Wisdom Wednesday: Statins Lower Risk for CV Events in Elders, But Benefits for Primary Prevention Still in Question

Statin therapy lowers the risk for vascular events in adults over age 70, according to a meta-analysis in The Lancet. However, the benefit seems apparent only in those with a history of vascular disease.

Researchers examined data from 28 randomized trials that either compared statin use with nonuse or compared intensive statin regimens with standard treatment. Over 185,000 participants were included, of whom 15% were age 71–75 and 8% were older than 75.

During roughly 5 years' follow-up, statin use or intensive treatment was associated with a significant reduction in major vascular events across all age groups — overall, a 21% reduction in risk with each 1-mmol/L (39-mg/dL) decrease in LDL cholesterol. However, when stratified by history of vascular disease, a significant benefit among those aged 71 and older was limited to those with prior vascular disease.

My Take:
The full article is available online from The Lancet. These findings are strikingly similar to those found with aspirin – it’s best used for patients with a history of cardiovascular disease than for prevention.

Higher Risk Thresholds May Be Needed for Starting Statins for Primary CVD Prevention, Study Suggests

The guideline-recommended risk thresholds for initiating statins for primary prevention of cardiovascular disease may be too low, a modeling study in the Annals of Internal Medicine suggests.

Researchers performed a network meta-analysis of studies comparing four low- or moderate-dose statins with no statins in patients aged 40 to 75 with no CVD history. They balanced statins' potential benefit of CVD event prevention with potential harms, like myopathy, hepatic or renal dysfunction, cataracts, hemorrhagic stroke, type 2 diabetes, and cancer.

Most current guidelines recommend statin initiation when a person's 10-year CVD risk is 7.5%–10%. In this study, the benefits only began to outweigh the risks when CVD risk was 14% for men aged 40 to 49. For men 70 to 75 years, the threshold was 21%. For women, thresholds ranged from 17% to 22%.

The authors conclude: "Our results suggest that guidelines should use higher 10-year risk thresholds when recommending statins for primary prevention of CVD and should consider different recommendations based on sex, age group, and statin type."

Of note, guidelines released last month by the American College of Cardiology and American Heart Association consider a 10-year risk score of 7.5%–19.9% to denote "intermediate risk."

Wisdom Wednesday: Is the ‘Anti-Statin” Trend Threatening Lives?

A wave of anti-science skepticism may put people with high cholesterol at risk if they’re convinced to quit life-saving statin medications, heart experts warn.

An “internet-driven cult” is attacking the safety and effectiveness of cholesterol-lowering statins, despite mounds of clinical trial data showing the drugs work and produce minimal side effects, said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic.

“We as physician scientists have to speak out,” Nissen said. “We have to regain the public’s attention around the fact that it isn’t a good thing to have high cholesterol, and a lot of heart disease is preventable by addressing risk factors like cholesterol.”

Nissen makes his case in an editorial published online July 24 alongside a new study in the journal Annals of Internal Medicine. That study found that patients who stick with statins even after suffering side effects are less likely to die or suffer a heart attack or stroke, compared to people who quit the drugs.

But as many as three-quarters of patients stop statin therapy within two years after they suffer a side effect, or “adverse event,” from the drugs, the authors of the new report said in background notes.

The new study found that patients who keep taking their statins had about a 12% incidence rate of death, heart attack or stroke, while those who quit statins had an incidence rate of about 14%, said senior researcher Dr. Alexander Turchin. He’s an endocrinologist with Brigham and Women’s Hospital in Boston.

