December 1st, 2011 by John Mandrola, M.D. in Health Tips, Research
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There was important news this month on statin drugs. As one of the world’s most effective and commonly used medications, statins provide great writing topics. Lots of people have high cholesterol–including cyclists. Lots of people are interested in avoiding our mostly deadly disease.
I’d like to tell you about a recently-published (Lancet) landmark study that should quell safety concerns over statin drugs.
The punch line after I tell you the study’s results are short and sweet. Scroll down if you wish. But first, statin drugs are misunderstood enough to warrant a little blog-like simplicity. Let’s start with some background.
A brief statin review:
Statin drugs are best known for their cholesterol-lowering properties. The notion is simple: Read more »
*This blog post was originally published at Dr John M*
September 6th, 2011 by HarvardHealth in Health Tips, Research
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Low-fat diets, move over. When it comes to lowering cholesterol, a “portfolio” diet that includes cholesterol-lowering foods such as oatmeal, nuts, and soy products is better.
Several years ago, researchers at St. Michael’s Hospital and the University of Toronto created what they called a “dietary portfolio of cholesterol-lowering foods.” It went after cholesterol by adding to a heart-healthy diet specific foods known to lower cholesterol: margarine enriched with plant sterols; oats, barley, psyllium, okra, and eggplant, all rich in soluble fiber; soy protein; and whole almonds.
In a head-to-head test against the low-fat diet traditionally recommended by the American Heart Association, the portfolio approach was the clear winner. (You can see the makeup of the test diet here.) After 24 weeks, it lowered harmful LDL cholesterol by 13%, while the low-fat diet lowered LDL by only 3%. As an added benefit, the portfolio approach also lowered triglycerides and blood pressure, and did not depress the level of beneficial HDL cholesterol. The results were published in the Journal of the American Medical Association.
What I appreciate about this study is that it Read more »
*This blog post was originally published at Harvard Health Blog*
July 3rd, 2011 by John Mandrola, M.D. in Health Tips
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The Biology of Omega-3 fatty acids: (Just a little science:)
When fish, flax-seeds or Brussels sprouts pass through the intestine, pancreatic enzymes transform the fat to free fatty acids. These acids are quickly taken up by the cells. Once in the cell, these fatty acids enter the mitochondria, endoplasmic reticulum and cytosol–places that you might recall because your mom helped you make a Cell sponge cake in 7th grade Biology.
In the cells, the Omega-3 fatty acids (ALA, DHA and EPA) exert their healthy influence in three major ways:
- in the control of chemical messengers;
- in the flux of ions—cell electricity;
- in the smoothness and health of the cell membrane.
That’s enough about cells.
How do these (good) fats help our bodies?
Omega-3 fatty acids reduce Inflammation:
–Omega-3s get in the cellular (not phone) mix and end up competing with chemicals that cause inflammation—medical people say they antagonize bioactive mediators of inflammation.
–Newly-discovered by-products of Omega-3s are important in the resolution phase of inflammation. Biochem people call these chemicals, resolvins. All you have to remember here is this: to resolve (inflammation) is heart-healthy.
–When omega-3s are incorporated into the membranes of cells they do a lot of good: things like making the membrane more fluid and less sticky. For some reason, they even block genes that induce hardening of the arteries. (Genomic effects.)
Omega-3s benefit the heart: They… Read more »
*This blog post was originally published at Dr John M*
June 8th, 2011 by John Mandrola, M.D. in Health Tips
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When cyclists find out that I am a heart doctor, they most frequently ask about cholesterol numbers.
“…My cholesterol is this…What do you think?”
“…My doctor wants me to take a statin…But I read that these drugs might lower my functional threshold power 2.014 watts/40km.”
All this focus on numbers saddens me. Remember, I am a forest guy, not a tree guy. What’s more, as a doctor that revels in the adrenaline rush of ablating rogue circuits with technology that would impress even a twenty-something, I find questions about biochemistry dreary–like eating quinoa.
I wish folks would ask me about how to terminate AF with a catheter, or how an (evidenced-based) ICD saved a mom’s life, or perhaps even this: “Do you do heart surgery?”
But more often than not people want to know about cholesterol.
Okay. It just so happens that this week brought some very interesting news concerning the treatment of abnormal cholesterol lab values. News that big-picture docs have to like. Read more »
*This blog post was originally published at Dr John M*
April 25th, 2011 by PeterWehrwein in News, Research
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Baseball fans have the Baseball Prospectus annual. Political junkies can get their fix from Nate Silver’s 538 blog.
For those of us with geeky interest in health and medicine statistics, graphs, and charts, the Health, United States, 2010 report from the National Center for Health Statistics is that kind of treat. The 41 charts and graphs and 148 trend tables in the 2010 report (it’s dated 2010 but was released earlier this year) could keep me happily occupied for hours.
One graph that really caught my eye shows the percentage of Americans that take a statin. Statins are prescribed mainly to lower “bad” LDL cholesterol, but they may have other benefits, too. The statins include atorvastatin (sold as Lipitor), rosuvastatin (sold as Crestor), and simvastatin (sold as Zocor but also available as a generic ).
Here is the graph I am talking about:
Many Americans take statins. No surprise there. But half of men, ages to 65 to 74, and 39% of women, ages 75 and older—that’s pretty stunning. Read more »
*This blog post was originally published at Harvard Health Blog*
