them in the past where the information you have may not be as accurate as you want it to be and you have to follow these people these are very expensive things to do because how long do you have to do it to get an effect five years 10 years well hell you know if i started a study today and I had to follow it out for 15 years, I most likely would be dead. Certainly I'd be retired before the study was done.

So these things are often hard to do, but that's how you have to do it to really be able to say these things. So when I see that it was carried out by the International Agency for Research on Cancer, I'm wondering if this was really a cancer study and they just happened to find this. And if that's the case,

then that makes all of this kind of suspect. even if they matched their controls, they were probably matching them for cancer, not for heart attack and stroke. But I'm just throwing that out. We're going to find out in a minute because I've got the original article, at least the abstract. Lead researcher, Dr. Neil Murphy, now let me see if this is the same one. Nope, that's a different effing study. See, and that's the other thing is they don't give a link to the original study. in these articles, and that drives me crazy.

So what I'm probably going to do is, well, I have a little dead air while I try to find the actual study because I pulled one up and I thought I had it, but this is actually something different. Lead researcher, Dr. Neil Murphy, said the striking observation in our study was that we found positive associations for both sugar-sweetened and artificially sweetened soft drinks with the risk of all-caused deaths. but wait a minute this article said

two diet coax a day increases your risk and now they're saying well it's really it's all soda right so the contradictions in this article now there may not be contradictions in the original study although there may be not every scientific study that's published is good or rigorous

but certainly this article is confusing AF So, and then he says it would probably be prudent to limit the consumption of all soft drinks and replace with a healthier alternatives such as water. Now, I can see the soft drink industry going ballistic over this, particularly if, as I said, this was a fishing expedition and they haven't done the rigorous prospective, you know, cohort trial. All right, so here we go. Now, it's a nice long study. The research track participants for 16 years, including Brits, and is the largest study of its kind. I like that.

It found chances of early death went up by 8% for those who consumed sugary drinks twice daily. So now we're getting to the difference between relative risk and absolute risk. Because that, so if that's a 50% increase, right, then. So let me see. So that would be, okay, if it was four, it would be 100% increase to go to eight. So like six plus three is nine. So it's somewhat less than six percent. So what they're implying by that is the risk of early deaths was around six percent, and it went up to eight percent,

which also means 92 percent of people who drank all kinds of soda didn't have a problem. So if we can get the original data, and I'll try to do that, I'll request the full text. We may be able to calculate a number needed to harm. How many people have to drink two sodas a day for there to be one extra heart attack or struggle? It might be kind of interesting. Now, oh, but for those glugging two glasses, God damn, you guys. You know, first they're guzzling, now they're glugging it. You just can't say that they're consuming it or they're drinking it.

They have to have this image of this guy. You know, just come on. Okay, for those glugging two glasses of diet pop each day, the risk went up by 26%. Now it's 26%. Okay, come on. This group also saw their chance of being killed by cardiovascular disease rise by 52%. So they're not saying 52% of people who were drinking these diet. They're saying their risk increased by 50%, which it was already low.

So if someone's risk is 4% and it goes up by 50%, then that would be 6%. Still, you want to mitigate your risk. I don't want to take any chances with that. You know, if I can decrease my risk by two absolute percentage points, I'm cool with that because I'm a little bit at risk now being 63, now with a little high blood pressure that I'm having to treat and all that kind of stuff. At least I don't smoke. By the way, quit smoking, please. Thank you. Take home message.

This is the next headline in this, or subheading. Drink water. The damning findings. Oh, now the findings are damning. published in JAMA Internal Medicine with an excellent journal coincide with the largest gathering of heart experts in the world

speaking from the European Society of Cardiology Congress in Paris professional Mitchell Elkind incoming president of the American Heart Association urged people to ditch soft drinks he said this study is important now look Mitch's opinion matters to me no question about that

I mean we have to trust some experts at some point there are concerns about both sugar, sweet, and beverage and so-called diet beverages. Okay? All right. Let me just stop here for a second. So what is it? If it's sugar, so if I eat an equivalent amount of grapes, is that a problem?

And people go, oh, no, that's ridiculous. Well, then what is it? What is it in these diet sodas? Is it the carbonation? is it some other ingredient like the, you know, the caramel coloring that's doing this? I mean, really, what is it? If there's an association with soft drinks in general, not just diet drinks, then what the F is causing this?