Wisdom Wednesday: Alternative Facts

Kelly Ann Conway may have coined the phrase, but “alternative facts” are nothing new to health care. Here are several that come to mind:

• High cholesterol causes heart disease – More than half of all patients suffering their first heart attack have normal or even low cholesterol.
• Stain drugs reduce the risk of heart attack by lowering cholesterol – No, however they due reduce the risk slightly by reducing vascular inflammation. Lowering cholesterol (and LDL) is a side effect of statin drugs.
• Red Yeast Rice works as well as a statin drug – No, red yeast rice is an uncontrolled statin drug with potentially fatal side effects.
• “Hysterectomy”, the removal of hysteria from a woman. You may laugh, but that was the original reason for the surgery and is still the accepted medical term.
• Preventive health care – Really? Less than half of PCPs run the A1c to look for diabetes in their obese population over the age of 45. I routinely see lab work from other doctors showing moderate kidney failure, anemia, or hypothyroidism without comment. The average physician knows less about nutrition then their patients.
• Managing polypharmacy – That’s a class for physician on how to manage a patient taking 5 or more prescription drugs daily. You cannot manage polypharmacy.
• Junk DNA – Ninety-eight percent of our DNA has unknown functions, therefore it is “junk” DNA.
• Vestigial organ – An organ in the human body that no longer serves a purpose, like the appendix. The thymus was considered vestigial at one point, but we now know it’s the hub of our immune system.
• The yearly flu shot – Given for ever changing viral infections that mutate so quickly that the shot is obsolete before it is distributed.
• Round-Up Ready seed – wheat seeds that have been genetically modified (by Monsanto) to survive direct application of the herbicide Round-Up. That way the herbicide can be sprayed directly on our food to kill the surrounding weeds. Which leads to the next one….
• Biodegradable – A chemical compound (like Round-Up) that is supposedly safe because it supposedly breaks down into safe compounds. Although the WHO (World Health Organization) classifies Round-Up as a carcinogen.
• The Food Pyramid – The official U.S. recommended diet consisting of a base of refined carbohydrates. A middle layer of dairy, meat and eggs, topped by a very small (think top of a pyramid) peak of fruits and vegetables.
• Sleep Aid – a drug that forces you to sleep, but disrupts the normal rhythmic patterns of sleep taking away most of the benefits of sleep.
• Efficacious Antidepressant – The best antidepressants work about in about one-third of patients. In order to be considered efficacious, a drug must work at least 50% of the time. The new twist, adding additional antidepressants when the first one (or two) fail to work.
• Better Living Through Chemistry – the concept that we are somehow healthier by taking prescription drugs.
• Longevity – Statistically we are living longer, but only because infant mortality has been markedly reduced in the past century skewing the statistics and because we can extend life without quality using drugs and machines.

The Bottom Line:
I bet you can add to this list.

Heart Failure Protein May Signal Early Brain Damage

N-terminal Pro-B-type natriuretic peptide (NT-proBNP) is a protein released into the blood in response to heart wall stress. Blood levels of NT-proBNP rise when heart failure worsens and fall when it gets better.

Previous research has found a link between heart disease and brain disease, but the role of NT-proBNP was unclear.

Researchers in the Netherlands looked at nearly 2,400 middle-aged and elderly heart disease patients without dementia and found a clear association between blood levels of NT-proBNP and brain damage detected on MRIs.

The study was published online Dec. 7 in the journal Radiology.

“We found that higher serum levels of NT-proBNP were associated with smaller brain volumes, in particular with smaller gray matter volume, and with poorer organization of the brain’s white matter,” lead author Dr. Meike Vernooij said in a journal news release. She’s a neuroradiologist at Erasmus MC University Medical Center in Rotterdam.

Damage to the heart and brain often occur before any signs or symptoms of disease become apparent. A blood marker that can reveal early-stage heart and brain diseases could lead to earlier treatment and lifestyle changes, and possibly slow or even reverse the disease, the study authors noted.

They said further research is needed to learn more about NT-proBNP and the link between heart and brain disease.

Are There Alternatives to Statins?

Statins are the go-to therapy for lowering “bad” LDL cholesterol, but other treatments also can effectively reduce risk of future heart problems, a new evidence review reports.

These alternative therapies – including a heart-healthy diet, other cholesterol-lowering medications, and even intestinal bypass surgery – seem to confer the same level of heart health protection as statins when cholesterol levels decrease.

Nonstatin therapies reduced the risk of heart problems by 25% for each 1 millimole per liter decrease in LDL cholesterol levels. That’s very similar to the 23% reduction per 1 millimole per liter decrease seen with statins like atorvastatin (Lipitor) and simvastatin (Zocor), the researchers said.

