A lesson from "Women’s Health Initiative (WHI) Dietary Modification Trial. "

Sandy Szwarc states the purpose of her blog Junkfood Science to be:

"Critical examinations of studies and news on food, weight, health and healthcare that mainstream media misses. Debunks popular myths, explains science and exposes fraud that affects your health. Plus some fun food for thought. For readers not afraid to question and think critically to get to the truth."

She then discusses some results of the WHI that didn't seem to make headlines. It's a good read and quite informative. Read her full article HERE.

Are you a woman taking cholesterol lowering statin medication? Please read this.

In their paper "Evidence for Caution: Women and statin use" authors Harriet Rosenberg and Danielle Allard make the following statement,

"Our review of these fields identifies a troubling disjuncture between the widespread use of statin medication for women and the evidence base for that usage. What we found instead was evidence for caution."

Then in their conclusion they state

"We have assessed the impact of statin use on women starting from the assumption that if a woman is put on a drug for the rest of her life, the reasons for doing so must be based on the highest quality, most credible data possible. There must be solid evidence of advantage over harm and careful analysis of any serious adverse outcomes that may arise immediately or with years or decades of use or when used in conjunction with other drugs commonly prescribed for women. In other words, a Canadian woman should be able to take a pill, safe in the knowledge that its benefits and safety were tested on women like her. She should embark on long-term commitment to a drug therapy with the understanding that she is highly likely to derive a clear advantage in terms of health and longevity and also feel confident that information about any risks will be explained to her in meaningful and accessible language.

These expectations have not been met. Instead we have found a pattern of overestimation of benefit and underestimation of harm."

Please read the full article HERE.

What? Me a Muscle Hack. ... I doubt it! In fact I deny it.

But there is a Muscle Hack that is up there in my book (actually I don't have a book - as in authoring one at least). And if you are a Muscle Hack (what is a Muscle Hack anyway?) please read an interview with one - Anthony Colpo. As usual, he has a strong, well informed, well researched, and entertaining view.
Caution: Anthony provides this disclaimer about the interview.
If you are a politically correct pansy who takes deep offense when a grown man speaks his mind, or if you are a member of The Church of Latter Day Metabolic Advantage Believers, then you read the interview at your own risk. Neither the interviewer or interviewee are in any way responsible for any resulting nervous breakdowns or intra-cranial hemorrhages occurring in those who can't handle information that clashes with their own deeply held beliefs.Though not a Muscle Hack I am interested in health and diet (I don't think they're distinctly different topics) and will say Anthony Colpo speaks on these topics with gusto.

Interview tith Colpo: Muscle Hack
Colpo's Books: The Great Cholesterol CON; The Fat Loss Bible

Colpo's article in the Journal of American Physicians and Surgeons: LDL Cholesterol:"Bad" Cholesterol, or Bad Science?

From the author of "The Fat Loss Bible"

Anthony Colpo author of "The Cholesterol CON" and "The Fat Loss Bible" speaks his mind on the unsubstantiated claim of those who espouse the metabolic advantage view of dieting. Read his expose here or select item under Credible Evidence column on the right.

Do You Drink 8 Glasses of Water a Day?

We hear a lot on advice, including from doctors, about how important it is to do just that.

How long has it been that you have gone through a day without seeing several or many people carrying and/or sipping from a bottle of water? The word has surely has gotten out and permeates our lives. Look at the tons of bottled water on the grocer’s shelves and in vending machines. And where I live there are ambitious hawkers along the busy streets selling same.

In a book written by a physician titled "Your Body's Many Cries For Water" it is claimed that simply drinking more water "cures many diseases like..."

So what is the truth about drinking water? Must I constantly be sucking on a water bottle as I go about my day? Do the 'scare' emails that have been going around for the past several years on this subject accurately portray the need and importance? Certainly your doctor who parrots the party line must know the truth, right?

Well I don't really know the answer myself but it's got to be out there somewhere. A nutrition researcher, Barbara Rolls has written a book on water and says of the "First Commandment of Good Health: Drink at least eight 8-ounces of water a day" she can't even tell you where it came from.

So as for me and my house, we will follow the "best general advice" as given at the end of this article http://www.snopes.com/medical/myths/8glasses.asp, to "rely upon your normal senses. If you feel thirsty, drink; if you don't feel thirsty, don't drink unless you want to."

That really makes sense to me.

Cholesterol lowering statin drugs and Cancer!

Today I came across an article in Medical News Today (http://www.medicalnewstoday.com/) in the section under the Main Category: Cholesterol News which re-opened my eyes to the scary connection between statin drugs and cancer. I've linked to the full article under Credible Evidence.

The first paragraph of this article states the following:

"Statins, a type of LDL cholesterol-lowering drug, were recently shown to have a significant, positive association with newly diagnosed cancer cases. When newly diagnosed cancer cases were correlated with cholesterol reduction, a disturbing significant correspondence was found, and recently published as, "Effect of the Magnitude of Lipid Lowering on Risk of Elevated Liver Enzymes, Rhabdomyolysis, and Cancer, by Alsheikh-Ali, et al., in Journal of the American College of Cardiology (Vol. 50, No. 5, 2007, pages 409-418)."

So I ask "Would you rather die of a Heart Attack or from Cancer?" Of course if we had our druthers we'd likely all say 'NEITHER' Right? Well think about it for a moment then answer.

And If I was a betting man I'd bet this won't make the big time news.

Furthermore it's not even new news.

The PROSPER trial found a 25% increase in newly diagnosed cancers among elderly individuals treated with pravastatin (Pravachol). There were 24 more deaths from cancer to more than offset the 20 fewer deaths due to coronary heart disease. This had also been observed in animal tests earlier with one of the highest increases observed in the gastrointestinal cancers. And who should be suprised that the PROSPER authors dismissed these findings by referring to pooled analysis which showed no statistically significant difference in cancer incidence between placebo and statin groups. The PROSPER trial did not even include skin cancer. Two others did however, the Scandinavian Simvastatin Survival Study (4S) and the HPS simvastatin trial. They both noted an increase in skin cancer. And in the CARE trial 12 women taking pravastatin developed breast cancer whereas only one in the placebo group developed breast cancer.

Other quotes from the Medical News Today article :

"Following the adage, "lower is better," intensive LDL cholesterol lowering has been practiced by physicians on their patients throughout America since 1987, with Lovastatin and more recently with a new generation of statins."

"With statin use, the increase in cancer deaths offset (counteract) the lower cardiac mortality associated with lower cholesterol, resulting in a neutral effect of overall mortality. TRANSLATION: With statins, you don't die of a heart attack, instead, you die of cancer."

Well now that you've thought about it would you die of a heart attack or of cancer?

A side note that makes this a bit personal for me:

• I was on cholesterol lowering statins for roughly 20 years beginning in the mid 1980s. I finally discontinues taking statins sometime in 2004

• In 1994 (with low cholesterol) I had a heart attack resulting in open heart surgery.

• P.S. Five subsequent heart attacks (most recent Jan 31, 2012), three requiring stents - all while having well below 'their recommended' serum cholesterol readings. (added this item Oct 8, 2007)

• In 2003 I had a fist sized gastrointestinal cancerous tumor removed along with about 9 inches of my small intestine.

• I've had one basal cell carcinoma (skin cancer) surgically removed about 3 years ago.

• I personally have no data to tie these events in my life together.

• I feel good now - like none of the above had happened. It almost seems surreal. But I've had five subsequent heart attacks - three with stents and there is some possibility that the cancer could reappear.

Something is going to get me sooner or later.

What will it be?
I'd pick the heart attack over cancer.

Am I worried? NO!

Because I believe the words of this hymn:

I know not why God's wondrous grace to me he hath made known,
nor why, unworthy, Christ in love redeemed me for his own.

But I know whom I have believed, and am persuaded that he is able
to keep that which I've committed unto him against that day.

I know not how this saving faith to me he did impart,
nor how believing in his word wrought peace within my heart.

I know not how the Spirit moves, convincing us of sin,
revealing Jesus through the word, creating faith in him.

I know not when my Lord may come, at night or noonday fair,
nor if I walk the vale with him, or meet him in the air.