Because we know, look, we know sugar is the enemy, but, you know, if I eat an equivalent amount of apples, you know, know. Does that make sense? This is very strange to me. Very strange indeed. And I really would want an answer to this. I could even accept that drinking sodas and diet sodas could increase your risk somewhat. So the risk to the individual would be low, but the risk to society would be large. And we need to limit it or at least encourage people to limit it. I'm a libertarian. So I think, just tell people what the problems are and let them make the choice for themselves. But I would really want to know what the mechanism is.

For example, grapes, don't give grapes to your dogs. You know, why it can cause renal failure. Hell, I had a dog in college that would eat grapes off the vine, and he was fine. I went on Quora and asked this question, you know, is it really, because I couldn't really find a good answer anywhere. And I just got Lambus, everyone knows that grapes are highly toxic to dogs. And you're playing Russian roulette with your dogs. And it's like, no, you know, I came on here looking to see if anybody knew what the mechanism was.

Because that drives me crazy. Grapes are awesome. They seem very benign. They're just kind of water with some sort of gel and a skin around it. What the hell could cause dogs to get renal failure after just eating one or two grapes? And how is it that all of my dogs, I've always talked. They've lost them grapes, and they've always been fine. So it's not all dogs, obviously, and not all grapes.

And once I find out about it, my dogs will never see a grape again unless they find one in the wild and they eat it and I don't have any control over it. But, you know, so, I mean, I'm not a lunatic, but it is very interesting to me. What is that? And no one seems to know the answer to that. Matter of fact, the Merck Veterinary Manual, which at least one veterinarian came on there and gave me some real information. says that this has never been confirmed experimentally. So there's no experimental model for grape and raisin toxicity in dogs. But yet it's widely, quote unquote, known to be a fact, which hell, I didn't know it.

But anyway, so I am very concerned about the mechanism of this. Because, look, if it's the caramel coloring, we can fix that. Just don't put it in there. And then we can have our drinks and our diet drinks. But to assume it's the sugar or the aspartame is asinine, what you have to do, if you really want to know if it's a spartame, then what you have to do is you give people a spartame pills. And you give another group placebo pills. And you control for everything else. Their diet's the same.

Smoking history is the same. Obesity is the same. cholesterol, everything's the same. If you've got somebody over here with hypertension that's taken Losartan and they're well-controlled, you've got to have somebody in the other group the same way, to the best of your ability to get it so that the statistical significance will actually mean something. And then now you can say something. So at the end of that, if there's a statistically significant difference,

and the only difference was you gave this group oral aspartame and this group of placebo, then you can say that that effect is real. more cancer, more heart disease, more stroke. I am just mind-boggled by this, that it's soft drinks, but not wine, not milk that has, you know, sugar in it, maybe not as much. I'm not an expert on that, but I can, by God, find out by next show. You know, and juices and stuff like that. Do they do it too?

What if you drink two glasses of orange juice every day? I would say that there's got to be an equivalent amount of sugar in that. Maybe Alexa knows. Let's ask her if she knows. I know everybody has. I'm going to change her name eventually to something that I'll change it to echo so that you all who have an Amazon Alexa at home don't go crazy every time I do this. Alexa, how much sugar is in an orange?

One orange has 12 grams of sugar. Other customers have also asked, how much sugar is in an apple? Would you like to know the answer? Yes, I would. One apple has 19 grams of sugar. Wow, that's interesting. More sugar in the apple. Alexa, how much sugar is in 12 ounces of Coke?

12 ounces of Coke has 33.8 grams of sugar. Okay, so it's more. So two apples. is right around the same as a Coke. So for me to get too freaked out about that, I'd have to eat four apples a day to be an equivalent of drinking two. And I'm just using Coke because, you know, that's sort of the gold standard. Sorry to the Pepsi drinkers.

So if you ate four apples a day, is that going to give you the same risk as drinking two glasses of Coke? Well, you could say, well, you know, you get the fiber and all that kind of stuff. Okay, well, how about apple juice then? You know, same volume, same amount of fiber, zero. Will that do the same? This bothers me. This is going to drive me crazy. I got to tell you because this doesn't make sense to me.

Things don't have to make sense, but they have to make some sense, right? I mean, like it didn't make sense. that a bacterium caused stomach ulcers. Just because the stomach is such a toxic environment, how got a bacterium survive in there? But yet, there's helicobacter pylori is right there, and it causes stomach ulcers, and every gastroenterologist not only agrees with that now,

but they'll treat people for that if they find it. So something that didn't make sense before, it doesn't really make sense to give people with congestive heart failure, beta blockers, Because one of the problems with congestive heart failure is the heart isn't beating hard enough, and yet a beta blocker kind of makes the heart not beat as hard. It's one of the things that they do. At least that's sort of the classical notion about it.

