Tuesday, December 30, 2008
Read full article here.
New Insights on the Importance of Cholesterol
Low Vitamin D Leads to More Muscle Injuries in Those Taking Statins
Statins are just plain bad news. Being deficienct in vitamin D makes matters worse.
Study Title:Among patients with vitamin D <20>30 ng/mL (P < .01).
From press release:
- Vitamin D deficiency appears to be prevalent among patients with hyperlipidaemia, but it occurs more frequently in patients with statin-associated myalgias, according to findings presented here at the American Heart Association (AHA) Scientific Sessions.
- Myalgia occurs frequently among patients taking statins, but it is sometimes uncertain whether it is drug-related. Vitamin D deficiency is common in the general population and is sometimes associated with reversible myalgia, according to Barton Duell, MD, Oregon Health & Science University, Portland, Oregon.
- Dr. Duell and colleagues conducted a study to determine whether vitamin D deficiency may contribute to symptoms of myalgia in 99 patients referred for tertiary care with a diagnosis of hyperlipidaemia.
- Patients were aged 58.7 years on average (range 20-84) and 43% were men. The mean serum 25-hydroxyvitamin D level was 26.7 ng/mL (range 5-64).
- Statin-associated myalgias were reported by 38.8% of patients. These patients had a 32% lower mean vitamin D level (20.5 vs 30.1 ng/mL, P = .0003) and were more likely to be female (68% vs 49%, P = .095).
- Vitamin D levels were similar in men and women (24.3 vs 28.8 ng/mL, P = .09). Deficiency was prevalent in the group (62.6% <30 ng/mL; 31.9% <20 ng/mL).
Patients with myalgias were more likely to have vitamin D levels <30 ng/mL (81.3% vs 52.5%, P < .01) and <20 ng/mL (62.5% vs 18.6%, P < .01).
- Among patients with vitamin D <20>30 ng/mL (P < .01).
- About one-third of patients with myalgia reported fewer statin-associated myalgias after 8 to 12 weeks of unblinded treatment with high-dose ergocalciferol, but most subjects also changed to a different statin, according to the researchers.
- They concluded that while vitamin D deficiency is common in patients with hyperlipidaemia, statin-associated myalgias were more commonly related to vitamin D deficiency, with a mean vitamin D level 32% lower than the mean for the entire group.
- They noted that vitamin D levels below 20 ng/mL were associated with 4-fold higher rates of myalgias than levels higher than 30 ng/mL, and reduced myalgias were anecdotally related to treatment with vitamin D in some of these patients.
- According to Dr. Buell, vitamin D deficiency either leads to statin-induced myalgias or may cause drug-unrelated myalgias in a subset of patients taking statins. This matter requires additional studies, he said.
Barton Duell et al. Among patients with vitamin D <20>30 ng/mL (P < .01). American Heart Association (AHA) Scientific Sessions. New Orleans. 2008. 2008 November Oregon Health & Science University, Portland, Oregon.
"Scientists have uncovered an alteration in a gene that causes statin drugs to be more readily absorbed by the liver, thereby making the drug very toxic. 15% of our population has the risk-related gene variant."
The article concludes...
Let’s look at it another way. For those who enjoy playing Russian roulette the odds are 1 in 6, close to 15%. How many people do you know who play Russian roulette? How many people do you know who take statins? Big Pharma and its salesman are more than willing to play this deadly game with the American public, as they rake in 20 billion in sales every year on this one class of medication. Whatever happened to “first do no harm.”
- Do you take a statin drug?
- Had your genes checked?
- Do you have the rs4363657 single-nucleotide polymorphism (SNP) located within SLCO1B1 on chromosome 12?
Statins Can Injure If You Have a Common Gene Variant
Sunday, December 28, 2008
"The Journal of the American College of Cardiology says people with low levels of the vitamin, which comes from sunshine and pills but not much else, are twice as likely to have a heart attack or stroke..."
Here is a larger exerpt from the article
Another study has emerged that says vitamin D is good for you - this time, for your heart.
This adds to evidence that people lacking vitamin D have a higher risk of various cancers and diabetes as well. ...
"Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated," said the study's main author, cardiologist James O'Keefe of the Mid America Heart Institute in Kansas City, Mo. "Vitamin D is easy to assess, and supplementation (with pills) is simple, safe and inexpensive."
The new evidence comes from the Framingham Heart Study. This is a famous study in a suburb of Boston that has followed thousands of ordinary people, beginning in the 1950s, to find links between their lifestyle and their cardiovascular health."
Read the full article here.
The Vitamin D Council is an excellent source of information on the research and news about vitamin D. Be sure to check out their web site.
I just received the December 2008 newsletter from the council with information on vitamin D blood tests which is produced in full below.
The Vitamin D Newsletter
December 28, 2008
The Vitamin D Council is happy to announce that we have partnered with ZRT Laboratory to provide an inexpensive, $65.00, in-home, accurate, vitamin D [25(OH)D] test. The usual cost for this test is between $100.00 and $200.00.
If you read this newsletter, you know about our interest in accurate vitamin D testing. In the next few weeks, you may read about the Vitamin D Council's quest for accurate vitamin D blood tests in the national media. Before we partnered with ZRT, we verified, repeatedly, that ZRT provides accurate and reliable vitamin D tests and that their method corresponds very well to the gold standard of vitamin D blood tests, the DiaSorin RIA.
Our ZRT service is not just inexpensive, it means no more worrying about your doctor ordering the right test or interpreting it correctly. You buy the test kit on the internet or by phone, a few days later the kit comes in the mail, you or a nurse friend do a finger stick, collect a few drops of blood, and send the blotter paper back to ZRT in the postage paid envelope provided with the kit. A week later you get results back in the mail and know accurate 25-hydroxy-vitamin D levels of you and your family.
For every test you order, ZRT will donate $10.00 to the Vitamin D Council. Please read the new page hyperlinked below on our website as it both explains the procedure and how to order the test.
Executive summary: keep your family's 25-hydroxy-vitamin D blood test above 50 ng/ml, year around. Most adults need at least 5,000 IU per day, especially this time of year. Most children need at least 1,000 IU per day per every 25 pounds of body weight. Bio Tech Pharmacal provides high quality and inexpensive vitamin D. Currently Bio Tech Pharmacal is providing vitamin D for numerous scientific studies. To see their prices and for ordering, click the hyperlink below.
As a gift to our readers for the New Year, Thorne publications have provided a free download to a basic paper about vitamin D. I wrote it earlier this year for educated lay people as well as health care practitioners. Please read this paper carefully, your family's well-being, even lives, may depend on you understanding it.
John Cannell, MD
Thank you for subscribing to the Vitamin D Newsletter from the Vitamin D Council. The Vitamin D Council is a non-profit trying to end the epidemic of vitamin D deficiency. Please reproduce this newsletter and post it on Internet sites. Remember, we are a non-profit and rely on donations to publish our newsletter and maintain our website. Send your tax-deductible contributions to:
The Vitamin D Council
9100 San Gregorio Road
Atascadero, CA 93422
Be sure to read the article by John J. Cannell, MD and Bruce W. Hollis, PhD titled "Use of Vitamin D in Clinical Practice" at the link provided in the newsletter.
See also "Vitamin D may be essential for heart health" in this article at CNN.com
Saturday, December 6, 2008
- No association between cholesterol and degree of atherosclerosis has been found in postmortem studies of unselected individuals
- High cholesterol is not a risk factor for women, patients with renal failure, diabetic patients, or old people
- Old people with high cholesterol live longer than those with low cholesterol
- In cohorts of people with familial hypercholesterolaemia, cholesterol is not associated with the incidence or prevalence of cardiovascular disease, and their average life span is similar to other people’s
- No randomised, controlled, unifactorial, dietary, cholesterol lowering trial has ever succeeded in lowering coronary or total mortality
- No clinical or angiographic trial has found exposure-response between individual degree of cholesterol lowering and outcome
- More than 20 cohort studies found that patients with coronary heart disease ate the same amount of saturated fat as did healthy controls
- Seven of 10 cohort studies found that patients with stroke ate less saturated fat than did healthy controls
- The concentration of short chain fatty acids in adipose tissue, the most reliable reflection of saturated fat intake, is similar or lower in patients with coronary heart disease compared with healthy individuals in five case-control studies
- The effect of statin treatment is grossly overstated and is not due to cholesterol lowering
- Only a small percentage gain benefit—and then only if they are men at high risk—and the benefit is easily outweighed by side effects that are more common and more serious than reported in the statin trials, if reported at all.