What’s more, the benefits of these therapies stack up if more than one proves effective at lowering a person’s cholesterol levels, said senior researcher Dr. Marc Sabatine, a cardiologist at Brigham and Women’s Hospital in Boston.

“The focus really should be not on a particular drug, but on reducing LDL cholesterol,” Sabatine said. “These data show there are multiple interventions that can do that.”

Statins, which work by reducing the liver’s production of cholesterol, were taken by more than one-quarter of U.S. adults aged 40 and over during 2011-2012, according to a national survey.

A heart-heathy diet reduces the amount of LDL cholesterol you eat while increasing dietary components like fiber has been shown to help clear cholesterol from the bloodstream.

Zetia (ezetimibe), is a drug that blocks absorption of cholesterol in the digestive tract.

Just a Little of Statins’ Effect Enough to Help Heart

Giving high doses of statins to patients with heart disease doesn’t lower the risk of future heart trouble any more than moderate doses of the cholesterol-lowing drugs do, a new study finds.

Having heart disease raises the risk of heart attack and stroke, as blood vessels become clogged and cut the normal flow of blood and oxygen to the heart. These patients are typically prescribed statins on a long-term basis, to lower levels of vessel-clogging LDL (“bad”) cholesterol. But experts remain conflicted about exactly how low LDL cholesterol levels should go.

“Our study demonstrates that physicians treating patients with heart disease and elevated levels of cholesterol with statins have to ensure that patients meet a target of less than 100 mg/dL to prevent further [heart] events,” said study author Dr. Morton Lelbowitz. He is a senior physician with the Clalit Research Institute in Tel Aviv, Israel.

According to the U.S. Food and Drug Administration (FDA), millions of Americans currently take statins, including well-known brands such as Crestor (rosuvastatin), Lipitor (atorvastatin), and Zocor (simvastatin), among others. But the FDA also stresses that the heart benefits of lowering cholesterol levels with statins is “indisputable.” What is in dispute is what the ideal target cholesterol level should be.

For example, while the American Heart Association does not advocate for any specific LDL target level, the European Society of Cardiology recommends that LDL be brought down to a relatively “low” level of 69 mg/dL or less.

To examine the issue, investigators tracked more than 31,600 patients, ranging in age from 30 to 84, all of whom had been diagnosed with heart disease between 2009 and the end of 2013. All had been taking statins for at least one year.

Nearly 30% were found to have “low” LDL levels, meaning a reading of 70mg/dL or less. More than half had a “moderate” LDL level of between 70.1 and 100mg/dL, while nearly 20% had “high” levels exceeding 100 and as high as 130.

Patients were followed for an average of 1.6 years, and during that time more than 9,000 either died or faced a serious cardiac event, including heart attack, stroke, chest pain (angina), heart bypass surgery or surgery to unblock arteries (angioplasty).

Wisdom Wednesday: High Cholesterol Revisited

I reference the fallacy of treating high cholesterol with statin drugs frequently. Maybe too frequently. However, for those of you taking a statin (soon to be 50% of the population over the age of 45) I would like to give some background information to discuss with your PCP.

These are the most common causes of high cholesterol:

