Archive for the ‘Science’ Category

Hospitals in time of COVID-19. Flatten the curve, folks.

March 16, 2020

I read “The U.S. has about 2.8 hospital beds per 1,000 people (South Korea and Japan, two countries that have seemingly thwarted the exponential case growth trajectory, have more than 12 hospital beds per 1,000 people; even China has 4.3 per 1,000). With a population of 330 million, this is about 1 million hospital beds. At any given time, about 68% of them are occupied. That leaves about 300,000 beds available nationwide.”

Current need for hospital stay with COVID-19 runs about 15% and doubling of cases is expected to be 6 days with moderate control of spread. (Italy to May 14 had a doubling period of 4 days.) (

Generously (given report from incoming air passenger) assuming 6 days, that gives the USA about 4 million cases by May 13. Being generous again, allowing 10% need hospital, that leaves USA with 400,000 COVID-19 sufferers needing hospital by May 14, and over 1.2 million by May 26.  For 1 million beds.

My sympathy to all the nice people in the USA.

Sympathy, because Australia had  3.9 hospital beds per 1000 people in 2018.  Including psychiatric beds.  Sympathy, because our testing is poor, due to a shortage of materials.  Sympathy, because  the published case figures are put out without the caveat that they only test those who

  • both (a) have symptoms AND b) have been overseas in the past fortnight or in contact with a confirmed case,
  •  those who have severe community-acquired pneumania
  • Or are health care workers hospitalised with moderate to severe community-acquired pneumonia.

As  people can shed the virus while appeaing healthy, even having a heavier viral load than people with symptoms, and as some people can take over 3 weeks to show symptoms, we will have cases missed by the testing protocols.

I hope my compatriots do take all the recommended precautions, and encourage the government and businesses to take the measures taken by Singapore and Hong Kong, including temperature scans on entry to all places where people gather.

Flatten the curve, folks!


Why I watch “Mad As Hell”

February 17, 2020

“Mad As Hell” is often seen as pure political satire, but it has a  lot of social commentary and occasionally puts our lives in a wider context.

This is an example of the type of work which keeps me watching.

For those concerned by proposed changes to Oz guidelines for Doctors re complementary medicine: what the proposed changes are

April 8, 2019

Actual proposed  Oz guidelines for doctors re complementary and unconventional medicine, from are copied in below.  Much of the concern seems to be from those who have not read them.  Read before worrying, then you will sound more sensible if you comment in the way described on the site.

The consultation is called

Public consultation on clearer regulation of medical practitioners who provide complementary and unconventional medicine and emerging treatments

Guidance for all registered medical practitioners

This section of the guidelines includes guidance for all registered medical practitioners including those doctors whose patients use complementary and unconventional medicine and emerging treatments, but who don’t themselves provide these treatments.

  1. Discussion with patients

The use of complementary and unconventional medicine and emerging treatments is increasing. It is therefore important that all medical practitioners are aware of these areas of practice and how they may affect their patients and impact other treatments, regardless of whether they themselves provide or recommend these treatments. There are resources available for medical practitioners when discussing complementary and unconventional medicine and emerging treatments with their patients.[1]

Good medical practice for all medical practitioners involves:

  • Asking your patients about their use of complementary and unconventional medicine and emerging treatments regardless of whether you provide or recommend these treatments.
  • Taking into consideration your patient’s use of complementary and unconventional medicine and emerging treatments when determining appropriate management for your patient.
  • Respecting your patient’s right to make informed decisions about their health and their right to choose complementary and unconventional medicine and emerging treatments.



Guidance for registered medical practitioners who provide complementary and unconventional medicine and emerging treatments

This section of the guidelines includes guidance for registered medical practitioners who provide complementary and unconventional medicine and emerging treatments.

  1. Knowledge and skills

Safe patient care relies on the medical practitioner having the knowledge and skills in the area of medicine in which they practise. This is both for the treatments being provided and the conditions for which patients seek treatment. This is particularly important where treatments may not be part of standard medical training, for alternative uses of conventional treatments and for new and emerging treatments that are continuously evolving.

