Interesting items from my inbox and elsewhere …
Yup, according to this article about a Harvard study, even more people should be on statins:
A new study from Harvard T.H. Chan School of Public Health researchers has found that it would be cost-effective to treat 48-67% of all adults aged 40-75 in the U.S. with cholesterol-lowering statins. By expanding the current recommended treatment guidelines and boosting the percentage of adults taking statins, an additional 161,560 cardiovascular-related events could be averted, according to the researchers.
Well, why the heck stop at 67 percent? The way these guidelines keep expanding the definition of “at risk,” you’ll soon be considered at risk for a heart attack the day you’re born. Best start adding statins to baby formula just to be sure. I’m reminded of something Dr. Malcom Kendrick wrote in his terrific book Doctoring Data:
The boundaries that define illness have narrowed inexorably. When I first graduated from medical school in 1981, a high cholesterol level was anything above 7.5 mmol/L. Over the years, this level has fallen and fallen to the point where a ‘healthy’ level is now 5.0 mmol/L. I suspect it will soon be 4.0 mmol/L. Anything above this figure, and you have an increased risk of heart disease – allegedly. Considering that over 85% of the adult population in the western world has a cholesterol level higher than 5.0 mmol/L this is a quite amazing concept. I will admit that I have never been that brilliant at statistics. However, it seems to me that attempting to claim that more than 80% of people are at high risk of heart disease stretches the concept of ‘average’ to the breaking point – and well beyond.
Back to the article about the Harvard study:
“We found that the new guidelines represent good value for money spent on healthcare, and that more lenient treatment thresholds might be justifiable on cost-effectiveness grounds even accounting for side-effects such as diabetes and myalgia,” said Ankur Pandya, assistant professor of health decision science at Harvard Chan School and lead author of the study.
Yeah, what’s a little muscle pain, memory loss or diabetes when you might reduce your risk of a heart attack by teensy-weensy percentage?
They also found that the optimal treatment threshold was particularly sensitive to patient preferences for taking a pill daily, which suggests that the decision to initiate statins for primary CVD prevention should be made jointly by patients and physicians.
When your physician sits down with you to make that joint decision, I suggest you give the answer I gave when a doctor suggested a statin for my (ahem) “elevated” cholesterol:
“I wouldn’t take a statin unless you held a gun to my head and I was convinced you’d pull the trigger.”
Fat makes you feel full … and makes you fat … and … say what?
Pronouncements by nutritionists often make me want to bang my head on my desk. Others just leaving me scratching my head in wonder. A reader sent me a link to an article about avocadoes which includes this gem from a nutritionist:
As with many other fruits, avocados’ primary risks are related to overconsumption. “Consuming too many avocados may lead to weight gain because of the fat content, even though it is an unsaturated fat,” said Flores. “It can also lead to nutritional deficiencies, since fat is digested slower and leaves you feeling fuller longer than [do] other nutrients.”
Go ahead, try to wrap your head around that one. I double-dog dare ya. In just two sentences we learned that 1) fat makes you feel full longer than other nutrients, but 2) fat also makes you fat. So I guess the key to weight loss is to eat foods that don’t make you feel full. Oh, and 3) feeling full leads to nutrient deficiencies.
Uh … uh … because you stop eating before you eat enough to get your nutrients? But then you gain weight?
I’m starting to think every time a nutritionist leaves a crowded room, the average IQ goes up by at least 10 points.
Soy sorry about the soybean oil.
Somebody get Paul Newman on the phone and convince him to change the formula for those Newman’s Own salad dressings. A new study reported in an online article suggests soybean oil induces weight gain:
Sugar has been blasted in recent years for its link to obesity and a slew of health problems, but now experts say the food world has a new problem child: Soybean oil.
Soybean oil, considered a “healthier” alternative to some oils that contain more saturated fat, actually leads to more weight gain than fructose, according to new research on mice that was published in the journal PLOS One.
Okay, how many scientists and health organizations have to announce that saturated fat isn’t actually bad for us before we stop seeing products labeled as “healthier” because they’re low in saturated fat? A hundred? A few thousand? All of them? Anyway …
For their research, scientists divided the mice into four groups and fed them each a different diet that contained 40 percent fat (similar to the average American diet). One diet used coconut oil (which largely consists of saturated fat), another used half coconut oil and half soybean oil (which primarily contains polyunsaturated, or “good” fat). The third and fourth diets had fructose added.
All four diets had the same number of calories, and the mice were fed the same amount of food.
