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Supplies convenient to use packets of multiple supplement products known to support healthy digestive function and gastrointestinal health' and provides broad nutritional support for normal detoxification pathways.
These statements have not been evaluated by the Food and Drug Administration (FDA). These products are not meant to diagnose' treat or cure any disease or medical condition. Please consult your doctor before starting any exercise or nutritional supplement program or before using these or any product during pregnancy or if you have a serious medical condition.
Serving Size: 1 Pack
Servings Per Container: 30
Amount Per Serving / % DV
Calories 20
Calories from Fat 20
Total Fat 2g / 3%**
Saturated Fat 0g / 0%**
Cholesterol 5mg / 2%
Vitamin A (as natural mixed carotenoids) 3'500 IU / 70%
Vitamin C (as ascorbic acid) 310mg / 517%
Vitamin E (as d-alpha-tocopheryl acetate and mixed tocopherols) 50 IU / 167%
Thiamin (B1) (as thiamin mononitrate) 1mg / 67%
Riboflavin 1mg / 59%
Niacin (as niacinamide) 8mg / 40%
Vitamin B6 (as pyridoxal-5-phosphate' pyridoxine hydrochloride) 1mg / 50%
Folate (as calcium folinate) 100mcg / 25%
Vitamin B12 (as methylcobalamin) 20mcg / 333%
Pantothenic acid (as calcium pantothenate) 5mg / 50%
Zinc (as zinc gluconate) 9mg / 60%
Selenium (from vegetable culture) 45mcg / 64%
Copper (as copper gluconate) 100mcg / 5%
Molybdenum (as molybdenum glycinate) 75mcg / 100%
Oregano (Oreganum vulgare) (standardized extract) (leaf) 100mg / *
Organic Beet Concentrate (Beta vulgaris) (whole) 300mg / *
Pancrelipase (porcine) 150mg / *
Bromelain (2'500 MCU/gm) (from pineapple) 200mg / *
Papain 20mg / *
Cellulase (fungal) 20mg / *
Lipase (fungal) 20mg / *
Amylase (fungal) 20mg / *
Ficin 20mg / *
Parotid tissue (bovine) 10mg / *
Choline (as choline bitartrate) 20mg / *
Inositol 20mg / *
Taurine 455mg / *
L-Methionine 135mg / *
N-Acetyl-L-Cysteine 95mg / *
L-Glutahione (reduced) 30mg / *
Alpha-Lipoic Acid 20mg / *
Cysteine (as L-Cysteine HCI) 10mg / *
Coenzyme Q10 1mg / *
Superoxide dismutase (from vegetable culture) 90mcg / *
Catalase (from vegetable culture) 90mcg / *
Proprietary Blend 2'455mg
Fish oil (from sardine' anchovy or tuna)*' Flax seed oil*' Borage Oil*' Milk Thistle (root & aerial part) (extract)*' Lycium Berry (extract)*' Cleavers (aerial part)*' Dandelion (root) (concentrate)*' Burdock (Artium lappa) (root)
(extract)*' Red Clover (flower)*' Eclipta (root & aerial part) (extract) *' Indian tinospora (stem) (extract)*' Andrographis (leaf & stem) (extract)*' Boerhavia (Boerhavia diffusa) (root & aerial part) (extract)*' Picrorhiza kurrooa
(root) (extract)*' Indian Barberry (stem) (extract)*' and Sugarcane (shoot) (extract)*.
**Percent Daily Values based on a 2'000 calorie diet.
*Daily Value not established.
Other Ingredients:
Cellulose' capsule shell (gelatin' glycerin' water & carob)' methylcellulose' potassium sorbate' stearic acid (vegetable source)' gum arabic silica' magnesium stearate (vegetable source)' food glaze and modified cellulose gum.
(Contains ingredients derived from Sardine' Anchovy or Tuna).
Take one (1) pack' three (3) times each day as a dietary supplement or as otherwise directed by a healthcare professional.
Not Recommended for pregnant or lactating women.
Allergy / Dietary Needs
- Dairy Free
- Gluten Free
Ratings & ReviewsReview This Item
Overall Rating for Bio-Detox Packs - 30 Packs
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By Catherine Smith
from Hot Springs Village Ark.
DeTox Packs
I first purchased Bio-Detox Packs by Biotics Research through Dr. D. Helped with the start of my effort to lower blood pressure. So am giving it another try, blood pressure went back up. This product seems to give me more energy. Thanks you.
√ I would recommend this item to a friend.
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If you have any general questions regarding orders or our policies and programs, please contact our Customer Happiness Team @ 1.800.383.6008
If you are pregnant, nursing, taking any medications or have any medical condition, consult your doctor before use. Your healthcare professional is the best source for guidance before beginning an exercise or nutritional supplement program.


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I've watched several of her videos now and am impressed with both her technique advice and quilting philosophy which reminds me more of my long-time machine quilting mentor Diane Gaudynski than anyone else I can think of. As the standard teachers of my formative quilting years begin to retire, it is reassuring to see their valuable lessons being carried forward by a new crop of enthusiastic teachers.
I still need to spend some time with pencil and paper, seeing if what's in my head will work. I want to use a method learned in a class by Jan Wildman many years ago that is essentially an edge to edge approach that gives all-over coverage without looking like a pentagram or just mindless meander. So the trick will be to meld these two ideas together - Angela's paisley feather which swoops and fills with Jan's idea of rows of repeat designs.
Many suggest this drawing out of the quilting design or at bare minimum using your finger to trace over a pattern to familiarize your mind with it before actually starting to quilt. This makes sense - there's a lot to be said for muscle memory. As I reviewed my handout from Jan's class, I ran across another helpful hint I'd forgotten about, one that actually might be more helpful to those of us using our domestic machines. She suggests rather than practicing on a quilt sandwich, just practice on a piece of paper. No thread, no cloth, but the action will be the same as when you sit down with the actual quilt. Because drawing with a pencil is a totally different coordination of hand and eye than what happens at the machine where the "pencil" suddenly becomes the stationary object (your needle) and the "paper" moves under it to create the design.

subset: commoncrawl


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I hardly want to share this beautiful little (huge) giveaway because I would love to be the lucky winner, but.... How would you like to own something like this?
You can have a chance over at Dreamy Whites! Make sure you read the whole post to see the very cool book and talented lady that the duvet is actually from.
Good luck, but not too much ;-)
Ahhhh, A Little Bit Of Heaven On Earth!
Posted by nove
Labels: giveaway, Inspiring Ideas
Subscribe to: Post Comments (Atom)


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I recently did an interview with Jeri "Kitty" Weaver for Deviant Art's Comic Week where i reveal all. No more secrets...no more lies! I dish the dirt, baby and sometimes...just sometimes...I almost make sense. You be the judge. Check it out here.
Ok. Actually...Kitty had me under her spell the whole time and I melted like butter on a piece of toast. What can I say!?
Play Nice.


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This can be seen as a case of the Precautionary Principle.
In the end, this is not an academic debate, because we and our children are part of the experiment. The consensus among scientists (with a few exceptions, as is always the case in science) is that we should decarbonise our economy as a matter of urgency.
Academics can debate ad infinitum, but politicians now have to make a choice.
Every choice involves a degree of uncertainty.
Say we decarbonise our economy, and it turns out (unlikely as that may be) that IPCC view is wrong?
- Well, we will have created hundreds of thousands of jobs in insulation and renewable energy manufacturing
- taken thousands out of fuel poverty.
- We will also have reduced the shock of Peak Oil and Peak Gas, and
- reduced the acidification of the oceans.
- And addressed our energy security problems.
- And increased prosperity in hot countries.
Not bad, not bad at all.
Say on the other hand, we go the way of the "skeptics", and it turns out, as per all reasonable expectations, that they are wrong?
We will have problems with energy security, Peak Oil, Peak Gas, acidified oceans, acid rain, fuel poverty, unemployment, poverty, civil unrest and finally, massive, catastrophic climate disruption from droughts, floods, crop failures, disease, and war. With massive migration caused by environmental collapse. Not good.
Any sensible decision maker will put our money into decarbonising the global economy.


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CRETE – The Doane Tigers are off to another great start this season.
Doane University ranked No. 7 in this week's poll after a 2-0 start. The Tigers will host No. 22 Dakota Wesleyan on Saturday, September 16, at 1 PM in Crete. Doane is coming off a 28-13 win over Friends University a week after defeating then-No. 14 Sterling, 34-28, in Kansas.
Watch the game live on NCN television or listen on Ol Red 99-5 radio.
Four teams from the Great Plains Athletic Conference are ranked in the Top 25, with a fifth member – Hastings – receiving votes.


