G'day G'day Folks,

  Scott J. Deron, D.O., FACC has written a book on C-reactive
Protein, subtitled "Everything you need to know about CRP and Why it's
more important than Cholesterol to your health."

You might expect a fired up attack on the cholesterol hypothesis but
you'd be mistaken.  Deron doesn't come with the angst that accompanies
McCully's devotion to the homocysteine hypothesis.  What Deron sets
out to show is that for many people with apparently normal levels of
blood cholesterol there is a still a risk of coronary heart disease.
As he puts it cholesterol is fundamental in building plaque.  CRP is
an indicator that the blood clots in the plaque are likely to be
unstable.  Put simply some people can have what are regarded as normal
amounts of plaque but if they are unstable then they are at risk even
if a cholesterol test doesn't show it.

What he sees as the issue is the combination of high LDL and CRP.  If
both are high then one is in double jeopardy.  In women, if one is
high and the other it low then high CRP is worse then high LDL.  Some
of the results are quite puzzling in this respect.  Results applicable
to women don't necessarily transfer over to men.

Most people accept that smoking causes lung cancer. About the only
people who pretend not to is the lawyers for tobacco companies. They
are the ones who shout "correlation isn't evidence of cause and
effect."  Most of us accept this.  Where correlation points to a three
or four fold increase in some outcome we are reluctant to accept
correlation as evidence of cause and effect.  With smoking there was a
fifteen times increase in lung cancer amongst smokers than non
smokers.  For most people this is convincing evidence.  The
correlation is too strong to ignore.  

What has this to do with CRP and the readers of ASD?  

Well, Paul Ridker at the Centre for Cardiovascular Disease Prevention
at Brigham and Women's Hospital found CRP was one of the best
predictors of future chronic disease. In particular he found that high
CRP was indicative of a sixteen fold increase in the rate of diabetes.
The book doesn't state whether that was T1, T2 or both combined.

As might be expected CRP correlates with many things people know
intuitively are bad for health but might underestimate.  

Obesity.  Fat cells pour out CRP. Losing weight is a benefit.

Gum disease.  The toxins from periodontal disease flood into the blood
and lead to elevated CRP.  Put simply gum disease is a major health
risk for diabetics.  This does provide one good reason for
supplementing with Vit C.  IMHO the safer course is to supplement with
say 500 mg per day rather than 1000 mg per day and to have a diet rich
in polyphenols so that the vitamin C gets recycled and never reaches
toxic levels.  Others might have different views on this matter.

Exercise.  
Exercise even without weight loss leads to lower CRP levels.

Smoking.  Smoking leads to higher CRP levels.

Inflammatory diseases.  Rheumatic fever, rheumatoid arthritis, lupus
all lead to increased CRP.  The issues here are more complex. Best one
talks them through with a medical professional if they are of concern.

Deron doesn't advise anything extraordinary in the diet line.  His
recommendations are largely in line with the AHA.  Reduce saturated
fats.  Reduce trans fats by avoiding corn, sunflower, safflower oil
etc because these are likely to be partially hydrogenated to improve
their stability.

Change to olive and canola oil.  He seems to think canola oil isn't
partially hydrogenated in the US.  I'm not so sure. Even deodorising
leads to some trans fat formation.  The one certain thing is extra
virgin olive oil never needs hydrogenation.

As an alternative he suggests the DASH diet.  The DASH diet with its
emphasis on vegetables was the starting place for my own dietary
explorations. The DASH diet made a few simple modifications to SAD the
standard American diet.  I simply pushed it further to make it more T2
diabetic friendly.

The rest of the book is devoted to proper breathing, relaxation,
meditation, visualization, petting a pet, massage, humour, lifestyle
change, asprin, statins, beta blockers.  The discerning reader will
note that it really doesn't matter how relevant CRP really is, doing
enough beneficial things in one's life is likely to lead to benefit
which ever feature actually produces the benefit.  

Put simply while the book title suggests it is about ground breaking
news about CRP the majority of the book is about common sense rather
conventional views on dealing with life without chronic disease.

Best wishes,