Read his full letter here.
Friday, November 28, 2008
Only 4 short years ago, November 18, 2004, FDA Director of Drug Safety David Graham shook the pharmaceutical word with testimony to the senate finance committee in which he named Crestor as a "bad drug" that should be banned. Here is one of many news reports about Dr. Graham and Crestor:
Concern about drug safety doesn't stop with Vioxx by Rita Rubin, USA TODAY 11/22/2004 "Crestor. This cholesterol drug has drawn regulators' attention in Europe and Canada. At the Senate hearing, Graham said Crestor is the only statin drug that causes kidney failure. And, he said, it carries a higher risk of rhabdomyolysis than any other statin. Rhabdomyolysis is a potentially fatal muscle complication that benched another statin, Baycol, in 2001."
Thursday, November 27, 2008
Wednesday, November 19, 2008
An article titled "Is it for real? Cholesterol screening in toddlers and statins from elementary school age?" found at Junkfood Science.
TARA PARKER-POPE writes in the New York Times about this health issue in an article titled "8-Year-Olds on Statins? A New Plan Quickly Bites Back" and another titled "Palpitations Over a New Pill for Kids"
Sandy Szwarc also has a critical look at the JUPITER which if you have followed the press releases on it may get the idea it's "... dramatic, huge, spectacular and unprecedented and statins are the wonder drug of hope." Read her insite here.
And you've gotta read Michael Eades, M.D. titled Truth versus hype in the Jupiter study which makes a clear point by beginning with the following cartoon.
Now this cartoon has nothing to do with the Jupiter study - or does it? It's about how things are reported. Any similarity between the actual data and what is reported is purely accidental or more accurately non-existent.
Tuesday, November 18, 2008
"American Academy of Pediatrics has recommended that children as young as eight be treated with cholesterol-lowering statin drugs." according to an article in NaturalNews.com
"But critics have questioned this logic, saying that there is not enough data to know if statins are safe or effective in children."
Sunday, November 16, 2008
' The Jupiter Study and associated editorial was published in the New England Journal of Medicine on November 9, 2008. Press releases and media hype followed.
The media reports suggested "that even healthy people would benefit from statin drugs." One CNN TV announcer even suggested that statins should be put into the water supply. '
Please go here and read the full article!
Or read Nutrition Data's blog on the same topic titled "Statins for Everyone!"
Thursday, September 18, 2008
The research Dr Mercola sites is from Lancet published Aug 31, 2008. Actually two articles,
one titled "Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial"
and the other titled "Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial".
Key words in the non-layman friendly medical journal lingo:
"n-3 polyunsaturated fatty acids" describes what we commonly call Fish Oil and
"rosuvastatin" which we know as Crestor, a powerful statin drug used to reduce cholesterol.
The study results, which were in part sponsored by Pfizer and AstraZeneca, were I'm sure, not what they would have liked the the tests to show because they're in the business of selling cholesterol lowering drugs which is a multi-billion dollar business . This comes on top of the studies showing increase of cancer due to cholesterol lowering drugs.
And you may want to read the articles listed under Credible Evidence to the right titled "NEW - Vytorin Rides Out Choppy SEAS from Medscape Today HeartWire " and "Pfizer's Cholesterol Drug Boosts Death Rate by 58 Percent.
Read the studies in Lancet here and here.
Sunday, September 7, 2008
"The reality is that there is no mortality benefit from lowering cholersterol with statin drugs: Both lines on the mortality chart below are superimposed meaning the number of deaths in the statin drug group was identical to the number of deaths in the placebo group. Chart Courtesy of (Eddie Vos). "
"No Female Should Ever Take A Statin Drug Let me repeat that so this is very clear: No female should ever take a statin drug to lower cholesterol for primary prevention of heart disease. They don’t work for women. Women who take Lipitor or any other statin drug to lower cholesterol do not live any longer than women who don’t take the drug. There is no benefit in terms of prolonging your life for women. "
Reat the complete article here.