And so how does it make sense that it's now malpractice not to give people beta blockers if they have congestive heart failure because they found that people live longer if they're placed on a regimen that includes a beta blocker. So, you know, things don't have to make sense, but that one ultimately, you can dope out the physiology of why beta blockers make sense. Incongestive heart failure. One of the things makes the heart work less hard. So if you've got a heart that isn't working as hard,

it's probably going to live longer, even if it's somewhat damaged. So very simplistic viewpoint, but, you know, you can wrap your head around that. I have trouble wrapping my head around this, what the possible mechanism could be. So, all right. Okay. Okay, so not so sweet. Here's the last headline of this. Previous research suggests sweeteners may affect blood vessel health, dementia risk, and also trigger weight gain.

Well, certainly the last one, I can, particularly if you're just glugging, large amounts of sweetened drinks. I mean, come on, we can at least all agree that's nuts, right? How many calories is in that? Alexa, how many calories is in 12 ounces of Coca-Cola? 12 ounces of Coke has 134 calories. Okay, so if you're drinking eight of those a day, you're adding another 1,000 calories to your diet.

and that's 12-ounce cans. I see people with these, you know, 64-ounce things and they're just down on them. So, you know, I think we can all agree that's probably not good for us in any measure. Even if it was apple juice, you wouldn't want to drink that much or take in that much extra sugar and calories.

With the spikes in your insulin, which again, apple probably won't do that as much because you've got to digest that apple to get all of that sugar. Whereas if you're taking a Coke, you're going to get that big spike in insulin. I could wrap my head around that could be part of the reason why drinks are more risky than eating the apples. Although then, okay, so then we also have to say the same thing for juice or any other drink that has sugar.

it, including coffee and all that stuff. Oh, and sweet tea, good Lord. If you are not from the South and you've never had Southern sweet tea, the amount of sugar that is in that is insane. It's got to be more than sodas. And if it touches my lips, I have to spit it out. I can't even swallow it. It just sort of coats my mouth with this awful, just sickening coating.

can't do it. But you should at least try it one time if you come down here and you can see why there's so much obesity and diabetes south of the Mason-Dixon line. It's that and gravy and biscuits. I see when I moved here back from Vermont, so my first practice, I left. I've always lived in the South,

except for a few years in my youth. But then I first practiced. in Vermont and I when I came back to Tennessee three years later with my tail between my legs by the way I noticed that I saw a lot more fatty liver and a lot more obesity and a lot more diabetes down here and I posited it to the Appalachian diet because I live in the foothills Appalachia and part of that is gravy and biscuits which if you've never had that now that you have to try get it at a good place even crack or barrel, pretty darn good.

But if you can go find an old country restaurant where they've been making this stuff forever, you get good old gravy biscuits with the white gravy, sausage gravy. It's insanely great, and it will sit on your stomach all day long. And if you're, well, anyway, the thing about it is, what's a biscuit made of? It's fat and flour and some leavening and milk, right? and then or buttermilk and gravy is fat and flour and milk and seasoning so when you have gravy biscuits you're really taking an uncooked biscuit and pouring it all over the top of a cooked biscuit that's basically what it is and and then you're throwing chunks of delightful sausage in there

breakfast sausage and it is it's an amazing thing but I know people that eat it day in and day out and then guzzle down to use the sun's words, you know, 32-ounce sweet teas along with it, and then wonder why their health fails relatively early in life. So we are what we eat. There's no question about that. So, yes, previous research suggests that sweeteners, and they're including sugar in that, may affect blood vessel health. That's coming from the spike in insulin that causes. some hardening of the arteries, dementia risk, interesting one there, and then also

and trigger weight gain, of course. And then one theory is it affects the body's sugar levels and key hormones such as insulin. Well, yeah, that's not even a, it's not a theory, it's a hypothesis, and it's pretty well verified. But others claim unhealthy adults are more likely to turn to diet drinks, which may explain the findings. Now, I used to have this problem with diet drinks causing weight gain, so we kept hearing that over and over and over again and I'm like they have no calories

how can that be? Someone finally put forth a hypothesis that does make sense to me that when you drink a diet drink the taste buds taste sweet and the body gears up because there are all

these signaling pathways in the body and the body starts to gear up to store all these calories that it's detecting that we're taking in and when we don't do it It's almost like it gets pissed and throws a tantrum and you start craving calories. So drinking the diet drink revs the body up, waiting for calories when it doesn't get it. It starts signaling to the brain.

