Tag Archives: obese

New Warning on Statins and Safe Alternatives

The FDA has come out with new warnings on statin medications.  The more we learn about these drugs, the clearer it becomes they are far over prescribed as the risk outweighs the benefit in many people who are taking them.

Read the transcript:

Hi everybody, this is Dr. Court bringing you another 90 Seconds of Knowledge. Today we’re going to talk about statin medications. This is the most popular class of drugs in the US and people use it to lower their cholesterol levels. And, potentially, although the evidence is not very good, reduce the evidence or the occurrence of heart disease.

Yesterday the FDA’s come out without new warnings. Number one, statins can potentially cause memory loss, confusion and other cognitive deficits. This may take a few weeks or a few years to manifest, and I’ve actually seen this in my patients. We get them off the statins and they do very well. Their cognitive abilities come right back so, it is apparently reversible.

The other warning is it does increase the risk of diabetes. It increases the risk of diabetes pretty significantly. It actually increases it by 27%. That’s a problem because diabetes significantly increases the risk of heart disease, the very thing that statins are supposed to protect us against.

It also increases HA1C or hemoglobin A1C. So, what that means is it prevents you from controlling your blood sugar very well, which is a big problem.

So, if we can’t use statins, what do we do?  Well, first diet and exercise. Those are the biggies. That’s really where we should focus. But if we do need some additional assistance there are some natural substances that work very well. Red yeast rice is one that is a natural statin. It is not without side effect. It is very much lower in side effect anyway, but you should always take CoQ10 when you’re taking any kind of statin whether synthetic or natural like red yeast rice.

There is niacin. Niacin works very, very well. Good old B3. It works exceptionally well. It lowers LDL’s. It lowers total cholesterol. What we want to focus on is the LDL.  And it also lowers lipoprotein A, a very dangerous, particular kind of cholesterol.

There are plant sterols. Plant sterols act by binding up the cholesterol that we eat and preventing us from absorbing it. There are medications that do that but the plant sterols are something that you can buy over the counter.

And then, of course, good old fish oil. We can’t talk about it enough. Fish oil has so much benefit. It reduces cardiovascular disease mortality better than anything. And, it reduces sudden cardiac death by 90%. It’s very, very effective. So, if you do one thing, take some fish oil.  Those are your options. The statins are still out there and they do have side effects but some of the natural options tend to have a lower side effect profile.

If you have any questions, let us know. We’ll be happy to answer them.

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See Where America Stacks Up In Life Expectancy

graph of female vs. male life expectancy at bi...

Image via Wikipedia

The U.S. is lagging behind other high income countries in life expectancy despite spending more on health care than any other country.

A new report from the National Research Council finds that Americans can expect to live shorter lives than in other industrialized countries.  They council blames two things – smoking and obesity.

The popularity of smoking has gone way down in the last 20 years, but it was very popular from the 50’s and into the 80′.  The effects of smoking are not realized until much later in life and we are seeing now that it is affecting the life expectancy of the baby boomer generation and beyond.

The other factor, obesity, is an obvious one.  The U.S. has the third highest obesity rate in the world. Over two-thirds of Americans are overweight or obese.  The only countries with higher rates of obesity are Kiribati and American Samoa.

See the list below and where the U.S. falls in life expectancy.

Women

Australia 83.78
Canada 82.95
Denmark 80.53
England and Wales 81.73
France 84.39
Italy 84.09
Japan 85.98
Netherlands 81.89
Sweden 82.95
United States 80.78

Men

Australia 79.27
Canada 78.35
Denmark 76.13
England and Wales 77.46
France 77.43
Italy 78.62
Japan 79.20
Netherlands 77.63
Sweden 78.92
United States 75.64

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Fast Food Chains To Offer Statins With Their Meals?

Below is a blog post from cnn.com.  It simply amazes me that a peer reviewed journal would suggest that fast food companies offer statins with their meals to offset their horrible health effects.  See my comments at the end of the article.

CNN Blog Post

A new report in the American Journal of Cardiology suggests that fast food restaurants should offer statins – a popular class of cholesterol-lowering medications – alongside their unhealthy food.

“We propose that the fast food industry is well placed to offer advice and supplements to counteract the cardiovascular harm arising from the foods they purvey,” the report said. “These companies already have an infrastructure for providing a variety of condiments… A generic statin could be added to the panoply of items in the self-service tray at little additional cost.”

