LifeCare Chiropractic

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Cholesterol

April 5, 2000 Research Update

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Here is yet another example of the poor quality of many nutritional products…

Among 25 major brands of supplements containing glucosamine and/or chondroitin used for treating osteoarthritis, nearly one third were found not to contain all labeled ingredients. These results were reported by ConsumerLab .com, which conducts the largest independent analysis of dietary supplements sold in the United States. More alarming, almost half (6 of 13) of the glucosamine-chondroitin combination products tested did not pass — all due to low chondroitin levels. Similarly, the 2 chondroitin-only products tested did not pass. In contrast, all 10 of the glucosamine-only products tested passed. One possible explanation for the low pass rate for chondroitin-containing products is economic — chondroitin costs manufacturers approximately 4 times as much as glucosamine.

A drug used for Crohn’s and Ulcerative colitis may be strong cause of birth defects when taken by the male. If only these parents knew that there are many non-pharmaceutical methods to handle these diseases.

Paternal use of 6-mercaptopurine shortly before conception may be linked to the development of “startling” congenital deformities, according to findings reported in the March issue of the American Journal of Gastroenterology.

New vaccine for pneumococcal disease, including ear infections. Now, before you go run out and get your little one vaccinated, consider how many drugs and vaccines are pulled off the market for safety reasons in their first few years. Let someone else be the guinea pigs..

A study published in the March issue of The Pediatric Infectious Disease Journal confirms that a newly approved vaccine is at least 90% effective in preventing invasive pneumococcal disease in young children. The study also shows that the vaccine, Prevnar, reduced common ear infections by 7%, multiple ear infections by 23%, and the need for ear tubes by 20%.

Major increases in asthma in our children. Could it be the poor diets? The poor quality air? The extensive use of antibiotics when they are not needed?

The prevalence of asthma-associated disability in US children has more than doubled since 1969, according to a report in the March issue of the Archives of Pediatric and Adolescent Medicine. They found that the prevalence of disabling asthma in children has risen 232% since 1969.

Or maybe it’s Tylenol use?? Thorax — Abstracts: Shaheen et al. 55 (4): 266

Yet another marker for heart disease that will go unnoticed for DECADES before someone decides it may be a good idea. Cholesterol levels is not becoming outdated, they ARE ALREADY outdated.

Our current study disclosed that RLP-C (remnant-like particle cholesterol) levels are strongly associated with coronary artery disease, especially in patients with normal total cholesterol levels. Moreover, RLP-C/HDL-C ratio may be even more significantly associated with the presence of coronary artery stenosis in normocholesterolemic patients. Am Heart J 139(2):305-310, 2000.

 

Research Update (April 2, 2000)

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Yogurt as a health food that can stimulate the immune system? There is very strong evidence that the probiotics in yogurt have numerous health effects. AJCN — Abstracts: Meydani and Ha 71 (4): 861

Soy can lower cholesterol. Not new news, but always nice to see further evidence backing it up. Watch out for the side effects, though: lower risk of breast cancer, endometrial cancer, prostate cancer, eases menopausal symptoms, may help with osteoporosis… AJCN — Abstracts: Normén et al. 71 (4): 908

Another study showing that whole grains can protect against diabetes. Won’t see this evidence from Dr. Atkins book… AJCN — Abstracts: Meyer et al. 71 (4): 921

Silica may prevent aluminum absorption, and aluminum has been linked to many health problems, including Alzheimer’s. AJCN — Abstracts: Jugdaohsingh et al. 71 (4): 944

Some people worry about the caffeine and tannins in tea effecting calcium absorption. My advice is usually not to worry about it because somehow things work out because nature somehow puts everything together right. Here’s evidence of tea protecting against osteoporosis. AJCN — Abstracts: Hegarty et al. 71 (4): 1003

This is scary…the incidence of diabetes is increasing in kids. The name “adult onset” has been dropped because too many kids are getting the disease. This is definately a result of kids eating such processed foods with no nutrition.

Diabetes Care 23(3):381-389, 2000 If the incidence and prevalence of type 2 diabetes in children are increasing and if this increase cannot be reversed, our society will face major challenges. That is, the burden of diabetes and its complications will affect many more individuals than currently anticipated, and the cost of diabetes to our society will cause us to consume enormous resources. Also, many more Americans will be taking potent medications, which have attendant risks, for most of their lives.

More bad news. It is becoming increasingly evident that the drugs commonly used to treat diabetes MAY ACTUALLY PROMOTE THE DISEASE. The reason? Certain drugs stimulate the pancreas to produce insulin (secretagogues), but it also produces a protein called amyloid, which can damage the pancreas itself. But don’t worry, they suggest using a relatively new drug called troglitazone (Rezulin).

South Med J 93(1): 24-28, 2000. We may wish to rethink our current methods of treating type 2 diabetes. We must ask whether we should allow this hyperinsulinemia/hyperamylinemia state to continue or even complicate matters by using insulin secretagogues, thus increasing endogenous insulin and amylin.

