Monday, February 28, 2011

Coronary Artery Calcium (CAC) Scanning

Texas Heart Attack Prevention legislation "premature," expert says

February 28, 2011 | Shelley Wood

Dallas, TX - The quiet passage of 2009's Texas Heart Attack Prevention Bill will have ramifications that will "ring loudly" for public health, predicts a Commentary published in the Archives of Internal Medicine this week [1].

As reported in-depth by heartwire, the bill, known as HB 1290, grew out of a bold, unprecedented proposal from the Society for Heart Attack Prevention and Education (SHAPE, a group with no ties to either of the main cardiology professional societies) and mandates insurance coverage at regular intervals for coronary artery calcium (CAC) scanning and carotid ultrasound in the state of Texas. A new bill modeled on the Texas legislation is also poised for consideration in Florida in the coming weeks.

Conspicuously absent, he notes, was any kind of expert testimony from the American Heart Association or American College of Cardiology. As previously reported by heartwire, both societies stayed mum on SHAPE, drawing criticism for their silence, although the ACC told heartwire that their Texas ACC chapter "officially supported this piece of legislation and [was] glad to see that it has passed."

For many prominent cardiologists who were involved in SHAPE—most of whom don't hail from Texas—the bill's passing in some ways validates the work of their organization. Several SHAPE members have told heartwire that they believe their aggressive support for population-based screening fills a void that the professional societies have been too slow to move into.

...that the State of Florida is poised to consider Senate Bill 360, inspired by the Texas bill, which would require insurance reimbursement for up to $200 for CAC and CIMT screening. The bill, sponsored by Florida State Senator Mike Fasano, has been submitted and assigned to committee; the Florida legislature begins its sessions tomorrow.

Asked what he thought about a screening bill now being considered in Florida, Khera said, "In some ways, I can understand why: this is the number-one cause of death, and I certainly appreciate that legislators want to do something, because people are dying from heart disease."

=================================

Read the full article here:

http://www.theheart.org/article/1190599.do?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+Theheartorg+%28theheart.org%29&utm_content=Google+Reader

Sunday, February 27, 2011

No-Bologna Facts from Tom Naughton

No-Bologna Facts

There’s never been a single study that proves saturated fat causes heart disease.
As heart-disease rates were skyrocketing in the mid-1900s, consumption of animal fat was going down, not up. Consumption of vegetable oils, however, was going up dramatically.
Half of all heart-attack victims have normal or low cholesterol. Autopsies performed on heart-attack victims routinely reveal plaque-filled arteries in people whose cholesterol was low (as low as 115 in one case).
Asian Indians - half of whom are vegetarians - have one of the highest rates of heart disease in the entire world. Yup, that fatty meat will kill you, all right.
When Morgan Spurlock tells you that a McDonald’s salad supplies almost a day’s allowance of fat, he’s basing that statement on the FDA’s low-fat/high-carbohydrate dietary guidelines, which in turn are based on … absolutely nothing. There’s no science behind those guidelines; they were simply made up by a congressional committee.
Kids who were diagnosed as suffering from ADD have been successfully treated by re-introducing natural saturated fats into their diets. Your brain is made largely of fat.
Many epileptics have reduced or eliminated seizures by adopting a diet low in sugar and starch and high in saturated animal fats.
Despite everything you’ve heard about saturated fat being linked to cancer, that link is statistically weak. However, there is a strong link between sugar and cancer. In Europe, doctors tell patients, “Sugar feeds cancer.”
Being fat is not, in and of itself, bad for your health. The behaviors that can make you fat - eating excess sugar and starch, not getting any exercise - can also ruin your health, and that’s why being fat is associated with bad health. But it’s entirely possible to be fat and healthy. It’s also possible to be thin while developing Type II diabetes and heart disease.
Saturated fat and cholesterol help produce testosterone. When men limit their saturated fat, their testosterone level drops. So, regardless of what a famous vegan chef believes, saturated fat does not impair sexual performance.