The study – which likened taking a statin before eating to putting on a bike helmet before biking – was based on analyses of other scientific studies, and concluded that taking the drugs could offset the risk of eating fast food just enough to render the food harmless.

“Most of the primary prevention statin regimes we examined, with the exception of pravastatin, had the strength to counteract the increase in risk caused by an unhealthy diet; or eating an additional 36 g[rams] of total fat or 2.8 g[rams] of trans fat per day – approximately equivalent to a Quarter Pounder with cheese and a small milkshake,” the British researchers said in the study.

But Dr. Ralph Sacco, president of the American Heart Association, says that not only isn’t the solution that simple, it could be dangerous.

“There are other things regarding obesity that are important that a statin won’t neutralize, such as diabetes and high blood pressure,” Sacco said. “Even though we agree statins have a lot of good evidence in reducing cardiovascular and stroke risk, there are certain risks with any medications.”

The risks are relatively infrequent but include liver damage, muscle cramps and long-term muscle damage.

The British researchers concluded that the risks of eating fast food are much greater.

“Statins have been shown to be safe even at high doses,” the report says. “The documented safety record of statins is substantially better than that of fast foods, which carry not only direct cardiovascular risks, but other risks due to obesity.”

But regardless of whether the benefits do in fact outweigh the risks,  Sacco says there are far better ways to reduce the negative effects of obesity.

“If you can control it with diet and exercise, that would be our preference rather than having to take a medicine.”

Dr. Court’s Comments

This is perhaps the most ridiculous recommendation I have ever seen from a mainstream medical publication.  They are suggesting that fast food chains offer cholesterol lower medications, called statins, with their meals to offset the negative health effects they have on human physiology. This is the pinnacle of not taking responsibility for one’s health.  Why take responsibility if you can take a pill to supposedly offset the detriments to your health from eating the most unhealthy foods in the world?

Statin medications are not as safe as Big Pharma would like you to believe. Statins are HMG-CoA reductase inhibitors, that is, they act by blocking the enzyme in your liver that is responsible for making cholesterol (HMG-CoA reductase). The fact that statin drugs cause side effects is well established—there are now 900 studies proving their adverse effects, which run the gamut from muscle problems to increased cancer risk.

For starters, reported side effects include:

  • Muscle problems, polyneuropathy (nerve damage in the hands and feet), and rhabdomyolysis (a serious degenerative muscle tissue condition)
  • Anemia
  • Acidosis
  • Sexual dysfunction
  • Immune depression
  • Pancreas or liver dysfunction, including a potential increase in liver enzymes
  • Cataracts

These side effects hardly seem harmless and to give them as an option with your value meal from McDonald’s is outrageous.  It is a great marketing ploy by the pharmaceutical industry to get as many American’s on statins as possible.  Think about it.  Wouldn’t this kind of strategy significantly increase sales of statin drugs?  Of course it would.  And where do we start and stop giving them to people.  Does a 3 year old eating a happy meal get a statin to go with it?  What about people who are already taking statins?  Do they just take extra because you really never can get to much medication can you?  The slope is a slippery one and I cannot believe this has even been suggested.

I was happy to see the president of the American Heart Association take the other side of this story.  He mentions that statins do nothing to offset the other health complications of fast food like diabetes and high blood pressure.  This is true.  You can’t take a statin to avoid diabetes.  What he doesn’t mention is the fact that those kinds of food – food high in refined sugar – are notorious for raising inflammation in the body.  When you raise inflammation you raise the risk of heart disease, stroke, cancer and osteoporosis to name just a few.  You can’t control inflammation by taking a statin.  Some new research does suggest that statins lower one of the inflammatory enzymes called CRP.  But that’s just one.  There are others that are still detrimental to one’s health.

This kind of a recommendation is dangerous.  Period.  It is also irresponsible for the American Journal of Cardiology to publish such information.  It plants a dangerous seed.  This kind of a recommendation encourages people to continue to make poor decisions regarding their diets.  It gives them an excuse to continue to destroy their health under the pretense that they are offsetting their bad decisions with a pill.  Instead, we should be encouraging people to make healthier choices regarding their diet and lifestyle.

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4 Simple Ways To Help You Lose Weight

One of the major health issues facing Americans today is obesity.  As a matter of fact more than two thirds of Americans are overweight or obese.  In my clinic we see lots of people who simply want to lose weight and get healthy.  While every case is a little different there are several things that you can do that will greatly improve your chances of losing weight and certainly get you feeling better.  Below I’ve listed somethings that are critically important in our program for people to get fit and most importantly, stay there.

