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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Simple Lifetime Diet

Posted on June 9, 2012. Filed under: cholesterol, diabetes, diet, high blood pressure | Tags: , , , , |

The Simple Lifetime Diet is a health-promoting diet for everyone. It encourages use of high fiber fruits, vegetables and whole grain foods as well as protein sources such as low-fat dairy products and lean meats such as chicken, turkey, fish and very lean cuts of pork and beef. This diet is especially beneficial for persons with diabetes, high blood pressure or blood fat abnormalities. Our research, summarized at andersonsimplediet.com, documents these benefits: prevention and reversing diabetes, lowering blood pressure, and “fixing” blood lipid derangements. The Green Light Calorie Guide guides you in daily intake of at least five servings of fruits and vegetables, three servings of whole grain cereal, bread, pasta or rice, two servings of low-fat dairy products and two three-ounce servings of lean meat such as chicken, turkey, fish or pork tenderloin. Eat to your heart’s content. Best, Nutdoc

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Health Benefits of Soy Foods

Posted on September 26, 2011. Filed under: Uncategorized | Tags: , , , , , , , |

Soy foods are the healthiest foods you can put on the table. Eating two servings of soy foods, like two glasses of low-fat soy milk, reduces risks for heart disease, stroke, high blood pressure, diabetes, and overweight. Over the last 20 years I have done research on soy foods for blood fat levels, high blood pressure, diabetes, kidney disease in diabetes, and obesity. In three dozen publications I have documented the health effects and safety of soy foods.
Soy foods are about the best choice for “fixing” abnormal blood fat levels. Two servings of soy protein (about 14 grams per day) lower the ‘bad-guy’ LDL-cholesterol, raise the ‘good-guy’ HDL-cholesterol, and reduce other ‘bad-actor’ blood fat triglycerides. Daily intake of two servings of soy protein has the potential to lower heart attack risk by 15 to 20%. Soy foods also lower blood pressures, further reducing risk for heart attack or stroke.
Diabetic individuals get special benefits from soy foods. In addition to improving blood fat levels, soy foods protect from kidney disease or actually improve kidney disease if it has developed. Soy foods have specific benefits in lowering blood glucose levels and also help in weight management.
Soy foods are widely available in the supermarket. Soy milk, such as Silk, soy burgers and other meat substitutes, edamame (green soybeans in the pod or shelled), soy beans (use like pinto beans in cooking), tofu, and soy shakes (try Revival soy shakes).
Soy foods are very safe. Like all proteins, there is the occasional soy protein allergy. Soy protein allergy is less common than peanut allergy and about as common as milk protein allergy. Soy protein does not affect thyroid function or interfere with effectiveness of thyroid hormone use. It does not have an adverse effect on male or female children. Some people recommend that women who have breast cancer should not use soy protein. My careful review of this area suggests that soy protein is protective from breast cancer and I have recommended its use to patients and family members who have a history of breast cancer.
So, select soy foods that you like and enjoy them daily.

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Why worry about your blood cholesterol?

Posted on February 28, 2011. Filed under: cholesterol, diet | Tags: , , , , , |

Your blood cholesterol level is a major indicator of the diet that you are eating. If your cholesterol is higher than 200 mg/dl (or your LDL-bad guy cholesterol is above 130 mg/dl) you probably are eating more saturated fat from meat and dairy products and too much cholesterol from eggs, meat, processed meats (sausage, lunch meat, etc.) and dairy products.

A high intake for saturated fat and cholesterol is associated with a very high risk for heart attack, stroke, high blood pressure, diabetes, obesity and cancer. These are major killer diseases for Western people. Vegetarians and societies that have low intakes of these animal products have much lower rates of all of these diseases.

Of course, you inherit genes from your parents that affect your blood cholesterol. I inherited high cholesterol genes from my mother and my LDL- (bad guy) cholesterol runs above 200 mg/dl if I do not watch my diet carefully. Since I inherited obesity genes from my dad who was very obese and high blood pressure genes from my dad (who had his first stoke at age 47), I need to watch my own diet very closely.

Most folks can reduce their risk for heart attack, stroke, high blood pressure, diabetes, obesity and cancer by 50 to 75% through diet, exercise and weight management. Even if your mother, aunts and sisters had breast cancer you can reduce your own risk by more than 50% through lifestyle measures.

Mark Twain said, “The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you would rather not do.” On a recent cruise, we observed that most folks choose to do what they like rather than do what they don’t like.

In upcoming blogs I will share my recommendations taken from my upcoming book, The Simple Diet, and my research.

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Soy for your Heart

Posted on January 10, 2010. Filed under: benefits, cholesterol, heart disease, high blood pressure, LDL-cholesterol, soy foods, statin drugs | Tags: , , , , , , , , , , |

High intakes of animal protein are associated with high rates of coronary heart disease.  However, high intakes of soy protein are associated with low rates of the disease.  Research shows that soy foods offer more protection for your heart than any other food that can be consumed. 

