Dr. Joe's Blog

Low vitamin D levels may contribute to development of Type 2 Diabetes

DrJoe's BLOG — Wed, 23 May 2012 16:12:00 GMT

Study finds low vitamin D levels associated with higher degrees ofinsulin resistance

A recent study of obese and non-obese children found that low vitamin D levels are significantly more prevalent in obese children and are associated with risk factors for type 2 diabetes. This study was accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

High rates of vitamin D deficiency have been found in obese populations and past studies have linked low vitamin D levels to cardiovascular disease and type 2 diabetes. The mechanisms by which obesity and its comorbidities are related to vitamin D deficiency are not fully known. This new study examined associations between vitamin D levels and dietary habits in obese children, and tested whether there were correlations between vitamin D levels and markers of abnormal glucose metabolism and blood pressure.

"Our study found that obese children with lower vitamin D levels had higher degrees of insulin resistance," said Micah Olson, MD, of The University of Texas Southwestern Medical Center in Dallas and lead author of the study. "Although our study cannot prove causation, it does suggest that low vitamin D levels may play a role in the development of type 2 diabetes."

In this study, researchers measured vitamin D levels, blood sugar levels, serum insulin, BMI and blood pressure in 411 obese subjects and 87 control non-overweight subjects. Study participants were also asked to provide dietary information including daily intake of soda, juice and milk, average daily fruit and vegetable intake, and whether or not they routinely skipped breakfast.

"Poor dietary habits such as skipping breakfast and increased soda and juice intake were associated with the lower vitamin D levels seen in obese children," said Olson. "Future studies are needed to determine the clinical significance of lower vitamin D levels in obese children, the amount and duration of treatment necessary to replenish vitamin D levels in these children and whether treatment with vitamin D can improve primary clinical endpoints such as insulin resistance."

To insure you and your children are getting the right amount of Vitamin D:

Choose the column than corresponds to your body mass, and the row that best describes your current sun exposure habits. Where they intersect, read off your vitamin D3 daily supplement dose in International Units (IU).

Sun exposure must be from strong sunlight (sun at least 30 degrees above the horizon) on bare skin, without sunscreen, and not through glass and for up to 20 minutes.

In winter, unless you live in a hot climate (e.g. tropical), select the "No Sun" group.

Vitamin D3 Dosage Table for Adults:

D3 Dose for adults	Body Mass (kg / Pounds)
Body mass (kg):	50-70	71-90	91-120	> 120
Body mass (pounds):	110-155	156-199	200-264	> 265
How much strong sun?	Vitamin D3 daily supplement (IU)
No Sun	3500	5000	6500	7500
A little on most days	3000	4000	5000	6000
Lots (outdoor type)	1500	2000	2500	3000
Very substantial, daily	0	0	0	0

The children's vitamin D dosage table works much the same way. Select the column according to the child's body mass (not by age).

Vitamin D3 Dosage Table for Children:

D3 Dose for children	Body Mass (kg / pounds)
Body mass (kg):	5-10	11-20	21-35	36-49
Body mass (pounds):	11-22	23-45	46-77	78-109
How much strong sun?	Vitamin D3 daily supplement (IU)
No Sun	500	1000	1800	2500
A little on most days	400	800	1500	2000
Lots (outdoor type)	200	400	800	1000
Very substantial, daily	0	0	0	0

Final step - for both adults and children

If you already take some vitamin D in a supplement (including a multivitamin, or cod-liver oil) subtract the amount of vitamin D in that supplement from the dose you just looked-up in the table.

That's it. You now have your personalized vitamin D dosage, adjusted for body weight and sun-exposure.

If you are currently in good health, you can take this dose with confidence. It will keep you from being vitamin D deficient and you will not be overdosing. But whether or not you will maintain an optimum level, or somewhat higher or lower, can only be determined by taking the blood test.