Another good credible discussion of the 'benefits' of taking statin drugs is found in this article titled "Dangers of Statin Drugs: What You Haven’t Been Told About Popular Cholesterol-Lowering Medicines" which states...
"Statins and Women (2003)
No study has shown a significant reduction in mortality in women treated with statins. The University of British Columbia Therapeutics Initiative came to the same conclusion, with the finding that statins offer no benefit to women for prevention of heart disease. Yet in February of 2004, Circulation published an article in which more than 20 organizations endorsed cardiovascular disease prevention guidelines for women with several mentions of "preferably a statin." "
What else can I say?
"My total time on Lipitor was no more than five months at 5-10 mg dosing, low by today's standards. I had joined the ranks of thousands of other people whose physiology had been seriously compromised by statins. Research evidence about the more serious side effects of statin drugs began to flood the internet. Statin induced mevalonate blockade with the consequences of CoQ10 and dolichol inhibition now was documented by research rather than just suspected. Then mitochondrial mutations induced by statins began to be reported as the cause of increasing numbers of serious disabilities affecting neurons of the brain as well as causing muscle damage. Inhibition of CoQ10 was allowing free radical excess to mutate our mitochondria. The World Health Association reported excess ALS in statin users world-wide. A new word was coined, cerebromyopathies, and currently, reports of ALS associated with statin induced mitochondrial mutations are in the research news."
Read the whole article by Dr Graveline here.
I tell you, based upon my own experience and so much evidence piling up (see Credible Evidence on the right) statins and the cholesterol lowering psuedo-religion have a terrorist like presence in our world. Please! Please! Read some of the credible evidence for yourself. Lowering your cholesterol is NOT the answer folks! Am I being overly dramatic? Maybe so! My heart felt recommendation is to either read the credible evidence then quit taking cholesterol lowering medication or better yet, quit taking the medication and then read the evidence. You will thereby reduce your risk tremendiously! Don't believe me believe those credible sources I've provided and if you still would rather have low cholesterol and risk cancer, ALS(see quote above), loss of memory, Statins & Associated Rhabdomyolysis, and who knows what else at least make your decision from an informed position rather simply because your doctor said your cholesterol is too high!.
Saturday, September 6, 2008
So... would you rather have that dreaded 'high cholesterol' or try your luck with cancer?
See this link to a Reuters article and also read this article in Natural News where they state that Merck's belatedly released data "... reveals a whopping 50% increase in cancer risk compared to patients taking a placebo! Hilariously, Merck says the difference is due to "chance." Isn't it funny how all the results they WANT to see in clinical trials are due to their drugs, but all the results they DON'T want to see are due to "chance?"
Also pay attention to Natural News list of related articles.
Wednesday, September 3, 2008
Also in the above mentioned issue of NEJM they published the results of the SEAS trial (Simvastatin and Ezetimibe in Aortic Stenosis). "In the trial, a combination of simvastatin and ezetimibe (Vytorin) was compared with placebo with respect to the incidence of cardiovascular events in older people with aortic-valve stenosis. The treatment had no impact on the progression of aortic stenosis or on cardiovascular clinical events in general, ..."
Now note the following from the NEJM editorial....
"There was, however, an unexpected finding in the trial. An excess of incident cancers was observed in the simvastatin–ezetimibe group, with 105 in that group as compared with 70 in the placebo group (P=0.01). There was an increase in the incidence of a variety of cancers, including prostate, gastrointestinal, and skin cancers. Also, deaths from cancer were more frequent in the active-treatment group (39 deaths, vs. 23 in the placebo group), ..."
Finally the editorial says ...
"Ezetimibe interferes with the gastrointestinal absorption not only of cholesterol, but also of other molecular entities that could conceivably affect the growth of cancer cells. The fact that the combined data from all three trials showed an increase in cancer mortality with ezetimibe should not be assumed to be a chance finding until further data are in. It is appropriate that SHARP and IMPROVE-IT continue. Careful follow-up of the patients in these trials will be essential, and other existing data sets on ezetimibe-treated patients should be analyzed for cancer end points. The Food and Drug Administration has already announced that during the next few months it will conduct its own analysis of the potential cancer hazard of ezetimibe."