  • Soy foods reduce the risk for heart attack and stroke by lowering the bad LDL-cholesterol by 15 to 30 points and lowering triglycerides while raising the good HDL-cholesterol.
  • They also lower blood pressure, thus reducing risk for heart attack and stroke.
  • Soy foods contain isoflavones with potent antioxidant properties that act to protect the arteries from oxidized fats by preventing the oxidation of lipid particles. 
  • Soy foods act to reverse hardening of the arteries in a similar manner to the statin drugs.  Evidence indicates that the combined use of soy protein, soluble fiber, and plant sterols have the potential to decrease serum LDL-cholesterol values by 25-30% which is equivalent to the effects of the statin drugs.    
  • They improve blood vessel health by helping the blood dilate to increase blood flow to the heart or brain. 

            After reviewing clinical studies of soy foods, the FDA approved the health claim that daily soy intake is heart-healthy.  There is an overwhelming amount of research supporting the claim that soy can help prevent heart disease.

            For a happy heart, enjoy two servings of soy protein per day, as I do.  Increasing your soy food intake can provide you with long-term heart protection; the sooner you start enjoying soy the better for your health.     

With Lacey Lamb 

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The Healthy Truth about Soy

Posted on January 10, 2010. Filed under: benefits, cancer, cholesterol, heart disease, high blood pressure, kidney disease, LDL-cholesterol, nutrition, obesity, osteoporosis, soy foods | Tags: , , , , , , , |

            Soy foods have been used around the world for thousands of years because so many people realize its healthy qualities.  Extensive research documents the many health benefits of soy foods; the FDA approved the health claim that daily soy intake is heart-healthy.  Soy foods are produced from the soybeans grown in the United States and other countries.  These foods are nutrient-rich foods that contain the following:

  • high-quality protein
  • carbohydrates
  • fiber
  • healthy fats
  • plant estrogens (isoflavones)
  • vitamins and minerals
  • antioxidants 

            The advantages of whole soy foods, as opposed to foods with soy ingredients, are that the whole soybean has many health promoting benefits in addition to those provided by the ingredients alone.  Some popular whole soy foods include whole soybeans, green soybeans, also known as edamame, and dry roasted soy nuts.  In order to experience the benefits of soy foods, two of the following serving sizes are recommended per day:  ½ cup of cooked soybeans, 2/3 cup of green soybeans in the pod, 1 oz of roasted soy nuts, one glass of soy milk, ½ cup tofu, or six grams of isolated soy protein. 

            Research shows the following conditions and diseases benefit from soy foods:

  • Coronary heart disease, stroke, and high blood pressure: View blog, “Soy for your Heart” for more details.
  • Menopause, breast cancer, osteoporosis:  Read blog, “Soy and Women’s Health,” for more information.
  • Cancer:  See upcoming blog, “Cancer Fighting Food:  Soy.”
  • Diabetes, obesity, kidney disease:  Upcoming blog titled, “Soy for Renal Health,” will have more details. 

Soy foods are one of the healthiest foods you can put on the table and are a tasty way to add variety to your diet.

With Lacey Lamb

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High Carbohydrate, High Fiber Diet to Lower Cholesterol

Posted on November 19, 2009. Filed under: cholesterol, diet, LDL-cholesterol, oat bran | Tags: , , , , , , |

Many of my patients have dropped their total cholesterol by 80 points through an intense diet. Their LDL (bad-guy) cholesterol has decreased from 150 to 90 points! In our research in Kentucky we documented for hundreds of patients that we could lower the LDL cholesterol by 35-45% through our high carbohydrate, high fiber diet without weight loss or exercise. These diets were rich in oats (oatmeal and oatbran), beans (pinto and other dry beans), vegetables and fruits.

Dr. David Jenkins at the University of Toronto has also demonstrated in hundreds of people that they can lower their LDL-cholesterol by 35-40% using his ‘Portfolio Diet.’

Both diets are high in complex carbohydrate and soluble fiber while being very low in red meat, processed meat, high fat dairy foods, and eggs.

And you do not have to lose weight to do this! But, if you are a few pounds overweight, this diet will help you make those love handles smaller.

So, with serious attention to your diet your can drop your cholesterol by 80 points and your LDL bad guys by 60 points.

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How To Lower Your Cholesterol By 30 Points

Posted on November 19, 2009. Filed under: cholesterol, diet, LDL-cholesterol, oat bran | Tags: , , , , , |

Your blood cholesterol level is a major cause of heart attacks. The foremost way to lower your cholesterol and protect yourself from heart attacks is to limit your intake of meats, processed meats (sausage, hamburger and lunch meat), high fat dairy foods (ice cream, milk and butter) and eggs.

The American Heart Association recommends the Therapeutic Lifestyle Change, which includes a diet limited in meat, animal fat and high fat dairy foods as well as walking 30 minutes daily. The goal also is to achieve a desirable, non-obese weight.

Know Your Numbers

  • LDL-cholesterol (the “bad guy” type)- desirable is less than 130 and ideal is less than 100 mg/dl (for persons with heart disease the goal is 70 mg/dl);
  • HDL-cholesterol (the “good guy” type)- desirable for women, more than 50; and for men, more than 40 mg/dl;
  • Triglycerides (the other type of blood fat), less than 150 mg/dl.