Good medical practice for medical practitioners providing complementary and unconventional medicine and emerging treatments involves:

  • Ensuring you have current knowledge and skills for your scope of practice to ensure safe patient care.
  • Only offering treatments if you have the appropriate training, expertise and experience in both the treatment and the condition being treated.
  • Arranging appropriate and timely specialist referral, when indicated.
  • Undertaking necessary training if you intend to change your scope of practice to include complementary and unconventional medicine and emerging treatments.
  1. Conflicts of interest

Conflicts of interest can arise when providing complementary and unconventional medicine and emerging treatments. This is the case when there are high costs involved as well as because of the experimental and commercial aspects of some treatments.

Good medical practice for medical practitioners providing complementary and unconventional medicine and emerging treatments involves:

  • Always acting honestly and only in your patient’s best interests when providing complementary and unconventional medicine and emerging treatments.
  • Ensuring that you do not have a financial or commercial conflict of interest that may influence the advice and/or treatment that you give your patients.
  1. Informed consent

Patients have a right to know if the treatment they are being offered is not considered to be ‘conventional medicine’. They have the right to know the evidence for its efficacy and safe use.

Medical practitioners proposing complementary and unconventional medicine and emerging treatments must obtain informed consent from their patient. Good medical practice involves:

  • Providing your patient with enough information, preferably in written form, for them to make informed decisions about proposed assessments, investigations and treatments.
  • Providing your patient with clear information about:
    • the extent to which the assessment, investigation and treatment is consistent with conventional medicine and accepted by the medical profession or if it is considered alternative and/or experimental
    • the degree to which, and how, diagnostic investigations and tests have been formally evaluated and what is known about their reliability, safety and risks
    • the degree to which, and how, the proposed treatments have been formally evaluated or proven and what is known about their safety, side effects, risks, likely effectiveness and a realistic likelihood of benefit for the proposed use.
    • the range of possible outcomes, taking into consideration the patient’s expectations
    • the likely number of investigations and treatments required and the costs involved
    • other treatment options (including conventional treatments), their risks, likely benefits and efficacy based on the best current available information.
  • Ensuring that patients who may be vulnerable because of the serious and/or chronic nature of their condition and/or because conventional medicine has not been effective, are not exploited or unduly influenced.
  • Ensuring that information provided about complementary and unconventional medicine and emerging treatments does not create unrealistic patient expectations.
  • Informing your patient of their right to seek a second opinion regarding their treatment and options from another independent medical practitioner when proposing treatments that are complementary, unconventional or emerging.
  1. Assessment and diagnosis

Some medical practitioners providing complementary and unconventional medicine and emerging treatments use diagnostic methods and tests that are not considered to be part of conventional medicine.

Good medical practice in the assessment and diagnosis of patients involves:

  • Ensuring the assessment and examination of your patient is comprehensive and considers all relevant information.
  • Ensuring that any recommendation for investigations or tests is based on the best current available information.
  • Performing and/or ordering any generally recognised diagnostic investigations and tests that would be reasonably expected for appropriate patient care.
  • Ensuring you consider appropriate differential diagnoses for each individual patient.
  • Ensuring that your diagnosis is supported by sound clinical judgement and informed by the best current available information.
  1. Treatment

Providing a treatment in the absence of an identified therapeutic need can unnecessarily expose a patient to risk of harm. Patient harm can also result if the provision of complementary and unconventional medicine and emerging treatments results in delays in accessing more appropriate treatments for the patient.

Good medical practice when providing complementary and unconventional medicine and emerging medicine involves:

  • Ensuring that you do not discourage the use of conventional treatment options when this is clinically appropriate.
  • Only recommending treatments where there is an identified therapeutic need, quality and safety can be reasonably assured and that have a reasonable expectation of clinical efficacy and benefit.
  • Ensuring that the provision of any complementary and unconventional medicine and emerging treatments comply with any relevant Therapeutic Goods Administration requirements.[2]
  1. Patient management

Good patient care is supported when there is good communication with, and coordination of care between, all treating practitioners. When the provider of complementary and unconventional medicine or emerging treatments does not have a role in the patient’s regular medical care it is important to ensure that there are measures in place for the coordination of care. Follow-up of patients is particularly important where treatment is provided that is experimental and/or part of a formal research clinical trial – both for the patient’s wellbeing and for the contribution to medical knowledge.