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After some days and some illness in the north country of Scandinavia, it was fortunately time to head back to Davos, Switzerland. The trip to Norway wasn't totally without redemption, as a top-10 in the Norwegian Cup got me some World Cup starts in Davos and Asiago, Italy. Sometimes the north can be nice, but this time I was not sad to leave at all.
With the approaching days, I would recover and get in a handful of good training sessions.
Here's one of those days, in bluebird conditions with the Estonian sprinters and the Swiss Power Sprint team. Here, we are getting ready for an impromptu prologue as part of a Wednesday form-sharpening workout. I felt great, and thought I was ready for the big race over the weekend. I'm missing the shape, and maybe more the right feeling at the moment, though. On Sunday, I missed racing in the rounds by just under 2 seconds. It's not an incredible amount, but in this game every second -- or every hundredth of a second -- counts. My flatmate Mauro Gruber missed scoring his first-ever World Cup points by the smallest of margins, one one-hundredth of a second.
Fortunately, I get one more weekend of chances in Asiago to demonstrate what I've been working on and perfecting all these days, months, and years. This picture of an eagle's impression captured in the snow shows what I look to do next time, be an opportunist with the opportunities I get.


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So, I hope you had a fabulous weekend! Guess what today is...PAINTING DAY! I'm taking the plunge and painting my kitchen Dunmore Cream by Benjamin Moore - the same color as our living room. I'm hoping to get my hands on a laser level this week so I can do the stripes on the wall, but we'll see. I'm a little sad about saying goodbye to the green paint, but I'm excited about the new look and heading in a new direction with my aesthetic and my "mature walls." So, no more this:
I'll send you an 'after' picture once I get the kitchen put back together again. Right now the walls are bare and kind of sad-looking!
I'll send you an 'after' picture once I get the kitchen put back together again. Right now the walls are bare and kind of sad-looking!
This weekend I also finished my mother-in-law's office chair. You might remember how it was before here:
Ugh, right? I thought it was just a random chair, but then after doing some research I learned that the style is a Chinese Chippendale chair that it is actually an expensive, well-known chair among decorators. Who knew? Here is the after:
Ahh! Can you believe it? Here is a shot of the back, which I think looks really, really good:
The challenging thing about this project was that the seat cushion didn't come off, so we had to come up with a creative way to hide the staples. Some kind of cording or trim would have been an option, but I love the way these nailheads look! I got the idea of doing upholstery nails, but had never actually used them before. After browsing around on one of my favorite blogs (thanks for the recommendation) and reading this post, I ordered nailhead trim by the yard from Amazon. I ordered two yards and then also ordered a package of 50 nails. The way it works is you can pick your trim where you nail it in ever third or fifth hole, so it looks like a series of nailheads, but really you didn't have to nail in every last one. Smart, right? It only came in one finish, which was kind of disappointing, but I think it works with this chair so no big deal. They also recommend using a rubber mallet to hammer in the nails, which I did not own and did not want to purchase, so I just used a regular hammer with a sock over the end. My MIL came over to help me hold and pull the fabric because in a project like this, you really need one person to hold the fabric in place while the other person staples.
I was seriously amazed at how well this project turned out. I'm super proud of it and cannot wait to find another project where I can implement the nailhead trim. The only problem was that this chair had been re-upholstered a few other times, so there were lots of staples already in the chair, so nailing go tricky because sometimes I would hit against an already-existing staple, which would make the trim crooked or the nail not go in straight. Thankfully my MIL is not a perfectionist and the back* looks really good, so no worries!
Okay, off to get my painting clothes on!
*One thing to remember when re-doing a chair that is going to be pushed up under a table or desk: pay particular attention to the back, because that is what is going to be seen the most. People are always more worried about the front, but they don't realize the back is what will be seen immediately upon entering a dining room or office. So, conversely, if the chair is filling up space in a corner, you need to pay more attention to the front because that is what will be seen.


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Sunday, January 22, 2017
Playing with Snail's Trail
This second print is better so I need to cut more squares.
I could stop here at 60" x 72" but it looks unfinished.
I cut three more dark squares and made two more Snail's Trail blocks. Now it will be 60" x 84". This is the first quilt, my trial quilt to see how these blocks work. I didn't choose most of the Snail's Trail block fabrics to go together. They are just what happened to be in the fat quarter pile plus 4 that I needed to cut from some yardage. I rarely buy fat quarters because I like full width fabric. Most of these were bonus pieces added to orders and the rest were one pack I bought to get 2 of the fabrics in it. The next quilt will be planned. The light fabrics need to be more consistent in value.
13 comments:
- Debbie said...
I super love this one!!! The second light fabric you chose is just wonderful, with lots of movement and contrast. I get what you mean about planning to be more consistent. Thanks for the great example.
- January 22, 2017 at 7:09 AM
- Gene Black said...
I wonder how the layout would look if the Snail's Trail blocks were arranged/rotated so the dark corners connected to create diagonal lines.
- January 22, 2017 at 7:22 AM
- Judy H said...
I love seeing your design process and how to 'figure things out'.
- January 22, 2017 at 7:50 AM
- Hedy Hahn said...
I really like your last quilt top layout. Heck, I like them all!
- January 22, 2017 at 8:23 AM
- Melinda Hirsch said...
I love , love, love your Snail's Trails. I think you said you used an accuquilt die--did you use it with the Go Big cutter? Thanks for any comments :)
- January 22, 2017 at 9:40 AM
- Helen said...
I'm wondering what you could do by making some 'right-handed' and some 'left-handed' snails?!
- January 22, 2017 at 12:13 PM
- Linda Swanekamp said...
Oh my! Love the alternate blocks and the pattern it makes.
- January 22, 2017 at 12:39 PM
- JJM said...
Fun to watch this one grow... For a quilt using bonus fat quarters, your combinations sure looks good.
I can see the Dairy Queen ice cream cone tops in this one too. (*._.*)
- January 22, 2017 at 2:27 PM
- A Left-Handed Quilter said...
Love what you have so far!! -
Helen - I got a chuckle out of your "right-handed" and "left-handed" - thanks. -
Wanda - I saw a variation you might like - I'll send you a link - privately - if I can remember where I saw it - ;))
- January 22, 2017 at 2:55 PM
- Judy Dietrich said...
Good experiment on this die. I have started collecting some of these & plan on playing too. Did not get this one, but the flowering blossom one. We have unseasonably warm weather right now in Ne. Happy stitching
- January 22, 2017 at 4:28 PM
- Lynn Dykstra said...
I really like this. I've also seen the solid large square space instead with an hourglass block.
- January 22, 2017 at 6:10 PM
- The Joyful Quilter said...
I'm quite fond of this scrappy Snail's Trail. I wouldn't have guessed that it was the prototype for a planned quilt. SEW many options!!
- January 22, 2017 at 8:58 PM
- patty a. said...
The quilt is coming along wonderfully. I like the darker plain squares all around the outside of the top.
- January 23, 2017 at 7:26 AM