Real vs refined food - an example

From Tom Naughton in Real Food Butter vs. Canola Oil: Spot the Real Food

" Canola oil, as you probably know, is the current “It Girl” among the lipophobes because it’s mostly monosaturated, like olive oil."
.
.
.
" But the big machines are making butter pretty much like your great-grandmother did: taking cream and churning it with some salt. The end result is real food."
.
.
.
"
Chemical solvents, industrial steaming, de-waxing, bleaching, and de-odorizing. Yummy. Have you ever heard of anyone having to de-odorize butter?

Real food on one hand, chemically processed industrial food on the other. And yet we’re supposed to believe it’s the real food that’s bad for us.

Your great-grandmother knew better."

Wednesday, February 23, 2011

The harm of low-fat high-carbohydrate diets in cholesterol uptake in the brain.

JustMEinT has a good article on cholesterol, while mostly not referring to it in relation to heart disease, it non-the-less deals with the importance of cholesterol in our bodies and especially the brain. Following is an exerpt.

==============================

.
.

Much research is also being uncovered now on the advantages of high HDL cholesterol levels, besides the study we mentioned above in direct relation to Alzheimer’s. A study appearing in the American Journal of Cardiology earlier this month (February 2011) showed that the higher men’s HDL cholesterol levels, the longer they lived and the more likely it was that they would reach the age of 85.4 A diet with adequate amounts of saturated fat is essential to keeping HDL high cholesterol levels. Those with deficiencies and suffering from neurological disorders need to consider a diet that is high in saturated fat, in stark contrast to the mainstream dietary advice for low-fat diets that might be causing many of these late-in-life diseases.
.
.
I find it terribly sad, and at times seriously frustrating that Doctors are still pushing the Fat is Bad philosophy - theory - rubbish! As I have said before on this blog, Ancel Keys has much to answer for.
.
.
===============================
Read the full article here

Other links in the article.
Health Impact News Daily
Coconut Oil
Dr. Mary Newport

Sunday, February 20, 2011

Eat It and Enjoy It from Dwight C. Lundell M.D.

The most recent definitive study of all the competent studies regarding saturated fats and heart disease called a meta-analysis and published in the AJCN January 13, 2010 shows that over a 5 to 23 year follow-up of 347,747 subjects, there is no association between the intake of saturated fat and heart disease or stroke.

(Ref )

The bottom line is that there is no connection between the intake of saturated fat and heart disease or stroke. But there is a connection between the currently recommended high carbohydrate diet and heart disease and stroke.

So enjoy bacon and eggs and forgo the oatmeal and bagels, your LDL will come down your HDL will go up, your weight will go down and your satisfaction with your diet will go up. The low fat diet is the worst dietary advice in the last 50 years and it is the proximate cause of our epidemics of heart disease, diabetes and obesity.

Accurate knowledge cannot come from reading abstracts of articles or reporters' interpretation of the abstract.

Dwight C. Lundell M.D.

Coronary Calcium Scoring

Here are selected quotes from Dr. William R. Davis's Track Your Plaque site on CT heart scans.

==========================

On July 17, 2006, the national experts of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force released guidelines for heart disease detection in the American public.

Why is that news? Aren’t there already guidelines in place for heart disease detection?

Shockingly, there are not. There are guidelines for heart disease risk factor assessment, but no set of guidelines that incorporate measures of atherosclerosis itself—a crucial distinction.

"We believe the time has come to replace the traditional, imprecise risk factor approach to individual risk assessment in primary prevention with an approach largely based on noninvasive screening for the disease itself…"

The SHAPE Task Force Report

American Journal of Cardiology, July 17, 2006

After years of political battling and resistance to CT scanning for coronary calcium scoring, the American Heart Association (AHA) has finally released a formal position paper acknowledging the ability of heart scans to predict heart attacks.

"The majority of published studies have reported that the total amount of coronary calcium (usually expressed as the 'Agatston score') predicts coronary disease events beyond standard risk factors [emphasis ours]. . . These studies demonstrate that coronary artery calcified plaque is both independent of and incremental with respect to traditional risk factors in the prediction of cardiac events."