We got to have those calories. And now you go out and you eat more than you would have had you not done the diet drink. So I like diet drinks for a weird reason because to me they taste really bitter and I like bitter. I'm a weirdo. I'm one of those people. If you ever did the genetics test in school where you could taste the bitter thing or you couldn't taste it, you either taste it or you can't. You can trace that gene through your family.

It's kind of a fun science experiment for like middle school or high school genetics class. So it tastes bitter to me and it's a little bit of stringent because I can't stand sugar and stuff that's just, you know, water consistent. see, it drives me crazy. So that's why I do it. And when I go to the movies, the one time that I ever have like a diet soda, because I don't drink, I never drink diet drinks, and I don't drink sodas at all. But I will if I go to the movies because I got that big machine that you can do all the

different flavors. So I do the diet, and I do Diet Coke, and then I add Raspberry. And that raspberry wafts up, and it smells like esters that I used in my chemistry lab. when I was in organic chemistry before I went to medical school. And that chemically smell is very nostalgic for me. And that's why, you know, so I'm a weirdo. So I would not expect anybody else to have the same motivation for drinking diet drinks that I do. Also, if you spill them, you clean it up.

There's no sticky residue unlike sugar-y drinks. So anyway, others claim unhealthy adults are more likely to turn to diet drinks. I think there is some validity to that. that if you've already got a problem and you figure, well, I can at least cut a couple of calories by getting rid of my regular drinks and drinking diet drinks. I think that's true. And then the other thing where the diet drinks actually stimulate the hunger reflex causes you to eat more, that I think is something real. Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said, this new research shows that people who regularly drink sweet and soft drinks have a slightly higher overall.

risk of dying as a result of heart and circulatory diseases. Thank you for at least putting some context to this and some sanity. Yeah, it's a slight increase in risk. If you look at this though, wait a minute, it says just two Diet Coke's a day increases

your risk of deadly heart attack or stroke by 50%. So I'm going to try to get the original study on this. Well, of course, okay, wait, I have one more thing to read to you. The last line of the article, I guess they wanted to be, quote, unquote, fair in balance, says Gavin Partington, Director General at British Soft Drinks Association said, quote, soft drinks are safe to consume as part of a balanced diet. So there you go.

That's, you know, they didn't give him any chance to provide any data or anything. They just, you know, and, you know, obviously they're saying, well, this guy's full of shit. So I have this association between soft drink consumption and mortality in 10 European countries. I don't see that guy that, oh, there's a million researchers in this. That may be why they found one of these people to speak. Neil Murphy, there he is. Okay, he's a PhD. So as a matter of fact, all of these people are at PhDs.

There's a couple of MDs in there, but this is, you know, a doctor of philosophy. philosophy-driven study, it appears. And that's fine. There's nothing wrong with that. They are perfectly capable of doing an adequate study. And I do see a scattering of MDs in here, but there's really, it looks like about 100 authors in this. So this is the study.

And the question is, is regular consumption of soft drinks associated with a greater risk of all cause and cause-specific mortality? So that's, they're positing this question and their findings. And I'll just give you their general findings in this population-based cohort study of 451,743 individuals from 10 countries in Europe, greater consumption of total sugar-sweetened and artificially sweetened soft drinks. So they're lumping it altogether was associated with a higher risk of all-cause mortality. Consumption of artificially sweetened soft drinks was positively associated with deaths from circulatory diseases and sugar-sweetened soft drinks were associated. with deaths from digestive diseases.

Now, isn't that interesting? So they did actually parse those things. That wasn't mentioned in the other thing, that GI diseases were more often associated with people with sugar, sweeten, soft drinks than artificially sweetened. And so we will look at this further. I want to pull the whole study and look at it. So I'm, for me, you know, selfishly, I'm in pretty good shape

because I do not drink these things. And, oh, so these risks, okay, yeah, it's like 1.08 compared to 1.0 with the control group. So I'm unimpressed by this, but, yeah, it bears further investigation. It's a big study. We can't really ignore it. And I'm not saying the stuff is safe, okay? I'm just saying I don't understand the mechanism. But I don't disagree with.