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Looking For Something Special?
Tuesday, July 8, 2014
17 comments:
Seriously, though, dude, he did HURT my feelings!ReplyDelete
All that bullshit aside, I'm sorry about your uncle.Replies
Thank you. He's home now, but it was not a good time by any measure.Delete
Zak once hurt my feelings so hard that I went around the whole spectrum and came out the "ecstasy" side. Like being tortured in the Pleasure Organ.*ReplyDelete
I hope that your uncle is well and comes through this.
* Disclaimers and Warnings: Zak has never hurt my feelings, though we have disagreed on things on occasion. Two Zaks don't make a wrong, but one Tracy does. Do not taunt happy fun Zak. If you get Zak on your shoes, wash the affected area with iodine and peppermint and see a doctor immediately. If no iodine or peppermint are available, pray for a quick, merciful death. If you get Zak on your hands, however, feel free to lick them clean.Replies
May your uncle get better, may you get your D&D fix, and may you start posting again regularly. :)ReplyDeleteReplies
I'm thinking that all of those things are happening!Delete
No worries on my end Charles, and I am sorry to here about your uncle. Hope all will be well.ReplyDelete
Isn't funny, you and I just had a conversation in which I stated, "Nearly every time Zak and I comment on each others blogs, we end up in a low-to-medium grade argument". Yet whenever I've seen Zak in person He is the nicest guy to me.
On the list of contributors is S. John Ross and Ken Hite, two guys involved in the Star Trek RPG from Last Unicorn Games. I've worked with them. They are brilliant. Robin Laws is named. Robin Laws! One of my heroes in the hobby. When I saw Zak's name amongst these others, my first thought was, "Awesome! What a range of talent."
I was once accused of only wanting to argue with those who would agree with me. If that were the case, Zak and I wouldn't be, as Zak once put it, 'Internet Pals'.Replies
The uncle is better but I've never seen someone have so many things go wrong all in the span of seven hours from just a single virus before. He had a low grade diabetic attack (even though he doesn't have diabetes), sepsis, and a viral attack that caused him to continuously vomit for hours.Delete
Fucking scary stuff.
"I was once accused of only wanting to argue with those who would agree with me. If that were the case, Zak and I wouldn't be, as Zak once put it, 'Internet Pals'."
No you wouldn't, and you wouldn't be half as much fun!
Our thoughts are with your family with hope for a speedy recovery.ReplyDeleteReplies
Thanks Marty! He's home now and things are looking better.Delete
- AnonymousJuly 8, 2014 at 12:38 PM
Best wishes for your uncle's speedy recovery.ReplyDelete
Regarding the other thing ... at least once a year, someone gets outraged about Zak. This is probably the most visible time, as it involves WotC, and unfortunately the most awful, since the trolls are spreading lies. But as they say 'the dogs bark but the caravan goes on'.Replies
You're absolutely right on all points Mike.Delete
Unrelated comment is unrelated.ReplyDelete
Sometime in the last couple days, the blog "Froths of 4e" seems to have vanished from the interwebs. I'm getting a "blog removed" error. I wondered if you had more information.
It's because he's changed names! Try http://frothsofdnd.blogspot.com/ instead.Delete
Tsk. Now how was I supposed to find that? By looking? ;)Delete
It took me a minute. I have Froths bookmarked both on his "about me" page and his old blog address. Once I found the about me page I was able to find the blog again.Delete
It gave me a hell of a start this morning. You could hear my "Big No" across the Internet -- even in Nigeria or wherever my spam comes from.Delete
GM Toolbox: Things to Do from January 24, 2005
Shortly before I was going to run my first game back in the early months of 2005 I was sitting in the Den working on a list of things that...
THE 2014 EDITION OF THE GREAT BLOG ROLL CALL IS UP! PLEASE UPDATE YOUR LINKS SO THAT THE DEAD BLOGS ARE OFF YOUR LISTS! I don...
Last year I started the Best Reads of the Week series to help publicize some of my favorite blogs and to help the community as a wh...
A couple of days ago, in the post So You Like Looking in Sacks , I was talking about +Chris Tamm of Elfmaids & Octopi 's fantast...


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Paul and Gill Ranson are getting into the 'Farrer medal habit'. With two magnificent well covered pans of Dionysia viscidula x freitagii EGW MK 91/1 to choose from, the neater dome took the day.
Rhododendron Pemakoense is one of the earliest species to flower, this free flowering Chinese beauty is worth considering. Quite hardy but watch for hard frosts if considering exhibition.
How useful that Corydalis malkensis one of the more attractive members of Sect. Corydalis can be a plunge or garden weed! There is a plant portrait on this site if you want to know more but the picture speaks volumes, courtesy of Don Peace.
The first of the season's orchids were on display. Like the closely related Dactylorrhiza sambucina and with no danger of this becoming a garden weed, this diminutive species will need careful cultivation in a pot.
A well established pan of Iris maracandica with three flowers was awarded a certificate of merit. Very neat, with tightly packed foliage, the yellow flowers have a pronounced wing to the falls.
Many Fritillaria species are best viewed 'inside'. F. latifolia is most obliging with large dumpy flowers held just above the top of the pan. Whether this represents F. nobilis I'm not sure - it certianly is attractive however.
The business end of Fritillaria biflora (I've excluded the 30cm or so of stem. A Californian coastal species which is hardier than you would think but certainly needs cold glass protection in the UK.
Dionysia termeana is now becoming established from the recent introduction, this is proving to be variable in habit and flower. Ranging from a lax mat to tight cushion, all are gorgeous with a generous supply of yellow flowers.
Probably seen on display for the first time, the newly described Dionysia iranica was keenly viewed. The flowers are most unusual as they unfurl - almost Campanula zoysii-like just before they open. Note the plastic pot, just to show that clays are not essential, the compost and watering regime are the critical factor
A new hybrid on the scene from Michael kammerlander. Dionysia Manuela is a cross of D. microphylla with D. archibaldii with roughly intermediate characteristics of both - and of course hybrid vigour, very attractive flowers.....
This cross of Primula allionii Crowsley x Joan Hughes between of the best darker P. allionii hybrids was much admired. This very neat form was raised by John Dixon and one of the most attractive on display.
The hall lighting didn't help in capturing the beauty of Primula allionii 'Alexina'. The flowers are actually a much deeper purplish hue, nestling at/amongst the foliage surface.
Only alpine afficianados would want to grow a cotton wool sponge! Haastia pulvinaris remains one of the greatest challenges to the alpine grower and provided care with winter water is taken, summer ventilation, masses of good luck - it is possible!
If the Haastia wasn't enough to whet your cushion appetite, how about this! Geoff Mawson has for the moment tamed Raoulia eximia, this equally difficult vegetable sheep - still a lamb by wild comparisons but getting to 'spectacular' proportions and worthy of a certificate of merit.
A third AGS medal of the season for your's truly. Galanthus 'Straffan', Iris rosenbachiana, Fritillaria pudica, Cyclamen pseudibericum, C. coum and Primula allionii Lismore P94/9/2.
The busy March season continues with milder weather promised for East Lancs in a weeks time. Watch this space for further reviews.........


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Gurudwara Singh Shaheedan, which is quite close to the city, has on display shoes of some 500 martyrs. Gurudwara Singh Shaheedan, Sohana, Mohali, a historical shrine situated in Village Sohana in Sas Nagar District, was made in the remembrance of martyrs of Anglo Sikh wars.
Photo of Gurudwara Singh Shaheedan
The Gurudwara is a place for spiritual solace and tranquility, also commemorates Baba Hanuman Singh Ji - the 7th Jathedar of Budhadal (A warrior Sect of Nihang Singhs) and the Jathadar of Akal Takth Sahib - while fighting against the invading Anglo armed forces at the age of 90 years. Till date crores of rupees have been spent on this spectacular marble structure with its roof lined with gold plating, the building itself is a symbol of tranquil peace, devotion, immense dedication and motivation towards self less service and personification of metaphysical being of the martyrs.


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I've been gone so long...where to begin...
I had to step away and get somethings in order...
Well I'm back and will try to post something at least every week.. I have missed my blog world friends.
Here is a bag I made for a close friend...it is a very large tote bag...with purple cotton blend lining
|adding in the lining...first for me
4 granny squares on each side panel
I absolutely love this bag!
So proud that I did this lining...love the color!
Sooooo...there it is...I hope you like.
Come back and visit.
Thanks! Smooches!


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Hello Friends,
Today I have to share with you another project made for my son's Eagle Scout Court of Honor. I made some cup cake toppers for his cup cakes, They will be what I will be serving at his event for the desert. Take a look at them below.
So as I have said before, Eagle Scout is a great honor and the highest rank for
boy scouts. These toppers are a part of the Scout Law with the words on the
back. A scout is trustworthy, loyal, helpful, friendly, courteous ,kind, obedient, cheerful,
thrifty,brave, clean and reverent.
I cut the circles at 2 inches and placed the words inside them using
Design space and then I changed the colors to match the theme of red
white and blue. Then I used the print then cut feature and my Explore
to cut and print them out.
Next step I did the exact thing to make the front of the toppers.
I used an image from the Be Prepared cartridge for scouting.
I changed the back ground color from yellow to red again keeping to my
I then got some tooth pics and added the two circles together
with some glue inserted the tooth pic between them and this is the finished product.
I think they will be cute on the cup cakes. I will share pictures after his celebration is over.
Get inspired today and make something great.
Thanks for stopping by
Cuttin Scraps


