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Wednesday, August 31, 2011

Wheat Belly

Tom Naughton just reviewed the book Wheat Belly by Dr. William R. Davis cardiologist. See that review here.

I just received my Kindle e-book copy and will read it soon.

I stopped consuming wheat products about two years ago at the recommendation of Dr Davis for the treatment of lipid disorders (it has a dramatic effect on small LDL) )and heart disease. Since I have a history of CAD that has resulted in 6 heart attacks I am of course interested in finally doing something to reduce the progression of plaque growth. The only advice I have received previous to this is to reduce my serum cholesterol i.e. take a statin and eat a low fat diet. But in the process of doing that I had my first four heart attacks. I treated that 'risk factor' (cholesterol) over the course of many years and while doing so had my first 4 heart attacks. Clearly it was not attacking the disease, only a non-significant risk factor in my case.

I am now following the Track Your Plaque regimen of measuring plaque using a heart scan, advanced lipid testing (VAP NMR, Berkley) , treating lipid disorders shown to be correctable in clinical trials and observations, following the TYP diet and monitoring blood glucose levels. I have only been on board fully with this approach since Feb 2011 so it is a work in progress.

I first began learning about this approach to actually treat the disease rather than a single risk factor back in 2006 or so but it took my skeptical self a while to become convinced. After all it was not exactly Main Stream Medicine. Was it quackery or something more. It took a couple more heart attacks and the realization that MSM had not served me well other than to patch the damage but not to treat the disease, to push me over the edge. I began blogging some of what I was finding in early 2007 to, if you will, document and share my findings, and keep track of what I think is Credible Evidence leading me to where I am now.

The Kindle version of Wheat Belly is only ten bucks. It is not the whole answer, but it does, I think, point to what is a significant piece of the puzzle.

Thanks Tom for the review.

Tuesday, August 30, 2011

Enjoy eating saturated fat but preferably from grass-fed animals.


In an article taken from a talk given by Donald W. Miller, Jr., MD at the 29th Annual Meeting of the Doctors for Disaster Preparedness in Albuquerque July 19, 2011, he stated

 "Enjoy eating saturated fat but preferably from grass-fed animals."

Read the full article here.

Wednesday, August 17, 2011

The information and online tools for health can handily exceed the limited “wisdom” dispensed by John Q. Primary Care doctor.

Crossposted from Heart Scan Blog====================================================================
How far wrong can cholesterol be?


from Heart Scan Blog 

Conventional thinking is that high LDL cholesterol causes heart disease. In this line of thinking, reducing cholesterol by cutting fat and taking statin drugs thereby reduces or eliminates risk for heart disease.

Here’s an (extreme) example of just how far wrong this simpleminded way of thinking can take you. At age 63, Michael had been told for the last 20 years that he was in great health, including “perfect” cholesterol values of LDL 73 mg/dl, HDL 61 mg/dl, triglycerides 102 mg/dl, total cholesterol 144 mg/dl. “Your [total] cholesterol is way below 200. You’re in great shape!” his doctor told him.

Being skeptical because of the heart disease in his family, had a CT heart scan. His coronary calcium score: 4390. Needless to say, this is high . . . extremely high.

Extremely high coronary calcium scores like this carry high likelihood of death and heart attack, as high as 15-20% per year. So Michael was on borrowed time. It was damn lucky he hadn’t yet experienced any cardiovascular events.

That’s when Michael found our Track Your Plaque program that showed him how to 1) identify the causes of the extensive coronary atherosclerosis signified by his high calcium score, then 2) correct the causes.

The solutions, Michael learned, are relatively simple:

–Omega-3 fatty acid supplementation at a dose sufficient to yield substantial reductions in heart attack.
–”Normalization” of vitamin D blood levels (We aim for a 25-hydroxy vitamin D level of 60-70 ng/ml)
–Iodine supplementation and thyroid normalization
–A diet in which all wheat products are eliminated–whole wheat, white, it makes no difference–followed by carbohydrate restriction.
–Identification and correction of all hidden causes of coronary plaque such as small LDL particles and lipoprotein(a)

Yes, indeed: The information and online tools for health can handily exceed the limited “wisdom” dispensed by John Q. Primary Care doctor.

Friday, August 12, 2011

The most important thing you probably don’t know about cholesterol


Summary:
  • The simplified view of cholesterol as “good” (HDL) or “bad” (LDL) has contributed to the continuing heart disease epidemic
  • Not all LDL cholesterol is created equal. Only small, dense LDL particles are associated with heart disease, whereas large, buoyant LDL are either benign or may protect against heart disease.
  • Replacing saturated fats with carbohydrates – which has been recommended by the American Heart Association for decades – reduces HDL and increases small, dense LDL, both of which are associated with increased risk of heart disease.
  • Dietary cholesterol has a negligible effect on total blood LDL cholesterol levels. However, eating eggs every day reduces small, dense LDL, which in turn reduces risk of heart disease.
  • The best way to lower small, dense LDL and protect yourself from heart disease is to eat fewer carbs (not fat and cholesterol), exercise and lose weight.
Read the full article here

Scientists sometimes shift the scientific goalposts

Dr. John Briffa

Scientists sometimes shift the scientific goalposts

It’s easy to believe that statins have dramatic life-saving properties. The reality is, however, that for the majority of people who take them, they don’t. In the biggest and best review published to date, statins were not found to reduce overall risk of death in individuals with no previous history of cardiovascular disease [1]. What this study shows is that for great majority of people who take statins, the chances of them saving their life are, essentially, nil (just so you know).