But I know whom I have believed, and am persuaded that he is able to keep that which I've committed unto him against that day.

Doctors recommend Omega 3s and CoQ10

My RSS reader has been monitoring a blog from "Rebuild from Depression" (http://www.rebuild-from-depression.com/). I'll admit I don't actually read it often but the beauty of Real Simple Syndication (RSS) is being informed when new content is added. This one did catch my eye and I clicked the link to read the full article. Why? I usually get depressed reading about depression so it had to be something else. As you can tell from my Credible Evidence listings to the right of my blog, my larger interest is health issues related to the heart and diet. So, why is that not depressing? Guess I'm just wierd - though not depressed - even though some might think I have reason to be (see my previous post).


The new content that caught my eye began as follows:


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"Best Omega 3 Food: Fish and Seafood

Every day it seems that there is new evidence that Omega 3 fatty acids can alleviate depression, heart disease, Alzheimer’s, and improve overall health. The Omega 3 supplement industry has soared.

Clinical trials on depression use high doses of Omega 3 fatty acids and find that people struggling with depression get some relief. Omega 3s are important in brain function generally and the western diet has been rather deficient in the fat for the last century.

What your best strategy is to improve your Omega 3 fatty acid status is to take an Omega 3 supplement and to add foods to your diet high in Omega 3 and low in Omega 6."
=======================================
I added the emphasis by italicizing, bolding, & bluing "heart disease" above.

I encourage you to read the full article at http://www.rebuild-from-depression.com/blog/2007/08/best_omega_3_food_fish_and_sea.html



Well Omega 3s have gotten a lot of press in the heart disease circles. I was even asked to begin taking fish oil supplements by my cardiologist several years ago. However I'd already been taking it for sometime but not on any of my doctor's advice as they mostly seemed to prefer statin drugs for what ails me and almost anyone else. And being advised to partake of FAT by a cardiologist who is mostly interested in your cholesterol levels (rather than your health), and the fact that Omega 3s have been shown to increase serum cholesterol in clinical trials, is a bit surprising. You may detect a bit of cynicism in my voice (or typed words). And it's true. I'll admit it. It's there. My parenthetical dig above, "rather than your health", is not entirely fair. In fact it was a stent toting cardiologist who I can thank for initiating my interest in what was to me, the good doobee patient, out of the box thinking which then led to my ongoing research into things good for my 'ticker'. What did he do or say? Well, after shoving a non-drug eluting stent up my groin into my heart to smash the nasty, gooey, fatty substance back out of the way of oxygen carrying red blood cells that were sorely needed (pun intended) by my suffering heart muscles, he suggested that I might look into taking a supplement called CoQ10 since I complained of statin myalgia (statin induced muscle soreness).

Anyway fish oil (not the same as snake oil), CoQ10, and many other interesting things have come from my search. Maybe one or more of my findings will be of interest to you as well.

Protect Your Family from Bad Drugs

In Dr. Jeffrey Dach's newsletter bearing the title above he begins with the following:

Over the last 30 years, 20 per cent of drugs approved by the FDA were classified as “BAD Drugs”, meaning that they were later withdrawn from the market or given a black box warning.
...
How can you tell if you are dealing with a BAD DRUG? Here are the early warning signs:
1) The drug has been recalled or given a black box warning.
2) The drug is in litigation with numerous lawsuits against the drug company.
3) The drug has been banned in other countries.

It is worth checking out his links to "black box" drugs, "Recalled or Banned drugs", "Consumer Reports listing of risky drugs", and "Drugs in Litigation".

Of note, at least to me, in his "short list of drugs currently in litigation" are the three Anti-Cholestrol Statin Drugs, Baychol, Lipitor, and Crestor. Why these? Well, I've been on two of them - Baychol and Lipitor. My experience with these two are good and bad.

The good: I was only on Baycol for a very short time (five days) before it was removed from the market. Many suffered severe side effects from Baychol including 385 nonfatal cases of rhabdomyolysis and 52 deaths.

The bad: I was on Lipitor and suffered painful muscle aches (a precursor to rhabdomyolysis). This resulted in the Dr's switching me to other statin drugs resulting in similar side effects (and as noted above one of those was Baycol). I ended up being on statins for most of 20 years bowing to the conventional wisdom in the medical and drug industry that it is better than the almost certain alternative - a heart attack (sometimes referred to in my presence as a 'widow maker'). Not wanting that inevetibility I obediently followed the statin trail to prevent cholesterol from doing me in. What a good doobee I was! I was such a good doobee that my serum cholesterol was always below the ever decreasing deadly level. Boy was I glad! And it kept my doctors from having a coronary should they see what my lipids normally gravitated to.

More bad: In July of 1994 at the age of 51, with a cholesterol well below 100, I was blessed with a myocardial infarction or MI (commonly referred to as a heart attack). The fact that I'm writing this reveals that it was not of the 'widow maker' genus. Just in the nick of time they did a CABG (Coronary Artery Bypass Graft) ripping an extra vein from my leg to replace the offending one on the wall of my heart, or at least bypassing it. Whew! Think of how much worse it could have been had I not been drugging my lipids low enough.

And more bad: I had four subsequent MIs three of them resulting in percutaneous coronary intervention (PCI) accompanied by inserting an expandable wire mesh tubes to prop open arteries which had been obstructed (also called a stent). And just think how much worse it could have been had I not been drugging my lipids low enough.

Oh yeah! Another bad: I also am a cancer survivor. Seems totally separate from the rest and maybe it is. Then again, I came across one of the statin drug trials which did show a decrease in mortality due to coronary artery disease (CAD) resulting from, presumably taking the statin drug. And the summary or conclusion along with the 'in unison chorus' from the press, loudly stated that. BUT... that trial showed an overall mortality rate higher when you included all death causes. Yup you guessed it. There were more deaths due to cancer in the intervention group that took statins than in the control group taking the placebo. OOps! And not so loudly chorused was this un-interesting bit of data cuz afterall they were trying to show how statins reduce CAD and it appeared to show exactly that.

What have I learned through all this? Since I began to ask questions and began to read some pretty heavy stuff (a sample included under "Credible Evidence" on the right), at least I've learned some big words but that's less impressive than learning to take a pro-active position on my health. I'm only a retired engineer not a medical professional. But I'm so much more informed than when I was being a 'good doobee'. The quest to be pro-active only began about two-three years ago and the informed experiment is still in progress. It's been a little over a year since my last MI and PCI and I really feel pretty good. That really means little since through the whole MI/PCI phase of my life I've never really felt that bad. I'm no longer on statins or anything else to lower my cholesterol. So what is it now after drugging it to in the 70's way back then? I don't know nor do I care. Why? Most of the answer to that is found in those cholesterol and diet articles cited under Credible Evidence, most of which come from medical journals or significant medical research which I continue to read.

Enough for now! But stay tuned if you want to learn some big words.

Innumeracy. What's that!

Innumeracy, a term coined by cognitive scientist Douglas R Hofstadter in the early 1980’s, is a term meant to convey a person's inability to make sense of the numbers that run their lives.

Gerd Gigerenzer, in his book Calculated Risks: How to Know When the Numbers Deceive You clearly demonstrates that innumeracy is common among physicians, and is exploited by medical vendors. (Italic emphasis added by B Davis)

The book is reviewed in the Journal of American Physicians and Surgeons Volume 9 Number 1 Spring 2004. Exerpts follow with the whole review found at http://www.aapsonline.org/jpands/vol9no1/bookreviews.pdf.

=========================================
“The object of this book was to clear the mist from typically misleading, if not fraudulent, claims for the effectiveness of drugs and the accuracy of clinical assays. Gigerenzer’s focus is on deceptive presentation of data, usually in the form of relative risk (RR) rather than absolute risks or number needed to treat (NNT).

Gigerenzer points out with many examples that relative risk is always a larger number than absolute risk. One example is a 5-year study of pravastatin.the anticholesterol drug Pravachol.vs. placebo. All-cause death was said in the original paper to be reduced by 22% (RR=0.78). Would you prescribe it? The absolute change was 0.9%, or just 0.18% per year! Would you still prescribe it? It is also known that studies of drugs sponsored by their maker are biased, so even the 0.9% was probably exaggerated.”

