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.
Monday, November 26, 2007
Wednesday, November 14, 2007
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?
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.
Wednesday, September 5, 2007
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.
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.
Thursday, August 30, 2007
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:
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.
Tuesday, August 28, 2007
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:
========================================
"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.
The new content that caught my eye began as follows:
========================================
"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.
Monday, August 27, 2007
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.
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.
Sunday, August 26, 2007
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.”
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
=====================================
"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"
===================================
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"
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