• The most common cause is a diet high in saturated fat or trans-fats. Saturated fats are found mostly in animal products and recent research indicates that in moderation, saturated fats are safe. Trans-fats are rare in nature but rather are the result of modifying fats to increase shelf life. The trans- bond is very difficult for the body to break. The half-life of a trans-fat in the body is 59 days and it takes five half-lives to eliminate a substance from the body. So the trans-fat oils in those French fries stay in your body for nine months.
• The second most common cause is an underactive thyroid. Hypothyroidism is epidemic in the U.S., especially in women after menopause. Although almost immune to heart attack prior to menopause, the rate of heart attack in women exceeds that of men within five years of menopause. This and insulin resistance are major factors in metabolic syndrome. Laboratory testing for the thyroid begins with a TSH (thyroid stimulating hormone). Although the lab normal range runs from 0.4 to 4.5, the ideal range is 1-2. Running a T3 and T4 gives a better perspective of hormone production and the TPO (thyroid peroxidase) and thyroid auto-antibodies can reveal autoimmune disease of the thyroid (Hashimoto’s thyroiditis).
• In third is dysbiosis. If the microbiome of the digestive tract is disturbed, harmful bacteria can liberate spent estrogen being discarded from the liver. They also produce estrogen analogs. These products are then resorbed in the lining of the large intestine and stimulate cholesterol production in the liver. A history of IBS (irritable bowel syndrome), GERD, acid-reflux or food sensitivities is usually evident but complete digestive stool analysis can identify offending organisms and evaluate the immune status of the gut.
• Last and the least common is genetic, inherited over production of cholesterol in the liver. The lab test for this issue is an L(p)a, a portion of the LDL cholesterol. It is seldom run because there are no drugs currently available to lower the L(p)a. However, both niacin and Gingko leaf extract can often reduce the L(p)a by 50% in three months.

The bigger issue is artery inflammation. This is the ultimate cause of atherosclerosis. When an artery wall becomes inflamed. The inflammation triggers homocysteine to attract LDL cholesterol and attach it to the inflamed artery wall. On a small scale, this protects the inflamed wall. When excessive coronary artery disease is the result.

Wisdom Wednesday: Iatrogenic Disease

Iatrogenic – induced inadvertently by [the words or action of] a physician or by medical treatment or diagnostic procedures.

I have experienced many examples of iatrogenic disease over the course of 39 years of practice. In the early years of my chiropractic career, it was trying desperately to treat patients that had failed back surgery syndrome. I have also treated a number of patients that became ill from bowel resections and cholecystectomies. But those number pale compared to the escalating numbers of patients developing new diseases from their medications.

This week alone I have two patients that appear to have developed type II diabetes from taking statin drugs. In both cases they have been taking statin drugs for years. When the diabetes was detected, their PCP (primary care physician) just added metformin and glyburide to their growing list of prescription drugs. One patient was on five meds, the other on ten. Neither case responded to the diabetic medications and they ended up in my office.

In another case this past week, a patient’s insomnia was due to her thyroid medication and another patient’s memory loss was secondary to his heart medication. His memory loss mimicked intermittent, advanced dementia. It was the radical swing in memory issues that keyed me in to the medications as the cause. Of course, he is on ten additional medications daily, so some the effect is probably from drug interactions.

Wisdom Wednesday: Coenzyme Q-10

Coenzyme Q-10 (CoQ-10) is a very popular supplement. Many people use CoQ-10 for heart conditions, chest pain, diabetes, breast cancer, Parkinson’s disease, muscular dystrophy, chronic fatigue syndrome (CFS), Lyme disease and increasing exercise tolerance.

The chemistry of Co Q-10 is well understood. In the mitochondria of every cell, it facilitates electron transport. This is the process by which energy is transferred from the Krebs’s Citric Acid Cycle (glucose metabolism) to make ATP, the energy molecule of the body. Deficiencies of Co Q-10 impair electron transport severely limiting energy production for all body functions.

Your body produces 75% of the Co Q-10 it needs. The rest comes from the diet. Co Q-10 is found in small amounts in most animal foods. Co Q-10 is a fat and requires other fats in the diet for absorption. So a vegan vegetarian restricting their fat intake might develop a deficiency.

However, the overwhelming cause of Co Q-10 deficiency comes from using statin drugs to lower cholesterol. Drugs like Lipitor inhibit the synthesis of Co Q-10 in the same manner as they inhibit cholesterol synthesis. The symptoms of Co Q-10 deficiency are low energy, fatigue, leg weakness and leg pain. The cardiac myopathy (heart muscle damage) that occurs in 10% of patients taking statin drugs is thought to be a result of Co Q-10 deficiency.

Wisdom Wednesday: Red Yeast Rice

About once a month a patient will tell me their primary care physician recommended red yeast rice because their cholesterol is high. It was bad enough when I just had to counsel patients against the use of this dangerous supplement. Now I have to convince them that their doctor gave them bad advice.