In essence, the AHA finally agrees that CT heart scans provide information about risk for heart disease that is not revealed by conventional cholesterol testing or other risk predictors.

"The coronary calcium scan is quantitative. In other words, you get a specific and precise score that tells just how much plaque your have. Recall that, although calcium is being measured, calcium is simply a means to measure total plaque since it consistently occupies 20% of plaque volume."

"Many centers acquiring 64-slice devices are hospitals. Hospitals as a general rule are not interested in prevention. They are interested in generating more heart procedures like bypass surgery. Shockingly, even though the 64-slice scanners are able to obtain heart scan scores, many of these centers don’t really care about coronary calcium scoring. They only want the angiograms, since these often lead to costly procedures."

"While not all Track Your Plaque participants can expect zero growth or reduction in heart scan score, the information we provide stacks the odds as heavily as possible in your favor. And we are indeed seeing more and more people obtain plaque regression."

"The principal goal of the Track Your Plaque program is to keep coronary plaque from growing, even reduce the amount of plaque you have. We track the quantity of hidden plaque through your heart scan score. If after one year of effort your score increases >10%, then adjustments to your program should be considered by you and your doctor. Regardless of your starting score or percentile rank, a rate of plaque growth of more than 10% per year is a red flag for escalating risk. It should be taken seriously and a re-examination of your program is in order."

============================================

I am personally working on this powerful technique for myself. I'm newly on board!

The Diet Heart Hypothesis was just that - a Hypothesis.... a thought up scheme, never proven.

======================================
Sunday, January 23, 2011 Here Comes Another $$$ Spinner

Seems there is talk in the food industry that the Fat is bad for you hypothesis is about to lie down and die! Can't say I am sorry, should have happened years ago - sorry Ancel Old Chap!

But why now you may ask...... what could possibly bring on such a huge about face? Couldn't possibly have anything to do with the fact that patents on some pharmaceuticals like Lipitor are or have already run out could it?

The Diet Heart Hypothesis was just that - a Hypothesis.... a thought up scheme, never proven. But because it was making so much money for the investors and companies involved, they fought long and hard to get everyman (grin) and his dog on board and popping their pills.

Now the pills will not make them so much money, they have to look for the next BIG blockbuster drug, with its own peculiar methodology and religion ... to drum up fervor and zeal, thereby making gazillions for the companies and their investors.

Watch out folks the fat is bad religion is about to have a HUGE about face! (please note italics are from the actual article)

However the very foundation of this hypothesis was shaken to the core at the AHA annual conference in Chicago in 2010. Amid great excitement, the pharmaceutical giant Merck revealed results of a preliminary safety study for a drug that could usher in a new age for treatment and prevention of heart disease: a cholesterol raising drug! In the safety study lasting 18 months with 1,600 participants, total cholesterol was raised 20% by the drug anacetrapib without any side effects. An efficacy trail of 30,000 participants with several cardiovascular end-points is scheduled to begin in 2011 and end in 2015 to verify if cholesterol raising can reduce actual incidence of heart disease. But the search for cholesterol raising drugs is not new. Most of the cholesterol lowering statin drugs have reached the limits of their heart protective capabilities (and are near the end of their patent lives). For several years drug companies have been quietly searching for the next blockbuster that will be more effective than statins. One class of candidates is cholesterol raising drugs.

Get ready to throw away your Lipitor folks, they will have a new drug to prescribe you in the near future. I can't wait to see how this unfolds, how they will explain away the untold damage they have done to humankind, by insisting we lower our cholesterol numbers, to unhealthy levels.

But haven't we been told over and over to lower our cholesterol, not increase it? Yes, but the cholesterol story has been repeatedly oversimplified. Total cholesterol is made up of 2 major components, good cholesterol (LDL) and bad cholesterol (HDL). So when your doctor tells you to lower your cholesterol, he really means lower your bad cholesterol – if you inadvertently lower your good cholesterol you could increase your risk of heart disease. The statin drugs selectively lower the bad cholesterol without lowering the good – and they work, reducing risk of heart attack by about 30%. The new class of drugs is designed to increase the good cholesterol, without increasing the bad. So in this case increasing cholesterol is a good thing. The scientific community is hoping that the upcoming Merck study will show a further reduction in risk of heart attack similar in magnitude to the statins – a real breakthrough.