Most people can lower their “bad guy” (LDL) cholesterol by 25 to 45% by making changes to their eating habits. I lowered my high LDL cholesterol from 200 to 110 through diet alone.

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Should you take a statin drug?

Posted on October 17, 2009. Filed under: 1 | Tags: , , , |

If your blood cholesterol level is too high or your LDL- (bad-guy) cholesterol is too high you should follow a health-promoting diet to lower it. As outlined in my Blog “Lower your cholesterol” you can lower your LDL-cholesterol by 20-40% by following a low-fat and low-cholesterol diet and using soluble fiber (oats or psyllium), soy protein, and plant sterols. It is safer to lower your LDL-cholesterol this way and by taking drugs. If you cannot get to the LDL-cholesterol levels recommended by your doctor you may need to take a statin drug. You should read my blog “How low should your cholesterol be” to decide how low you want your LDL-cholesterol value to be and whether you should take a statin or other type of drugs.

Statin drugs lower risk of heart attack by about 25%, especially for men who are less than 60 years old (1). However they have side effects. They may cause muscle aching in one out of  ten people (2) with serious damage to muscles occasionally (3)  as well as problems with muscle tendons  (4). They also can affect liver function and irritate the stomach. I have seen all of these side effects in my patients.  Not uncommonly they may cause neuropathy (nerve pain or tingling) (5), infrequently cause decreased cognition and very rarely they can cause serious neurological problems such as amyotrophic lateral sclerosis (Lou Gehrig’s disease)(6-8). Because they may accelerate loss of cognitive function as people age, I agree with some experts who recommend that people over age 70 should not take them unless there are extremely strong indications (progressive coronary heart disease)(1). Informed patients receive better health care and I think you should discuss your need with yours doctors (primary care doctor and cardiologist or specialist) before deciding to take a statin drug.

Statin drugs decrease levels of Co-enzyme Q10 in the blood and body tissues such as muscles and heart (1). This can cause muscle aching and impair heart pumping action. Taking a supplement of Co-enzyme Q10 may protect from these problems. I recommend that everyone who takes a statin drug take at least a 100 mg gel capsule of Co-enzyme Q10 twice daily. I have done research with the brand Q-Gel® and am convinced that it is the most effectively absorbed form of Co-enzyme Q10.                                                                                                                                                                            1.    Golomb BA. Implications of statin adverse effects in the elderly. Expert Opin Drug Saf 2005;4:389-97.

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

    3.    Mohaupt MG, Karas RH, Babiychuk EB et al. Association between statin-associated myopathy and skeletal muscle damage. CMAJ 2009;181:E11-E18.

    4.    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.

    5.    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.

    6.    Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB. Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med 2004;117:823-9.

    7.    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.

    8.    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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How low should your cholesterol be?

Posted on October 17, 2009. Filed under: 1 | Tags: , , , , |

High blood cholesterol levels increase your risk for a heart attack or stroke. The best information is related to the low-density lipoprotein cholesterol level or the LDL-cholesterols (called the ‘bad guys) and cardiovascular risk. Many experts recommend that everyone should have a LDL-cholesterol value below 130 mg/dl (or a total cholesterol below 200 mg/dl). They recommend that the ideal LDL-cholesterol should be between 70 to 100 mg/dl for persons who do not have coronary heart disease (CHD). If you have CHD or have had a heart attack some experts recommend that your LDL-cholesterol should be below 70 mg/dl (total cholesterol below 140 mg/dl) (1;2). My research leads me to recommend that if you have CHD or have had a heart attack and are less than 70 years old your LDL-cholesterol should be between 60 and 80 mg/dl (total cholesterol of 130 to 150 mg/dl). Lower LDL-cholesterol levels may lead to more rapid loss of brain (cognitive) function as you get older (3). If you are over 70 years old, my research suggests that maintaining your LDL-cholesterol between 80-100 mg/dl (total cholesterol of approximately 150-170 mg/dl) is the prudent thing to do to sustain optimal brain (cognitive) function.
People with LDL-cholesterol values below 110 mg/dl (total cholesterol below 180 mg/dl) appear to have lower brain(cognitive) function than persons with LDL-cholesterol values above 110 mg/dl (3). The evidence that statin drugs decrease risk for heart attack for persons above the age of 70 years old is unclear (4). Some evidence indicates that statin drugs decrease brain (cognitive) function—perhaps by decreasing cholesterol available for to maintain the cholesterol levels required for the brain (4;5).
Reference List
1. Expert Panel. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). J Amer Med Assoc 2001;285:2486-97.
2. Keevil JG, Cullen MW, Gangnon R, McBride PE, Stein JH. Implications of cardiac risk and low-density lipoprotein cholesterol distributions in the United States for the diagnosis and treatment of dyslipidemia: data from National Health and Nutrition Examination Survey 1999 to 2002. Circulation 2007;115:1363-70.
3. 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.
4. Golomb BA. Implications of statin adverse effects in the elderly. Expert Opin Drug Saf 2005;4:389-97.
5. Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB. Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med 2004;117:823-9.

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