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"The Court's ruling effectively freed corporations and unions to spend money both on 'electioneering communications' and to directly advocate for the election or defeat of candidates (although not to contribute directly to candidates or political parties)." (Wikipedia).
In Citizens United v. Federal Election Commission, it is clear that the majority argued that the First Amendment keeps the government from interfering in the "marketplace of ideas" and "rationing" speech, and that it is not up to legislatures or courts to create a sense of "fairness" by restricting speech. Such hogwash! Legislatures and courts restrict and regulate speech all the time. For instance, try planning to foment an action that could be interpreted as terrorism. Use face book or E-mail to communicate the plan with friends. The Patriot Act will come into play and you will be arrested. Try slandering your ex-spouse by calling him a child-abuser. Will you be liable for slander and will he sue you for slanderous speech? Is fairness involved? Of course it is, as there always is in the finding of the courts against a plaintive or defendant in a slander trial, or hate speech trial or false advertising trial. Try harassing someone by what you say or write. Think you can get away with it by pleading "free speech"? Not likely.
Speech is already restricted. There is no such thing as completely free speech, because some forms of speech can lead to consequences that are criminal. Take a perpetrated scam for instance. Try getting out of that particular criminal behavior by pleading innocence on the basis of free speech. Think you can say anything you want to, even though it might harm someone else? Think again. You can't yell "Fire" in a crowded theater if there is none. You can't slander someone; you can't scam someone; you can't claim something for a product or a service that is patently false as in "false advertising." Try speaking malevolently about a group of people such as gay persons, or about an ethnic group such as Afro-Americans. Hate speech is now restricted and penalties are in place. Try malevolent speech aimed at harming a politician or an office-holder; you will risk being arrested even though you actually never carry out your threats.
Oh, and try speaking on-line in any way you choose. There are many websites that do not allow "inappropriate speech" and you risk being disengaged from that site if you insist on violating their restrictions or are reported as doing so. Free speech? I'm sorry. Your free speech ends at the point where it impinges on someone else's life in a harmful or distorted or abusive way. "Free" speech is not unlimited speech or unrestrained speech. Justice and fairness are always being judged by legislatures and courts. To say otherwise is simply fantasy. And, the Supreme Court conservatives are full of such fantasy judgments.
The conservative majority challenged the reasoning in Austin vs. Michigan Chamber of Commerce that the "distorting effect" of large corporate expenditures constituted a risk of corruption or the appearance of corruption. Rather, the conservative majority argued that the government has no place in determining whether large expenditures distorted an audience's perceptions, and that the type of "corruption" that might justify government controls on spending for speech had to relate to some form of "quid pro quo" transaction: "There is no such thing as too much speech." Justice Stevens in his dissent argued that independent expenditures were sometimes a factor in gaining political access and concluded that large independent expenditures generate more influence than direct campaign contributions. Furthermore, Stevens argued that corporations could threaten Representatives and Senators with negative advertising to gain unprecedented leverage.
The conservative Justices apparently do not live in the modern world. To even say that corporate expenditures do not have a risk of corruption or even the appearance of corruption is to believe that corporate money does not have a distorting power at all. Yet, take a look at corporate advertising in TV commercials particularly. TV commercials are rampant with psychological gambits that distort reality. They are rife with claims that cannot be substantiated. They are meant to persuade and cajole the viewer into a state of belief in what they are selling; what they fear most is that the viewer will not accept the corporate "pitch". TV commercials are intended to distort one's own reality into the reality of the corporation doing the advertising. They cajole, they distort, they lie, they pander, they tend to "corrupt" one's own beliefs and principles and actions if they can in order to sell their service or their product. One might even go so far as to say that corporate speech is all about corruption in the broadest sense: a corrupting influence. Corporate ads tend to influence one toward acceptance of a distortion of one's reality in order to be able to sell us a product or a philosophy or a way of living.
Take cigarette advertising from our recent past. It tried to make you want to smoke, not by lauding the contents of the cigarettes, but by distorting your own view of reality. The tobacco industry sold much more than cigarettes; they sold a style of life; they sold sophistication; they sold a distorted reality that one could be considered to be like the Marlboro Man; they sold the idea that smoking was healthy and showed smoking doctors to prove it. Cigarette advertisements, and their progenitors, were the epitome of distortion and corruption. My mother died at age 52 from a cerebral hemorrhage because her life and her beliefs were corrupted and distorted by the tobacco industry. She knew tobacco was not her friend; that it was contributing to her ill health. But she still sent me to the store for a carton of cigarettes whenever she was running low (two packs left in the old carton). She was addicted to tobacco because the industry sold her the lie that smoking was not injurious to health. The conservative Supreme Court Justices have perhaps forgotten the corrupting influences of the tobacco industry who kept Congress, state legislatures, and even the courts "in line" with their lies and distortions by spending great amounts of corporate lobbying money until finally it all came to a conclusion that could no longer be hidden or ignored: too many were dying of smoking-related causes, and scientific reality caught up to distorted reality.
But somehow the conservative Justices missed the boat by arguing that corporate money does not corrupt the market place of ideas, or that governments should not decide whether large expenditures of money by corporations distort an audience's perception, or that only a "quid pro quo" constitutes corruption, or that there is no such thing as too much speech. Too bad they forgot all the legislation that resulted from the lies and distortions by the tobacco industry. Too bad they forgot all the court decisions that shot down laws made under the influence of tobacco industry lobbying money that distorted reality. Too bad they forgot the summary judgments issued by the courts against the tobacco companies for their lies and distortions. Too much free and unfettered speech by means of corporate lobbying is worse than "quid pro quo" because it goes to the corruption of reality, beliefs and principles of sound living. Free and unfettered speech can destroy as well as preserve or innovate. It is the mission of the legislatures and the Courts to determine which is which, as they finally did with the curtailing of false advertising by Big Tobacco.
Fortunately, Justice Stevens in dissent reminds us of the nature of corporations. Stevens argued that the unique qualities of corporations and other artificial legal entities made them dangerous to democratic elections. These legal entities, he argued, have perpetual life, the ability to amass large sums of money, limited liability, no ability to vote, no morality, no purpose outside of profit-making, and no loyalty. Therefore, he argued, the courts should permit legislatures to regulate corporate participation in the political process. Hooray for Justice Stevens!
The conservative judges also asserted that the public has a right to have access to all information and to determine the reliability and importance of that information. Additionally, the majority did not believe that reliable evidence substantiated the risk of corruption or the appearance of corruption. What fools these mortals be! Reliable evidence and information is not what corporations are peddling. Big Tobacco, Big Oil, Big Coal, Big Whatever are not in the business of providing reliable evidence so that the public can make informed decisions. In fact, the "Bigs" do not want the public to be well-informed lest they make decisions that do not turn a profit.
Natural gas extraction from the earth is now a major issue because Big Energy sees big dollar signs whenever they discover more shale deposits from which they can draw natural gas. Unfortunately, the process by which that gas is being extracted ("hydro-fracking") has not been proven to be environmentally safe for the people who live on the affected lands. The chemicals used in the extraction process are potentially hazardous to drinking water, land use, and human consumption of produce grown near those fracking sites. Are the corporations involved providing all the information necessary for the public to make a decision about hydro-fracking? Not on your life. They are instead using corporate money to lobby for drilling rights, to promote hydro-fracking as a safe procedure, to distort the results of studies of the effects of such extraction, and above all to convince the public that job-creation is more important than environmental safety.
The corrupting influence of the Natural Gas companies is reminiscent of Big Tobacco, but more so of the Chemical company involved in the Love Canal debacle of decades past (1970s) when a local newspaper brought to light that a 36 square-block area of the city of Niagara Falls was contaminated with 21,000 tons of toxic waste buried underground by Hooker Chemical (now Occidental Petroleum Corporation) in the 1950s. Liability for the toxicity was denied by Hooker Chemical until the deaths and birth defects became overwhelming enough to spur real investigations and a finding of negligence and the settlement of subsequent lawsuits brought by individuals.
The corrupting influence of corporate speech begins with the distortion of information, not with a quid pro quo. That is what the Justices missed. They themselves distorted the issues in this case in order to protect the coercive and blatantly distorted speech of the corporations. There is no such thing as undistorted speech from corporations that deal in profits, selling, and marketing. Distortion is their bread and butter. It is how they get us to buy, and to feel good about spending our hard-earned dollars. The conservative Justices are naïve in their belief that there is no corruption or appearance of corruption when distortion and coercion are at the heart of corporate speech and influence. And why is that? Justice Stevens in dissent alludes to the reason: corporate spending on politics should be viewed as a business transaction designed by the officers or the boards of directors for no purpose other than profit-making. Stevens called corporate spending "more transactional than ideological".
Apparently, the majority opinion also relied heavily on the reasoning and principles of the landmark campaign finance cases of Buckley and First National Bank of Boston v. Bellotti, in which the Court struck down a broad prohibition against independent expenditures by corporations in ballot initiatives and referenda. The majority argued that to grant First Amendment protections to media corporations but not others presented a host of problems, and so they concluded that all corporations should be equally protected from expenditure restrictions.
And now, we all are bearing the consequences of the decision of the five conservative Justices. We now have unrestricted third-party political advertisements by corporations and individuals through the advent of Super PACs. Unfortunately, those advertisements are not meant to support a particular candidate or a particular issue, but are overwhelmingly negative in nature, meant to distort one's view of whatever issue or candidate the donor opposes. These advertisements follow a pattern of distortion, misleading and false information, outright lies, and innuendo. They are not in any way constructive. They are a form of corruption. That is, they distort the process of sorting out the best candidates; they distort the character of the opposition, and most of all they are secretive. There is no requirement that the perpetrators of such ads must come forth to approve the ads or to reveal their intent, or even to say who is funding them. One of the aspects of "secretiveness" is that of concealment; another is that of "not open". The majority of Justices has willingly consented to a falsity, a covering-up, a reduction of the amount of information that they said would contribute to the public being able to make informed decisions. So here they are contradicting themselves, and providing the very means by which corruption can take place.
In spite of the Justices' decision, corruption is not the main problem. The main problem with the free political speech granted to corporations (as individuals) is that their ability to spend enormous amounts of money on political advertising is a distortion, and indeed a corruption, of the right of other individuals to an equal quantity of free speech, and to the equity of one's vote. By granting free speech rights to corporations, and allowing them to spend unlimited amounts of money, the Supreme Court has unwittingly distorted and minimized the free speech of all those who cannot afford to equal those expenditures. In other words, the Court has given an enormous advantage to the rich that is not available to others. They have distorted the electoral process so that "one man, one vote" no longer has meaning. It is now one substantial corporation or rich person against whom only a huge association of other persons can stand. Our speech, our voices, our political clout has been undermined by a Court decision that by its very nature, introduces inequity into the electoral process.
The conservative wing of the SCOTUS missed the point of this in more ways than one. They said that corporate spending was not corruptive. They claimed it does not even approach the level of the appearance of corruption. But the very nature of corporate advertising is to distort and corrupt. The justices said that we should have all the information we need to make political judgments, but they missed the point that corporations tend to limit the amount of information provided the public so that the public can be lured into their reality. The five conservative Justices unwittingly allowed secretiveness to conceal, not only truth, but the perpetrators of negative and false advertising about candidates and issues. They thus introduced into the electoral process the very thing they had touted: the concealment of substantive information from the public.
In my opinion, Citizens United is not just a bad decision; it is a corrupting decision because it distorts the electoral process and destroys the one person, one vote principle. Ill-conceived is too polite a phrase for this failure to understand the coercive power of money, and the corrupting influence it has on our electoral process. Citizens United must be over-turned!