Is Saturated Fat Really Bad For You?

Here's the first paragraph of the article titled "Is Saturated Fat Really Bad For You?"
=====================================
"To many people this is a surprising question. After all, we all "know" that saturated fat raises cholesterol, and that raising cholesterol raises your risk of heart disease and other cardiovascular diseases. However, it turns out that actual research that shows a link between saturated fat consumption and cardiovascular diseases is not very convincing. We have already discussed this topic in our series on Cholesterol Skeptics, where we report on the discussion between Dr. Uffe Ravnskov and Dr. William Weintraub. Following that discussion, we opined that changing quantities and ratios of fats in one's diet within normal limits make very little difference to one's risk, even if one's cholesterol level does change. The mere fact that an effect is so difficult to pinpoint, and is open to discussion after so many years of diet advice, shows that it cannot be very significant."
=====================================
Read the complete article at http://www.factsmart.org/satfat/satfat.htm

In the letters section in the British Medical Journal BMJ 2002;325:1114 ( 9 November ) a response by Malcolm Kendrick, medical director. Adelphi Lifelong Learning, Adelphi Mill, Bollington, Macclesfield SK10 5JB malcolm@llp.org.uk states the following:
===================================

Can Law and Wald fit these figures onto their semilogarithmic scale? The suggestion that no levels of any risk factor in the Western world are currently normal, and that what we call a normal blood pressure is actually high and should be lowered, is dangerous nonsense.

Are Law and Wald aware of data from Framingham, which show that falling cholesterol concentrations are directly associated with an increased risk of coronary heart disease?3 Are they aware of research from Japan that shows a completely inverse relation between rising cholesterol concentrations and deaths from coronary heart disease?4 Hundreds of papers contradict the association between raised cholesterol concentrations and death from coronary heart disease.

Shestov in his lipid clinics study in Russia even showed an inverse relation, with higher rates of coronary heart disease in patients with hypocholesterolaemia. The Honolulu study shows that, in people older than 50, a low cholesterol concentration is by far the most important risk factor for premature death.5 Law and Wald did not show one curve relating to cholesterol loweringthe J shaped curve of total mortality with 5.2 mmol/l at the bottom of that curve (figure).
Law and Wald are effectively suggesting that there is no non-dangerous blood pressure or cholesterol concentration and that, therefore, almost everyone in the Western world should be given some kind of drug treatment. This is dangerous nonsense, and we should not be afraid to say so. Malcolm E Kendrick, medical director. Adelphi Lifelong Learning, Adelphi Mill, Bollington, Macclesfield SK10 5JB malcolm@llp.org.uk

1.
Law MR, Wald NJ. Risk factor thresholds: their existence under scrutiny. BMJ 2002; 324: 1570-1576. (29 June.)2.
Law MR, Wald NJ. Why heart disease mortality is low in France: the time lag explanation [with commentaries by M Stampfer, E Rimm, D J P Barker, J P Mackenbach, and A E Kunst]. BMJ 1999; 318: 1471-1480[Free Full Text].3.
Anderson KM, Castelli WP, Levy D. Cholesterol and mortality: 30 years of follow-up from the Framingham study. JAMA 1987; 257: 176-180.4.
Okayama A, Ueshima H, Marmot MG, Nakamura M, Kita Y, Yamakawa M. Changes in total serum cholesterol and other risk factors for cardiovascular disease in Japan 1980-1989. Int J Epidemiol 1993; 22: 1038-1047[Abstract/Free Full Text].5.
Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet 2001; 358: 351-355[CrossRef][ISI][Medline].
========================
The point being High Cholesterol is NOT the bad guy its made out to be. Read these statements again:
"...data from Framingham, which show that falling cholesterol concentrations are directly associated with an increased risk of coronary heart disease?3 "

"...research from Japan that shows a completely inverse relation between rising cholesterol concentrations and deaths from coronary heart disease?4"

"Hundreds of papers contradict the association between raised cholesterol concentrations and death from coronary heart disease."

"The Honolulu study shows that, in people older than 50, a low cholesterol concentration is by far the most important risk factor for premature death.5"

Messed up food pyramid is ruining our health!

I've linked to the article in the Journal of American Physicians and Surgeons under Credible Evidence but here's a quote from the abstract and the conclusion of the article with bold highlighting added by myself.

ABSTRACT
The USDA-sponsored Dietary Guidelines for Americans (DGA) and its Food Guide Pyramid are nutritionally and biochemically unsound. The DGA was nevertheless accepted wholeheartedly by nutrition authorities, who took Ancel Keys as their guiding spirit and his lipid hypothesis their mantra. They radically changed the food habits of tens of millions of Americans in a massive human experiment that has gone awry. Much evidence suggests that the current epidemics of cardiovascular diseases,

Conclusion
It is no secret that the lipid hypothesis, now dogma, is facing a serious challenge. America's long dietary experiment with the lowfat, high-carbohydrate diet has failed. Today, there is little doubt that there is a clear temporal association between the "hearthealthy" diet and the current, growing epidemics of cardiovascular disease, obesity, and type-2 diabetes. Many scientific papers and books support this association and explain exactly how and why the low-fat, high-carbohydrate diet causes these diseases.

Long-held beliefs that animal fat is the cause of cardiovascular disease and that grain products are the staff of life will not be relinquished without a struggle. The articles and comments widely circulated in the public press, exemplified by the denigration of the "low carb" diet and its author, the late Dr. Atkins, are evidence of this struggle.

Hope for a solution may well lie with physicians and nutritionists schooled in the biochemistry of nutrientmetabolism and open to revisiting past dogmas. As Dr. Sylvan LeeWeinberg, past president of the American College of Cardiology, states in his insightful and courageous critique of the validity of the dietheart hypothesis:

"Defense of the LF-Hcarb[low-fat, high-carbohydrate] diet, because it conforms to current traditional dietary recommendations by appealing to the authority of its prestigious medical and institutional sponsors, or by ignoring an increasingly critical medical literature, is no longer tenable."

I hope you will consider reading the whole article at: http://www.jpands.org/vol9no4/ottoboni.pdf

Dr. Jeffrey Dach on Lipitor and ....

At the top of the doctors web site is the following quote from none other than...

"You Bet Your Life"
“Politics (BioBiz) is the art of looking for trouble, finding it, misdiagnosing it and then misapplying the wrong remedies.” — Groucho Marx (Hank Barnes)


Jeffrey Dach on Lipitor and ....

"Graveline also points out that statins are useful for secondary prevention of heart disease in patients with significant pre-existing coronary artery disease (link), however the benefit is independent of cholesterol response during statin use. Contrary to the secondary prevention findings, no statin primary prevention study has ever shown a benefit in terms of all cause mortality in healthy men and women with only an elevated serum cholesterol, and no known coronary artery disease (link). Patients with known heart disease are customarily placed on statin drugs by the medical system with no need for direct to consumer (DTC) advertising to this group. DTC ads for Lipitor are clearly directed at the larger group of untreated primary prevention patients, for which there is no benefit in terms of all cause mortality.

The J-Lit study actually showed higher mortality at the lowest serum cholesterol (both total and LDL-C), a paradox called the J-Shaped Curve. The highest mortality was found at the lowest total cholesterol of 160 mg/dl, and lowest mortality at serum cholesterol around 240 mg /ml, exactly the opposite one would expect if cholesterol lowering was beneficial for health. The authors state that the increased mortality at the lower cholesterol levels was due to increased cancer. Another statin trial, CARE (Cholesterol And Recurrent Events), showed 1500 % increase in breast cancer among women in the statin treated group, explained as merely a statistical aberration. This is disputed by Uffe Ravnskov who feels that the difference is significant, and points to rodent studies showing statin drugs cause cancer in animals.

The Honolulu Heart Study of elderly patients showed the lowest serum cholesterol predicted the highest mortality. A study by Krumholz found lack of association between cholesterol and coronary heart disease mortality and morbidity in persons older than 70 years. Jenkins (BMJ) states that no statin drug study has ever shown an all cause mortality benefit for women."