Red yeast rice (RYR) is made from yeast (Monascuspurpureus) grown on rice. It is a dietary staple in some Asian countries. Processed red yeast rice supplements include red yeast rice extract (RYRE), which is any extract of red yeast rice, and Xuezhikang, an alcohol extract of red yeast rice.

RYR contains several compounds known as monacolins, which block the production of cholesterol. One of these, monacolin K, has the same structure as the drugs lovastatin and mevinolin. Studies suggest that RYR use may lead to a 10-33% reduction in low-density lipoprotein (LDL, or “bad”) cholesterol.

While that all sounds good, physicians should not be recommended this supplement, nor should anyone take it.

There are several problems with this supplement:

The first issue is dosage. There is no standardized amount of monacolins or lovastatin in these products. One tablet may contain as much as 20mg of lovastatin (twice the recommended starting dose to lower cholesterol) and the next tablet may contain little or none of the active compounds. If the supplement company standardizes the active compounds, like the manufacturer Pharmanex did with Cholestin, the FDA ruled that should be considered a drug not a dietary supplement. The U.S. District Court followed suit and ruled that Cholestin is an unapproved drug and it was removed from the U.S. market.

The second issue is potential toxicity and death from citrinic acid. Again, the levels of this toxic chemical vary from tablet to tablet and brand to brand.

2014 in Review

I posted 136 blogs during 2014, quite an increase from the 17 posted during the last few months of 2013 when I began this process. I reviewed them all this week, picking the top four topics for the year. If you would like to catch up on any of these areas of research, I have listed the related blogs following each area.

The fourth most popular topic was stem cell research. I my mind I thought it was number one and next year, and maybe for years to come, it might be. Stem cell research holds great promise to heal damaged tissues and organs of the body. Although readily available in children, as we age, stem cells radically decrease. Hospitals are already offering to store stem cells from the umbilical cord at birth for possible future use. The biggest hurdle is reproducing stem cells in sufficient numbers from an aging population that needs them. The political environment that delayed stem cell research for so many years appears to have faded. Please review my blog “Stem Cell Research Expanding” posted on Wednesday, February 26, 2014.

In third place is the shifting perception on high cholesterol and statin drugs. With the exception of general practitioners and cardiologists, most physicians have long admitted that there are several myths that have been perpetrated by the drug industry about statin drugs. This year was a continuing dichotomy. Respected cardiologists and cardiac research scientists began to speak out against the widespread use of statins while the new guidelines for the use of statins would dramatically increase the number of people taking this drug. Here are the blogs on this topic:

• Friday, March 21 Saturated Fat is Not Bad for Health, Says Heart Expert
• Friday, June 13 High Statin Doses Increase the Rick of Diabetes
• Monday, December 8 Most Seniors Could Use Statins under New Guidelines

Second place was occupied by research on the digestive tract. A new term, the ‘microbiome’ became popular as a description of the vast variety of life that lives in our digestive tract. We learned that virtually every illness in the body is somehow connected to this microbiome. DNA mapping of all existing microbes in the gut is ongoing with close to 15% having been identified and verified with the Centers for Disease Control (CDC). Fecal implants, a cure for C. difficile, have become popular with implant clinics popping up all over the country. We are still early in this research, certainly too early for these clinics to properly identify and treat patients correctly. I fear the widespread use of probiotics by Americans will create more dysbiosis as we do not yet know what probiotic(s) are needed by any one individual. Please review the following blogs:

• Friday, March 14 Serious Diarrheal Infection in Kids Linked to Antibiotics
• Wednesday, April 23 Probiotics Revisited
• Wednesday, April 16 Gut Associate Lymphatic Tissue (GALT)
• Friday, June 20 Exercise May Spur More Varied Gut Microbes
• Friday, August 5 Experts Issue Guidelines for Treating Irritable Bowel Syndrome