Note: In the above quotes from the NEJM editorial the 'bolded' text was emphasis added my me and did not occur in the original article which you can read in its entirety here. You can also read results of the (SEAS) trial here.
See also this Natural News article on the same subject.
Now a bit of personal history as related to the above information and also cited in this blog over one year ago ( see it here).
- I was on cholesterol lowering statins for roughly 20 years beginning in the mid 1980s.
- In 1994 (with low cholesterol) I had a heart attack resulting in open heart surgery.
- P.S. Four subsequent heart attacks (most recent June 2006), 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 might change this statement as this connection is further explored)
- I feel good now - like none of the above had happened. It almost seems surreal. But I've had four subsequent heart attacks - three with stents and there is some possibility that the cancer could reappear.
And a piece of info not included in the above is that for a significant length of time while taking statin drugs to lower my cholesterol and thus presumable reduce chances of heart attack, I was also taking Ezetimbe. All that before the gastrointestional cancer and basal cell carcinoma (skin cancer) were discovered and treated seemingly successfully.
Friday, August 29, 2008
My previous blog entry refers to a NewsTarget article based on the Canadian Medical Association Journal article which states under 'Background' in the Abstract that
"The risk association between low-density lipoprotein (LDL) cholesterol and cancer remains controversial and largely unexplored for people not receiving statin therapy."
Now my interest is a bit more than academic. My post exactly one year ago Aug 30, 2007 (look it up) is titled "Cholesterol lowering statin drugs and Cancer! and summarizes some of my history, medically speaking, that puts me right in the middle of this topic having been a long time statin user to lower my cholesterol and during that "on statin" period of my life had 5 heart attacks and cancer.
In my humble opinion it is about time that this topic gets study and press to get it out in the open and before the public. Public exposure to this cannot hurt, only help individuals to take a proactive involvment in their own health issues. I Have!
"In a major shot fired across the bow of the statin marketing machine, the levels of LDL cholesterol that are the artificial targets of "health" promoted by the American Heart Association (AHA) are now found to be associated with a significant increased risk of cancer and death."
He further says...
"The Vytorin fraud has pointed out quite clearly that lowering LDL cholesterol to very low levels does not reduce cardiovascular disease. Another Vytorin study also shows doing so increases cancer risk by 64%. The new study paints the clear picture that lowering LDL too low actually increases the rate of death from any cause. This new study also points out the statistical shenanigans that the statin industry uses to hide the actual risks of these drugs in the studies that have been published."
Read the complete article here.
Link to full Canadian Medical Association Journal article here.
Monday, May 19, 2008
"More than 31,000 scientists across the United States, including more than 9,000 Ph.D.s in fields including atmospheric science, climatology, Earth science, environment and dozens of other specialties, have signed a petition rejecting "global warming," the assumption that the human production of greenhouse gases is damaging Earth's climate."
It is an update since my previous mention stated 19000 signers. Going on double that now.
Read the article at http://www.worldnetdaily.com/index.php?fa=PAGE.view&pageId=64734
You can even find out their names and breakdown by state. Click here for names.
Will the other side which claims a consensus do that?
See also here and here.
Saturday, May 3, 2008
Thursday, May 1, 2008
Pfizer's Cholesterol Drug Boosts Death Rate by 58 Percent
(NaturalNews) Patients who take the cholesterol drug torcetrapid, intended to increase levels of HDL ("good") cholesterol and lower LDL ("bad") cholesterol levels, have a 58 percent higher risk of death than similar patients who do not take the drug, according to a study led by researchers at the Heart Research Institute in Sydney and published in the New England Journal of Medicine.
Researchers studied 15,067 participants, all considered to be at high risk of cardiovascular disease. All the patients were treated with the cholesterol-lowering drug atorvastatin, while half were also treated with torcetrapid.
Torcetrapid is marketed by Pfizer, as is atorvastatin (under the brand name Lipitor).
Patients receiving both drugs had a 58 percent higher chance of dying and a 25 percent higher chance of experiencing cardiovascular events such as heart attacks than those who were treated only with atorvastatin.