Also in the article is this:

"Eight controlled clinical trials have shown that statin drugs cause Coenzyme Q10 depletion by inhibition of HMG-CoA reductase, which is the rate limiting step in cholesterol and Coenzyme Q-10 biosynthesis. Coenzyme Q10 serves in the mitochondria as an electron carrier to cytochrome oxidase, the major system for cellular energy production. Heart muscle requires high levels of Co-Q10. Side effects of Co-Q10 deficiency include muscle wasting, muscle pain, heart failure, neuropathy, amnesia, and cognitive dysfunction. Deaths from heart failure have doubled nationwide since the introduction of statin drugs in 1987. Statin induced heart failure can be prevented by supplementing with Co Enzyme Q10, a form of intervention considerably less expensive and less traumatic than an artificial heart operation followed by cardiac transplantation."

Also...

"Another statin trial, CARE (Cholesterol And Recurrent Events), showed 1500 % increase in breast cancer among women in the statin treated group, explained as merely a statistical aberration. This is disputed by Uffe Ravnskov who feels that the difference is significant, ..."

Please read the complete article at: http://barnesworld.blogs.com/barnes_world/2007/01/jeffrey_dach_on.html

Are They Above Reproach?

USA Today reports the following
========================
"By Rita Rubin, USA TODAY
Virtually all doctors in a national survey of six specialties reported some sort of relationship — from free lunches to payments for consulting and lecturing — with medically related industries such as those for drugs or medical devices, a report says today.
Researchers mailed surveys and a $20 check to a random sample of 3,167 practicing anesthesiologists, cardiologists, family practitioners, general surgeons, internists and pediatricians in late 2003 and early 2004. Slightly more than half responded. Among the findings, reported in The New England Journal of Medicine:
•Cardiologists were more than twice as likely as family practitioners to receive payments from industry.
•On average, family practitioners reported meeting 16 times a month with industry reps — the most of any specialty surveyed."
http://www.usatoday.com/news/health/2007-04-25-docinfluence_N.htm?csp=34
======================
No real surprise there. This has been known for sometime. My question is "Can they make an unbiased and purely scientific or medical decision/recommendation under these circumstances?" Ask yourself that and ask your health professional that same question. See the full article in The New England Journal of Medicine at http://content.nejm.org/cgi/content/full/356/17/1742 "A National Survey of Physician–Industry Relationships".

STATIN SIDE EFFECTS INFORMATION

UCSD is familiar to me because back in the 1970's they provided "UCSD Pascal" which I used in my Apple II Plus. WOW! Is that ancient or what.


Well anyway they are also now involved in studying statin side effects. See their site on the subject at http://medicine.ucsd.edu/ses/. The opening statement about their research says...


"The UCSD Statin Study group, headed by Beatrice A. Golomb, MD, PhD, has actively been researching statin medications and their risk-benefit balance, including possible side effects."


Also I posted a link to their STATIN SIDE EFFECTS INFORMATION links under Credible Evidence at the right.

Duane Graveline MD MPH strikes again!

If you are, or have been, a statin drug user (Zocor, Lipitor, Vytorin, Crestor, Mevacor, Baycol, etc.) or just want to be up to date on side effects of this ubiquitious medication some tout with evangelistic fervor as though it is the magic bullet to solve coronary artery disease, cardio vascular disease, atherosclerosis and the like, you'll be interested in what this former USAF Flight Surgeon and Former NASA Astronaut has to say. His "Statin Drugs Side Effects" book is on my shelf and has worn pages from re-reads. He hasn't stopped however with the publication of the book but continues to research this topic. Read his book and read the many articles available on his web site - http://www.spacedoc.net . I also added a link from his last newsletter to "Credible Evidence" about Rhabdomyolysis. Good heavens what is that? I can't even say it!


Well, Wikipedia explains it this way "Rhabdomyolysis is the rapid breakdown of skeletal muscle tissue due to traumatic injury, either mechanical, physical or chemical."

Of particular interest in that definition pertinent to this discussion is the word 'chemical' because I'm dealing here with "Statin Associated Rhabdomyolysis". Statins are a group of chemicals primarily used to reduce c... eh... cho.... oops! hard to say the word many near to me only refer to as the "C" word ... chol... er... - Oh well see the right side panel for many references to it.

Looking under 'causes of the "R" word' I find the following at http://members.tripod.com/~baggas/rhabdo.html#acquired.
Read the full article yourself if you dare.

"Drugs and Toxins A large range of drugs and toxins have been seen to cause rhabdomyolysis.... Some drugs appear to have a direct toxic action on skeletal muscle when given systemically. These include cholesterol lowering drugs (clofibrate, gemfibrozil, HMG CoA reductase inhibitors), emetine (ipecac), zidovudine (AZT), vincristine, and epsilon-aminocaproic acid."

Wow that is getting pretty technical and hard to understand ( for me at least ). I'll zero in a bit more with the following explanation of a cause of Rhab.... "A large range of drugs ... have been seen to cause rhabdomyolysis.... Some drugs appear to have a direct toxic action on skeletal muscle.... These include cholesterol lowering drugs (.... HMG CoA reductase inhibitors), ...."

Well the 'HMG CoA reductase inhibitor' is a technical way of saying STATINS! Statin drugs are a significant cause of rhabdomyolysis.

You might ask, "Why do I care enough about all of this to take the time to blog about it?" I dare you to ask, cuz I might just tell you. But I will say here that is more than just a intellectual curiosity. Being a twenty year or so user of HMG CoA reductase inhibitors (statin drugs), including Baycol which resulted in liver failure and death to around 100 people, and was taken off the market by the FDA in 2001 just after I began taking it, and putting up with drug induced side effect - myopathy (of which rhabdomyolysis is the most severe form) most of those 20 years, I ask you "Why shouldn't I be interested?"

Maybe in some small way this blog, which is mainly about the "C" word and related health stuff with an occasional 'out-of-the-ball-park' other topic thrown in for whatever reason, will be stumbled upon by someone and my hope is that they will be helped.

"We been conned!"

Read in The Daily Mail about Dr. Malcolm Kendrick's new book. I've added a new link under Credible evidence to the full article. Again here's a small quote from the article
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"...and what your doctor should be saying, is the following:

• A high diet, saturated or otherwise, does not affect blood cholesterol levels.

• High cholesterol levels don't cause heart disease.

• Statins do not protect against heart disease by lowering cholesterol - when they do work, they do so in another way.

• The protection provided by statins is so small as to be not worth bothering about for most people (and all women). The reality is that the benefits have been hyped beyond belief.

• Statins have many more unpleasant side effects than has been admitted, while experts in this area should be treated with healthy scepticism because they are almost universally paid large sums by statin manufacturers to sing loudly from their hymn sheet."

Good Source of Diet Information

Sally Fallon founded the Weston A. Price Foundation in 1999 to disseminate the research of Dr. Weston Price. You will see a link to one of their site pages titled "Myths & Truths About Nutrition" to the right of this page under Credible Evidence.

The foundations stated intention is to "...support those trying to create better health through education and by improving their dietary practices according to the ancient wisdom of traditional cultures as shown by the research of Weston Price and written about in Sally Fallon's Nourishing Traditions cookbook.

One of our most fundamental messages is that animal fats and cholesterol are not villains but vital factors in the diet, necessary for normal growth, proper function of the brain and nervous system, protection from disease and optimum energy levels." (underline emphasis provided by B Davis)

further...
The Foundation

• Provides a reliable source of accurate nutrition information
• Raises a strong voice against imitation foods and warns consumers about the dangers of processed and denatured foods and modern soy foods.
• Promotes access to unprocessed whole milk products, meat and eggs from pasture-fed animals.
• Campaigns for a return to healthy traditional fats such as butter, pasture-fed beef and lamb tallow, lard and coconut oil.
• Helps consumers find healthy, farm-fresh foods through a system of local chapters.

Sally Fallon is doing a tour in Australia in May and June 2007. For more information see http://www.westonapriceaus.org.au/
The Weston Price main web site is http://www.westonaprice.org/ with lots of excellent reliable information. Please make use f it.