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I'm a huge fan of swatching. I'm always surprised when I hear other knitters talk about either not swatching all together, or just flat-out detesting it. For me, it gives me the time to practice a stitch pattern, get to know the yarn and develop a little bit of muscle memory for a particular match-up between needles, yarn and pattern. I call it bonding time. Sometimes it's hard for me to leave bonding time and actually move into the project. I have a whole bag full of swatches which I try to remember to label with what yarn it is and what needle size I used, and whether or not I used a stitch pattern from a particular book.
I'm not always successful, and I find myself treasure hunting for all the missing information. I pull them out of the bag every once in awhile and lay them out on my table, like puzzle pieces. Turning them right side up and positioning them correctly, I remember back to what I thought a particular yarn would be good for, or where I bought it. They're like little bits of memory for me.
So when I finally finished my poncho design from VK Holiday 2010, I had quite enough bonding time with Cascade 128 Superwash. Quite. Enough. But, I do love it and wear around the house all the time. When I sit on the couch, it sort of lays out like a blanket and I've started referring to it as my Snuggie. It's just better 'cause it's got a hood too.
Speaking of bonding, I had a lot of extra bonding time with Cascade 128 Superwash. The design I have in VK Winter 2010/11 is knit in the same yarn.
I do love it. It's a bulky weight workhorse'uva yarn. I had such a great time knitting up this particular design. The cabling becomes mindless, and the switch-up towards the top with the lace keeps it fun. Annie Maloney, the author of Aran Lace, the book where I got the stitch pattern from, gave me a shout-out on Ravelry and is knitting it up herself! I was so flattered when she e-mailed me.
And, what better way to bond with your fellow knitters than at VK LIVE!!! I was there yesterday helping out at the Pro Lab with one of their technical editors (Hi Lori!), and what a blast! I've had good and bad experiences when it comes to conventions, and this one was done right. Very organized, great venue, plenty of space and just enough to see, hear and talk about. Amidst all the yarn, I came across the most adorable knitted and felted dolls from ak traditions. I'm not a huge fan of knitting and sewing little things. I always lose interest by the time I have to put all the little pieces together. But, I couldn't resist these little cuties! So I bought one of their pattern books and am going to make a "Huggable". The little huggable bodies are like pillows. So adorable.


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Green Villain has enlisted the services of Bradley Ehrsam to craft the technology that will take it out of this world. These hyper-flux transducers have two modes of operation:
In afferent mode they detect those subtle fluctuations in The Force indicating the existence of opportunities for aesthetic intervention by any means necessary. In efferent mode they provide power for Green Villain's fleet of interstellar transport vehicles:
where Greg calls the shots in the far-flung GV empire:
Notice the prototype intergalactic mass driver on the shelf at the right edge of the photo. Finally, Jerkface has provided a hypothetical rendering of a creature for a star system far far away. The rendering, of course, is based on emanations detected by hyper-flux transducers:


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The Erasmus Mundus European Masters Program in Language and Communication Technologies (LCT) is designed to meet the demands of industry and research in a rapidly growing area. It offers education and training opportunities for the next generations of leaders in research and innovation. It provides students with profound knowledge and insight into the various disciplines that contribute to the methods of language and communication technologies and it strengthens their ability to work according to scientific methods. Moreover, the students acquire practice-oriented knowledge by choosing appropriate combinations of modules in Language Technology, Computational and Theoretical Linguistics, and Computer Science.
It involves studying one year at one of the Universities of the consortium, and completing the second year with a stay in one of the partner Universities. After this, the student will obtain two already approved Master of Science/Arts degrees with legal value in the countries of issue.
The amount of the Erasmus Mundus scholarship for students beginning in 2010 is 24,000 Euros per student per year for overseas students and aproximately 10,000 Euros per student per year for non-overseas students. The application for an Erasmus Mundus scholarship is done through the Application Form of the LCT Masters Program, that is, when you apply to the EM LCT program, you are simultaneously applying for the scholarship.
Application procedure and deadlines
Complete applications are due for both, overseas and non-overseas applicants on January 17th, 2011 (new deadline).
Non-overseas applicants are defined as nationals of an EU member state, an EEA-EFTA state (Iceland, Norway and Liechtenstein) or other nationals who have carried out their main activity (studies, work, etc.) for more than a total of 12 months over the last five years in one of these countries. Overseas applicants are all others.
NB: Special note for applicants from Switzerland, Turkey, Western Balkans region (i.e. Albania, Bosnia-Herzegovina, Croatia, Kosovo under UNSC resolution 1244/99, Former Yugoslavian Republic of Macedonia, Montenegro and Serbia). Unless otherwise determined due to residency abroad, your application should be submitted under the area "overseas".
Prerequisites and Admission
- Applicants must have a Bachelor degree or equivalent in the area of (Computational) Linguistics, Language Technology, Cognitive Sciences, Computer Science, Mathematics, Artificial Intelligence, or other relevant disciplines, subject to the consent of and the approval by the consortium's admission committee.
- Proficiency in English (for non-native speakers) must be certified by one of the following:
- TOEFL score of at least 79 (internet-based test), 213 (computer-based test) or 550 (paper-based test).
- Cambridge Certificate in Advanced English -- at least B
- Cambridge Proficiency Exam -- pass.
- As defined by the individual partner institutions as being sufficient for pursuit of university courses taught in English.
In order for your application to be considered complete, please:
I. Please, submit via online form:
- a statement of interest written in English. Please write at most two pages focusing on:
- your reasons for applying
- your areas of interest in relation to the various disciplines that contribute to the methods of language and communication technologies (Language Technology, Computational and Theoretical Linguistics, and Computer Science)
- your preferences for the host and partner Universities
- a current Curriculum Vitae (CV), written in English
- certified copies of:
- a. your Bachelor's degree
- b. certificates attesting to the fulfillment of the language requirements
- a transcript of academic records.
II. You will be providing the names of 2 referees of your choice on the application form. Using the email address you provide, your referees will be contacted and asked to upload letters of recommendation. For your information, the referees will be provided with these forms for the recommendation:
- Letter of Recommendation for overseas application or
- Letter of Recommendation for non-overseas application
Alternatively, your referee may send their letter by post to our contact address, but it must come directly from the referee (not from you), be securely sealed, and sent by the deadline.
If your original documents are in a language other than English, please also submit certified translations.
Notification of acceptance will be issued by March 31, 2011.


