Chapter 2

Pg. 28 "Hygiene, quarantine, sanitation, and immunization were the first major wins for public health."

Pg. 28 "By the second half of the nineteenth century, canning of food was all the rage, and so was lead poisoning...The government didn't get involved for decades, because it's harder to remove a chronic exposure than it is to prevent an acute one; especially when Big Business stands to make a profit. Lead toxicity was first described in 1892, but the US government didn't get the lead out of paint and gasoline until 1982. 

Pg. 29 "In 1940, Albert Alexander, a London constable, was the first human to receive a dose of penicillin for an acute facial infection. His response to the medication was 'remarkable.' But it didn't last--the infection relapsed within six months, and he died a year later. Nonetheless, the "Golden Age" of Modern Medicine was launched. Therapy targeted to the pathology. The right antibiotic could kill the right bacteria, and people got better. Screw prevention, which takes time, infrastructure, and investment. Now, you could achieve a cure. There's a pill for that. Targeted therapy via personal intervention became the unyielding goal of Modern Medicine."

Pg. 31 "The prime directive of metabolic therapy is 'get the insulin down.' And that's true, regardless of your weight."

Pg. 32 "Everyone thinks that first you gain weight, and then you get sick. Yet, 80 percent of the time, it's actually the other way around. First, you get sick, then you gain weight. How do we know this? Because only 80 percent of obese people are metabolically ill. The other 20 percent of obese people are metabolically healthy. We even have a name for them--metabolically healthy obese (MHO)...The key is that these people have lots of subcutaneous fat, very little ectopic fat (fat in cells that shouldn't have fat), normal metabolic function, and low insulin levels."

Pg. 36 "There are two different LDLs, but the lipid profile test measures them together. The majority (80 percent) of circulating LDL species are called large buoyant or type A LDL, which are increased by dietary fat consumption. This is the species reduced by eating low-fat or taking statins. However, large buoyant LDL is cardiovascularly neutral--meaning it's no the particle driving the accumulation of plaque in the arteries leading to heart disease. Then there's a second, less common (20 percent) LDL species called small dense or type B LDL. There is some debate as to whether or not it's the actual perpetrator of the plaque, but it doesn't matter; small dense LDL is predictive of risk for a heart attack. The problem is that statins will lower your LDL-C because they're lowering the type A LDL, which is 80 percent of the total, but they're not doing anything to type B LDL, which is the problematic particle."

Pg. 41 "...the kidney is very adept at excreting excess sodium. But there's one thing that inhibits sodium excretion by the kidney--insulin resistance. High insulin levels increase blood pressure, even with relatively low sodium intake. And many people are insulin resistant--and those people do need to lower their salt as a treatment of the disease. It isn't just the salt--it's also our processed food."

Pg. 45 "Glucose levels are a poor man's proxy for insulin levels, and not a very good one."

Metabolical - Book Darts