Will a diet help you loose weight - AND keep it off?

According to Science Daily, reporting on a UCLA researchers report in the April issue of American Psychologist, "....the majority of people regained all the weight, plus more. Sustained weight loss was found only in a small minority of participants, while complete weight regain was found in the majority. Diets do not lead to sustained weight loss or health benefits for the majority of people." See the 'Dieting Does Not Work' link to the right under Credible Evidence.

Of course everyone is on a diet if you define 'diet' as "the sum of the food consumed" as opposed to "the deliberate selection of food to control body weight".

In my estimation gleened from reading and perusing various books and studies, the BEST diet is one rich in the needed nutrients yet which limits the caloric intake to the amount your body burns off. A very common imbalance occurs when, as we in the western culture tend to do, eat way too much highly processed (read 'mostly devoid of nutrition') junk foods and drinks thereby gaining more calories than the nutritional content justifies. And whether the food intake is healthy or unhealthy (as expressed in the ratio of nutrition:calories), we also tend to eat too much making it difficult for our bodies to burn off the calories given our chosen exercise level. So I say, the best diet is composed of healthy foods in smaller quantities than we're use to accompanied by adequate exercise.

And 'diet' should not principally be a weight gain/loss device. It is the right thing to do for our wellness. The out of control diabetes, heart disease, and cancer rampant in our society has occured largely since falsly devised and highly promoted 'low-fat low cholesterol" diets have been pushed on us. Folks, they're not our healer, rather our downfall!

For a good look at the highly complex and interactive thing we call our body and it's needs and reactions to what we eat, I recommend reading books by Dr. Diana Schwarzbein MD. She has written several on "The Schwarzbein Principle"
(see http://www.schwarzbeinprinciple.com/ ) Good Stuff for all!

And if you're into 'dieting', please read the article in Science Daily.

Patient Safety in Hospitals

Under my "Credible Evidence" links on the right I have added a new link to the full Fourth Annual Patient Safety in American Hospitals Study by HealthGrades. Please look over the report as well as their web site http://www.healthgrades.com/. I have taken the liberty to quote part of the summary of the study findings here. It's well worth looking at though not exactly a pat on the back to our health care system. Goodness, is something broke? If you examine some of the other links under Credible Evidence you will see that more than this study seem to point that direction.

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"Summary of Findings
AHRQ’s development of the Patient Safety Indicators (PSIs) was based on the Institute of Medicine’s (IOM) definition of patient safety— “freedom from accidental injury due to medical care, or medical errors.” Medical error is defined as “the failure of a planned action to be completed as intended or the use of a wrong plan to achieve an aim…[including] problems in practice, products, procedures, and systems.”

In 2002, AHRQ, in collaboration with the University of California-Stanford Evidence-Based Practice Center, identified 20 indicators of potentially preventable patient safety incidents that could be readily identified in hospital discharge data. This tool set of 20 evidence-based PSIs was created and released to the public in 2003 to be used by various healthcare stakeholders to assess and improve patient safety in U.S. hospitals.
.
.
.
In our study, we found:
• Approximately 1.16 million total patient safety incidents occurred in over 40 million hospitalizations in the Medicare population, which is almost a three-percent incident rate. These incidents were associated with $8.6 billion of excess cost during 2003 through 2005.
• More than half (10 of 16) of the patient safety incident rates studied worsened from 2003 to 2005. These ten indicators worsened, on average, by over 11.5 percent while the other six indicators improved, on average, by eight percent.
• The total patient safety incident rate worsened by an additional 2.0 incidents per 1,000 hospitalizations in 2005 compared to 2003.
• The PSIs with the highest incidence rates were decubitus ulcer, failure to rescue, and post-operative respiratory failure. Failure to rescue improved six percent during the study period, while both decubitus ulcer and post-operative respiratory failure worsened by almost 10 and 20 percent, respectively.
• Of the 284,798 deaths that occurred among patients who developed one or more patient safety incidents, 247,662 were potentially preventable.
• Medicare beneficiaries that developed one or more patient safety incidents had a one-in-four chance of dying during the hospitalization during 2003 to 2005.
• There were wide, highly significant gaps in individual PSI and overall performance between the Distinguished Hospitals for Patient Safety™ and the bottom ranked hospitals.
• Medicare patients in the Distinguished Hospitals for Patient Safety™ had, on average, approximately a 40-percent lower occurrence of experiencing one or more PSIs compared to patients at the bottom ranked hospitals. This finding was consistent across all 13 PSIs studied.
• If all hospitals performed at the level of Distinguished Hospitals for Patient Safety™, approximately 206,286 patient safety incidents and 34,393 Medicare deaths could have been avoided while saving the U.S. approximately $1.74 billion during 2003 to 2005. "
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See also this and this.
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"Choosing a hospital for even for a simple, routine procedure can be a life or death decision, and the key element that determines a patient’s outcome for any given procedure or diagnosis is a hospital’s adherence to quality measures."
http://www.healthgrades.com/business/news/ratings/
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Aborted Fetus Sings

Aborted Fetus Sings

Phil Harris

Saturday, March 17, 2007

This is from an article in my archives, which I originally published in June of 2006. As we move closer to another round of electioneering by those who would be our leaders, it seems there are more important issues hanging over our heads this time around, than there are bats hanging from the roof of a Central American cave. It is tempting to pick a few issues that are meaningful to the present day's news cycle, but doing so runs the risk of forfeiting hard-won ground on issues that are old and battle weary. Abortion is one such topic.