We shouldn't be going nuts with soft drinks. And if you're drinking 20 of them a day, just cut the shit. I need to add that to the thing at the end. All right. Let's answer some questions. Whoops. Advice from some asshole on the radio. Oh, damn.

Let me try that again. Number one thing. Don't take advice from some asshole on the radio. All right. Thank you, my friend. Well. Well. of course

what's all concerned or modern mirror what the hell why do I always sneeze if I'm looking at the sun I mean is that just

the designer is making me stop looking at the sun or there's something else behind it that kind of triggers that

see it yeah that's called the photic sneeze reflex and there there's a

hilarious. Physicians try to be funny. Colloquially, it's called sun sneezing, but it's also called autosomal-compelling, heliophthalmic outburst syndrome, or achew, get it? Oh, who, who, who, who. Oops, wrong, wrong drops. All right. But it's also known as the photic sneeze reflex. And you'll see this when people are exposed to numerous stimuli, bright lights. I know there have been people that had it when they get their eyeballs injected, so any kind of stimulus around there can cause this. Wikipedia says it affects 18 to 35% of the world's population. That seems high to me.

But the exact mechanism isn't well understood. It is autosomal dominant, meaning that if you have an unaffected parent and an affected parent, their kids, 50% of them will be at risk for having this. Whereas if it's autosomal recessive, then both the parents have to have the gene, and then for the kid to have it, they have to, that kid has to get both of the genes, okay? So like blue eyes. So blue eyes, you have, if you have a brown-haired parent and another brown-eyed parent, another brown-eyed parent, but they have, they both have the brown-blue gene. You know, they've got one brown gene, one blue gene, and blue is recessive. Then when they mate, you know, if they had a perfectly statistically accurate bunch of kids,

one of their kids would be blue, blue, and so they'd have blue eyes. Three of their kids would have brown eyes. One of them would be brown, brown, and two would be brown blue. I did that in my head, so I think that's right. Anyway, so that's autosomal recessive, but autosomal dominant, if they have, if, let's just say blue eyes was autosomal dominant, if the parent was brown-blue, they'd have blue eyes, and the kids would be, you know, brown, white. Let's say the parent has red eyes.

So the other parent is red-red. So half the kids would be red-brown, and so they would have red eyes, and the other half would be red-blue, and they would have blue eyes. So half of their kids would have blue eyes. That's a weird example because, you know, we all know, I know you all know from listening to the show, that blue eye is recessive, but I'm just using that as an example, in some alien planet where blue eyes is autosomal dominant. Anyway, so that's photoc sneezing.

Not a whole lot you can do about it. Don't look in the, how about not looking in the sun? How about that? Does that work for you? Okay, thanks. But, yeah, it's a real deal. Okay, we've got about a minute I can do this one, I think. I was watching, I watched a lot of detectives and true crime shows on TV.

Sure. And I saw one the other day that it was a woman who had been murdered, and they found drips of blood in the bathroom and in the bedding, and I forgot how she died. She may have been strangled, but they tested the blood, and they said it was menstrual blood. and I was just wondering, how can they tell? Oh, that's easy.

Okay, good. I'm glad this is easy because I have 33 seconds to go. You look at it under a microscope, and if you see endometrial cells, in other words, cells from the lining of the uters, because remember, women who are having the period aren't bleeding. They're sloughing off a layer of tissue.

You see tissue. If it's blood, you just see blood cells, so that's it. All right, well, thanks for joining us. What am I talking about? Thanks for joining me. You can't forget Rob Sprantz, Bob Kelly, Greg Hughes, Anthony Coomia, Jim Norton, Travis Teft, Lewis Johnson, Paul Off Charsky, Eric Nagel, Roland Campos, Sam, Roberts, Pat Duffy, Dennis Falcone, Ron Bennington and Fez Watley, whose early support of this show has never gone on appreciated.

Listen to our SiriusXM show on the Faction Talk channel, SiriusXM Channel 103, Saturdays at 8 p.m., unless we're preempted, Sundays at 5 p.m. where we're never preempted, on demand, which is the best and other times at Jim McClure's pleasure. Many thanks to our listeners whose voicemail and topic ideas make this job very easy. Go to our website at Dr. Steve.com for schedules and podcasts and other crap. Until next time, check your stupid nuts for lumps, quit smoking, get off your asses and get some exercise. We'll see you in one week for the next edition of Weird Mets. Thank you.