Of course, you wouldn’t expect everyone to take this finding lying down. A number of people responded to this study with letters to the journal in which it appeared, attempting to cast doubt on its findings. None of it amounted to much, but I thought I would focus on one response, which in my view demonstrates how some scientists and doctors attempt to shift the scientific goalposts to make their point and suit their ends.

The response came from Drs Gabriel Chodick and Varda Shalev [2]. The main thrust of their objections come in the form of three studies that were included in the review referred to above that they claim have ‘major limitations’. Here’s what they say about each of these studies:

“…their meta-analysis included 3 studies with major limitations: a significant decrement in low-density lipoprotein cholesterol levels over the study period in the placebo arm (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial [ALLHAT]), old age at therapy initiation (Pravastatin in Elderly Individuals at Risk of Vascular Disease [PROSPER] Study), and incomplete information on low-density lipoprotein cholesterol levels over the follow-up period (Air Force/Texas Coronary Atherosclerosis Prevention Study [AFCAPS/TexCAPS]). All these studies showed negative results; their inclusion would have biased against finding a benefit to statin treatment.”

With regard to the first study, what Drs Chodick and Shalev seem to be saying is that the control group (the group treated with placebo rather than statin) saw natural reductions in cholesterol, so the benefits of taking a statin did not to show up. However, the impact that statins had on cholesterol levels relative to a control group is not important – the only important thing is the impact statins had on health (and, in particular, overall risk of death). This is also true for the last study highlighted by Drs Chodick and Shalev.

As regard the second study, it’s not clear why the advanced years of participants would be a barrier to determining the effectiveness of statins. Actually, the elderly are known to be at particularly high risk of cardiovascular disease, meaning that if anything, this population would, theoretically, be generally most likely to benefit from statin therapy.

In summary: none of Drs Chodick and Shalev’s objections hold any water at all. But they don’t stop there. Here’s the final paragraph from their letter.

“Also, randomized controlled trials are often characterized by limited follow-up periods. Therefore, all-cause mortality benefits may not be apparent in randomized controlled trials among a primary prevention population. It would be informative in this regard to take into account the results of large observational studies with longer follow-up periods to better capture the benefits of statins in primary prevention patients.”

What they’re saying here is that clinical trials don’t go on long enough to detect benefits. It’s better, in their mind, to revert to longer studies that are observational (also known as ‘epidemiological’) in nature. However, such studies look at associations between things, but can never be used to prove the benefits of statins. Only intervention studies can do this.

So, what the authors of this letter are effectively saying is that we should ignore the best evidence we have in favour of quite-useless epidemiological evidence.

One of the authors of this letter is, in fact, an epidemiologist, and really should know better. But then again, both of the authors work for a company that assists drug companies in, among other things, ‘reducing the time to market’ and the writing and submission of scientific articles for publication.

See here for more details. It’s a clear conflict of interest, of course, and perhaps goes some way to explain why they make apparently spurious objections to existing evidence and appear to be calling for an approach that can never really get to the truth.

References:
1. Ray KK, et al. Statins and all-cause mortality in high-risk primary prevention: a meta-analysis of 11 randomized controlled trials involving 65 229 participants. Arch Intern Med. 2010;170(12):1024-1031
2. Chodick G, et al. Statins and all-cause mortality in high-risk primary prevention: a second look at the results. Arch Intern Med. 2010;170(22):2041-2
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Read the full article here.

Sunday, August 7, 2011

"I would never subject a patient to the potentially severe side effects of statins..."

"While inflammation may be involved in either one or both I would not recommend statins as therapy. The supposed benefit provided by statins in reduction of non-fatal heart attacks by a few percentage points is no greater than that achieved with other anti-platelet and/or anti-inflammatory drugs. Therefore I would never subject a patient to the potentially severe side effects of statins in order to achieve a questionable benefit that can be provided by drugs of much lower risk."
Dr. Ernest N. Curtis, M.D.
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From: The Cholesterol Delusion Part 2

"A delusion is a false belief held with conviction despite incontrovertible evidence to the contrary."

The Cholesterol Delusion

Ernest Curtisby Ernest N. Curtis M.D. ( Internal Medicine and Cardiology )
A delusion is a false belief held with conviction despite incontrovertible evidence to the contrary.
In the medical field no delusion has had wider acceptance and a longer run than the belief that cholesterol levels in the blood are a major factor in the causation of atherosclerosis and its two chief complications - heart attack and stroke.

The supposed benefit provided by statins in reduction of non-fatal heart attacks by a few percentage points is no greater than that achieved with other anti-platelet and/or anti-inflammatory drugs.

Therefore I would never subject a patient to the potentially severe side effects of statins in order to achieve a questionable benefit that can be provided by drugs of much lower risk.
Read the full 'The Cholesterol Delusion' two part article here:
Dr. Ernest N. Curtis received his B.A. In Biological Sciences from the University of California, Berkeley and his M.D. From the University of California, Irvine.
After a Residency in Internal Medicine and a Fellowship in Cardiology, he entered private practice in Long Beach, California where he has practiced for the last 32 years.

Friday, August 5, 2011

The switch from an $11-billion/year drug juggernaut to an OTC medication won't be easy for Pfizer

New York, NY - Pfizer is hoping to sell atorvastatin (Lipitor) to consumers over the counter (OTC) as a way to offset the expected plunge in revenue as the world's best-selling prescription drug goes off patent in November, according to the Wall Street Journal.

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Read full article here.