I came across an interesting statin study the other day. It’s from last year, but I hadn’t seen it until recently. The study, entitled “Statins Do Not Decrease Small, Dense Low Density-Lipoprotein,” sought to understand the effect of statin therapy on small, dense LDL, the truly “bad” kind of “bad” cholesterol, the stuff that’s strongly associated with increased heart disease risk in many studies. We know that statins reduce LDL cholesterol – they are extremely effective at curtailing the cholesterol-synthesizing hydroxy-methyl-glutaryl-coenzyme A reductase, if you’re into that sort of thing – but their effectiveness at lowering sdLDL is unknown. They reduce the rate at which cholesterol is produced and that’s as specific as it gets.
Read MoreAn alarming new health trend has medical professionals scurrying around issuing dire warnings of impending doom and death. As a recent piece in the Wall Street Journal relays, consumers are taking their health into their own hands by foregoing expensive, redundant doctor’s visits in favor of mail order lab tests. Blood lipids, A1C, vitamin D, C-reactive protein – you can get just about any lab value tested online, no insurance required. Lipids run between $30 and $50, A1c between $25 and $40. Even people with (overpriced) insurance and high deductibles are skipping the doctor. This is part of an overall larger worldwide trend toward going it alone. The home blood glucose monitoring industry, for example, grew from $3.8 billion worldwide in 2000 to $8.8 billion in 2008.
What should we make of it?
Read MoreOverburdened doctors sure do love tangible targets, like lipid numbers. They’re easy to hit with drugs. There’s no guesswork – statins and the like actually do lower cholesterol (whether that’s helpful or harmful is the question) – and that makes a physician’s life simpler. Oh, sure, lifestyle changes work, but most patients won’t bother trying them (especially when the changes you prescribe are founded in faulty science and no fun following). Doctors can usually get patients to take a pill.
There’s yet another cholesterol-busting wonder drug on the coming horizon called anacetrapib. A recent eighteen-month trial found that it boosted HDL (from 40 to 101) 138% greater than placebo and slashed LDL (from 81 to 45) 40% better than placebo in patients already taking statins by hampering the effects of the CETP enzyme. Another potent CETP-inhibitor – torcetrapib – made similar headlines in 2006 when it boosted HDL and reduced LDL like nothing else before it, but those headlines were overshadowed when 60% excess mortality occurred in people taking the drug versus those on placebo. So far, anacetrapib seems safe enough, but I’m not holding my breath. I tend to get a little uneasy when we change a single variable and mess with enzymatic pathways in a very complex closed system, with a single goal (raise that HDL, drop that LDL!) in mind. Focusing on numbers that are largely an indication of your lifestyle without doing anything about the lifestyle itself is like pissing into the wind: quite often, it’ll splash all over you, and you’re lucky if it’s just the shoes.
Read MoreLast week I shared news from the Pharma front, specifically the latest on questionable business practices and undisclosed alliances that continue to dog the industry’s public image. Pharma, however, isn’t the only part of the health field cast in doubt these days. What would you say to a person who claimed that some 90% of medical studies were false – flawed in their parameters, riddled with basic error, skewed by presumption and bias? (No, it’s not me sayin’….) I’m talking about an insider: a highly esteemed, widely acclaimed, much admired, often cited medical researcher who has to turn down speaking engagements left and right. He’s a professional with a flair for statistics and penchant for credibility. His initial groundbreaking research (meta-research, actually) hit the medical scene years ago, but he’s still going strong and in more public headlines these days as the focus of an in-depth Atlantic Magazine feature.
Read MoreThere’s been a lot of news from the Pharma realm these last few weeks. As you all know, I make a point of passing this kind of thing along…. Given the massive role pharmaceutical drugs play in our society’s conventional health care, I like to keep on top of the developments. Speaking of “massive,” first there’s news from the National Center for Health Statistics, which released a report measuring trends in prescription drug use and cost in the last decade. Between 1999 and 2008, prescription drug use rose in all age categories, as did the number of people taking multiple prescriptions. Approximately 88% of people over the age of 60 take one or more prescription medications on a regular basis. A whopping 66% use five or more prescriptions. Not surprisingly, cholesterol-lowering medications topped the list for this age group. In those 20-59, the most popular prescription was antidepressants. In children, 22% take a prescription drug, most commonly asthma medication. In the teenage category, the number jumps to 30%, with ADD/ADHD related meds first on the list. Not surprisingly, what we shelled out for Pharma products soared as well. Already taking inflation into account, Americans in 2008 spent more than twice ($234 billion) what they did in 1999 ($106.4 billion). Against this backdrop, we also learned that two popular prescription drugs were shown to actually cause the very problems they prescribed to prevent. Telling stories and statistics, I’d say. What’s more sobering, however, are a number of recent publications that illuminate the cultural and financial underbelly of the pharmaceutical industry as a whole. I think you’ll find it thought-provoking.