Good medical practice for the care of your patients to whom you are providing complementary and unconventional medicine and emerging treatments involves:

  • Documenting information including the diagnosis, treatment, efficacy, side-effects and known risks of interactions in the patient’s medical record.
  • Ensuring that you take responsibility for appropriate monitoring and follow-up of patients to whom you are providing complementary and unconventional and emerging treatments. This is even more important when you are providing experimental treatments.
  • Encouraging your patients to tell their other health practitioners about their use of complementary and unconventional medicine and emerging treatments.
  • With permission from your patient, communicating with their other treating doctors (if applicable). You should inform other treating medical practitioners of the investigations, the diagnoses, treatments, known risks of interactions and patient progress.
  • Reporting adverse events to the relevant authority to assist safety monitoring.
  1. Advertising

Some patients who seek complementary and unconventional medicine or emerging treatments may be vulnerable to advertising that may lead to unreasonable expectations. The advertising provisions in Section 133 of the National Law include that a regulated health service must not be advertised in a way that is false, misleading or deceptive or creates an unreasonable expectation of beneficial treatment.

Good medical practice when advertising complementary and unconventional medicine and emerging treatments involves:

  • Ensuring that all advertising material, including practice and practitioner websites, complies with the Board’s Guidelines for advertising of regulated health services, including the advertising requirements of section 133 of the National Law, of the Therapeutic Goods Administration and the Therapeutic Goods Advertising Code and of the Australian Competition and Consumer Commission.
  • Ensuring that you do not create the impression that you are a specialist in an area of practice that is not a recognised specialty.
  • Ensuring advertising material does not create unreasonable patient expectations of the benefits of the complementary and unconventional medicine and emerging treatments.
  1. Research and advancing knowledge

Innovation and research in new treatments is necessary to improve health outcomes. However, there must be protections in place for patients. Efforts to make advancements in treatments should not jeopardise patient safety.

Good medical practice in the research and advancement of complementary and unconventional medicine and emerging treatments involves:

  • Ensuring that research involving complementary and unconventional medicine and emerging treatments complies with the National Health and Medical Research Council’s (NHMRC) current ‘Australian Code for the Responsible Conduct of Research’ and ‘National Statement on Ethical Conduct in Human Research’.
  • Where tests and treatments are experimental, being prepared to contribute to and share new knowledge with the profession.


The Board acknowledges the following organisations’ codes and guidelines, which helped inform the development of the Board’s draft guidelines:

  • Medical Council of New South Wales (2015) Complementary health care policy
  • Medical Council of New Zealand (2011) Statement on complementary and alternative medicine

Implementation date and review

These guidelines will take effect on <date>.

The Board will review these guidelines at least every five years.

[1] For example, National Health and Medical Research Council (NHMRC), Talking with your patients about Complementary Medicine – a Resource for Clinicians, 2014 and NHMRC, Stem Cell Treatments – A Quick Guide for Medical Practitioners, 2013

[2] For example, Therapeutic Goods Administration (TGA), Australian regulatory guidelines for complementary medicines, 2018 and TGA, Australian regulatory guidelines for biologicals, 2017.

Urinary tract infection – Hiprex may help, but ware pain! (And see your GP, it can maskinfection)

June 5, 2018
Urinary tract infection, ouch. 3 days to medical appointment, not bad enough for hospital emergency, but disinclined to any activity…
Previously used Ural (urinary alkaliniser), as it helps keep enough urine flow to wash tract clean and start healing (by reducing ouch-factor in urination so one can drink enough water, I think).  I do not have a good response to cranberry pills, though some find they help.
Pharmacy suggested hiprex (hexamine hippurate) instead of urinary alkaliniser, as “it will kill bacteria” – but also said “Don’t use an alkaliniser as it stops the stuff working.” Tried it – even more ouch.
Checked online: Hexamine hippurate relies on acidity in urine to break it into ammonia and formaldehyde, and if urine not acid (likely if vegetarian/low protein diet) best to take 1g vitamin C with each dose, to increase acidity. So acid urine plus ammonia plus formaldehyde running over open wound in urinary tract – kills germs, sure, but not much fun for the sufferer unless masochist.
Should be dispensed with advice on pain relief!
After a day, and with added vitamin C, much reduced discomfort but trace blood on toilet paper.  Second day, well enough to get out to do gardening.  Two days after that got to doctor, test showed active infection despite lack of symptoms, antibiotics cleared it.
Would use it again if unable to get to doctor for a while.

Bitcoin – not for me.

December 8, 2017

The recent enthusiasm for Bitcoin bothers me.