Oops… that new drug they’re recommending? The FDA pulled it because it has some strong links to liver failure… But never fear, nature to the rescue. Troglitazone is a PPAR agonist. So is congugated linoleic acid (CLA), an essential fatty acid with no side effects.

The diabetes drug troglitazone (Rezulin) was withdrawn from the market on Tuesday following a request from the US Food and Drug Administration (FDA). The drug, which lowers blood sugar in diabetics, has been linked to potentially life-threatening liver failure in some patients. An FDA spokesperson said that the drug has been linked to 63 deaths and 90 confirmed cases of liver failure. The drug has been on the US market since mid-1997, but soon after its launch, reports of liver failure emerged among patients taking the drug.

YOU KNOW YOUR CHOLESTEROL, BUT DO YOU KNOW THIS LEVEL?

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In today’s health environment, thanks to aggressive marketing by the pharmaceutical companies promoting the near godlike power of the statins to lower levels, most everyone knows where their cholesterol sits.  The reality is that total cholesterol, as a risk factor for heart attacks and cardiovascular mortality, is just short of worthless.  The more important value, however, is not known by most people.

Triglycerides have long been known to be a major player in heart disease risk.  The relationship between triglycerides and HDL (“good”) cholesterol is a key factor to look at in evaluating your risk.  Ideally, a ratio of 2:1 or less is desirable.  There are only a handful of patients I have seen where the triglycerides are close to or even lower than the HDL levels.

There reason these levels are so important is that they are driven by our relationship between our insulin and our cells (i.e. prediabetes).  Since prediabetes and diabetes absolutely destroy our cardiovascular system you can see why this ratio is so important.

This particular study further reinforces this, finding that non-fasting levels of triglycerides were the strongest predictor of total mortality.  While non-fasting cholesterol levels were associated with risk of heart attack, the risks of high non-fasting triglycerides were much more severe.   Levels above 443 (normal fasting values should be well under 150) increased the risk of heart attack by 420% and risk of death overall by 50%.  THIS is why you need to know your numbers.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2010.02333.x/abstract

HOW DO I RAISE MY HDL (“GOOD”) CHOLESTEROL?

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Most importantly, you do not EVER, EVER, EVER (get the point…) do it with drugs.  Just ask the patients who were taking torcetrapib, a drug made by Pfizer that was designed to raise HDL levels and lower risk of heart attacks.  Wait–you can’t ask many of these patients because the risk of death was 60% HIGHER in patients taking the drug, which obviously was never brought to market.

In my dreaming, society will someday wake up and realize that modifying a single marker (called a surrogate endmarker suchas total cholesterol, HDL, LDL, HbA1c, blood pressure or uric acid) synthetically with a drug does very little to change the endpoint.  In other words, taking a drug to lower cholesterol makes your number look better, but the true impact on heart attacks and cardiac death is small.  Drugs to increase HDL will be no different.

Want to raise your HDL the better way?  Soy, exercise, niacin, red wine, dark chocolate and general healthy, anti-diabetic lifestyles will all do the trick.  Just don’t believe that a medication will do it for you safely.

http://jcem.endojournals.org/content/96/5/1246.abstract

HOW WELL ARE WE MANAGING HEART DISEASE RISK FACTORS?

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Let’s face it.  If you are willing to make changes, managing cardiac risk factors is a piece of cake (or rather…avoiding that piece of cake…).  Lifestyle changes are not difficult, but require commitment.  Society does not easily support healthy lifestyle and requires a shift from what you’ve been doing.  But the payoffs are massive for you and your family.

I continue to contend that lifestyle changes are the ONLY way to manage chronic diseases.  Maybe if we did not live under the false pretense that, because our “numbers” look better (cholesterol, HbA1c, blood pressure, blood glucose, etc…), we’ve dodged the bullet of early death.  I cannot stress enough that this is just not true.  We live in a society dominated by surrogate end markers.  We think that because our cholesterol has magically been lowered by the coveted, mystical statin that we’ve lowered our risk for a heart attack or stroke.  Ok–so maybe you have, but only by a SMIDGEN (which, in medical terminology, is about 1%).  This is NOT prevention, it is false hope.  Lifestyle changes, on the other hand, have true global health benefits that are unquestionable.

This particular study just reinforces how pathetic “we” are when it comes to cardiac risk factors.  We can’t even do it right using drugs!  In shooting for lower LDL levels AND optimal CRP levels (a marker of inflammation) only 12% of the patients in this large study managed to achieve the desired numbers.  You will hopefully note that they were looking at LDL levels and not total cholesterol.  Hopefully, we are finally abandoning the futility of checking total cholesterol in lieu of better markers.

The authors’ suggestions?  “Smoking cessation, weight reduction, and the greater use of more potent statins at higher doses might be able to improve these outcomes.”  We just don’t get it.  It’s almost laughable how sickeningly dependent we have become on medication to “protect” our health.  Even with a society heavily dependent on meds, we still can’t get 88% of the population to target levels.

http://www.sciencedirect.com/science/article/pii/S0002914911004632