The number one topic of research interest this year was testosterone and male sexual dysfunction. Fifty percent of men over the age of 40 have some form of sexual dysfunction. Testosterone is routinely prescribed for these men despite studies showing increased risk of heart attack with use. The following blogs are available for review:

• Friday, March 7 Higher Risk of Suicide and Autism in Children Born to Older Dads
• Friday, April 25 Study Question Safety Thresholds for Hormone-Disrupting Chemicals
• Friday, May 30 Toothpaste, Sunscreen Chemicals ‘Interfere with Sperm Function’
• Friday, June 27 Sperm, Semen Defects May Be Tied to Shorter Lives
• Monday, August 11 New Drug Could Treat Low Testosterone with Fewer Side Effects
• Friday, October 24 Practice Guidelines Nixes Testosterone Therapy for Women

THE BOTTOM LINE:
Please take some time to review some of these blogs. It is vital to your own health that you be an educated participant in your own health care.

Most Seniors Could Use Statins under New Guidelines

Most older Americans qualify for treatment with cholesterol-lowering statins under new guidelines intended to reduce the risk of heart attack or stroke, a new study shows.

Guidelines for the treatment of blood cholesterol released late last year by the American College of Cardiology and the American Heart Association target people most likely to benefit from taking statins such as Zocor (simvastatin) and Crestor (rosuvastatin).

The new study of more than 6,000 black and white Americans age 66 to 90 found that 70% were eligible for stain therapy, including 97% of those 66 to 75 years of age and all of the men. The findings appear in a research letter published November 24th in the journal JAMA Internal Medicine.

“The guidelines are a significant change from prior guidelines that relied heavily on levels of bad cholesterol to determine who to treat,” letter author Dr. Michael Miedema, a research cardiologist at the Minneapolis Heart Institute Foundation, said in a foundation news release.

“Instead, the new guidelines recommend focusing statin therapy on the individuals that are at the highest risk for heart attack and stroke, even if their cholesterol levels are within normal limits,” he explained.

The guideline recommend statins for people with heart disease, diabetes or high cholesterol levels, but also recommend the drugs for people who don’t have these conditions but do have a higher than 7.5% risk of heart attack or stroke in the next 10 years based on a risk calculator.

“Older individuals will likely cross the 7.5% threshold based on age alone, even if they have normal cholesterol levels and no other cardiovascular risk factors, and our study confirms this notion,” Miedema said.

High Statin Doses Increase Risk of Diabetes

In a study covering more than 100,000 patient records in three nations, researchers with the Canadian Network for Observational Drug Effect Studies (CNODES) found that patients taking higher strength statins face an increased risk of developing diabetes.
Wednesday, June 4, 2014 (Health Data management)

The study published in the British Medical Journal, found a 15 percent relative increase in the risk of diabetes within two years of starting treatment with high potency statins, as compared with low potency statins. Patients included in the study had started statin therapy after experiencing a major cardiovascular event such as a heart attack or stroke. About two-thirds of these patients were prescribed a high-potency statin.

Statins considered to be high potency were rosuvastatin (e.g. Crestor) at doses of 10mg or higher; atorvastatin (e.g. Lipitor) as doses of 20mg or higher; and simvastatin (e.g. Zocor) at doses of 40mg or more. All other statins were considered lower potency.

To conduct the study, CNODES researchers from across Canada examined the health records of 136,966 patients who were 40 years of age or older in Canada, the United States, and the United Kingdom. As its mandate, CNODES has the ability to analyze a large amount of anonymous patient data to assess questions of drug safety more reliably that would otherwise be possible in smaller studies.

MY TAKE:
I keep saying it, but few are listening, statin drugs are dangerous. Statins do reduce the risk of CVA (cardiovascular accident) slightly. But they do so because they reduce vascular inflammation, not because they reduce cholesterol levels.

More than half the people who suffer their first heart attack have normal or even low cholesterol. The medical response to that statistic is “see everyone should be taken statin drugs”. Putting statins in our drinking water has been a topic of discussion at cardiac conferences across the country.