The House began its final floor session on a contentious note Monday when Rep. Ted Harvey, R-Highlands Ranch, introduced guest Gianna Jensen. At his request, she had been granted permission to sing the national anthem. He told how the Nashville woman had been born two months prematurely and had cerebral palsy. Lawmakers were touched when he said that Jensen, 29, who wasn't expected to crawl, now can run marathons.
But then Harvey said that the reason Jensen was disabled was that her 17-year-old mother tried to have a late-term abortion. He said he wanted lawmakers to know that fact, because later in the day they were planning to vote on a resolution honoring Planned Parenthood.
Some lawmakers were livid.
"I came this close to standing up and saying something," said Rep. Mark Larson, R-Cortez. He and others said Harvey violated House rules and protocol.
"It was despicable," said House Majority Leader Alice Madden, D-Boulder. "Ted Harvey doesn't care about proper decorum or the rules. He just wants to push his narrow agenda."
Said Harvey: "That was not my intention."
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My father sent to me an email, with the subject line: FW: A Pro-Life Hero. It is a letter from Ted Harvey, who at the time was serving in the Colorado House of Representatives for the Highlands Ranch district. Ted wrote to me after this article was published. He said the letter was sent to a few of his friends as a legislative update.
I believe this publicity might have given Ted Harvey a boost in his run for the State Senate, and perhaps, such an example will not go unnoticed by politicians who will seek our support in the national arena. Now as you read the letter below, I hope Gianna's story will grab you by the guts, as it did mine. Hopefully, it will provide for you a renewal of energy, to stay the course in this battle for the most innocent of lives.
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I want to share with you an awesome experience I recently had in the Colorado House of Representatives. It is a humbling experience to look back and realize that God used me to play a role in His divine orchestration.
I was leaving the House chambers for the weekend when our Democrat Speaker of the House mentioned that the coming Monday would be the final day of this year's General Assembly. He went on to state that there were still numerous resolutions on the calendar which we would need to be addressed prior to the summer adjournment. Interestingly, he specifically mentioned that one of the resolutions we would be hearing was being carried by the House Majority Leader Alice Madden, honoring the 90th anniversary of Planned Parenthood of the Rocky Mountains.
As a strong pro-life legislator I was disgusted by the idea that we would pass a resolution honoring this 90 year legacy of genocide. I drove home that night wondering what I could say that might pierce the darkness during the debate on this heinous resolution.
On Saturday morning I took my eight-year-old son up to the mountains to go white water rafting. The trip lasted all day. As we were driving home, exhausted and hungry, I remembered that I had accepted an invitation to attend a fundraising dinner that night for a local pro-life organization. One of my most respected mentors had personally called me several weeks earlier and asked me to attend, so I knew I'd have to clean up and head over.
After our meal, the executive director of the organization introduced the keynote speaker. I looked up and saw walking to the stage a handicapped young lady being assisted to the microphone by a young man holding a guitar.
Her name was Gianna Jessen.
Gianna said "Hello," welcomed everyone, and then sang three of the most beautiful Christian songs that I have ever heard.
She then began to give her testimony. When her biological mother was 17 years old and 7 ½ months pregnant she went to a Planned Parenthood clinic to have an abortion. As God would have it, the abortion failed and a beautiful two-pound baby girl was brought into the world. Unfortunately, she was born with cerebral palsy and the doctors thought that she would never survive. The doctors were wrong.
Imagine the timing! A survivor of a Planned Parenthood abortion arrived in town just days before the Colorado House of Representatives was to celebrate Planned Parenthood's "wonderful" work.
As I listened to Gianna's amazing testimony the Lord inspired me to ask her if she could stay in Denver until Monday morning so that I could introduce her on the floor of the House and tell her story. Perhaps she could even begin the final day's session by singing our country's national anthem!
To my surprise she said she would seriously consider it. If she were to agree, she wanted her accompanying guitar player to stay as well. A lady standing in line behind me waiting to meet Gianna overheard our conversation and said that she would be willing to pay for the guitarist's room. Gianna then said that she would think about it.
As I was driving home from the banquet my cell phone rang. It was Gianna and she immediately said, "I'm in, let's ruin this celebration." Praise God!
When Monday morning came, I awoke at 6:00 to write my speech before heading to the Capitol. As I wrote down the words I could sense God's help and I knew that this was going to be a powerful moment for the pro-life movement.
Following a committee hearing, I rushed into the House Chambers just as the opening Morning Prayer was about to be given. Between the prayer and the pledge of allegiance I wrote a quick note to the Speaker of the House explaining that Gianna is an advocate for cerebral palsy. I took the note to the Speaker and asked if I could have my friend open the last day of session by singing the national anthem. Without any hesitation the Speaker took the microphone and said, "Before we begin, Representative Harvey has made available for us Gianna Jessen to sing the National Anthem."
Gianna sang the most amazing rendition of the Star Spangled Banner that you could possibly imagine. Every person in the entire chamber was completely still, quiet, and in awe of this frail young lady's voice.
Due to her cerebral palsy, Gianna often loses her balance, and shortly after starting to sing she grabbed my arm to stabilize herself, and I could tell that she was shaking. Suddenly, midway through the song, she forgot the words and began to hum and said, "Please forgive me I am so nervous." She then immediately began singing again and every House member and every guest throughout the chambers began to sing along with her to give her encouragement and lift her up.
As I looked around the huge hall I listened to the unbelievable melody of Gianna's voice being accompanied by a choir of over 100 voices. I had chills running all over my body and I knew that I had just witnessed an act of God.
As the song concluded the Speaker of the House explained that Gianna has cerebral palsy and is an activist to bring awareness to the disease. "Let us give her a hand not only for her performance today but also for her advocacy work," he said. The chamber immediately exploded into applause...she had them all in the palm of her hand.
The Speaker then called the House to order and we proceeded as usual to allow members to make any announcements or introductions of guests. For dramatic effect, I waited until I was the last person remaining before I introduced Gianna.
As I waited for my turn, I nervously paced back and forth praying to God that he would give me the peace, confidence and the courage necessary to pull off what I knew would be one of the most dramatic and controversial moments of my political career.
While I waited, a prominent reporter from one of the major Denver newspapers walked over to Gianna and told her that her rendition captured the spirit of the national anthem more powerfully than any she had ever heard before.
Finally, I was the last person remaining, so I proceeded to the microphone and began my speech:
"Members, I would like to introduce you to a new friend and hero of mine-- her name is Gianna Jessen. She is visiting us today from Nashville, Tennessee where she is an accomplished recording artist.
She has cerebral palsy and was raised in foster homes before being adopted at the age of four.
She was born prematurely and weighed only two pounds at birth. She remained in the hospital for almost three months. A doctor once said she had a great will to live and that she fought for her life. Eventually she was able to leave the hospital and be placed in foster care.
Because of her cerebral palsy her foster mother was told that it was doubtful that she would ever crawl or walk. She could not sit up independently. Through the prayers and dedication of her foster mother, she eventually learned to sit up, crawl, then stand. Shortly before her fourth birthday she began to walk with leg braces and a walker.
She continued in physical therapy and after a total of four surgeries, she was able to walk without assistance.
She still falls sometimes, but she says she has learned how to fall gracefully after falling for 29 years.
Two years ago she walked into a local health club and said she wanted a private trainer. At the time her legs could not lift 30 pounds. Today she can leg press 200 pounds.
She became so physically fit that she began running marathons to raise money and awareness for cerebral palsy. She just returned last week from England where she ran in the London Marathon. It took her over 8 ½ hrs to complete. They were taking down the course by the time she made it to the finish line. But she made it none the less. With bloody feet and aching joints she finished the race.
Members would you help me recognize a modern day hero...Gianna Jessen?
At this point the chamber exploded into applause which lasted for 15 to 20 seconds...Gianna had touched their souls...
Ironically, Alice Madden the Majority Leader and sponsor of the Planned Parenthood Resolution walked over to Gianna and gave her a hug.
As the applause began to die down I raised my hand to be recognized one more time...
"Mr. Speaker, members, if you would allow me just a few more moments I would appreciate your time.
My name is Ted Harvey not Paul Harvey but please let me tell you the rest of the story.
The cause of Gianna's cerebral palsy is not because of some biological freak of nature, but rather the choice of her mother.
You see when her biological mother was 17 years old and 7 ½ months pregnant she went to a Planned Parenthood clinic to seek a late term abortion. The abortionist performed a saline abortion on this 17-year-old girl. This procedure requires the injection of a high concentration of saline into the mother's womb which the fetus is then bathed in and swallows which results in the fetus being burned to death, inside and out. Within 24 hrs the results are normally an induced still-born abortion.
As Gianna can testify the procedure is not always 100% effective. Gianna is an aborted late term fetus that was born alive. The high concentration of saline in the womb for 24 hrs resulted in a lack of oxygen to her brain and is the cause of her cerebral palsy.
Members, today we are going to recognize the 90th anniversary of Rocky Mountain Planned Parenthood,"
BANG! The gavel came down.
Just as I was finishing the last sentence of my speech...The climax of the morning...The Speaker of the House gaveled me down and said, "Representative Harvey, I will allow you to continue your introduction but not for the purposes of debating a measure now pending before the House."
At which point I said,
"Mr. Speaker I understand, I just wanted to put a face to what we are celebrating today".
Silence...Deafening silence.
I then walked back to my chair shaking like a leaf. The Democrats wouldn't look at me...they were fuming. It was beautiful. I have been in the legislature for five tough years and this made it all worthwhile.
The House Majority Leader wouldn't talk to me the rest of the day.
Was it because I introduced an abortion survivor, or was it because we touched her soul? She could hug an inspirational cerebral palsy victim and advocate, but was outraged when she discovered that the person she hugged was also an abortion survivor.
The headline in the Denver Post the next day read Abortion Jab Earns Rebuke. The Majority Leader is quoted as saying "I think it was amazingly rude to use a human being as an example of his personal politics,"
Yes Representative Madden, Gianna Jessen is a human being. She was when she was in her mother's womb and she was when she sang the National Anthem on the Floor of the Colorado House of Representatives.
The paper went on to quote Gianna Jessen, stating she was glad Harvey told her story.
"We need to discuss the humanity of it. I'm glad to be able to speak up for children in the womb," she said. "If abortion is about women's rights, where were my rights?"
Leslie Hanks, one of the matriarchs of the pro-life movement in Colorado, was in the House Chamber that morning and told me that it was the single greatest moment she had witnessed in the State Legislature in the 20 years that she'd been lobbying in the Capitol.
All I can say is, "Glory to God!" He orchestrated it all, every minute of it, and I was so honored to have been chosen to play a part. May we all continue to be filled with and to fight for the passion of our Lord Jesus Christ!
In His service,
Ted Harvey
Assistant Minority Leader
Colorado House of Representatives
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Thank you for that Mr. Harvey !!!
Phil Harris is a software engineer, author of Cry for the Shadows and blogs at Citizen Phil.
Copyright © 2006 Salem Web Network. All Rights Reserved.
From:
http://www.townhall.com/columnists/column.aspx?UrlTitle=aborted_fetus_sings&ns=PhilHarris&dt=03/17/2007&page=1