1. Increase Your Activity Level With Exercise

This one seems like a no brainer, but when I talk to people about exercise I find that they don’t really understand what is necessary for them to actually see results.  I always ask people what they do for exercise.  For women, one of the standard answers is, “I have a young child at home and that gets me plenty of exercise.”  For men, a standard answer is, “My job is very physical so I don’t need to exercise.”  Other general answers patients give me for the dreaded exercise question include, “I walk to dog every day,” or “I like to garden on the weekend,” or “I don’t have time to exercise.”

Now, I can certainly appreciate that taking care of a young child can be fatiguing.  I can also understand that a physical job like construction is taxing.  I also know that walking the dog and gardening might seem like exercise, but if we examine these a little closer we will see that they do not qualify as exercise unfortunately.

Taking care of a young child and a job in construction are something that must be done every day (or almost every day).  At one point both of those might have burned you enough calories to qualify as an increase in your activity level.  However, after doing these things over and over again, your body figures out a way to to expend the least amount of energy possible while still performing those tasks.  This means that they no longer qualify as “exercise.”  Take this example.  If you went to the gym and you wanted to start getting in shape you might start by running on the treadmill.  You might start my running just a single mile.  Over time this single mile would no longer be difficult for you and would no longer qualify as exercise or produce the results you are looking for.  The same principle applies to your daily activities.

So to see the results you want, you must include exercise into your activities.  You don’t need to exercise every single day but at least several times per week.  Patients often tell me there is no time in their day for this.  The fix for this is simply that you must make the time.  No magic solutions for that one.

The exercises that I like people to include are weight training with high intensity interval training for cardiovascular health.  Weight training has many benefits.  It raises the amount of calorie you burn when you are at rest, it improves strength which reduces injury and it helps keep bones healthy and strong.  The high intensity interval training is cardiovascular work mostly using your body weight for resistance.  Often times this work is no more than a single 8-10 minute session after a weight training session.  The benefits are well studied and the shorter duration work out is equivalent to much longer workouts that are purely cardiovascular in nature.

2. Improve Your Diet

Again, this one sounds so simple, yet when done incorrectly will lead to poor results.  I always recommend that people reduce carbohydrate in their diet.  For a jump start I generally recommend that people get no more than 20-40 grams of carbohydrate per day.  For a little perspective on that, a single slice of whole wheat bread has about 15 grams of carbohydrate in it.  I also recommend that they get ketone strips from the local pharmacy.

Ketones are a by product of fat metabolism.  When you are exclusively burning fat for energy (as opposed to sugar) ketones will be excreted into your urine.  You may test this with ketone strips.  Simply pass them through a stream of urine several times per day and compare the color coded strip with the reference chart of the bottle.  You will want to see a trace to small amount of ketones.  This ensures that you are burning your body stores of fat for energy.

A diet low in carbohydrate will also help you gain control of a hormone called insulin.  People who have diets high in carbohydrate over produce insulin.  This is problematic because insulin is a storage hormone.  It causes your body to store energy in the form of fat.  Obviously if you produce too much of this hormone you will tend to store fat very easily.  Insulin is released in response to carbohydrate in your diet.  Reduce the carbohydrate and you reduce your fat storing hormone!

As a side note, continually over producing insulin will lead to diabetes and all the health complications associated with it.  Do not take insulin over production lightly.

3. Take Fat Burning Supplements

Many supplements tout their ability to lose weight for you.  No supplement will lose the weight for you.  To do that you will have to do the first two steps above.  There are, however, supplements that will help you lose weight.

One great example is something called carnitine.  It is available from many sources.  It works because carnitine is necessary for the body’s cells to transfer fat into the mitochondria.  This mitochondria is the power house of each cell.  It is what produces energy so the cell can keep up with it’s daily activities.  In order for it to burn fat it needs carnitine.  It is simple to take and is available in capsule form.  It is also very safe, unlike many other weight loss supplements.

Y0u may also benefit from taking supplements to stabilize blood sugar and reduce insulin production.  These are available through reputable supplement companies and I would urge you to see a doctor that specializes in functional medicine to find these types of supplements.

4. Check Your Thyroid

The thyroid can be thought of as the thermostat on the metabolism.  If it is under active your metabolism will be under active as well.  This means you will tend to gain weight very easily among other symptoms like lethargy, insomnia and general low energy.  Checking the thyroid is simple to do through a blood test.  I routinely check my patients on it.