Torcetrapid is one of a new class of drugs called cholesteryl ester transfer protein (CETP) inhibitors. Unlike older cholesterol drugs, which only lower LDL levels, CETP inhibitors are intended to raise HDL levels at the same time. The drugs function by blocking the action of a protein that transfers cholesterol from HDL to LDL, thus forcing the cholesterol to remain in HDL form.
In the recent study, torcetrapid was found to raise HDL levels by an average of 72.1 percent, and lower LDL levels by an average of 24.9 percent.
Scientists are still unclear why torcetrapid appears to increase patient death rates and heart attack risk. While the drug is known to raise blood pressure, many of the patients who died in the recent study actually had blood pressure levels below normal.
Researchers have hypothesized that the drug may increase the levels of a hormone involved in regulating blood pressure, and that this may lead to stress on the cardiovascular system.
Merck and Roche Holding have placed the development of their own CETP inhibitors on hold, pending the results of further trials on torcetrapid.
Thursday, March 27, 2008
Sunday, March 16, 2008
The following article from the New York Times might offer some enlightenment on the subject. It's a bit long but worth the read. Hope you will agree.
But what does this all have to do with 'cascades'? Well pay particular attention to author John Tierney's explanation of and discussion of an 'informational cascade' within the context of the dieting and fat arena.
I do believe I have noted a very similar effect also in the 'science' of global warming. Or am I the victim of or participant in an informational cascade?
October 9, 2007
Diet and Fat: A Severe Case of Mistaken Consensus
By JOHN TIERNEY
In 1988, the surgeon general, C. Everett Koop, proclaimed ice cream to a be public-health menace right up there with cigarettes. Alluding to his office’s famous 1964 report on the perils of smoking, Dr. Koop announced that the American diet was a problem of “comparable” magnitude, chiefly because of the high-fat foods that were causing coronary heart disease and other deadly ailments.
He introduced his report with these words: “The depth of the science base underlying its findings is even more impressive than that for tobacco and health in 1964.”
That was a ludicrous statement, as Gary Taubes demonstrates in his new book meticulously debunking diet myths, “Good Calories, Bad Calories” (Knopf, 2007). The notion that fatty foods shorten your life began as a hypothesis based on dubious assumptions and data; when scientists tried to confirm it they failed repeatedly. The evidence against Häagen-Dazs was nothing like the evidence against Marlboros.
It may seem bizarre that a surgeon general could go so wrong. After all, wasn’t it his job to express the scientific consensus? But that was the problem. Dr. Koop was expressing the consensus. He, like the architects of the federal “food pyramid” telling Americans what to eat, went wrong by listening to everyone else. He was caught in what social scientists call a cascade.
We like to think that people improve their judgment by putting their minds together, and sometimes they do. The studio audience at “Who Wants to Be a Millionaire” usually votes for the right answer. But suppose, instead of the audience members voting silently in unison, they voted out loud one after another. And suppose the first person gets it wrong.
If the second person isn’t sure of the answer, he’s liable to go along with the first person’s guess. By then, even if the third person suspects another answer is right, she’s more liable to go along just because she assumes the first two together know more than she does. Thus begins an “informational cascade” as one person after another assumes that the rest can’t all be wrong.
Because of this effect, groups are surprisingly prone to reach mistaken conclusions even when most of the people started out knowing better, according to the economists Sushil Bikhchandani, David Hirshleifer and Ivo Welch. If, say, 60 percent of a group’s members have been given information pointing them to the right answer (while the rest have information pointing to the wrong answer), there is still about a one-in-three chance that the group will cascade to a mistaken consensus.
Cascades are especially common in medicine as doctors take their cues from others, leading them to overdiagnose some faddish ailments (called bandwagon diseases) and overprescribe certain treatments (like the tonsillectomies once popular for children). Unable to keep up with the volume of research, doctors look for guidance from an expert — or at least someone who sounds confident.
In the case of fatty foods, that confident voice belonged to Ancel Keys, a prominent diet researcher a half-century ago (the K-rations in World War II were said to be named after him). He became convinced in the 1950s that Americans were suffering from a new epidemic of heart disease because they were eating more fat than their ancestors.
