July 24th, 2007 by Dr. Val Jones in News
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A provocative press release crossed my desk today, “Study Finds Association Between Low Cholesterol Levels and Cancer” with subtitle: “Benefits of Statin Therapy Outweigh Small Risk.” Well that’s fairly terrifying, isn’t it? It sounds as if they’re saying that taking a statin (like lipitor or zocor) is good for your heart but might carry with it the “small” risk of developing cancer.
First of all, let me assure you that this is a gross misinterpretation of the metanalysis. The authors themselves never postulated a cause and effect between statins and cancer, and in fact did all they could to avoid drawing this conclusion. They merely observed that there was a slight trend towards higher cancer rates among people with low LDL cholesterol.
There are two very good explanations for the higher cancer rates in people with low cholesterol:
1. Everyone knows that “unexplained weight loss” is an ominous sign. Often times a patient’s first clue that they have cancer is sudden weight loss – since cancer has a voracious appetite and steals nutrients from the rest of the body. When people lose weight, their cholesterols decrease. So it’s possible that low LDL cholesterol is really just a surrogate marker for those who already have very early stages of cancer that have not yet been detected otherwise.
2. Statins are well known to reduce cholesterol and the atherosclerotic plaques that put people at risk for heart attacks and strokes. Lower cholesterol levels can reduce overall mortality risk/year by 30%, and so people live longer when they have lower cholesterol levels. People who live longer extend their opportunity to develop cancer. And so lower cholesterol levels inadvertently raise your cancer risk simply because they may extend your life.
Why else do I think the link between cancer and statins is faulty? Because the observed increase in cancer rates was in ALL cancer types – the genetics of cancer is so complex, and the reasons why certain cell types begin to divide in an uncontrolled manner is so diverse, that it’s hard to imagine any possible trigger could stimulate all cells to become cancerous. Also, most cancers develop very slowly, and the 5 year window in which the authors observed people taking statins and developing cancers is too short to be a cause and effect. And finally, previous statin safety studies showed no link between them and the development of any form of cancer.
The Journal of the American College of Cardiology admits in an
accompanying editorial, “In the 5 years that we have been stewards of
the Journal, no other manuscript has stimulated such intense scrutiny
or discussion.” Do I think they should have published this study? Yes – but to me the most interesting question out of all of this is: could cholesterol screening be used for early cancer detection? If an extra low LDL is observed, maybe that should prompt some additional investigations to rule out occult malignancies?
Obviously, more studies are needed to determine the potential validity of such an approach… but for now, there is absolutely no reason (based on this study) to cease statin therapy for fear of developing cancer. Hope that allays some fears!This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 15th, 2007 by Dr. Val Jones in News
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I read an interesting series of articles about improving nutritional status in the US and Britain. First, the New York Times reports that trendy Manhattan bars are offering vitamin-fortified cocktails – fresh, organic fruits and/or veggies are muddled with vodka martinis to create a “healthy” alternative to your typical beverages. I’m skeptical – given the volume of fruits and veggies recommended for a healthy diet, you’d have to drink a whole lot of vodka martinis to get the vitamins you need in a day. Probably better to go for a fruit salad.
The British are still debating the utility of a “fat tax” as a way to discourage people from eating food high in refined sugar, flour or unhealthy oils. So far the government’s position is that taxing non-nutritive food is too controlling (creates a “nanny state”), and that people will just find an unhealthy alternative to the taxed foods. Interestingly, some research suggests that if all unhealthy foods were taxed, and healthy foods were made less expensive, thousands of heart attacks and obesity-related conditions might be avoided each year. However, this study has been received with much skepticism.
