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Myths and Misinformation About Saturated Fat and Cholesterol: How Bad Science and Big Business Created the Obesity Epidemic Departments of Psychology,

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Presentation on theme: "Myths and Misinformation About Saturated Fat and Cholesterol: How Bad Science and Big Business Created the Obesity Epidemic Departments of Psychology,"— Presentation transcript:

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2 Myths and Misinformation About Saturated Fat and Cholesterol: How Bad Science and Big Business Created the Obesity Epidemic Departments of Psychology, Molecular Pharmacology and Physiology, University of South Florida and Research and Development Service, J.A. Haley Veterans Hospital David Diamond, Ph.D.

3 Years Bad News: Abnormal Blood Lipids Triglycerides(mg/dl) Heart Disease Risk

4 Bad News: Abnormal Blood Lipids Years Total/HDL Heart Disease Risk

5 The Solution: Diet Changes and Exercise Total/HDL Heart Disease Risk Years

6 Diet Skinless Chicken, Low Fat Foods (Cheese, Yogurt), Olive Oil, Bread, Vegetables, Fruit, Nuts, Cereal, Potatoes Total/HDL Heart Disease Risk Years

7 Total/HDL X Diet Skinless Chicken, Low Fat Foods (Cheese, Yogurt), Olive Oil, Bread, Vegetables, Fruit, Nuts, Cereal, Potatoes Years

8 Total/HDL Heart Disease Risk X Diet Skinless Chicken, Low Fat Foods (Cheese, Yogurt), Olive Oil, Bread, Vegetables, Fruit, Nuts, Cereal, Potatoes Years

9 Really Scary News Heart Disease Risk Triglycerides(mg/dl) ! Years

10 Total/HDL ! Years Really Scary News

11 Obesity and Heart Disease in My Future Years weight in 1980 Body Weight (lb)!

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13 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease

14 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease Myth #2: - Cholesterol clogs arteries and causes heart disease - You will live longer if you take medication to lower your cholesterol

15 Myths and Misinformation: Misinformation: Food and Drug Company-Supported Research and the government have provided incorrect recommendations on ideal sources of food for optimal health – we have been misled Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease Myth #2: - Cholesterol clogs arteries and causes heart disease - You will live longer if you take medication to lower your cholesterol

16 Obesity Heart Disease Diabetes Alzheimers Disease Hypertension Stroke Cancer Arthritis Metabolic Syndrome

17 Historical Perspective on Diet, Obesity and Health ( Present) 55 >200 lbs Obesity-related health problems William Banting (1797 – 1878)

18 Historical Perspective on Diet, Obesity and Health ( Present) His doctor (Dr. William Harvey) prescribed a low carbohydrate diet: Unlimited consumption of meat No potatoes, bread or sugar William Banting (1797 – 1878) 55 >200 lbs Obesity-related health problems

19 Historical Perspective on Diet, Obesity and Health ( Present) His doctor (Dr. William Harvey) prescribed a low carbohydrate diet: Unlimited consumption of meat No potatoes, bread or sugar The Banting diet was a great success Banting lost 46 lbs, enjoyed great health, and lived into his 80s. (no clogged arteries!) William Banting (1797 – 1878) 55 >200 lbs Obesity-related health problems

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21 An obese person … may be given a diet of meat, excluding bread and potatoes, and the patient will reduce to his normal weight. As soon as the patient returns to his diet of bread and potatoes, he straightaway begins to increase in weight. 1892

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27 Eat Meat (fat): Lose weight But is it a healthy diet? Does eating red meat, full fat cheese, butter and eggs increase serum cholesterol?

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31 HDL (good cholesterol) Total Cholesterol Triglycerides LDL (bad cholesterol) Ratio Total/HDL Blood Glucose

32 Low Carb Diet (unlimited red meat): Lose Weight and Lower Cholesterol!

33 If a low carb diet reduces serum cholesterol, will a high carb diet (sugar) increase serum cholesterol? Low Carb Diet (unlimited red meat): Lose Weight and Lower Cholesterol!