Not because it has got to the “taxi drivers are talking about it” indicator of bubble status.

Because it is being used widely enough to stay in use when the bubble bursts.

Many of the people using it are interested in the environment, and approve of replacing still-working globes with LED globes to reduce power consumption. They may have installed solar PV panels to contribute to low-emission power.

How will they feel when they understand the impact of the bitcoin computing approach?

The ConversationDigiconomist and IEEE   put it clearly.  A Bitcoin transaction uses 5,000 times as much energy as using a  credit card, and the energy cost will increase as the blockchain lengthens.  The multiple servers maintaining copies of the ledger, and comparing their versions, and doing the complex calculations to solve a puzzle  to be the lucky one to generate a Bitcoin (all the others’ discard the work they have done, wasted electricity) – all burn power and generate waste heat.

I believe  that cold climates are more ethical server locations, as the heat generated can at least be used for warming buildings or preheating for hot water systems, but even so the process leaves me uneasy.

I am glad that the alternative blockchain designers are testing less power-hungry approaches.  Until Bitcoin changes its approach, I think it should be avoided.

What future for the average intelligence student? The problem with education “for employment”

July 10, 2016

Both our major political parties are talking about education to fit students for jobs in “the new economy.”  At the same time  Our Coalition Government wants to give Company Tax reductions to large businesses.  However, for large companies,  increased company profits invested in expansion tend to lead to job losses.

Not just from offshore subcontracting of labour to exploited workers with no leave entitlements, OH&S rights,  or superannuation. Consider

It includes a quote from a former McDonald’s senior staffer : “It’s cheaper to buy a $35,000 robotic arm than it is to hire an employee who is inefficient, making $15 an hour bagging French fries.”

The main item in the article is that 60 000 (probably OH&S nightmare) jobs have gone because Chinese factories invested in technology not humans – even at their pay rates the robots are cheaper.

These job losses are not just the semi-literate jobs.  Consider the rise in expert systems, even self-reprogramming learning systems: the first white-collar job robots are already here, even doing work for lawyers:

The students know about this.  They know that machine intelligence researchers are even starting to find ways to program the machines for creativity.
(see John Gero on Creativity emergence and evolution in design concepts and framework
and  )

So why should the less bright and less creative struggle to learn the basics, if they are told education is “to get a job” and they know they are headed for love on the dole?   (Read Greenwood’s book, or at least a detailed review, if you haven’t come across a film or play adaptation yet )

It is time for the meme of “education to be fit for work” to die.  Move to “education to get tools to make more fun and happiness, or dodge trouble.”  Start classes in “Learning something new without a teacher’s help, and demonstrating it to others,” “Comparing and testing health benefit claims,”  “Bullshit detection,” “website reliability testing,” “effective complaints,” “Dealing with Bureaucracy 1:  Completing a basic tax return so you don’t pay your refund to an accountant,” and  “Dealing with Bureaucracy 2:  Complying with Dole paperwork requirements.”

Of course, you may end up with a lot of activists trying to improve the Nation because they realise that the  current socio-economic system is the source of much unhappiness.  They may even realise that money is just another social construct – and not a good one – and demand a world run on social obligation instead.
Would that be so bad?

Paracetamol, Aspirin, Fashion and Changing Disease Patterns.

March 25, 2014

I remember the last days of  “A cup of tea, a Bex, and a good lie down.”  I also remember the reports that kidney failure  was related to Bex’s phenacetin and digestive tract ulcers were  linked to its aspirin, and  the start of the emphasis on paracetamol (AKAacetaminophen  in the USA)  as a safe alternative.

Now there is research suggesting that aspirin use has many useful side effects.  This has hit the popular press – compare and

There are also problems with overuse of paracetamol having its own risks, and (unlike aspirin) it does not much reduce inflammation, so will not provide the same range of beneficial side effects as aspirin.  (As an aside,  it has great value for those who cannot risk aspirin’s blood-thinning properties, and for those young enough to be at risk of Reye’s syndrome.)  Other new painkillers (e.g. ibuprofen, naproxen) are selling well, and will no doubt be found to have a range of unexpected good and bad side effects.  There is a lot unknown about analgesics – for example, they don’t yet know why some people don’t respond to some analgesics, but some genes (e.g. melanocortin 1 receptor (MC1R)) seem to play a role.