As far as I am concerned, that statement above in red (coloured by me) is a barefaced lie, manufactured by the pharmaceutical industry to keep doctors pushing these drugs onto their patients!

Where does this leave the diet heart hypothesis, saturated fat and the simplified "lower your cholesterol" story? It leaves it in deep trouble. The advent of drugs that increase good cholesterol and thereby reduce risk of heart disease (yet to be proven), will force scientists to take another look at the effects of food ingredients on good cholesterol, not just the total and the bad. Applying this new approach could have a significant impact on national dietary recommendations that are designed to reduce risk of heart disease.

Ohhhh I can hardly wait to see the advertising campaign they work up for this new scheme. Hopefully they will turn the Food Pyramid upside down, while at the same time telling us that fats are good for us! I can dream can't I?

A large body of data showing the effect of food ingredients on both good and bad cholesterol has already been generated over the last 40 years. So far, the evaluation of this data has mostly focused on the bad cholesterol, while neglecting or even ignoring data for good cholesterol. But a review of the data for saturated fat gives a very unexpected result. The food component that increases good cholesterol the most is saturated fat! Yes, the same "artery clogging" saturated fat that has been demonized for decades. Although saturated fat still raises bad cholesterol, it appears that it raises good cholesterol by an equivalent amount and the effect of the bad cholesterol is mostly cancelled out. In this scenario saturated fat is expected to have little or no effect on risk of heart disease.

UFFE was right folks. Eat fat and live!

But good and bad cholesterol are components of blood, and not actual disease. What about direct evidence for the effect of saturated fat on incidence of heart disease? Early in 2010 a large human study measuring the link between intake of food components and heart disease was published. The study included over 340,000 people spanning 23 years. Here is what the authors said about saturated fat: "…there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD." Or in plain English - saturated fats have no effect on heart disease. Although this statement appears to fly in the face of everything we have been taught for decades, it corresponds exactly with powerful ability of saturated fat to increase good cholesterol. Neglect of the positive effect of saturated fat on good cholesterol has made it look worse that it really is.

A convincing body of evidence already exists that saturated fat is not as bad as once thought. Nevertheless public policy continues to demand further big reductions in saturated fat intake. The 2010 Dietary Guidelines Advisory Committee (DGAC) recommended reducing saturates by 5% of the diet. If this huge reduction was ever implemented, the US dairy and meat industries - the main dietary source of saturated fat - would be severely damaged, and all for nothing. Isn't it time to abandon the failed Diet Heart Hypothesis and focus our resources on issues that really make a difference to public health?

The Diet Heart Hypothesis is DEAD folks..... time we buried it and moved on.... be be very very careful, they will make a pill, another blockbuster drug to raise your HDL folks..... when all you need to do is reduce your carbohydrates, white breads, simple starches, junk foods etc, and go back to eating good health fats again.

I wonder how they will breed the fat back into the food chain? Could it be as simple as feeding cattle on grass, and stopping the hormones?

Above Article from: Food Processing.com
Also worth a read:
The Dirty Little Secret of the Diet-Heart Hypothesis
WHY THE CHOLESTEROL-HEART DISEASE THEORY IS WRONG Dr. Malcolm Kendrick M.D.

Friday, February 18, 2011

Eggs and Cholesterol

Article by two I have learned a lot from.

==================================================

by Dr. Malcom Kendrick, M.D. and Dr. Duane Graveline, M.D., M.P.H.

According to the U.S. Government's latest guidelines, one egg per day does not result in increased blood cholesterol levels. Nor does it increase the risk of cardiovascular disease in normal people.

What it might have said is that 12 eggs per day will not increase your blood cholesterol or have a significant impact on cardiovascular risk. And the government could say this about many other cholesterol containing foodstuffs such as whole milk and butter.