And forgive me Mr. Harvey and Salem Web Network if this violates copyright protocol but I thought this would be my amen. Bill Davis

One of the most effective ways to demonstrate the absurd horrors of abortion is to put a face on the issue. No one wants to look at photographs of aborted babies. Abortion advocates would rather lay an ostrich egg, before they would knowingly stand in the same room with such an outrageously inappropriate image.
Read the following snip from a Rocky Mountain News article, about the final day of the Colorado House of Representatives session. Following the article snippet, read a letter from then Colorado State Representative Ted Harvey, as he explains the episode in detail. It is a bit long, but worth it. You can draw your own conclusions, but from where I sit... way to go Ted!
This is not so much about Ted Harvey, who I believe now serves in the Colorado State Senate, but rather, it is about the willingness of our elected leaders to look the abortion beast in the eye, while standing firm on the convictions they profess while running for office. Some of our Republican Presidential candidates have a rather ambiguous history on the issue. I hope that as we evaluate the current contestants, we will perform adequate due diligence in fleshing out their pro-life fortitude.
It is important to remember, that the term Fetus does not describe some "thing" which is not human. It is a term, coined by medical science, which conveniently refers to a specific period during the growth of a human child. Keep that in mind as you read the story of Gianna Jessen.
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From Rocky Mountain News: They laughed, cried and kept on bickering">http://www.rockymountainnews.com/drmn/government/article/0,2777,DRMN_23906_4684680,00.html>From Rocky Mountain News: They laughed, cried and kept on bickering

European Heart Journal on "Low Fat/Low Cholesterol"

I came across this article from the European Heart Journal with evidence from clinical trials about the so called heart healthy diet. It can be found on line at http://www.omen.com/corr.html. I reduced the text size of the 'Reference' section not because that information is less important rather to save some space. In fact the #1 principal to defend against junk science (as found in "The Junk Science Self-Defense Manual" by Anthony Colpo) is to 'Check the research yourself!'.

Here's a quote from that publication.

"I’ve lost count of the number of times I’ve checked studies that were cited in support of a specific stance, and found they either did not support that stance or even contradicted it!

A striking example of this phenomenon can be found in a joint statement by the American Heart Association and the NIH's National Heart, Lung, and Blood Institute entitled The Cholesterol Facts, where one finds the following claim: "The results of the Framingham study indicate that a 1% reduction…of cholesterol [corresponds to a] 2% reduction in CHD risk"[1].

Incredibly, one of the papers cited in support of the above statement was a thirty-year follow-up report from Framingham that flatly contradicts any claim that cholesterol reduction is beneficial. This report found that those whose cholesterol levels decreased during the study experienced an increase in both total and cardiovascular mortality! To quote the Framingham researchers themselves: "There is a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years…". So don’t be satisfied with the fact that someone has posted a bunch of scientific-looking citations at the end of their article. Check those citations for yourself! Doing so will often paint a very different picture to the one the original author wants you to see!"

Well enough intro - on to the article that prompted this post.
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The low fat/low cholesterol diet is ineffectiveReprinted with permission from: European Heart Journal (1997) 18, 18-22
L.A. Corr, Guy's and St. Thomas' Hospitals, London, U.K. M.F. Oliver, National Heart and Lung Institute, London, U.K.
Correspondence: Dr. Laura A. Corr, MB, BS, MRCP, PhD, FESC,Consultant Cardiologist, Guys and St. Thomas' Hospitals, St. Thomas Street, London SE1 9RTAsk almost member of the general public about a diet which would reduce their chance of heart disease and the reply is the same: "a low fat diet". On closer questioning, this means a diet with a reduction in cholesterol and saturated 'animal' fats, i.e. less meat, butter, milk and cheese. Most national and international recommendations for the prevention of heart disease, whether for primary prevention of or for patients who have developed the clinical manifestations of coronary heart disease, have made dietary restriction of total and saturated fats and of cholesterol the primary advice and often the sine qua non in relation to all other forms of management. To this extent they are to be congratulated that the message seems to be so universally accepted. Unfortunately, the available trials provide little support for such recommendations and it may be that far more valuable messages for the dietary and non-dietary prevention of coronary heart disease are getting lost in the immoderate support of the low fat diet.

The origin of the 'low fat' diet

The international bodies which developed the current recommendations based them on the best available evidence[1-3]. Numerous epidemiological surveys confirmed beyond doubt the seminal observation of Keys in the Seven Countries Study of a positive correlation between intake of dietary fat and the prevalence of coronary heart disease[4] although recently a cohort study of more than 43,000 men followed for 6 years has shown that this is not independent of fiber intake[5] or risk factors. The prevalence of coronary heart disease has been shown to be correlated with the level of serum total and low density lipoprotein cholesterol (LDL) as well as inversely with high density lipoprotein. As a consequence of these studies, it was assumed that the reverse would hold true: reduction in dietary total and especially saturated fat would lead to a fall in serum cholesterol and a reduction in the incidence of coronary heart disease. The evidence from clinical trials does not support this hypothesis.

The evidence from clinical trials

It can be argued that it is virtually impossible to design and conduct an adequate dietary trial. The alteration of any one component of a diet will lead to alterations in others and often to further changes in lifestyle so it is extremely difficult to determine which, if any, of these produce an effect. Dietary trials cannot generally be blinded and changes in the diet of the 'control' population are frequently seen: they may be so marked as to render the study irrevocably flawed. It is also recognized that adherence to dietary advice over many years by large population samples, as for most people in real life, is poor and that the stricter the diet, the worse the compliance. Nonetheless, the evidence for a reduction in saturated fat from dietary trials for both primary and secondary prevention merits closer scrutiny.

Trials of low fat diets in primary prevention

There have been six randomized, controlled trials with the long-term follow-up designed to modify the development of coronary heart disease in healthy subjects [6-11]. Remarkably, no primary prevention trial of sufficient size or sensitivity to examine the effect of a low total and saturated fat diet alone has ever been conducted. All six primary prevention trials involved alteration of one or more other risk factors such as cigarette smoking, blood pressure and exercise.

Of the three smallest trials(approximately 300-600 subjects per group), two suggested a significant reduction in coronary events. In the Oslo Study[7], men at high risk were given dietary advice aimed at reducing saturated fat intake and modestly increasing polyunsaturated fat intake, and counseled to stop smoking. General advice was given to increase fish, whale meat, vegetable and fruit intake. Over 5 years the mean difference in serum cholesterol between the two groups was relatively large for a dietary trial - 13% and tobacco consumption was lower in the intervention group. There were fewer coronary events in the control group (P<0.028)Trials of low fat diets in secondary prevention
There have been two trials of the effect of a low saturated fat diet alone in patients with coronary heart disease. The MRC study[13] followed 252 men randomized to a very low fat diet or no change in diet over three years: the low fat diet was poorly tolerated but achieved a 10% reduction in cholesterol. There was no difference in the rate of reinfarction or death and the researchers concluded that the low fat has no place in the treatment of myocardial infarction. An Australian trial of 458 men substituted polyunsaturated margarine for butter and found a slightly lower 5 year survival in the intervention group (3.3% deaths per year) than in the control group (2.4% deaths per year) although multivariate analysis showed that none of the dietary factors was significantly related to survival[14]. Following the negative results of these trials, no further studies of a low saturated fat diet alone have been conducted.

Should we be recommending diet at all?