34 Triglycerides(mg/dl) Cholesterol(mg/dl) Normal Diet No Sugar + Sugar No Sugar Weeks

35 Years My Diet (2007 – Present) Eggs, Butter, Beef, Chicken (with the skin), Full Fat Cheese, Coconut, Dark Chocolate, Nuts and Vegetables (Broccoli) Small Quantities of Fruit, Bread, Potatoes and Sugar Heart Disease Risk Triglycerides(mg/dl) Low Carb Diet

36 Triglycerides(mg/dl) Years Heart Disease Risk 70% Fat 20% Protein 10% Carbs Low Carb Diet My Diet (2007 – Present) Eggs, Butter, Beef, Chicken (with the skin), Full Fat Cheese, Coconut, Dark Chocolate, Nuts and Vegetables (Broccoli) Small Quantities of Fruit, Bread, Potatoes and Sugar

37 Years 70% Fat 20% Protein 10% Carbs Heart Disease Risk Total/HDL Low Carb Diet My Diet (2007 – Present) Eggs, Butter, Beef, Chicken (with the skin), Full Fat Cheese, Coconut, Dark Chocolate, Nuts and Vegetables (Broccoli) Small Quantities of Fruit, Bread, Potatoes and Sugar

38 Body Weight (lb) Years weight in % Fat 20% Protein 10% Carbs Low Carb Diet My Diet (2007 – Present) Eggs, Butter, Beef, Chicken (with the skin), Full Fat Cheese, Coconut, Dark Chocolate, Nuts and Vegetables (Broccoli) Small Quantities of Fruit, Bread, Potatoes and Sugar

39 Our Current State of Confusion

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42 Consequences of the Fat Phobia

43 Carbohydrates Fats Protein Excess Consumption of Carbs

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45 Simple Message to the Obese: Stop the Vilification of the Atkins Diet Its ok to eat meat, lose weight! Eat Less Carbs: Less Potatoes, Bread and Anything Sweet

46 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease

47 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease X

48 How Did Food Recommendations Go Awry?

49 Deaths from Cardiovascular Disease Lloyd-Jones et al, Circulation

50 Deaths from Cardiovascular Disease Lloyd-Jones et al, Circulation

51 Keys (1953). Journal of the Mount Sinai Hospital New York There is a remarkable relationship between death rate from heart disease and the proportion of fat calories in the national diet

52 Keys (1953). Journal of the Mount Sinai Hospital New York - Ancel Keys cheated - He selected data from 6 countries to create the linear relationship. Data were actually available from a total of 22 countries!

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55 No Significant Relation Between Fat Consumption and Heart Disease Mortality (r 2 =0.1, p > 0.05) Significant Relation Between Sugar Consumption and Heart Disease Mortality (r 2 =0.41, p < 0.05)

56 A generation of citizens has grown up since the Diet/Heart Hypothesis was launched as official dogma. They have been misled by the greatest scientific deception of our times: the notion that consumption of animal fat causes heart disease. Coronary Heart Disease – Doing the Wrong Things Nutrition Today (July, 1985) George Mann, Sc.D., M.D. Professor, Nutritional Biochemist, Vanderbilt University Associate Director of the Framingham Study

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58 Intake of total fat was not significantly associated with coronary events (heart attacks) or mortality Intake of saturated fat (animal fat) was not significantly associated with coronary events or mortality Fatal heart disease was not reduced by low-fat diets or by replacing saturated (animal) fats with polyunsaturated (vegetable) fats

59 Walter Willett, M.D. Chair, Department of Nutrition Harvard School of Public Health data on nearly 300,000 individuals … clearly contradict the low-fat-is-good-health message … the exclusive focus on adverse effects of fat may have contributed to the obesity epidemic.