The statistics on western women’s life expectancies in the seventies were based on generations of women who used aspirin-based medicines to keep going when family needs meant they had to keep going – no sick leave for Mothers.   (Well, not until they got bleeding bowels or failed kidneys from other things in the painkillers.)  They also had generations of  men who soldiered on bravely – painkillers were for softies.  And generations where women got heart problems and the diseases of aging later than the men.

Now we have a generation who changed from aspirin to paracetamol and other analgesics, and  under 40s who grew up with paracetamol for both genders.  Here is one more  public health change among the thousands of deliberate improvements in our lives.

And look, the gap between the genders’ life expectancies has shrunk while both genders have greater life expectancies.

Ten years ago I said that there would be a decline in the gap between the genders’ life expectancies.  I would now bet that there will be a continued decline in the gap between male and female  life expectancies, possibly a reversal of the gap, and that the change will have many causes.  I expect that most of the talk will be about the social changes such as mothers working outside the home – but I hope someone does some research on the outcomes by preferred general painkiller.

Why I am optimistic

March 4, 2014

Many people I know are less prone to depression than I am, yet seem overall more down when they talk about the world and the people in it.

Why?  Partly  because I grew up in a politically aware household, and understood the huge changes in and from the years of my childhood.  So many people don’t seem to have paid attention, and don’t realise how much things can change in our country.  Partly because I know some deep history of places-other-than-this, so I know how much human lives have changed globally, how they can react to a changing environment, and just how amazingly NICE many people can be.

But, day to day, I find the thing that keeps me up-beat is … reading New Scientist and listening to ABC Radio National science/health programs.

Here’s an example.   New Scientist, page 18, 22 Feb 2014, “Tiny rod reels cancer cells to their death.”

So you have glioblastoma,  brain cancer cells, sitting beside some vital part of the brain that you really don’t want to lose, building up numbers and crushing something like your ability to make new memories, or to distinguish between your wife and a hat until one of them speaks.   If you cut out the cancer you may lose the ability anyway, and drugs to kill the cancer may kill you before they kill all the cancer.

So the doctors get a thin tube lined with a sneaky material, and at the top have a chemotherapy gel.  They poke the tube down into the cancer, and the cancer cells crawl up the tube and are killed with minimal disruption to your biochemistry.  Imagine saying to your cancer “Crawl off and die!”

Imagine if they put a collection chamber on the end and an access-flap in your skull, and took out live cells to analyse their weaknesses, or to prime your immune system against them.

How cool is that?  It brightened my whole day.

Fight “Lying for the cause”: time for the pillory.

August 7, 2012

Too many people speaking with authority on serious public controversies are “either lying or incompetent”; too few interviewers / debate participants call them on it.

I don’t mean just that they are pushing the predictions of a model which has not yet made reliably accurate predictions – a model may only fit known results, but it is arguable that it should  be considered in decision making if no other model has yet succeeded.

I mean claiming that which has been tested and found not so, or denying the existence of things which are.  For example, in the former case, claiming that the MMR vaccine puts children at greater risk of brain damage or death than not vaccinating despite the statistics.  For an example of the latter,  claiming that there are no GM [genetically modified (other than by selection of natural mutations)] crops in existence which are not designed to need increased use of Big Chemical Companies’ products – despite the news, months before, that activists had whippersnipped a test-field of three types of wheat GMd (a new abbreviation as far as I’ve read) for better nutrition and for better growth with less fertilizer ; depite Golden Rice; and despite statistics showing that GM cotton resulted in lower use of industrial chemicals.

Also, there are those who make claims that a high-school student who has followed the news can see are laughable.  For instance, one said (of the Queensland premier blaming previous governments for budget problems) “What’s he grumbling about?  So he has a budget shortfall – his state is barely a year past two major natural disasters, and his budget is only 10% in deficit! That’s pretty good.  Catastrophes will happen, and cut our income – isn’t that why we save in good years?””

This “lying for the cause” attacks the foundation of Western democracy – serious decisions the electorate makes on on the basis of best available information cannot be good if the information is corrupted.  Most citizens have not the scientific and mathematics training to see flaws in research, and do not follow scientific news enough to know of the background to claims, so they rely on those “who ought to know”.  Appeal to Authority may be a logical fallacy, but it is the basis of daily decision making.