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Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in MenClinical Perspective
Jump to
Background—Sugar-sweetened beverage consumption is associated with weight gain and risk of type 2 diabetes mellitus. Few studies have tested for a relationship with coronary heart disease (CHD) or intermediate biomarkers. The role of artificially sweetened beverages is also unclear.
Methods and Results—We performed an analysis of the Health Professionals Follow-Up Study, a prospective cohort study including 42 883 men. Associations of cumulatively averaged sugar-sweetened (eg, sodas) and artificially sweetened (eg, diet sodas) beverage intake with incident fatal and nonfatal CHD (myocardial infarction) were examined with proportional hazard models. There were 3683 CHD cases over 22 years of follow-up. Participants in the top quartile of sugar-sweetened beverage intake had a 20% higher relative risk of CHD than those in the bottom quartile (relative risk=1.20; 95% confidence interval, 1.09–1.33; P for trend <0.01) after adjustment for age, smoking, physical activity, alcohol, multivitamins, family history, diet quality, energy intake, body mass index, pre-enrollment weight change, and dieting. Artificially sweetened beverage consumption was not significantly associated with CHD (multivariate relative risk=1.02; 95% confidence interval, 0.93–1.12; P for trend=0.28). Adjustment for self-reported high cholesterol, high triglycerides, high blood pressure, and diagnosed type 2 diabetes mellitus slightly attenuated these associations. Intake of sugar-sweetened but not artificially sweetened beverages was significantly associated with increased plasma triglycerides, C-reactive protein, interleukin-6, and tumor necrosis factor receptors 1 and 2 and decreased high-density lipoprotein, lipoprotein(a), and leptin (P<0.02).
Conclusions—Consumption of sugar-sweetened beverages was associated with increased risk of CHD and some adverse changes in lipids, inflammatory factors, and leptin. Artificially sweetened beverage intake was not associated with CHD risk or biomarkers.
Consumption of sugar-sweetened beverages has repeatedly been associated with weight gain and type 2 diabetes mellitus (T2D).1–3 However, few studies have investigated the relationship between sugar-sweetened beverage intake and incident cardiovascular disease (CVD). Such a relationship might be expected, given their association with adiposity and T2D. In an analysis of the Nurses' Health Study, sugar-sweetened beverage intake was associated with incident coronary heart disease (CHD) even after adjustment for these factors,4 which suggests that other mechanisms are involved.
Editorial see p 1718
Clinical Perspective on p 1741
Although artificially sweetened beverages such as diet soda have been suggested as alternatives, some prospective cohort studies have linked the consumption of these beverages to cardiometabolic dysfunction.5–7 In an analysis of the Health Professionals Follow-Up Study, we found strong evidence that such relationships are due to confounding and reverse causality.8
The primary objective of this study was to further define the association between sugar-sweetened and artificially sweetened beverage intake and CHD in the Health Professionals Follow-Up Study, a large prospective cohort study of men. The secondary objective was to identify a possible mechanism by adjusting for potential mediators of this relationship and measuring cross-sectional associations between beverage intake and blood lipids, hemoglobin A1c, inflammatory factors, and adipokines.
The Health Professionals Follow-up Study is a prospective cohort study that began in 1986 with the recruitment of 51 529 middle-aged (age, 40–75 years) male dentists, pharmacists, optometrists, osteopath physicians, podiatrists, and veterinarians. Approximately 97% of participants were of white European descent. Questionnaires were mailed to participants at baseline and biennially to assess health and lifestyle traits (94% response rate). The Health Professionals Follow-up Study was approved by the Harvard School of Public Health Institutional Review board, and all participants gave written consent.
Beverage Intake
A semiquantitative food frequency questionnaire was sent to participants every 4 years. The food frequency questionnaire asked participants to report their usual intake (never to ≥6 times per day) of a standard 355-mL (12-oz) serving (1 glass, can, or bottle) of sugar-sweetened (caffeinated colas, caffeine-free colas, other carbonated sugar-sweetened beverages, noncarbonated sugar-sweetened beverages [fruit punches, lemonades, or other fruit drinks]) and artificially sweetened (caffeinated low-calorie beverages and noncarbonated low-calorie beverages) beverages. Frequency of intake was multiplied by the nutrient content for each food item and summed to produce daily intakes of nutrients and energy.
In a validation study, intake of cola was highly correlated (deattenuated for measurement error) with mean intake from two 7-day diet records (0.84 for sugar-sweetened, 0.74 for artificially sweetened). Intake of noncolas had poorer correlations with intake from 7-day diet records (0.55 for carbonated noncolas, 0.40 for fruit punches/lemonades/other fruit drinks).9
Blood Samples
Between 1993 and 1995, 18 225 participants provided a blood sample. Blood was collected in tubes containing liquid EDTA and returned to the laboratory on ice via an overnight courier, where the samples were frozen in liquid nitrogen. Participants were subjects in nested case-control studies (eg, T2D, CVD, Parkinson disease, prostate cancer, pancreatic cancer, colon cancer) or healthy men who were randomly selected on the basis of their alcohol-consumption patterns for a study on alcohol intake and biomarkers of ischemic heart disease. Nearly 60% of participants fasted for >9 hours.
Ascertainment of End Points
Incident CHD was defined as nonfatal or fatal myocardial infarction. Participants were asked in a biennial follow-up questionnaire whether they had experienced a myocardial infarction between January 1986 and December 2008. When an event was reported, we asked permission from the participant to obtain medical records for confirmation. Nonfatal myocardial infarction was defined by use of the World Health Organization criteria, which required clinical symptoms and diagnostic changes on ECG or elevated cardiac enzymes. Death ascertainment was performed by searching the National Death Index,10 by family members' responses to follow-up questionnaires, or by reports from participants' professional organizations. We requested access to medical records, autopsy reports, and death certificates to confirm all suspected deaths caused by myocardial infarction. Fatal myocardial infarction was confirmed by medical records or autopsy reports. Death certificates alone were not considered sufficient to confirm myocardial infarction as the cause of death unless family members or medical records indicated that the participant was diagnosed with coronary artery disease before death but after admission into the study.
Measurement of Biomarkers
Plasma concentrations of total, high-density lipoprotein, and direct low-density lipoprotein cholesterol and triglycerides were measured by standard methods with reagents from Roche Diagnostics (Indianapolis, IN) and Genzyme (Cambridge, MA).11,12 Lipoprotein(a) was measured with a turbidimetric assay on the Hitachi 911 analyzer (Roche Diagnostics) using reagents and calibrators from Denka Seiken (Niigata, Japan). This is the only commercial assay not affected by Kringle type 2 repeats.13 Red blood cell glycohemoglobin (hemoglobin A1c) was measured by a temperature-controlled high-performance liquid chromatography method.14 C-reactive protein (CRP) was measured on the Hitachi 911 analyzer (Roche Diagnostics) with an immunoturbidimetric assay (Denka Seiken). Interleukin-6, tumor necrosis factor receptors 1 and -2 (TNFr1 and TNFr2), intracellular adhesion molecule-1, and vascular cell adhesion molecule-1 were measured by ELISAs (R&D Systems, Minneapolis, MN). Plasma adiponectin and leptin concentrations were measured by competitive radioimmunoassay (Linco Research, St. Charles, MO). Coefficients of variation for most assays were <10%.
Statistical Analysis
Participants with a history of T2D, CVD (heart attack, stroke, angina, coronary artery bypass graft), and cancer (except nonmelanoma skin cancer) at baseline were excluded. Participants with an implausible energy intake (<335 or >1758 MJ/d) were also excluded, leaving 42 883 participants for analysis (see the online-only Data Supplement for a flowchart showing all exclusions).
Person-time was calculated from the return of the baseline questionnaire until December 31, 2008, death, loss to follow-up, or diagnosis of CHD (fatal or nonfatal), whichever occurred first. Cox proportional hazard models with time-varying covariates with age as the time scale were used for all analyses. Cumulative averages of beverage intake and dietary variables were calculated at each time point and were not updated after a diagnosis of cancer or CVD to limit recall bias. Other covariates were updated at each time point. This was compared with a secondary analysis that used only baseline dietary information. For missing data, the last value was carried forward for body mass index (BMI), smoking, and physical activity.