60 Ancel Keys – Created the Artificial Link Between Fat and CHD Became Editor of Circulation on the cover of Time Magazine, January, 1961

61 In 1977, a Senate Committee led by George McGovern released its "Dietary Goals for the United States." Without any evidence to support their conclusions, the committee identified fat as the culprit causing obesity.

62 The President of the US National Academy of Sciences, Dr. Philip Handler, an expert on metabolism, referred to McGoverns Dietary Goals as nonsense.

63 Steak for Dinner, Angioplasty for Dessert? The Myth That Cholesterol Clogs Arteries

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65 Thanks solely to Madison Avenue promotion by commercial food producers and the American Heart Association, a great many people imagine that if they lower their blood cholesterol … they will prevent heart disease... Few people realize that there has never been a proven, scientific relationship between lowering blood cholesterol levels and preventing heart disease The Cholesterol Controversy, 1973 by Edward Pinckney, M.D. Editor of Journal of the American Medical Association

66 An almost endless number of observations and experiments have effectively falsified the hypothesis that dietary cholesterol and fats, and a high cholesterol play a role in the causation of atherosclerosis and cardiovascular disease. The hypothesis is maintained because allegedly supportive, but insignificant findings, are inflated and most contradictory results are ignored. A hypothesis out-of-date: The diet-heart idea by Uffe Ravnskov, M.D., Ph.D. Journal of Clinical Epidemiology, 55: , 2002

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68 - of 480,000 men, screened the top 5% in cholesterol level (290 mg/dl) to be in the study -followed for 7.4 years, treated with cholestyramine or placebo 24% reduction in heart disease-related deaths!

69 - of 480,000 men, screened the top 5% in cholesterol level (290 mg/dl) to be in the study -followed for 7.4 years, treated with cholestyramine or placebo 24% reduction in heart disease-related deaths!

70 Start: 480,000 men 98% (Placebo) vs 98.4% (Treated) Survived

71 Start: 480,000 men 0.4% becomes 24%

72 Start: 480,000 men 0.4% becomes 24% 96.3% (Placebo) vs 96.4% (Treated) Survived

73 Start: 480,000 men The $120 Million Study That Produced a Non- Significant Treatment Difference of 3 People! = 0.1%

74 The Drug Trial Failed Miserably – Lowering Cholesterol Had no Significant Effect on Mortality

75 The Lead Investigators Declared Victory – Predicting Heart Disease Would Be Eradicated With Drugs

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78 No sensible person can avoid the conclusion that the NCEP is an expensive fraud perpetuated by avaricious business enterprises and dishonest scientists. George Mann, Sc.D., M.D. Professor, Nutritional Biochemist, Vanderbilt University

79 The Missing Conflict of Interest Statement

80 ATP III Update 2004: Financial Disclosure Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca; he has received research grants from Merck, Abbott, and Glaxo Smith Kline. Dr. Grundy Dr. Cleeman has no financial relationships to disclose. Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer, and EHC (Merck); she has received unrestricted institutional grants for Continuing Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca, and Bristol- Myers Squibb Medical Imaging; she has received a research grant from Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical, and Biosite. Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering- Plough, Fournier, Tularik, Esperion, and Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and Novartis. Dr. Clark has received honoraria for educational presentations from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has received grant/research support from Abbott, AstraZeneca, Bristol- Myers Squibb, Merck, and Pfizer. Dr. Hunninghake has received honoraria for consulting and speakers bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for consulting from Kos; he has received research grants from AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and Pfizer. Dr. Pasternak has served as a speaker for Pfizer, Merck, Merck/Schering-Plough, Takeda, Kos, BMS- Sanofi, and Novartis; he has served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer Health Solutions, Johnson & Johnson-Merck, and AstraZeneca. Dr. Smith has received institutional research support from Merck; he has stock in Medtronic and Johnson & Johnson. Dr. Stone has received honoraria for educational lectures from Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant. Dr. Grundy … honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb and AstraZeneca; … research grants from Merck, Abbott and Glaxo Smith Kline.