Here’s what researchers discovered: Mice that were on the soybean oil diet gained 12 percent more weight than those that ate a fructose diet, and 25 percent more weight than mice on the coconut oil diet.
The mice on the soybean oil diet also had larger fat deposits in their bodies and fatty livers, and were more likely to have developed diabetes and insulin resistance. Mice on the fructose diet didn’t get off easy, either — they had similar issues, but to a less severe degree.
It’s only a mouse study, so let’s not get too excited. We can’t conclude that the effects on human beings would be the same. But here’s what I find most interesting: the ol’ calories-in/calories-out theory sure didn’t hold up in this study, did it? Yes, these are mice, but we’re told over and over that CICO is A LAW OF PHYSICS. Mice aren’t immune from the laws of physics.
Neither are humans, of course. If you gain weight, you absolutely, positively consumed more calories than you burned. But what this study demonstrated (again) is that the quality of the calories consumed affects the number of calories burned. To repeat a quote from the article:
All four diets had the same number of calories, and the mice were fed the same amount of food.
So only an idiot would believe the mice on the soybean-oil diet gained 25% more weight because of calories alone.
It could also be a matter of calories alone, certified dietitian-nutritionist Jessica Cording tells Yahoo Health. Soybean oil is a fat, and fats contain nine calories per gram, she says. However, carbohydrates such as fructose contain four calories per gram.
Every time a nutritionist leaves a crowded room …
This thing will stop your weight from ballooning?
Up, up and away …. or down, down and in your belly. A balloon is the latest, greatest weapon in the Just Eat Less! battlefront, according to this article:
The FDA has approved a gastric balloon to treat obesity, adding to a fat-busting device arsenal that includes gastric banding and a vagal nerve stimulator.
The ReShape dual balloon system is indicated for obese adults who have a body mass index (BMI) of 30 to 40, and at least one other obesity-related comorbidity such as hypertension, high cholesterol, or diabetes.
It’s placed into the stomach using an endoscope, and once it’s inflated it is meant to diminish obesity by triggering feelings of fullness, “or by other mechanisms that are not yet understood,” according to the FDA press release.
It gives me great confidence in the FDA to hear that they’re approving medical devices whose mechanisms are not yet understood. But I totally understand that “triggering feelings of fullness” method for losing weight. I feel full after my meals. But those meals don’t include sugars or grains (or soybean oil) that induce weight gain. In fact, I’ve lost weight while eating meals that made me feel full.
So what kind of dramatic weight loss does the up, up and away balloon induce?
In a 326-patient clinical trial, patients on the device lost an average of 14.3 pounds over 6 months, compared with 7.2 pounds for those in the control group.
Hmm, let’s do a little simple math here. The balloon-belly treatment group lost 14.3 pounds, while the control group lost 7.2 pounds. The trial lasted six months. Okay, hang on … subtract, divide … WOW!! That balloon was responsible for an additional weight loss of 1.18 pounds per month!
I think it would do more good if they filled it with helium and gave it a slow leak. Then people could at least sound like the munchkins from the Wizard of Oz when they say, “I walked around with an inflated balloon in my belly all month, and I only lost one extra pound? What the @#$% is the point of that?!”
Rice not nice to teeth?
This isn’t from an article; it’s from a book. When I commute to Nashville or spend five hours behind a mower cutting the back pastures, I listen to books. The one I just finished is Helmet For My Pillow, by Robert Leckie. If you saw the terrific HBO series The Pacific, Leckie was one of the marines featured. The audiobook is read by James Badge Dale, the same actor who portrayed Leckie in the series, which is a nice touch. You can listen to part of the book and then watch an episode of the series (as I did last week), and you’re hearing the same character speaking with the same voice.
Anyway, in Helmet For My Pillow, Leckie describes how after a battle, some marines would go prospecting in the mouths of dead Japanese soldiers. Why? Because at the time, Japanese dentists filled cavities with gold – and according to Leckie, some of the Japanese soldiers had a treasure of gold in their mouths. Lots and lots of cavities.
The Japanese weren’t eating lots of sugar in the 1940s – even today, the Japanese consume less than half as much sugar per capita as Americans. But they were certainly eating plenty of white rice in the years before WWII. In fact, on Guadalcanal, the U.S. navy was forced to withdraw for awhile, which left the marines stranded without a food supply. They ended up living on rations captured from the Japanese — which mostly consisted of rice.
So I’m thinking whatever its status as a safe starch, perhaps white rice isn’t so great for keeping a pearly smile.
Good thing I don’t much like the stuff.