Beverage intake was grouped into fourths (quartiles), and the Wald test (1 df) of the median value in quartiles was used to evaluate linear trends. Models were adjusted for smoking (never, past, current 1–15 cigarettes/d, current >15 cigarettes/d, missing), physical activity (quintiles of metabolic equivalents per week, missing), alcohol intake (abstainers, 0–9.9 g/d, 10–20 g/d, >20 g/d, missing), multivitamin use, family history of CHD, pre-enrollment (1981–1986) weight gain (0, 0.9–1.8, 2.3–4.1, 4.5–6.4, 6.8–8.6, 9.1–13.2, or ≥13.6 kg) or weight loss (0, 0.9–1.8, 2.3–4.1, 4.5–6.4, or ≥6.8 kg), adherence to a low-calorie diet (1992), total energy intake (quintiles), and BMI (<23, 23–23.9, 24–24.9, 25–26.9, 27–28.9, 29–30.9, 31–32.9, 33–34.9, >35 kg/m2, missing). Smoking status was missing in 3.9% of participants, whereas physical activity was missing in 0.5% and BMI in 2.2% of participants.
We also adjusted for the alternative Healthy Eating Index (quintiles)15 to help rule out confounding by other dietary factors. The alternative Healthy Eating Index ranks participants according to their adherence to a healthy dietary pattern, awarding points for higher intakes of fruit, vegetables, nuts/soy, cereal fiber (fiber from cereals, eg, wheat) polyunsaturated:saturated fat, white:red meat; moderate alcohol intake, daily multivitamin use, and low intakes of trans fat. Potential mediators (updated values for self-reported high cholesterol, high triglycerides, high blood pressure, and a past confirmed diagnosis of T2D) were adjusted for in a separate model.
We tested for nonlinear associations using cubic splines (5 knots), and in a sensitivity analysis, we excluded CHD cases occurring during the first 4 years of follow-up. This was done to evaluate the influence of subclinical disease on associations. We also performed an 8-year latency analysis in which diet was updated only after 8 years to determine the role of elapsed time between the assessment of beverage intake and CHD.
Analyses were stratified by age (≥65 versus <65 years), smoking (ever versus never), alcohol consumption (drinker versus abstainer), physical activity (low [quintiles 1 and 2], medium [quintiles 3 and 4], high [quintile 5]), family history of T2D (yes versus no), BMI (<25, 25–29.9, ≥30 kg/m2), past diagnosis of CHD (yes versus no), self-reported high triglycerides (yes versus no), high cholesterol (yes versus no), and high blood pressure (yes versus no). We also stratified for all combinations of mediators (eg, high triglycerides plus T2D versus neither). Interaction tests were performed with the Wald test of cross-product terms (eg, median beverage intake by median BMI in categories).
Cross-sectional associations between cumulatively averaged sugar- and artificially sweetened beverage intake and blood total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, lipoprotein(a), hemoglobin A1c, CRP, interleukin-6, TNFr1, TNFr2, intracellular adhesion molecule-1, vascular cell adhesion molecule-1, adiponectin, and leptin were examined in 1994 by use of linear regression with a robust variance estimator. As a result of skewed distributions for CRP and interleukin-6, these variables were log transformed. All analyses were adjusted for the case-control study from which blood samples were drawn, and associations were evaluated for differences by fasting state using cross-product terms (fasting by sugar-sweetened beverages).
SAS version 9.1 was used for all analyses. A 2-tailed value of P<0.05 was considered statistically significant.
Baseline Characteristics
At baseline, participants reported consuming fewer sugar-sweetened beverages (2.5 per week, 0.36 per day, SD=0.61) than artificially sweetened beverages (3.4 per week, 0.49 per day, SD=0.94).
Consumption of sugar-sweetened beverages was associated with several unhealthy lifestyle traits at baseline, including a higher prevalence of current smoking and lower physical activity, but a decreased family history of CHD (Table 1). It was also associated with a lower overall diet quality (alternative Healthy Eating Index) and intake of cereal fiber, protein, alcohol, and multivitamins but a higher intake of carbohydrate, glycemic load (product of glycemic index [white bread as reference food] and carbohydrate), total fat, trans fat, and energy (Table 1). Sugar-sweetened beverage consumption was associated with higher pre-enrollment weight gain, decreased pre-enrollment weight loss, and a lower adherence to a low-calorie diet (Table 1). Conversely, artificially sweetened beverage consumption was associated with some healthy lifestyle traits, including a lower prevalence of current smoking and higher physical activity, but a greater family history of CHD (Table 1). It was also associated with a higher prevalence of high triglycerides, high cholesterol. and high blood pressure (Table 1). Artificially sweetened beverage consumption was associated with higher overall diet quality (alternative Healthy Eating Index); a lower intake of carbohydrate, cereal fiber, and glycemic load; but a higher intake of protein, total fat, saturated fat, trans fat, and multivitamins. Artificially sweetened beverage intake was also associated with higher pre-enrollment weight gain, pre-enrollment weight loss, adherence to a low-calorie diet, and BMI (Table 1).
Cox Regression
There were 3683 incident cases of CHD over 22 years of follow-up (790 852 person-years). Sugar-sweetened beverage intake was associated with an increased risk of CHD (top versus bottom quartile, relative risk=1.21, 95% confidence interval, 1.10–1.33; P for trend <0.01; Table 2); however, artificially sweetened beverages were not (relative risk=1.04, 95% confidence interval, 0.96–1.15; P for trend=0.05; Table 2).
Adjustment for smoking, physical activity, alcohol intake, multivitamin use, and family history attenuated the association for sugar-sweetened beverages but strengthened the association for artificially sweetened beverages (Table 2). Further adjustment for pre-enrollment weight change and adherence to a low-calorie diet in 1992 strengthened the association for sugar-sweetened beverages but weakened it for artificially sweetened beverages (Table 2). Adjustment for dietary factors had the opposite effect, but after adjustment for BMI, the association for artificially sweetened beverages was no longer significant (Table 2). Further adjustment for a past diagnosis of T2D, high blood lipids, and high blood pressure only slightly attenuated these associations (Table 2). Cubic splines revealed no evidence of nonlinearity in these associations (P for curvature >0.21).
Using continuous intake yielded similar results (Table 3). For each additional serving per day, sugar-sweetened beverage consumption was associated with a 19% to 25% increased risk of CHD (P<0.02; Table 3). Overall, artificially sweetened beverages were not associated with risk of CHD (P=0.05). Artificially sweetened carbonated noncolas were associated with increased risk; however, their contribution to intake was small.
Repeating this analysis with continuous covariates did not substantially alter the results (data not shown). Associations were similar when baseline beverage intake was used, after the elimination of CHD cases in the first 4 years (n=272), and in a latency analysis in which diet was updated after 8 years (data not shown). No significant interactions with age, smoking, alcohol, physical activity, family history, BMI, or any mediators or their combinations were observed (data not shown).
Blood Biomarkers
Intake of sugar-sweetened beverages was associated with significantly higher triglycerides, CRP, interleukin-6, TNFr1, and TNFr2 and lower high-density lipoprotein, lipoprotein(a), and leptin (Table 4). Associations did not differ significantly according to fasting status (data not shown).
In this analysis, consumption of sugar-sweetened but not artificially sweetened beverages was associated with an increased risk of CHD. Sugar-sweetened beverage consumption was associated with some adverse changes in blood lipids, inflammatory factors, and leptin.
Sugar-sweetened beverages provide ≈63 MJ per serving16 and are less satiating than solid foods,17–19 which make them important determinants of BMI. In a pooled analysis of the Health Professionals Follow-Up Study and the Nurses Study I and II, an increase in sugar-sweetened beverage intake was associated with a 0.45-kg greater 4-year weight gain in men and women.3 Conversely, in the PREMIER lifestyle intervention and weight loss trial, a reduced intake of sugar-sweetened beverages was associated with significant weight loss.20 In trials among overweight children and adolescents, subjects randomized to consume fewer sugar-sweetened beverages lost significantly more weight than participants in control groups.21,22 Sugar-sweetened beverages also have a high carbohydrate content and glycemic load, which may elevate the risk of T2D23 and lead to unfavorable changes in blood lipids independently of BMI. In a meta-analysis of 60 trials, replacing dietary fat with carbohydrate increased triglycerides and lowered high-density lipoprotein.24 A similar effect is attributed to fructose from sugar-sweetened beverages, which increases de novo lipogenesis25 but also the synthesis of uric acid, which may elevate blood pressure.26 In the PREMIER trial, a reduction in sugar-sweetened beverage intake was associated with a significant decrease in systolic and diastolic blood pressures.27 Finally, advanced glycation end products present in the caramel coloring of colas may play a role as they decrease insulin sensitivity in rodents.28 In light of this evidence and the fact that in 2004 sugar-sweetened beverages made up ≈7% of the total daily energy intake of Americans,29 sugar-sweetened beverages are important risk factors for CVD.