81 ATP III Update 2004: Financial Disclosure Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca; he has received research grants from Merck, Abbott, and Glaxo Smith Kline. Dr. Grundy Dr. Cleeman has no financial relationships to disclose. Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer, and EHC (Merck); she has received unrestricted institutional grants for Continuing Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca, and Bristol- Myers Squibb Medical Imaging; she has received a research grant from Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical, and Biosite. Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering- Plough, Fournier, Tularik, Esperion, and Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and Novartis. Dr. Clark has received honoraria for educational presentations from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has received grant/research support from Abbott, AstraZeneca, Bristol- Myers Squibb, Merck, and Pfizer. Dr. Hunninghake has received honoraria for consulting and speakers bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for consulting from Kos; he has received research grants from AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and Pfizer. Dr. Pasternak has served as a speaker for Pfizer, Merck, Merck/Schering-Plough, Takeda, Kos, BMS- Sanofi, and Novartis; he has served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer Health Solutions, Johnson & Johnson-Merck, and AstraZeneca. Dr. Smith has received institutional research support from Merck; he has stock in Medtronic and Johnson & Johnson. Dr. Stone has received honoraria for educational lectures from Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant. Dr. Grundy … honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb and AstraZeneca; … research grants from Merck, Abbott and Glaxo Smith Kline. $150,000/drug company x 10 = $1,500,000/year!

82 ATP III Update 2004: Financial Disclosure Dr. Grundy has received honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb, and AstraZeneca; he has received research grants from Merck, Abbott, and Glaxo Smith Kline. Dr. Grundy Dr. Cleeman has no financial relationships to disclose. Dr. Bairey Merz has received lecture honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer, and EHC (Merck); she has received unrestricted institutional grants for Continuing Medical Education from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca, and Bristol- Myers Squibb Medical Imaging; she has received a research grant from Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson, SCIPIE Insurance, ATS Medical, and Biosite. Dr. Brewer has received honoraria from AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering- Plough, Fournier, Tularik, Esperion, and Novartis; he has served as a consultant for AstraZeneca, Pfizer, Lipid Sciences, Merck, Merck/Schering-Plough, Fournier, Tularik, Sankyo, and Novartis. Dr. Clark has received honoraria for educational presentations from Abbott, AstraZeneca, Bristol-Myers Squibb, Merck, and Pfizer; he has received grant/research support from Abbott, AstraZeneca, Bristol- Myers Squibb, Merck, and Pfizer. Dr. Hunninghake has received honoraria for consulting and speakers bureau from AstraZeneca, Merck, Merck/Schering-Plough, and Pfizer, and for consulting from Kos; he has received research grants from AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, and Pfizer. Dr. Pasternak has served as a speaker for Pfizer, Merck, Merck/Schering-Plough, Takeda, Kos, BMS- Sanofi, and Novartis; he has served as a consultant for Merck, Merck/Schering-Plough, Sanofi, Pfizer Health Solutions, Johnson & Johnson-Merck, and AstraZeneca. Dr. Smith has received institutional research support from Merck; he has stock in Medtronic and Johnson & Johnson. Dr. Stone has received honoraria for educational lectures from Abbott, AstraZeneca, Bristol-Myers Squibb, Kos, Merck, Merck/Schering-Plough, Novartis, Pfizer, Reliant, and Sankyo; he has served as a consultant for Abbott, Merck, Merck/Schering-Plough, Pfizer, and Reliant. Dr. Bairey Merz … honoraria from Pfizer, Merck, and Kos; she has served as a consultant for Pfizer, Bayer and Merck; she has received grants from Pfizer, Procter & Gamble, Novartis, Wyeth, AstraZeneca and Merck; she has stock in Boston Scientific, IVAX, Eli Lilly, Medtronic, Johnson & Johnson... Dr. Grundy … honoraria from Merck, Pfizer, Sankyo, Bayer, Merck/Schering-Plough, Kos, Abbott, Bristol-Myers Squibb and AstraZeneca; … research grants from Merck, Abbott and Glaxo Smith Kline. $150,000/drug company x 10 = $1,500,000/year!