Statin drugs disrupt the chemistry of cholesterol metabolism. It also limits the production of CoQ10, another fat produced in the liver. CoQ10 is necessary to run the Krebs’ Citric Acid Cycle (CAC) that produces energy for every cell in the body. (Please refer to my blog on CAC posted on Wednesday, May 7, 2014.) CAC takes glucose (blood sugar) and coverts it to energy. Without adequate CoQ10, the CAC just doesn’t work.

I believe that all statin drug therapy impairs glucose metabolism. This extensive records review suggests that high doses of statin drugs impair glucose metabolism to the extent that Type II Diabetes more frequently develops.
In all fairness, Metabolic Syndrome is a precursor to both cardiovascular disease and diabetes. This is a vulnerable population that is likely to become diabetic anyway. The statins are just pushing them over the edge before their time.

Several recent research articles have been published questioning the emphasis on cholesterol lowering therapies. A few brave scientists in the field of cardiology have even come forward to question the validity of the original research in support of statin drug therapy. However, they have been quickly criticized and silenced by their peers.

Statin drug therapy is big pharmaceutical business. It is by far the most commonly prescribed drug in the world today. Until there is a financial penalty associated with statins, rather than a financial incentive, use of these drugs will continue to increase regardless of any research articles.

THE BOTTOM LINE:
If you are concerned about cardiac risk factors, have your glycohemoglobin A1c, CRP (high sensitivity C-reactive protein), homocysteine, and L(p)a checked in addition to the serum lipids. Those tests are much more indicative of your risks than the serum lipids.

If you choose to take statin drugs, at least supplement with CoQ10 to reduce some of the risk factors associated with this class of drugs.

Saturated Fat Is Not Bad For Health, Says Heart Expert

NHS guidelines which advise cutting down on high fat foods like butter, cream and chocolate may be putting the public at risk and should be urgently revised, a leading heart scientist has warned.
March 6, 2014

Diets that are low in saturated fat do not lower cholesterol, prevent heart disease or help people live longer, Dr. James DiNicolantonio insists.

He is so concerned about the misinterpretation of ‘flawed data’ that he has called for a new public health campaign to admit ‘we got it wrong’. British health experts and nutritionists backed his comments claiming that for too long ‘uncomfortable facts’ have been stifled by ‘dietary dogma’.

Saturated fat is traditionally found in butter, cheese, fatty meat, biscuits, cakes and sausages. But Dr. DiNicolantonio claims sugar and carbohydrates are the real culprits driving high cholesterol and the obesity epidemic. He suggests that the guidelines should be changed urgently. “There is no conclusive proof that a low-fat diet has a positive effect on health. Indeed the literature indicates a general lack of any effect, good or bad, from a reduction in fat intake.”

DiNicolantonio points out that the ‘vilification’ of saturated fats dates back to the 1950’s when research suggested a link between high dietary saturated fat intake and deaths from heart disease. But the study author drew his conclusions on the data form six countries, choosing to ignore the data from 16 others which did not fit with his hypothesis. Nevertheless the research stuck and since the 1970’s most public health organizations have advised people to cut down on fat.

“It seemingly led us down the wrong ‘dietary road’ for decades to follow”, said Dr. DiNicolantonio, of Ithaca College, New York, writing in the BMJ journal Open Heart. “This stemmed from the belief that since saturated fats increase total cholesterol (a flawed theory to begin with) they must increase the risk of heart disease.”

Dr. DiNicolantonio believes the switch away from fat towards carbohydrates has harmed public health. He suggests the rise in high-carb diet is responsible for the increase in diabetes and obesity epidemic in the US.

The best diet to boost and maintain heart health is one low in refined carbohydrates, sugars and processed foods, he recommended.

MY TAKE:
What Dr. DiNicolantonio is saying is nothing new. It is common knowledge in the world of nutrition that the studies on cholesterol were flawed. What is new is that someone in the field of cardiology is finally admitting what most of science and health care has known for 30 years. He is a very brave man to buck the establishment and should be applauded.

After thirty years of low fat diets the rate of heart attacks should be dropping in this country, not skyrocketing. In truth, more than 50% of people suffering their first heart attack have normal or even low cholesterol.