In this study, consumption of sugar-sweetened beverages was significantly associated with an increased risk of CHD. This was after adjustment for multiple lifestyle-related factors, including overall diet quality and BMI, which were strong risk factors for CHD. We also adjusted for prior weight change and dieting, which could motivate participants to switch from sugar-sweetened to artificially sweetened beverages.30 For a 1-serving-per-day increase in sugar-sweetened beverage intake, the risk of CHD increased by 19% (relative risk=1.19; 95% confidence interval, 1.11–1.28; P<0.01). Similar results were observed in the Nurses' Health Study (n=88 520; cases, n=3105; follow-up, 24 years) in which a 1-serving-per-day increase in sugar-sweetened beverage intake was associated with a 15% increase in risk (relative risk=1.15; 95% confidence interval, 1.07–1.20; P<0.01).4 The average baseline intake of sugar-sweetened beverages was slightly higher in the Nurses' Health Study (0.41 servings per day) than in the Health Professionals Follow-Up Study (0.36 servings per day).4
Our results were stable after a number of sensitivity analyses. Using baseline dietary intake did not change the results, and associations were still significant after the exclusion of early cases of CHD, which could be a marker of preexisting disease and a more recent change in beverage intake. Results were essentially the same in an 8-year latency analyses. We found no differences in associations among different strata, including past diagnosis of T2D, self-reported high triglycerides, high cholesterol, high blood pressure, or their combinations.
As in the Nurses' Health Study,4 we found that the relationship between sugar-sweetened beverage consumption and CHD was not explained by conventional mediators. After adjustment for a past diagnosis of T2D, self-reported high triglycerides, self-reported high cholesterol, and self-reported high blood pressure, the relationship was only slightly attenuated. This suggests that sugar-sweetened beverages may affect CHD risk above and beyond traditional risk factors.
We looked for possible biochemical mediators in our study and found that sugar-sweetened beverage consumption was associated with higher triglycerides and lower high-density lipoprotein. This is consistent with results from a meta-analysis of intervention studies evaluating the replacement of fat with carbohydrate on blood lipids,24 as well as other trials of fructose intake.31 We found a slight decrease in lipoprotein(a) with increased consumption of sugar-sweetened beverages; however, the reason for this finding is unclear. Importantly, sugar-sweetened beverage consumption was associated with increased levels of several circulating inflammatory factors, including CRP, interleukin-6, TNFr1, and TNFr2. In the Nurses' Health Study, a dietary pattern rich in sugar-sweetened beverages was associated with higher levels of TNFr2, CRP, and interleukin-6.32 These findings have been validated in a recent trial in which low to moderate intake of sugar-sweetened beverages increased inflammatory factors such as CRP.33 In this study, fructose-enriched beverages produced the greatest increases in inflammatory factors.33 Inflammation is a key factor in the pathogenesis of CVD and cardiometabolic disease34 and could represent an additional pathway by which sugar-sweetened beverages influence risk. Intake of sugar-sweetened beverages could stimulate an inflammatory response through hyperglycemia, which can activate the electron transport chain to produce superoxide radicals.35 Fructose also stimulates transcription of inflammatory factors by activating nuclear factor-κB in mice.36 Finally, we observed an inverse relationship between sugar-sweetened beverage intake and leptin. Small trials indicate that fructose-supplemented meals lead to poor stimulation of leptin, lower satiety, higher energy intake, and weight gain.37
We found no evidence to suggest that overall consumption of artificially sweetened beverages was associated with CHD risk or changes in biomarkers; however, noncarbonated artificially sweetened beverages were associated with increased risk in an analysis of continuous intake. The reason for this is unclear, especially because we found no significant associations between artificially sweetened beverages and biomarkers. Previous studies have found significant associations between artificially sweetened beverage consumption, cardiometabolic dysfunction, and T2D5–7; however, these findings are probably due to confounding and reverse causality. In the Health Professionals Follow-Up Study, participants appear to be consuming artificially sweetened beverages as part of a weight-loss strategy or in response to the diagnosis of a chronic condition. In a previous analysis of this study, sugar-sweetened beverage consumption was associated with an increased risk of T2D, but this was not significant after adjustment for BMI, pre-enrollment weight change, and dieting.8 We saw a similar pattern of attenuation in the present analysis; however, the magnitude of confounding was smaller. Our results highlight the need for cautious interpretation of studies reporting positive associations between diet drinks and cardiometabolic and cardiovascular outcomes.
Our study has some limitations. First, dietary intakes were measured with some error. Second, participants in our study may be dissimilar to those living in the general population. For example, intake of sugar-sweetened beverages was much lower in our study (mean, 0.36 servings per day) than in US adults (mean, >1 serving per day).38 However, the similarity of the sugar-sweetened beverage–CHD relationship across various strata suggests that it is likely to be the same in different populations. Third, we cannot exclude the possibility of unmeasured and residual confounding. To address this issue, we adjusted for a wide range of potential confounders and used continuous covariates in an attempt to control residual confounding. We could not account for residual confounding resulting from missing smoking, physical activity, and BMI data. Fourth, we tested for a large number of cross-sectional associations. However, our results are supported by other studies, which suggests that they are not due to chance.
Consumption of sugar-sweetened but not artificially sweetened beverages was associated with a significantly increased risk of CHD. Sugar-sweetened beverage intake was also associated with adverse changes in some blood lipids, inflammatory factors, and leptin. These results and those from other observational studies and trials support recommendations to reduce the consumption of sugar-sweetened beverages to prevent CVD.
Sources of Funding
This analysis was supported by a postdoctoral fellowship from the Canadian Institutes of Health Research to Dr de Koning. The Health Professionals Follow-Up Study is supported by 4 grants from the National Institutes of Health (CA55075, HL35464, AA11181, and DK58845).
Guest Editor for this article was Clyde W. Yancy, MD.
The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIRCULATIONAHA.111.067017/-/DC1.
- Received September 8, 2011.
- Accepted February 8, 2012.
- © 2012 American Heart Association, Inc.
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Clinical Perspective
Consuming sugar-sweetened beverages such as cola puts individuals at an increased risk for weight gain and type 2 diabetes mellitus, both of which are risk factors for coronary heart disease (CHD). However, few studies have assessed the relationship between sugar-sweetened beverage consumption and CHD events. In our analysis of the Health Professionals Follow-Up Study, a prospective cohort study that includes a well-characterized population of >40 000 men, we found that sugar-sweetened beverage consumption was associated with a higher risk of CHD independently of body mass index, type 2 diabetes mellitus, and other established cardiovascular risk factors. For each additional serving per day, sugar-sweetened beverages were associated with a 19% increased risk of CHD. We also found that sugar-sweetened beverage consumption was associated with adverse changes in blood lipids, higher circulating inflammatory factors, and lower leptin. These biomarker changes may help to explain why sugar-sweetened beverage consumption is a risk factor for CHD and, in the case of leptin, obesity. Conversely, consumption of artificially sweetened beverages such as diet soda was not associated with CHD risk or biomarkers in our study but was associated with baseline comorbidities, higher body mass index, pre-enrollment weight change, and dieting, which could lead to confounding.
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- Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in MenClinical PerspectiveLawrence de Koning, Vasanti S. Malik, Mark D. Kellogg, Eric B. Rimm, Walter C. Willett and Frank B. HuCirculation. 2012;125:1735-1741, originally published April 9, 2012https://doi.org/10.1161/CIRCULATIONAHA.111.067017
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- Sweetened Beverage Consumption, Incident Coronary Heart Disease, and Biomarkers of Risk in MenClinical PerspectiveLawrence de Koning, Vasanti S. Malik, Mark D. Kellogg, Eric B. Rimm, Walter C. Willett and Frank B. HuCirculation. 2012;125:1735-1741, originally published April 9, 2012https://doi.org/10.1161/CIRCULATIONAHA.111.067017