83 * These guidelines were developed by people with a financial conflict of interest.

84 Are they wrong?

85 A Different Opinion From Scientists Unsupported by the Statin Industry

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91 * These guidelines were developed by people with a financial conflict of interest. ** These guidelines have been disputed by scientists without a conflict of interest.

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93 Isnt there a benefit from statins in the reduction of cardiac events?

94 "What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 would have no benefit?" Jerome R. Hoffman, M.D. Professor of Clinical Medicine, UCLA School of Medicine Isnt there a benefit from statins in the reduction of cardiac events?

95 Adverse Side Effects of Statins

96 Adverse Side Effects of Statins: Erectile Dysfunction, Type 2 Diabetes, Rhabdomyolysis, Acute Renal Failure, Cancer and Liver Dysfunction

97 Final 2 Issues: What Caused the Increase in Deaths from Cardiovascular Disease in the 20 th Century? How is Cholesterol Involved in Heart Disease? Villain or Misunderstood Hero?

98 Lloyd-Jones et al, Circulation Does Butter or Saturated Fat Consumption Parallel the Increase in Heart Disease-Related Death?

99 Deaths from Cardiovascular Disease No Relation of Butter Consumption to Heart Disease

100 No Relation of Saturated Fat Consumption to Heart Disease Deaths from Cardiovascular Disease

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102 Clear Relation of Smoking to Heart Disease Deaths from Cardiovascular Disease

103 Cross Section of a Damaged Artery What Causes Coronary Heart Disease? sugar

104 What Causes Coronary Heart Disease?

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106 LDL WBC What Causes Coronary Heart Disease?

107 Thickening of the Artery Wall Following Repeated Injury and Repair

108 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease

109 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease X

110 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease Myth #2: - Cholesterol clogs arteries and causes heart disease - You will live longer if you take medication to lower your cholesterol X

111 Myths and Misinformation: Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease Myth #2: - Cholesterol clogs arteries and causes heart disease - You will live longer if you take medication to lower your cholesterol X X

112 Myths and Misinformation: Misinformation: We have been misled Myth #1: Consumption of food high in saturated fat and cholesterol (beef, butter) makes people fat and causes heart disease Myth #2: - Cholesterol clogs arteries and causes heart disease - You will live longer if you take medication to lower your cholesterol X X

113 The Bittersweet End Of Humans as Hunters

114 My Mentors My Mentors Anthony Colpo Gary Taubes Barry Groves Anthony Colpo Gary Taubes Barry Groves Paul Rosch, M.D.Jeff Volek, Ph.D. Paul Rosch, M.D.Jeff Volek, Ph.D. Rodney Hayward, M.D.Walter Willett, M.D. Joel Kauffman, Ph.D.John Abramson, M.D. Walter Willett, M.D., Ph.D.Robert C. Atkins, M.D. Uffe Ravnskoff, M.D., Ph.D.Germain Brisson, Ph.D. James H. Salisbury, M.D.Emmet Densmore, M.D. C. De Lacy EvansMarcia Angell, M.D. Jean Anthelme Brillat-SavarinJohn Abramson, M.D. George Mann, ScD., M.D.James H. Salisbury, M.D. Duane Graveline, M.D.Kilmer McCully, M.D. Nancy Appleton, Ph.D.Bruce Fife, C.N., N.D. Jay S. Cohen, M.D.William Rothstein, Ph.D. Edward H. Ahrens, M.D.Michael F. Oliver, M.D. Edward R. Pinckney, M.D. and Cathey Pinckney Sally Fallon and Mary G. Enig, Ph.D.

115 Are there any questions?


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