It is time for a public pillory: a program which is watched in full school assemblies, where top experts in the field which was misrepresented stand together to say that the person (picture and name of organization in backdrop) was “either lying or incompetent”, and making clear the facts.  The person concerned is invited to  provide expert support foot their claims – but the expert support is tested and the case decided by qualified people before the program is run, as many “expert” claims are not based on scientific and mathematically sound approaches.  The expert support – if found to be unconscionably flawed – is also criticised in the program.  And the experts’ faces are shown, with name and organization,  as their claims are demolished.

Watching what you eat: foods having delayed effect on appetite

November 28, 2011

On a very low energy diet(often called VLCD), the dieter starts considering each additional item of  food or drink on the basis of the energy it will add.   Science has provided another basis for considering foods:  the subsequent effect on appetite.  I want to list a few where it will be interesting to watch for future research:

1. Milk products:  In those with a low calcium intake, reduce feelings of hunger more than an energy-matched drink. The calcium and protein in milk may be the triggers for this effect.(1, 2)

2. fats and oils

The short-term effect of fats is to reduce the sensation of hunger shortly after the fatty acids from digestion of fats reach the duodenum.   Surprisingly small amounts of oil can have this effect, but in those who eat much fat it is suppressed –  the whole matter of fat digestion is horribly complex (3)   However, improved sensitivity was measured in obese men after 4 days on a VLCD . (4)

Unfortunately, it has been found that eating fats/oils  does not always reduce appetite later, and may increase appetite the next day (5).   This fits with anecdotal evidence – for example, following a cheesecake relapse, a dieter experienced more hunger than usual the next two days, where the same effect was not felt after a protein-binge.

More confusingly, the type of oil is important – for example, fish oil seems to add less energy (that is, result in less fat) than do maize oil or beef fat. (6)

3. Citrates

Lemon juice, and various similar chemicals often added to cordials.   In some people, citrates seem to make it more difficult to adhere to a VLCD.  This may be linked to  the role of citric acid in favouring gluconeogenesis over ketogenesis (7).  (VLCDs emphasise ketogenesis for weight loss.  Making glucose inside the body does burn energy, but seems linked to increased appetite

Research needed:

Most studies emphasise same-day or long-term effects of particular food types.   More reliable studies on two- or three-day effects on appetite and perceived tiredness/energy levels, with titles showing on net searches, would be welcome.


1. Gilbert JA, Joanisse DR, Chaput JP, Miegueu P, Cianflone K, Alméras N, Tremblay A.   (2011)  “Milk supplementation facilitates appetite control in obese women during weight loss: a randomised, single-blind, placebo-controlled trial.”     Br J Nutr. 105(1):133-43.

2. Major GC, Alarie FP, Doré J, Tremblay A. (2009) “Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control.” Br J Nutr. 101(5):659-63.

3. Little, Tanya J. and Feinle-Bisset, C  (2010)  “Oral and Gastrointestinal Sensing of Dietary Fat and Appetite Regulation in Humans: Modification by Diet and Obesity” Front Neurosci. 2010; 4: 178. Published online 2010 October 19. Prepublished online 2010 May 20. doi:  10.3389/fnins.2010.00178


Brennan, I M,  Seimon, R V, Luscombe-Marsh, N D, Otto, B, Horowitz, M and Feinle-Bisset C (2011). “Effects of acute dietary restriction on gut motor, hormone and energy intake responses to duodenal fat in obese men” International Journal of Obesity 35, 448–456; doi:10.1038/ijo.2010.153; published online 3 August 2010

5. (does not display well in my browser, but deserves credit for links to the fulltext article

Blundell, JE, Burley, VJ,  Cotton, JR, and Lawton CL  (1993) “Dietary fat and the control of energy intake: evaluating the effects of fat on meal size and postmeal satiety.”  American Journal of Clinical Nutrition, Vol 57, 772S-778S

6.Jang IS, Hwang DY, Chae KR, Lee JE, Kim YK, Kang TS, Hwang JH, Lim CH, Huh YB, Cho JS. (2003) “Role of dietary fat type in the development of adiposity from dietary obesity-susceptible Sprague-Dawley rats.”  Br J Nutr. 2003 Mar;89(3):429-38.

7. Kreitzman, S.N. (1992)  Factors influencing body composition during very-low-calorie diets   Am J Clin Nutr 56:217S-23S.