Four decades ago when the U.S. Government abruptly placed eggs, butter and whole milk on the restricted list, doctors began to counsel patients likewise and warned about the evils of these farm products.

Families were placed on a no egg, margarine instead of butter and low fat milk instead of whole milk diet. The typical farmer's diet from a generation or two ago was homemade butter from Jersey fat, whole milk and plenty of eggs.

For 20 years doctors carried on like this, lackeys to Big Pharma, marching lockstep with medical peers to the music of cholesterol causation of heart disease. When Big Pharma created statins, doctors bowed again in allegiance to them for having given to us this new cholesterol lowering club.

Now after years of researching the true purpose of cholesterol and the terrible consequences of statin use to lower cholesterol we have discovered that cholesterol is not the cause of cardiovascular disease. It has never truly been Public Health Enemy #1.

Foods containing cholesterol don't raise blood cholesterol for several reasons. The main one is that our bodies, like the bodies of all living creatures, are capable of an amazing thing called homeostasis. Namely, keeping the level of things that are important e.g. temperature or potassium levels, at a constant level. No matter what you do on the outside, things remain calm and in control on the inside.

If your body couldn't do this, you would die in about two seconds flat. Looking at cholesterol, our livers synthesize around five times as much cholesterol as you are ever likely to eat in your diet. If you eat less cholesterol, your liver will synthesize more (of this vital substance). If you eat more cholesterol, you liver will synthesize less. This is homeostasis in action.

Quite how much cholesterol you would need to eat to overwhelm your homeostatic system is unknown. Nobody has managed to do it yet. People fed up to ten eggs a day kept their 'cholesterol levels' constant; something first proven by Ancel Keys - ironically the man who almost single handedly created the diet-heart/cholesterol hypothesis in the 1950s.

The body controls 'cholesterol levels' - actually the level of low density lipoprotein (LDL) through the action of LDL receptors in the liver. If the LDL level rises, LDL receptors on the liver catch hold of it, drag it back into the liver and recycle the cholesterol contained within the LDL.

If you have a lack of LDL receptors - the underlying cause of Familial Hypercholesterolaemia (FH) - your LDL/cholesterol level will rise. Not, because of anything you eat. In fact, despite anything you eat. In short, the body normally controls LDL/cholesterol levels within certain levels, completely independent of diet. If this system fails, it has nothing whatsoever to do with what you eat. It is entirely due to errors within your homeostatic system. It is as simple at that.

Cholesterol is perhaps the most important biochemical in our bodies. The true cause of heart attacks and strokes is a form of inflammation. For the past 40 years our dietary guidelines have been wrong. Is anyone coming out with an apology for all this - some words from our national leadership? Don't hold your breath while you are waiting.

The most we will ever get is this really foolish statement, "One egg a day gets the OK." Meanwhile Big Pharma alone has made some 75 billion in profits from the use of statins to lower cholesterol and no doubt the food industry has taken its share as well.

Meanwhile the game has changed. Statins work to lower cardiovascular risk not by cholesterol reduction, which they do well, but by inflammation reduction. The same doctors who put you on statins for cholesterol reduction are keeping you on statins for their anti-inflammatory properties. And testing your blood for cholesterol? Forget about it! From now on we will be using the C-reactive protein test for the level of inflammation in your bloodstream. Cholesterol is the most important biochemical in your body.

Dr. Malcolm Kendrick, M.D.Dr. Kendrick has worked in family practice for almost twenty years.

He has specialized in heart disease and set up the on-line educational website for the European Society of Cardiology.

He is a peer-reviewer for the British Medical Journal.

Duane Graveline MD MPH

Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor

Thursday, February 17, 2011

Coronary artery calcium scoring

Jan 31, 2011 @ 1:30AM (i.e. middle of the night while sleeping) I was in Brooke's Point Palawan, I had my sixth heart attack (they say practice makes perfect and so I'm working on it).