Read MoreWhile preexisting conditions and required coverage have taken the main stage on the health care reform bill, many of the smaller changes hold just as much weight in the future of America’s health. These changes and additions have been largely ignored by mainstream media despite several billion dollars allocated to new preventative care initiatives.
Additionally, the bill includes some surprising fine print regulations. Most regulations won’t take effect immediately, but the sum of so many new laws and restrictions could cause major repercussions on our system over the next several years.
Finally, while the bill is certainly heavy on spending, there are several programs included to reduce overall health care costs, but such programs appear highly unorthodox on a first reading. The Worker Bees and I have combed through thousands of pages of minutiae to find nine lesser known stipulations, clauses, regulations, and programs in the new bill.
Read MoreYesterday I challenged you to estimate my body fat percentage by looking at a recent picture. To be scientific about this little exercise I chose to reference as the correct answer the results of the “gold standard” hydrostatic weighing I had subjected myself to at the Malibu gym (it was actually a specialized truck that shows up once a year and performs the intricate and expensive underwater weighing tests for $60 each). 317 of you took a stab at guessing from the photo of me. It’s clear to me that many of you are quite good at estimating actual body fat levels (the average guess was 6.7%), but Gwen, anticipating the tenor of today’s post, took the prize with the closest guess at 12.5%… Ironically, that was also the highest guess of all and yet it was still a full 4 percentage points lower than what the actual “gold standard” test demonstrated. That’s right, my test score showed that I am 16.9% body fat. That’s 28 pounds of pure fat – if you believe the lab values. Even my wife Carrie tested lower at 13%. Am I really that fat? Probably not, but I went through this exercise to illustrate a point about which I will write today: that quite often, these so-called “gold standard” lab values are of little actual predictive value. Sometimes these tests are just plain wrong. And sometimes they can create far more problems than they solve. And if they are that far off when something is largely visible, what happens when they are dealing with more intricate hidden body chemistry? In this case, my jeans still fit loosely, so I really don’t care what the lab value was. I know the reality. But if I lived only by the lab values, I’d be inclined to start cutting calories immediately to lose weight.
Read MoreWhen Winston Churchill, in the 1932 essay ?Fifty Years Hence,? mused that ?we shall escape the absurdity of growing a whole chicken in order to eat the breast or wing by growing these parts separately under a suitable medium,? he may have been more prescient than credited. Alexis Carrel had already been keeping a cultured chunk of chicken heart ?alive? in a Pyrex flask for the past twenty years by feeding it nutrients (though Carrel was only interested in whether cell death was inevitable, not whether meat could be grown in a lab for human consumption). Sci-fi author Frederik Pohl was one man who took the idea of in vitro meat seriously enough to write about it ? in the novel The Space Merchants, where cultured meat is the primary source of protein. That was science fiction, sure, but most good sci-fi is borne of the author?s honest opinion of what the future might hold and it?s usually inspired by the scientific advancements of the day. And sometimes, science fiction comes true. Like this time.
Read MoreOne benefit of the national debate over health insurance is the spotlight on health care itself. I don’t pretend to have the answer to the political quagmires, but I have to say I’ve enjoyed the deliberation (most of it anyway). Most of all, I appreciate seeing health care issues hashed out in a wide public forum. (I’m holding out hope that it will lead to a real discussion of genuine health itself. A few public figures have tried to steer it that way to little avail so far.) While politicians and talking heads bicker and vent, I tend to take more interest in the stories of independent-minded people who’ve learned to steer the system in their favor, those who’ve fought it tooth and nail and those who’ve checked out of it altogether to go their own route. (Gee, no one fitting that description here … wink). In the last year I’ve gotten a good number of emails from folks trying to do just that – navigating the health care system and their insurance companies as they take charge of their health and buck CW in favor of what they consider more effective interventions that complement their Primal journeys. Here’s one such message…
Read MoreNow that we’ve turned the page on August’s Primal Challenge, we’re digging into some of our “regular programming,” including news highlights. We like keeping a finger on what’s new and novel – and occasionally outrageous. This one definitely fits the latter. (Hint: Are you sitting?) A few weeks ago the Archives of General Psychiatry reported the following: “Antidepressants have recently become the most commonly prescribed class of medications in the United States.” Yikes, yowza, criminy, uff da! No foolin’, folks. According to the findings, “The rate of antidepressant treatment increased from 5.84% … in 1996 to 10.12% … in 2005.” Want hard numbers? Approximately 27 million people in the U.S., the report says, used antidepressants in 2005.
Read More
Ⓒ 2023 Mark's Daily Apple
