Archive for August, 2012

STATINS AND DIABETES

Posted on August 12, 2012. Filed under: Uncategorized | Tags: , , |

Statin cholesterol-lowering drugs reduce risk for heart attack and premature death from cardiovascular disease but have significant risks. In 1975 our research showed how dramatically diet could reduce serum cholesterol (down 35%) and LDL (bad-guy cholesterol by 40%)(1). In 2003, editors of the Journal of the American Medical Association asked me to write an editorial about the side effects of statin drugs (2). Since then I have closely followed the mounting evidence related to the side effects of statin drugs. Now we should add diabetes to this list of risks or side effects.

In mid-August 2012 another study confirms that taking statins increases risk for diabetes (3) as well as risk for dementia and neurological diseases. These are common side effects of statins: stomach irritation; one in ten get muscle aching and some get severe muscle damage (4) or damage to tendons (5); and neuropathy (tingling or pain in legs) or damage to the nerves (6). Serious concerns related to statin use are these: more rapid loss of cognition with aging (7;8); occasional cases of serious neurological conditions such as Lou Gehrig’s disease (9;10).

Most people can lower their LDL (bad-guy) cholesterol by 33% through diet (including soluble fiber like oats and soy protein) and using supplements such as psyllium and plant sterols. For most adults, an LDL less than 130 mg/dl is desirable and less than 100 mg/dl is ideal. If someone has high risk for heart attack, their value should be 70-100 mg/dl. If you have heart disease of history of stroke—and you are less than 70 years old– your LDL should be in the 50-70 mg/dl range. Since statins accelerate loss of cognition for persons over 70 years, you should have your LDL in the 70-100 mg/dl range, no matter what your heart attack risk is. Details of my research on statins and LDL-cholesterol and that of others are provided on other Nutdoc posts. Best, Nutdoc

   1.   Kiehm TG, Anderson JW, Ward K. Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men. Am J Clin Nutr 1976;29:895-9.

2.   Anderson JW. Diet first, then medication for hypercholesterolemia. JAMA 2003;290:531-3.

3.   Ridker PM, Pradhan A, MacFayden JG, Libby P, Glynn RJ. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis of the JUPITER trial. Lancet 2012;380:565-71.

4.   Joy TR, Hegele RA. Narrative review: statin-related myopathy. Ann Intern Med 2009;150:858-68.

5.   Marie I, Delafenetre H, Massy N, Thuillez C, Noblet C. Tendinous disorders attributed to statins: a study on ninety-six spontaneous reports in the period 1990-2005 and review of the literature. Arthritis Rheum 2008;59:367-72.

6.   de Langen JJ, van Puijenbroek EP. HMG-CoA-reductase inhibitors and neuropathy: reports to the Netherlands Pharmacovigilance Centre. Neth J Med 2006;64:334-8.

7.   Xiong GL, Benson A, Doraiswamy PM. Statins and cognition: what can we learn from existing randomized trials? CNS Spectr 2005;10:867-74.

8.   Elias PK, Elias MF, D’Agostino RB, Sullivan LM, Wolf PA. Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med 2005;67:24-30.

9.   Cramer C, Haan MN, Galea S, Langa KM, Kalbfleisch JD. Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study. Neurology 2008;71:344-50.

10.   Edwards IR, Star K, Kiuru A. Statins, neuromuscular degenerative disease and an amyotrophic lateral sclerosis-like syndrome: an analysis of individual case safety reports from vigibase. Drug Saf 2007;30:515-25.

 

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FISH FOR HEALTH

Posted on August 9, 2012. Filed under: heart disease, nutrition | Tags: , , , , , |

Fish is one of our healthiest choices for protein. Consumption of fish or fish oil has major health protective effects including these: decreased risk for cardiovascular disease (heart attack and stroke); preservation of cognitive thinking; and, probably, reduced risk for diabetes. Fish or fish oil intake also lowers blood triglyceride levels. Fish oils are omega-3 fatty acids that include DHA (decosahexaenoic acid) and EPA (eicosapentaenoic acid) and ALA (alpha-linolenic acid). Flax seeds provide ALA but the health benefits of taking flax seeds alone are not well established. Early observations suggested that fish oil intake might increase risk for diabetes but later, more persuasive studies, indicates that fish oil intake decreases risk for diabetes. Having pre-diabetes myself for 14 years has led me to take fish oil capsules twice daily. Ideally, everyone should eat two servings of fish weekly. I recommend that all adults consume one capsule daily and seniors should consume one capsule twice daily.  I use two capsules of high-potency Fisol (VitaminShoppe.com) daily. We also enjoy salmon broiled on a cedar board. Delicious, enjoy. Nutdoc

 

1.   Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis 2006;189:19-30.

2.   Wang C, Harris WS, Chung M et al. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr 2006;84:5-17.

3.   Djousse L, Gaziano JM, Buring JE, Lee IM. Dietary omega-3 fatty acids and fish consumption and risk of type 2 diabetes. Am J Clin Nutr 2011;93:143-50.

4.   Nurk E, Drevon CA, Refsum H et al. Cognitive performance among the elderly and dietary fish intake: the Hordaland Health Study. Am J Clin Nutr 2007;86:1470-8.

 

 

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SHAKE UP YOUR DIET

Posted on August 5, 2012. Filed under: Uncategorized | Tags: , , , , , , , , |

Try my favorite shake. Add one packet of vanilla shake to 12 oz. chilled diet rootbeer to blender. Add 4 to 5 large strawberries (fresh or frozen) and blend. Add 5 ice cubes and bend well to you have your smoothie.

For chocolate lovers: blend in 1 tsp. of Special Dark Cocoa (100% cacao).

For ready-made shakes, add 4-6 oz. of diet soda and the other ingredients.

More recipes to follow. Enjoy, Nutdoc

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SLEEP WEIGHT AWAY

Posted on August 5, 2012. Filed under: diet, diet | Tags: , , , , , |

Many of us do not get adequate sleep. The routine of not getting enough sleep contributes to weight gain and make weight loss more difficult. Most people require seven (7!) hours of sleep each night for optimal health and weight management. Sometimes people on weight loss plans use more caffeine to reduce food intake. This may be counterproductive because increased caffeine intake may aggravate the weight problem. Often inadequate sleep is related to poor stress management. Good sleep “hygiene” or practices include: planning your bedtime so you will get seven hours of sleep each night; doing relaxing things like reading or listening to soothing music for 30 minutes before “to sleep time”; quiet meditation at bedtime; and not watching TV during this last 30 minutes before “to sleep time.” Good luck, Jim

References

1.   Leproult R, Copinschi G, Buxton O, Van CE. Sleep loss results in an elevation of cortisol levels the next evening. Sleep 1997;20:865-70.

2.   Vgontzas AN, Bixler EO, Chrousos GP, Pejovic S. Obesity and sleep disturbances: meaningful sub-typing of obesity. Arch Physiol Biochem 2008;114:224-36.

3.   St-Onge MP, Roberts AL, Chen J et al. Short sleep duration increases energy intakes but does not change energy expenditure in normal-weight individuals. Am J Clin Nutr 2011;94:410-6.

4.   Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring) 2008;16:643-53.

5.   Chen X, Beydoun MA, Wang Y. Is sleep duration associated with childhood obesity? A systematic review and meta-analysis. Obesity (Silver Spring) 2008;16:265-74.

6.   Patel SR, Malhotra A, White DP, Gottlieb DJ, Hu FB. Association between reduced sleep and weight gain in women. Am J Epidemiol 2006;164:947-54.

 

 

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