And a new British study also showed a surprising similarity between middle class and lower income eating habits. Both groups ate equally poorly, though the lower income group was more likely to smoke and engage in less physical activity. The similar eating habits came as a surprise, as it had been incorrectly assumed that the lower income group had a substantially poorer diet.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 2nd, 2007 by Dr. Val Jones in News
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New research suggests that people with allergies to molds, pollen, and dust mites but NOT cat dander, may have heightened asthmatic reactions to their usual triggers in the presence of cats. This is unfortunate news for cat owners or anyone who is fond of kitties but has environmental allergens. Researchers note that :
Avoidance of cat exposure would be beneficial to a much wider
population than previously expected. Furthermore, cat allergen levels
were ubiquitous in cat-owning communities, and their results showed
effects of cat allergen exposure at lower levels than generally
regarded necessary to produce a measurable result.
So basically, if you live in a “cat-owning community,” their airborne fluff will probably make your pollen and mold-induced asthma worse. Aside from declining to pet and/or play with them, I doubt that there’s much you can do to completely avoid their dander. But there is some cause for all allergy sufferers to eye cats with suspicion… time to trade in Tiger for Fido?
[View cat allergy cartoon]This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 1st, 2007 by Dr. Val Jones in News
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There’s a new trend in the pharmaceutical industry: repurposing old drugs for new indications and/or combining current drugs to create brand new effects. Recent studies suggest that two drugs (Lyrica and Neurontin) approved for the treatment of neuropathic (nerve) pain may also be helpful for improving sleep quality. And since disordered sleep is also at the root of conditions like fibromyalgia, there seems to be reason for enthusiasm. Another study suggests that Wellbutrin (an anti-depressant often used as a smoking cessation aid) could be useful for enhancing libido. Again, some cause for celebration – quit smoking AND improve your sex life with one pill? Not bad.
The New York Times describes the new trend in drug combination research – robots combine random drugs to see if together they have stronger effects on tissue cultures than they do alone. Sounds like low-brow trial and error, but companies such as CombinatoRx are betting that this approach will turn up potential therapeutic benefits at a faster rate (and at much lower costs) than the old-fashioned process of original drug research and development.
This should be handled with a healthy dose of skepticism – is combining nexium (a stomach acid reducer) and naproxen (pain medicine that can harm the stomach lining) anything more than a commercial gimmick? What about the chance finding that anticoagulants enhance the effects of inflammation-reducing steroids? Perhaps that is indeed relevant and helpful?
It’s clear that testing drug combinations has the potential to create a financial windfall for pharmaceutical companies – so the FDA will need to make sure that these new combo drugs offer real benefits over taking them separately.
Still, if you asked me where I’d rather put my research dollars – testing unusual drug combinations in Petri dishes or analyzing whether or not water has memory (a foundational principle of homeopathy), I think you know where I’d place my bet.
Go ahead and shuffle and re-deal, Big Pharma. Maybe you and the FDA will uncover something useful after all? We’ll be watching with interest and a critical eye.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 29th, 2007 by Dr. Val Jones in News
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Well, having grown up on a yogurt farm – nothing delights me more than scientific evidence that this fine dairy treat is good for your health. Hats off to my friends at the Imperial College, London who just published a study showing that elderly, hospitalized individuals may use yogurt to avert nasty bacterial infections that cause explosive diarrhea.
Yes, it’s the battle of the bugs at its best – the most common yogurt bacteria: Lactobacillus casei, L. bulgaricus, and Streptococcus thermophilus work together as pretty effective colonic bouncers for enemy bug C. difficile. In this study, elderly patients (n=57) at risk for hospital acquired diarrhea (due to antibiotic use) were given 2 small active culture yogurt drinks/day during the time they received antibiotics and for one week afterwards. Another group (n=56) was given similar drinks, but the yogurt cultures had been sterilized with heat (so there were no actual live bacteria in the yogurt).
And guess what? None of the patients who drank the live yogurt got C. difficile infections, while 9 in the other group did! That means that for every 5 elderly people in the hospital (and taking antibiotics) you could potentially save one from getting a painful gut infection.
So if grandma’s in the hospital on antibiotics, you might want to ask her doctor if she can eat yogurt. It may make the difference between a short stay and a long and unpleasant healthcare experience.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