There were two glaring problems with this theory, as Mr. Taubes, a correspondent for Science magazine, explains in his book. First, it wasn’t clear that traditional diets were especially lean. Nineteenth-century Americans consumed huge amounts of meat; the percentage of fat in the diet of ancient hunter-gatherers, according to the best estimate today, was as high or higher than the ratio in the modern Western diet.
Second, there wasn’t really a new epidemic of heart disease. Yes, more cases were being reported, but not because people were in worse health. It was mainly because they were living longer and were more likely to see a doctor who diagnosed the symptoms.
To bolster his theory, Dr. Keys in 1953 compared diets and heart disease rates in the United States, Japan and four other countries. Sure enough, more fat correlated with more disease (America topped the list). But critics at the time noted that if Dr. Keys had analyzed all 22 countries for which data were available, he would not have found a correlation. (And, as Mr. Taubes notes, no one would have puzzled over the so-called French Paradox of foie-gras connoisseurs with healthy hearts.)
The evidence that dietary fat correlates with heart disease “does not stand up to critical examination,” the American Heart Association concluded in 1957. But three years later the association changed position — not because of new data, Mr. Taubes writes, but because Dr. Keys and an ally were on the committee issuing the new report. It asserted that “the best scientific evidence of the time” warranted a lower-fat diet for people at high risk of heart disease.
The association’s report was big news and put Dr. Keys, who died in 2004, on the cover of Time magazine. The magazine devoted four pages to the topic — and just one paragraph noting that Dr. Keys’s diet advice was “still questioned by some researchers.” That set the tone for decades of news media coverage. Journalists and their audiences were looking for clear guidance, not scientific ambiguity.
After the fat-is-bad theory became popular wisdom, the cascade accelerated in the 1970s when a committee led by Senator George McGovern issued a report advising Americans to lower their risk of heart disease by eating less fat. “McGovern’s staff were virtually unaware of the existence of any scientific controversy,” Mr. Taubes writes, and the committee’s report was written by a nonscientist “relying almost exclusively on a single Harvard nutritionist, Mark Hegsted.”
That report impressed another nonscientist, Carol Tucker Foreman, an assistant agriculture secretary, who hired Dr. Hegsted to draw up a set of national dietary guidelines. The Department of Agriculture’s advice against eating too much fat was issued in 1980 and would later be incorporated in its “food pyramid.”
Meanwhile, there still wasn’t good evidence to warrant recommending a low-fat diet for all Americans, as the National Academy of Sciences noted in a report shortly after the U.S.D.A. guidelines were issued. But the report’s authors were promptly excoriated on Capitol Hill and in the news media for denying a danger that had already been proclaimed by the American Heart Association, the McGovern committee and the U.S.D.A.
The scientists, despite their impressive credentials, were accused of bias because some of them had done research financed by the food industry. And so the informational cascade morphed into what the economist Timur Kuran calls a reputational cascade, in which it becomes a career risk for dissidents to question the popular wisdom.
With skeptical scientists ostracized, the public debate and research agenda became dominated by the fat-is-bad school. Later the National Institutes of Health would hold a “consensus conference” that concluded there was “no doubt” that low-fat diets “will afford significant protection against coronary heart disease” for every American over the age of 2. The American Cancer Society and the surgeon general recommended a low-fat diet to prevent cancer.
But when the theories were tested in clinical trials, the evidence kept turning up negative. As Mr. Taubes notes, the most rigorous meta-analysis of the clinical trials of low-fat diets, published in 2001 by the Cochrane Collaboration, concluded that they had no significant effect on mortality.
Mr. Taubes argues that the low-fat recommendations, besides being unjustified, may well have harmed Americans by encouraging them to switch to carbohydrates, which he believes cause obesity and disease. He acknowledges that that hypothesis is unproved, and that the low-carb diet fad could turn out to be another mistaken cascade. The problem, he says, is that the low-carb hypothesis hasn’t been seriously studied because it couldn’t be reconciled with the low-fat dogma.
Mr. Taubes told me he especially admired the iconoclasm of Dr. Edward H. Ahrens Jr., a lipids researcher who spoke out against the McGovern committee’s report. Mr. McGovern subsequently asked him at a hearing to reconcile his skepticism with a survey showing that the low-fat recommendations were endorsed by 92 percent of “the world’s leading doctors.”