There are several things to look for.  Many times physicians will order something called a TSH or thyroid stimulating hormone.  TSH is a brain hormone that tells the thyroid to secrete it’s hormone.  TSH is inversely proportional to thyroid function.  That means that the higher the TSH the lower your actual thyroid function is.  The reference ranges for most labs for TSH are 0.30-5.0.  This range is far too large.  A more appropriate range is actually 0.3-3.0.  In my practice if a patient’s TSH is above 2 I like to treat them and help them optimize thyroid function.  Other things that need to be checked are the actual thyroid hormones called T3 and T4.  Sometimes those are low, but the TSH is normal.  If the only test ordered is a TSH you might miss the fact that your thyroid is under active.  I also like to see something called the thyroid antibodies.  Sometimes people have antibodies to their own thyroid which reduces its effectiveness.

This list is by no means all inclusive.  It does, however, provide you and insight into the first few steps that go through my mind when someone asks for my advice in helping them lose weight.  We have been very successful in helping people get fit and achieve their weight loss goals.  It is not something that can be done for you, but the reward for achieving your goals is a great one.

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High Cholesterol? Go Nuts!

The article below is from the NY Times.  See my comments at the end of the article.

NY Times Article

Eating about two and a half airplane snacks’ worth of nuts every day helps lower total cholesterol and “bad” LDL cholesterol, and improves the ratio of total cholesterol to “good” HDL cholesterol, a study reports.

Researchers pooled the results of 25 clinical trials that involved 583 participants over all. The study reported that eating just 2.4 ounces of nuts of any kind was associated with declines of 10.2 milligrams per deciliter in bad cholesterol, a drop of about 7.4 percent, and 10.9 milligrams in total cholesterol, or 5.1 percent.

The study, which appeared in the May 10 issue of Archives of Internal Medicine, was partly financed by a nut-industry foundation, and two of the authors receive research money from other organizations representing the nut and peanut industries.

But the authors noted that some of the trials they analyzed had no corporate financing, yet came to similar conclusions.

“Nuts are rich in unsaturated fats, and that is a main driver in lowering cholesterol,” said the lead author, Dr. Joan Sabaté, a professor of nutrition at the School of Public Health at Loma Linda University in California. “They are the richest source of protein in the plant kingdom, and they also contain fiber and phytosterols, which compete with cholesterol to be absorbed. All these nutrients have been demonstrated to lower cholesterol.”

The effect was most pronounced among people with higher LDL cholesterol to begin with and among those who were not obese. The more nuts they ate, the greater the effect.

Dr. Court’s Comments

This is great information to get out there.  We have all seen those commercials touting cereal as a way to lower cholesterol.  I have never been a fan of that because telling people to eat cereal to lower their cholesterol is a slippery slope.  There are a lot of consumers in this country who cannot or do not make the distinction between Coco Puffs and a high fiber, whole grain cereal that could potentially be good for you.

While some very basic cereals, like steel cut oats for example, may be good for you in moderation, the vast majority of cereal out there is a major contributor to obesity and high cholesterol in this country.  Oatmeal, in some studies, has been shown to mildly lower cholesterol levels when eaten every day for two months, but I don’t advise that my patients eat oatmeal frequently.

I do, however, recommend that my patients consume nuts as often as possible.  This new research gives me another reason to tell my patients to go nuts!  The greatest thing about this is that the results showed that the more nuts people consumed the better they did!

The study has some weaknesses.  For one it was financed partly by the nut industry.  However, almost all studies done on pharmaceuticals are funded for the most part by the pharmaceutical industry itself.  Despite that fact we are supposed to take what we see and hear about those studies as gospel.  In my opinion this study would be a little more substantial if it were not funded by the nut industry, but the results seem reasonable and from my experience as a clinician it makes sense.

Secondly, they did not delineate what type of nuts people should be eating.  For my patients I recommend that people consume all nuts with the exception of peanuts.  Peanuts are highly inflammatory and contain a mold toxin called aflatoxin that can cause a litany of health issues.  Almonds, cashews or walnuts are all better options.

The moral of the story is eat as many nuts as you can.  They are great as snacks or as an addition to a salad.  I eat them as often.  The best way to make sure you get them in is to buy them in bulk and have them on hand where ever you are.  Buy a bag for the house and one for work and keep them there.  They stay fresh for a very long time when properly stored and provide a great boost of energy, are loaded with vitamins and mineral and now help you lower your cholesterol.  It’s a miracle food!

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