The overwhelming importance of coronary heart disease in terms of morbidity, mortality and economic cost in the Western world made dietary advice, which was perceived to be cheap and safe, very attractive to Governments and their Health Departments. Vast sums of money have been invested in nutritional programs, dietary advice and nurse counseling to promote low saturated fat, low cholesterol diet--yet the trials to date for both primary and secondary prevention suggest that these diets do not work. However, this does not mean that all dietary interventions are futile. Other trials of secondary prevention have to a greater or lesser extent tried to alter the quality of the dietary fat intake and other components in patients with coronary heart disease, rather than restrict the quantity of saturated and total fat, and the results are more encouraging.

Trials of diets not dependent on fat reduction

Vegetable oil supplements were used in four of these trials[15-18]. In the LA Veterans Administration study, increasing ingestion of corn, safflower, soyabean and cottonseed oils significantly reduced total cardiovascular events after eight years[15]. The study by Rose et al, found no evidence of clinical benefit in patients given a low fat diet and supplements of olive or corn oil[16]. Similarly, the MRC group added soyabean oil as a supplement to the diet and found no difference in the incidence of death or myocardial infarction compared to men taking their normal diet[17], but a similar study from Oslo did show a significant reduction in pooled coronary heart disease relapses after 5 years and fewer fatal myocardial reinfarctions by 11 years[18]. However, none of these produced a significant difference in total mortality.

Saturated fat reduction, vegetable oil supplements and lifestyle changes in keeping with the current recommendations of the American Heart Association were advised for both the intervention and control groups in a study of Indian patients randomized within 48 h of a suspected myocardial infarction, but in addition the intervention group received a diet high in dietary fiber, omega-3 fatty acids (from fish and nuts), antioxidant vitamins and minerals[19]. The intervention group achieved remarkable wide-ranging and sustained changes in their nutrient intake associated with a modest reduction in serum cholesterol and weight loss. Cardiovascular events were reduced in the intervention group after only 6 weeks and after 1 year there was a significant reduction in myocardial infarction, a 42% reduction in cardiac deaths and a 45% reduction in total mortality compared to the control group on the standard 'low fat' diet. The study does not seem to have been continued beyond on year.

The first successful dietary study to show reduction in overall mortality in patients with coronary heart disease was the DART study reported in 1989[20]. The three-way design of this 'open' trial compared a low saturated fat diet plus increased polyunsaturated fats, similar to the trials above, with a diet including at least two portions of fatty fish or fish oil supplements per week, and a high cereal fibre diet. No benefit in death or reinfarctions was seen in the low fat or the high fibre groups. In the group given fish advise there was a significant reduction in coronary heart disease deaths and overall mortality was reduced by about 29% after 2 years, although there was a non-significant increase in myocardial infarction rates. The reduction in saturated fats in the fish advice group was less than in the low fat diet group and there was no significant change in their serum cholesterol.

Finally, the more recent Lyon trial[21] used a Mediterranean-type of diet with a modest reduction in total and saturated fat, a decrease in polyunsaturated fat and an increase in omega-3 fatty acids from vegetables and fish. As in the DART study there was little change in cholesterol or body weight, but the trial was stopped early following a 70% reduction in myocardial infarction, coronary mortality and total mortality after 2 years.

The most effective diet for secondary prevention is therefore not reduction of saturated fats and cholesterol but appears to be an increase in polyunsaturates of both omega-6 and omega-3 fatty acids. Unfortunately, the design and conduct of these trials are insufficient to permit conclusions about which polyunsaturates and other elements of these diets are the most beneficial. The long term effects of these trials[20,21] and the compliance with the dietary regimes remain to be seen. But the mechanism of any benefit of the omega diets would appear not to be associated with reduction in the total or LDL cholesterol levels and may be more related to reduction of a thrombotic tendency.

The case for recommending similar changes in diet in primary prevention is less clear cut. Although the benefit of olive oil receives strong epidemiological support from several Mediterranean countries, particularly Crete, and short-term studies of diets rich in oleic acid (the principle monounsaturate in our diet) have demonstrated a reduced LDL susceptibility to oxidation, no formal randomized long-term trial of monounsaturates has yet been attempted. There is no consensus from population or cohort follow up surveys about the protective effects of increased fish consumption on coronary mortality. The recently published report from the physicians Health study[22] found no evidence of an inverse association between the intake of fish or fish oils and the risk of myocardial infarction and, while the highest coronary mortality was found among men who ate no fish, the risk did not decrease with increasing fish intake. At present, there does not appear to be any dietary advice which is effective in primary prevention.

Is drug treatment better?

An important aspect of the lipid-lowering dietary trials is that on average they were only able to achieve about a 10% reduction in total cholesterol. The results of recent drug trials have demonstrated that there is a linear relation between the extent of the cholesterol, or LDL, reduction and the decrease in coronary heart disease mortality and morbidity, and a significant effect seen only when these lipids are lowered by more than 25%[23].

Until 1994, the trials with lipid lowering therapy for primary and secondary prevention had been as disappointing and confusing as the trials with diet. They tended to show a reduction in coronary events, including deaths from myocardial infarction, but no reduction in overall mortality. Even though an excess of deaths from cancer and suicide was not shown to have any casual relationship with the treatment, there was no widespread acceptance of lipid lowering therapy.
This changed in 1994 with the publication of the seminal 4S study on secondary prevention of coronary heart disease in 4444 patients with cholesterol levels greater than 5.5 mmol . 1-1 who were randomized to treatment with simvastatin or placebo in addition to 'usual care' including dietary advice[24]. The 4S study showed highly significant (30%) reduction in cardiac events and deaths from myocardial infarction and, for the first time, in overall mortality. The benefits were apparent after 18 months and the difference between the treated and the control groups continued to increase over the five years of follow-up. The more recent CARE study showed a similar outcome with a 28% reduction in reinfarction using pravastatin in 4159 patients following myocardial infarction despite the fact their cholesterol levels before treatment were not high (mean 5.4 mmol . 1-1)[25]. As part of their usual care, patients in this study also received high levels of antiplatelet agents and beta-blockers and 55% had undergone revascularization with angioplasty or bypass surgery. There was no change in coronary heart disease deaths or in all-cause mortality. Over 5 years of follow-up in both these statin trials the treatment was extremely well tolerated with around 90% compliance and no serious effect, indeed there was almost no difference in the side-effect profiles between the statins and the placebo.

With primary prevention the results of treatment with the statins appears equally encouraging. The West of Scotland Coronary Prevention study treated over 6000 healthy men (aged 44-65 years) who had total cholesterol levels greater than 6.5 mmol . 1-1 with either pravastatin or placebo[26]. Again the trial was continued for 5 years, and normal advice was given to both the intervention and the control groups. The risks of death from coronary heart disease and non-fatal myocardial infarction were reduced significantly in the pravastatin group by 31%, and there was a non-significant but favourable trend for all-cause mortality (-22%) with no adverse effect on non-cardiovascular mortality.

The cost effectiveness of treatment with the statins has been assessed at current prices for both primary and secondary care. It varies greatly according to the risk, being obviously more efficient for those at the highest risk, but has been shown to be greater than drug treatment for mild-to-moderate hypertension which is widely endorsed and used in general practice. For those at lower risk, diet should be able to provide a cheaper regimen but at present none has proved sufficiently beneficial.

Conclusions

The commonly-held belief that the best diet for the prevention of coronary heart disease is a low saturated fat, low cholesterol is not supported by the available evidence from clinical trials. In the primary prevention, such diets do not reduce the risk of myocardial infarction or coronary or all cause mortality. Cost-benefit analyses of the extensive primary prevention programmes, which are at present vigorously supported by Governments, Health Departments and health educationalists, are urgently required.

Similarly, diets focused exclusively on reduction of saturated fats and cholesterol are relatively ineffective for secondary prevention and should be abandoned. There may be other effective diets for secondary prevention of coronary heart disease but these are not yet sufficiently well defined or adequately tested. The circumstantial evidence of benefit from oils, particularly olive oil, vegetables, fruit and fish is strong.

For those at high risk, drug therapy, with the statins provides effective primary and secondary prevention and should be considered, with or without a diet, in the same way as drug treatment for mild or moderate hypertension.L.A. Corr, Guy's and St. Thomas' Hospitals, London, U.K.
M.F. Oliver, National Heart and Lung Institute, London, U.K.

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