At least I'm here to blog about it.
This one was unique in a couple of ways:

1. It was painful. None of the other 5 were in that category.

2. I was quite a ways from real help. The hospital had an ECG/EKG that did make a chart which they said looked abnormal. Wanted to put me on heparin but said otherwise they could only observe me if I accepted their recommendation to be checked in. It was a 120 mile (almost 4 hour ride) north to the airport, then a one hour plane ride, then a 45min drive to my now favorite hospital St Lukes Medical Center where they were capable of acute care.

Well, I made it. Underwent an ECG, Troponin T blood enzime lab test, catheterization exam, etc. etc. etc.

Where to go from here???????

I think I've got a plan.

While in the hospital this time I accidently discovered that this relatively new hospital had facilities to perform a Cardiac Calcium Scoring procedure that uses computed tomography (CT) scan. I had read of this and had been lurking about a source on the web touting it as an effective tool to actually measure plaque buildup not just crystal balling CVD using factors which hadn't worked worth beans in my case in the past - yeah you guessed it basic old cholesterol!

Doesn't sound like that exciting of a find since I know I have cardiovascular disease and therefore plaque buildup. Well it is exciting given the following. If you can quantify it (the calcium score does that) and identify causes you should be able to take steps to slow down, stop, or (stop the presses) even shrink plaque growth - that is begin healing the disease - WOW!

So here's the plan.

1. Get a calcium score. [DONE] (I'm in the 59th percentile by my score, age and gender and I've heard of much worse results than mine).

2. Begin evaluating causes of my CVD by measuring quantifyable and controllable factors. [PARTIALLY DONE].
Have yet to undergo Lipoprotein Analysis using Nuclear Magnetic Resonance (NMR).
Had a VAP Cholesterol test some years back but my cardiologist hadn't a clue what to do with all those 'new' numbers. But the VAP is more complete and actual measured values as opposed to the Friedewald calculated, but not measured, LDL cholesterol approximation most often used today.

3. Take steps to bring into line those specific factors that have been shown to reduce the growth or even actually reduce the quantity of cardiovascular plaque. [ONGOING]

4. Check interim progress (maybe even using some old Friedewald calculated LDL - since it's cheaper) then eventually have another calcium scoring CT scan to measure artery plaque and compare with the score I got today and make adjustments to the process. [FUTURE]

So that's the plan. Won't be a quick fix or even a magic bullet or likely much more than a more educated attempt at reducing the risk of number 7.

I think I like this approach better than the previous approach that gave me sleep robbing muscle aches, low enough "C" numbers to make the cardiologists pat themselves on the back and smile like Cheshire Cats thinking they had saved another doomed soul (oh and according to some clinical trials, may have had something to do with the cancerous intestinal tumor discovered after almost 20 years on statins).

Stay tuned. I'm determined and committed.

If you are interested more in what I'm doing check here and/or here.

Tuesday, February 15, 2011

Lies, damned lies, and statistics

A blog I follow View from the hill just had a good article titled Lies, damned lies, and statistics which has very good points some of which I've feebly discussed here in the past.

Here's a quote exerpting one small paragraph along with a couple of his summary statements of note.

==========================================================

"There has been much publicity, about the trials of various drugs recently, highlighting the pro's and the con's (literally) of their worth. The use of statin's, for example, was initially believed to be a panacea for low risk (should that be no risk?) patients in the prevention, of future heart disease. But this has been clearly shown to be of little benefit, whilst at the same time as increasing risks for other diseases such as diabetes. The use of statin's in primary prevention is now pretty much a 'dead parrot', but will GP's stop prescribing them for the achievement of a highly dubious surrogate end point? Well, err, no, because they are paid to achieve them by the QOF (Quality Outcomes Framework). And let not the science, get in the way of a nice little earner!"

.
.

"So, long suffering reader, I would urge scepticism in all data, that is presented to you as 'proof' of anything, especially a drug or treatment, that has been provided as a preventative measure by your 'hard pressed' GP."
.
.

"Finally, be a sceptic, and believe only that, which is proven by real science, not Daily Mail headline drivel, or advocacy research, or perhaps worse, what your Doctor tells you (if it's QOF'ed)."

=============================================

Please read the complete article here

Credible Evidence

FB-TW