I’ve often thought if I crashed on a deserted island, I’d be the first to die. I don’t know if I could make myself even eat fish. Let alone the raw liver of some strange animal.

I don’t think a lot of patients with pernicious anemia were actually treated with that. The majority of them would probably have given up. William B. Castle used stomach content of healthy individuals in an experiment to show that vitamin B12 needed intrinsic factor produced by the stomachs parietal cells to be absorbed.

Minot and Murphy didn’t win the Nobel prize for designing a diet prescribing raw liver. Rather rare would be just fine. William P. Murphy himself on the subject:

“The liver and the muscle meat should be eaten rather rare, and may be cooked in various ways in order to make it palatable and appetizing; but it should not be fried or prepared with fat. The liver is usually very satisfactorily cooked by broiling or baking it.”

W.P. Murphy, Diet In Perniciious Anemia, Am J Public Health, 1927.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1321559/pdf/amjphealth00001-0105.pdf

” Or blood pudding in Scotland! (the term pudding isn’t used the same way in Britain as here”

“Blood pudding” is typically called “black pudding” here in the UK. However, aside from black pudding, white pudding and Yorkshire puddings, the word “pudding” is only otherwise used for desserts.

In Northern dialects the word “pudding” is generally used to refer to all desserts, as there are (obviously) fewer French words used in areas not touched by the Norman invasion. So you would ask “What’s for pudding?” rather than “What’s for dessert?”.

WRT ingesting haem iron from food in an attempt to reverse anaemia, I’d like to add how glad I am that pernicious anaemia no longer requires daily ingestion of raw liver or liver juice, or partially digested and regurgitated minced beef as the only available treatments. I think I might have just given up! At least black pudding is cooked, and can be disguised or drowned in something. Half a pound of raw liver though? To use a colloquialism, that’s proper minging.

Thanks be to Todd and Folker, for the discovery and isolation of cobalamin!

http://en.wikipedia.org/wiki/Gayelord_Hauser

http://www.vitacost.com/natural-swiss-kriss-herbal-laxative-bulk?csrc=GPF-PA-075820158354&ci_sku=075820158354&ci_gpa=pla&ci_kw={keyword}&gclid=CKm2q56P2rICFQyZ4AodQjkA2Q

Another meta-analysis did indeed find that replacing SFA with PUFA reduced cardiac risk:
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000252
But they said “it is not possible from this evidence alone to distinguish between the benefits of reducing SFA and the benefits of increasing PUFA. Furthermore, the small number of trials identified in this study all had design faults,”

The book I reviewed, Heart 411, pointed out that only 20% of our cholesterol comes from diet; we manufacture the rest. It said saturated fat contributes to heart disease and recommended the Mediterranean diet, but it didn’t stress PUFAs and it said existing studies were not definitive for the Mediterranean diet.

And no, I didn’t mean diet is unimportant; I only meant that dietary intervention is seldom sufficient by itself. A review article in AFP estimated that dietary advice only lowers total cholesterol levels by 3-6%. http://www.aafp.org/afp/2005/0315/p1137.html Even if it is more successful than that, I think cutting calories to lose weight is probably more important than worrying about the exact content of the diet.

Am I missing something more recent or more definitive? If I’m wrong, I’d appreciate being shown why with citations. I’m always willing to learn by being pointed to better published evidence, but I don’t learn anything from gratuitous put-downs.

You should probably review the ATPIII guidelines again. Obviously statins are important, and I believe in aggressive statin therapy, but to say that dietary intake is not clinically important compared to statins is just wrong. In fact, that kind of statement is the exact opposite of good medicine. That’s very unlike the Harriet I’ve read in the past.

“Sigh, old Harriet is out of date.”
The 2010 meta-analysis I cited is not out of date.

“Evidence finds that replacing dietary saturated fat with unsaturated fat decreases LDLs and CVD in a dose-response relationship.” That may be, but the meta-analysis didn’t show any association between saturated fat intake and CVD, and the effect of dietary changes is not very clinically important compared to the effect of statins.

“Saturated fat greatly contributes to blood cholesterol levels.”

That’s a common understanding, but it’s not substantiated by the evidence.
High cholesterol levels usually only decrease by 10% or less with dietary modification, and most patients with high LDLs can’t lower them sufficiently without a statin.
And this recent meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824152/

I have to say – fried blood sounds absolutely disgusting But I’m as picky as they come when it come to food. I’m surprised to read you misspeak, when you wrote: “The contribution of dietary fat to blood cholesterol levels is small.” That’s a half truth – it of course depends on the type of dietary fat. Saturated fat greatly contributes to blood cholesterol levels.

I wonder how you would survive in Spain. Olive oil is essential to Spanish cuisine, from gazpacho to paella.
And yet the death rate from cardiovascular disease is an order of magnitude lower than in the US.

Although low-fat diets are still commonly recommended for the prevention and treatment of heart disease, the evidence for effectiveness is questionable. See http://query.nytimes.com/gst/fullpage.html?res=FA0F13FD3F5A0C7B8CDDAB0894DE404482 The contribution of dietary fat to blood cholesterol levels is small.

You can eat fried food?!

It simply isn’t possible for me. I get about a Tbsp. of oil/day so I use it for dressing for my greens or to saute my garlic–or spray it on my 2 Tbsp of popcorn. It’s so unfair–but I did get very good results on my recent lipid panel and other tests.

@nybgrus

blutwurst! You too (eating stuff I used to love)! Man, I get nothing fun to eat anymore. All that salt and fat–you may be sorry one day.

Still, I really do LIKE kale–it’s not a penance for past indulgences.

As for getting the blood – you can usually pick it up, cooked or raw, from Asian markets. Back in Southern California we had 99 Ranch Markets which sold blood. It was usually pigs blood, but it all tastes the same to me.