“Senator McGovern, I recognize the disadvantage of being in the minority,” Dr. Ahrens replied. Then he pointed out that most of the doctors in the survey were relying on secondhand knowledge because they didn’t work in this field themselves.
“This is a matter,” he continued, “of such enormous social, economic and medical importance that it must be evaluated with our eyes completely open. Thus I would hate to see this issue settled by anything that smacks of a Gallup poll.” Or a cascade.
This article copied without permission from http://www.nytimes.com/2007/10/09/science/09tier.html?pagewanted=1&_r=4&partner=rssuserland
Thursday, February 21, 2008
Doctors in Denial about Patients' Side Effects from Prescription Drugs
by David Gutierrez (NaturalNews)
Doctors are overwhelmingly inclined to dismiss patients' complaints about potential side-effects from cholesterol-reducing statins and rarely report those complaints to the FDA, according to a survey conducted by researchers from the University of California at San Diego and published in the peer-reviewed journal Drug Safety.
The study suggests that doctors have a tendency to attribute patients' complaints to age or other factors unrelated to prescription drugs, and that this problem may extend to drugs other than statins.
"Person after person spontaneously [told] us that their doctors told them that symptoms like muscle pain couldn't have come from the drug," said lead researcher Beatrice Golomb. "We were surprised at how prevalent that experience was.
"The researchers solicited survey respondents through advertisements and over the Internet, including on web sites where patients had complained about side effects from the drugs. Most of the respondents lived in the United States, and the average age was in the early 60s. The majority of respondents reported having complained to their doctors about problems that arose after they began the drugs, particularly memory and attention problems or tingling and numbness in the extremities. But few doctors made a connection between these complaints and the drugs, even when the symptoms were documented side effects.
"Overwhelmingly, it was the patient that initiated that conversation," Golomb said. Doctors instead tended to blame the symptoms on aging or even to dismiss them as insignificant or imaginary.
As much as 30 percent of patients taking statins may experience muscle pain or other side effects. But these numbers may be on the low end if doctors are not reporting side effects when they occur.
The FDA relies primarily on doctors to fill out "adverse event reports" to help monitor drugs after they have hit the market. Patients can also file reports at http://www.FDA.gov/medwatch but few people are aware of this program. In contrast, other countries such as New Zealand rely heavily on data from patients to continue monitoring drugs.
According to Golomb, one-fifth of all FDA-approved drugs will eventually be withdrawn from the market or given black-box warnings due to severe side effects.
Article from http://www.naturalnews.com/022687.html
Monday, February 11, 2008
Sunday, February 10, 2008
Current clinical evidence does not demonstrate that titrating lipid therapy to achieve proposed low LDL cholesterol levels is beneficial or safe.
by Rodney A. Hayward, MD; Timothy P. Hofer, MD, MSc; and Sandeep Vijan, MD, MSc
"The authors found no clinical trial subgroup analyses or valid cohort or case–control analyses suggesting that the degree to which LDL cholesterol responds to a statin independently predicts the degree of cardiovascular risk reduction."
Here are the 'Key Summary Points"
- No high-quality evidence could be found that suggests that titrating lipid therapy to recommended low-density lipoprotein (LDL) cholesterol targets is superior to empirically prescribing doses of statins used in clinical trials for all patients at high cardiovascular risk.
- Studies addressing benefits of achieving LDL cholesterol goals have had avoidable problems, such as reliance on ecological (aggregate) analyses, ignoring statins' other proposed mechanisms of action, and not accounting for known confounders (especially healthy volunteer effects).
- Much more reliable evidence on currently proposed LDL cholesterol goals could be expeditiously produced by conducting cohort analyses of past statin trials that control for statin dose and pill adherence.
- Dichotomous comparisons (such as comparing those who reach goal vs. those who do not) can mistakenly suggest that not achieving the treatment goal results in moderate risk when in fact almost all of the risk is caused by large deviations from the ideal goal.
- Proposals for treatment goals should also consider the risks, patient burden, and societal costs of the treatments that may be needed to reach those goals.