The cholesterol myth is all about statin drugs, the most commonly written prescription in the world. Currently 49% of Americans over the age of 60 take statin drugs. With the new guidelines that number is estimated to become 49% of Americans over the age of 45. The American Heart Association (AHA) and the American Cardiology Association (ACA) have both advocated adding statin drugs to our drinking water. That is the level of dogma that Dr. DiNicolantonio references.

THE BOTTOM LINE:
Fats are essential to health. Feel free to eat butter, eggs, cheese, and animal fats as part of a balanced, healthy diet. Just remember to have two servings of fruit and five servings of vegetables in the mix. Quit obsessing over your cholesterol readings and take a look at your waistline. Reduce those refined carbohydrates and processed foods.

New Recommendations for Statin Therapy

Harvard professors claim the new online cholesterol calculator is flawed and overstates a person’s risk of heart disease.
Monday, November 18, 2013

The new guidelines were developed by the American Heart Association (AHA) and the American College of Cardiology (ACC).

Under the new guidelines, people will be advised to take statins based on a number of different health risk factors. These risk factors include if they already have heart disease, if their LDL cholesterol is extremely high (180mg/dl) or if they’re middle aged with type 2 diabetes.

In addition, people between 40 and 75 years of age with an estimated 10-year risk of heart disease of 7.5% or more are advised to take a statin. Experts say this new rule could greatly increase the number of patients who will now be advised to take these drugs.

MY TAKE:
Forty-nine percent of Americans over the age of 60 currently take statin drugs. Statins are the most commonly written prescription in the United States. Statistically, statin drugs reduce the risk of sudden heart attack by one third. That seems like pretty compelling evidence to support statin use. However, the risk of sudden heart attack is only three percent and statin drugs reduce it all the way down to two percent. That’s a whopping decrease of one percent! Furthermore, more than half the population’s suffering their first heart attack have normal or even low cholesterol. The ACC has countered that statistic by suggesting that statin drugs should be added to our drinking water so everyone will be treated.

Statin drugs work (when they work) because they reduce inflammation, not because they lower total cholesterol and LDL cholesterol. In fact, the disruption of cholesterol metabolism by statin drugs causes cardiac myopathy (heart muscle disease) in ten percent of patients. Cholesterol is the raw material necessary for the body to create sex hormones, vitamin D, and a host of other complex chemicals needed for the body to function properly.

The most common cause of high cholesterol is an excess of saturated fat and trans-fats in the diet. Although the AHA and ACC both claim that dietary changes are the cornerstone of treatment, little or no attention to diet occurs in practice. The second major cause is an underactive thyroid. Synthroid (synthetic thyroid hormone) is the second most commonly prescribed medication in the United States. It is estimated that at least one third of cases of hypothyroidism are autoimmune in nature. Clinically, I estimate that number is closer to half of all cases. Although Synthroid alleviates some symptoms, it does not treat the underlying cause or reduce the cardiac risk associated with hypothyroidism.

The number three cause of high cholesterol is an imbalance in the flora of the digestive tract. Unhealthy bacteria can produce an estrogen analog, a chemical that resembles estrogen. The body absorbs this estrogen look-a-like and it stimulates cholesterol production. Overproduction of cholesterol from genetic flaws is the forth most common cause of high cholesterol. This can be determined by a simple blood test, the L(p)a. Elevation of the L(p)a is the only lipid blood test that does correlate with an increased risk of heart disease. The test is seldom run before placing a patient on statin drugs. Despite being genetically controlled, both niacin and gingko leaf extract have been shown to be very effective in reducing the L(p)a in several studies.

THE BOTTOM LINE:
Talk to your doctor about truly implementing a serious program of diet and exercise before resorting to statin drugs. You must be an active participant in your health care. Have through laboratory testing to include a thyroid profile, glycohemoglobin A1c, fibrinogen, homocysteine, and CRP (high sensitivity C reactive protein) in addition to the serum lipids. If you and your physician still decide you need to take a statin, add Co Q 10 to your supplements to offset some of the side effects of this drug.