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Javier E

New Alternatives to Statins Add to a Quandary on Cholesterol - The New York Times - 0 views

  • “We’ve reached a point where patients are increasingly facing five- and six-figure price tags for medications that they will take over the course of their lifetimes,” said Matthew Eyles, an executive vice president for America’s Health Insurance Plans, the national trade association for the insurance industry. “If this is the new normal to treat common and chronic conditions, how can any health system sustain that cost?”
  • Doctors with patients who maintain they are intolerant to statins say they are confronted with a clash between the art and the science of medicine.
  • Dr. Peter Libby, a doctor and researcher at Brigham and Women’s Hospital in Boston, said that in his role as a physician, “the patient is always right.” But, he added, “as a scientist, I find randomized, large-scale, double-blind studies more persuasive than anecdote.”
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  • The statin trials, which involved tens of thousands of people, found no more muscle aches, the most common complaint, in patients who took statins than in those who took placebos.
  • The widely held belief that statins affect memory also has not been borne out in clinical trials, said Dr. Jane Armitage of the University of Oxford. She and her colleagues studied memory problems in 20,000 patients randomly assigned to take a statin or a placebo. “There was absolutely no difference,” she said.
  • In a separate study, they looked at mood and sleep patterns and again found statins had no effect. Another study, in Scotland, detailed cognitive testing of older people taking statins or a placebo, and also found no effect.
maxwellokolo

Are Cholesterol-Lowering Statins Associated With Reduced Alzheimer's Risk? - 0 views

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Javier E

This Is Your Brain on Gluten - The Atlantic - 0 views

  • that’s how you get on the bestseller list. You promise the moon and stars, you say everything you heard before was wrong, and you blame everything on one thing. You get a scapegoat; it’s classic. Atkins made a fortune with that formula. We’ve got Rob Lustig saying it’s all fructose; we’ve got T. Colin Campbell [author of The China Study, a formerly bestselling book] saying it’s all animal food; we now have Perlmutter saying it’s all grain. There’s either a scapegoat or a silver bullet in almost every bestselling diet book.”
  • The recurring formula is apparent: Tell readers it’s not their fault. Blame an agency; typically the pharmaceutical industry or U.S. government, but also possibly the medical establishment. Alluding to the conspiracy vaguely will suffice. Offer a simple solution. Cite science and mainstream research when applicable; demonize it when it is not.
  • “It makes me sad that somebody like you is going to reach out to me, so you can get what I’d like to think are sensible comments about a silly book. If you write a sensible book, which I did—it’s called Disease Proof , and it’s about what it really takes to be healthy, brain and body—nobody wants to talk about that. It has much less sex appeal. The whole thing is sad.
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  • “Is there a weight of evidence that says we can totally ignore both dietary cholesterol and LDL? Absolutely not,” he said. “You can legitimately say we’re starting to rethink some things, but ignoring LDL could absolutely result in heart attacks and strokes.
  • The medical community’s understanding of the danger of cholesterol is changing. Many cardiologists are starting to think that independent of other considerations, the level of LDL in our blood may not be as important as it previously seemed.
  • In November, the American Heart Association and the American College of Cardiology released new guidelines that redefined the use of statins. While they continue to recommend that people at high risk for heart disease and people with LDL levels above 189 take a statin, the long-standing goal of lowering one’s LDL level to 70 is no longer deemed worthwhile to monitor.
  • Katz acknowledges that dietary cholesterol may be an innocuous part of an overall healthy diet. “The problem is that people are going to get their dietary cholesterol from things other than fish and eggs; they’re going to get it from meats and dairies. The problem with diets like that is if you eat more of A, you’re probably going to eat less of B. So people who are eating more meat and dairy and high-fat, high-cholesterol foods are eating fewer plants—they’re not eating beans; they’re not eating lentils. So yes, I think it’s entirely confabulated and contrived, and potentially dangerous on the level of lethal.”
  • Having talked to all of these people and read their work, here is how I walk away from this. Oxidative stress will increasingly be the target of medical treatments and preventive diets. We’ll hear more about the role of blood sugar in Alzheimer’s and continue to focus on moderating intake of refined carbohydrates. The consensus remains that too much LDL is bad for you. We do not have reason to believe that gluten is bad for most people. It does cause reactive symptoms in some people. Peanuts can kill some people, but that does not mean they are bad for everyone
  • I agree with Katz that the diets consistently shown to have good long-term health outcomes—both mental and physical—include whole grains and fruits, and are not nearly as high in fat as what Perlmutter proposes.
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