The Importance of Protein with each Meal

DrJoe's BLOG — Wed, 16 May 2012 16:12:00 GMT

A study published in the Journal of the American Medical Association, Professor George Bray, of the Pennington Biomedical Research Center of Louisiana State University at Baton Rouge documented that people who eat a low protein diet tend to gain more fat and decrease their lean body mass.

In other words, they shrank their muscles, but gained fat. And as body composition changes, it can fool the BMI (Body Mass Index) charts into classifying you as being less fat than you really are.

The investigation studied 25 young adults over a period of three months, who lived and ate under strict supervision in a university metabolic unit. Their meals were carefully prepared by staff and were closely monitored to be sure they ate everything that was prepared for them.

They were divided into three groups: low protein (defined as only 5% of total calorie consumption), "normal" protein and high protein dietary intake groups, with the same number of total calories. They were also given 1000 extra calories a day.

What they found was that all groups gained weight, but less overall weight in those on a low protein diet. But, that group also lost lean body mass, so they were actually FATTER than the members of other groups; they got fatter as a percentage of their body weight.

Those in the high protein group also gained some weight, but they preserved lean body mass AND raised their metabolic rate. Everyone gained some weight, because they were all eating extra calories. But the results demonstrated that those who ate protein maintained their muscle mass and that made a lot of difference in their body composition.

It all starts with the fact that FAT LOSS is the only truly beneficial form of weight loss. In standard low fat, low protein, calorie restricted diets, at least HALF of your weight loss is...MUSCLE! And, to experience rapid fat loss, you need every bit of muscle. You can't afford to lose any of it. That's where the protein comes in.

Protein does important things for your metabolism; it KILLS your appetite. Most diets fail because of uncontrolled HUNGER. The desire for food just overwhelms your resolve and the next thing you know, you're piggin' out like there’s no tomorrow. So this effect is HUGE and a major advantage when you're trying to trim the lard.

Protein stimulates the release of glucagon, a hormone that is the opposite of insulin - it RAISES your blood sugar, but also mobilizes fat deposits, so they can be used as fuel, inhibits the conversion of carbohydrates to fat and increases your metabolism. It also inhibits the use of muscle tissue as fuel, so it preserves your muscles (i.e., lean body mass), which require ever more energy to function and therefore utilize your fat deposits at a much higher rate. The more muscle you have, the more weight you lose, because the muscles burn fat. It's as simple as that.

These findings reinforce what is already known about the metabolic effect of different food groups. Calories still count, but WHAT you eat, and HOW you eat and WHEN you eat are all factors that make a tremendous difference in how much and how fast you can burn fat.

This recent study is just more evidence that these principles WORK. If you're tired of programs that are all hype, or rely on artificial, prepackaged foods that literally starve you (and melt away muscle, as well as fat), you will find eating real food a refreshing change.

It’s really simple: a protein at breakfast, a protein snack about two hours after breakfast such as an ounce or two of walnuts and a cheese stick. Lunch: a protein and all the fresh veggies you want. Snack: same as before about two hours after lunch. Supper: a protein and all the fresh veggies you want. Snack: a protein smoothie about two hours before bedtime. Monitor your weight on accurate scales first thing in the morning and before bedtime. Keep a food journal. Drink filtered water. Exercise at least three times a week for about thirty minutes each time. Try to get seven to eight hours of sleep and a daily nap if possible. Avoid sugars and artificial sweeteners as much as possible. Avoid acidic coffee as much as possible. Avoid sodas and diet drinks at all costs.

Household Cleaners

DrJoe's BLOG — Wed, 09 May 2012 16:12:00 GMT

Detergents, cleaning solvents, and indoor fragrances sound like good ideas because marketers have worked long and hard to get you interested in buying them. But the bottom line is that many are toxic and can affect your health. Besides being loaded with chemicals, many household cleaners are labeled as “antibacterial,” which is just a fancy term for describing the active ingredient: pesticides.

Some scientists suggest that the overuse of cleaning agents, antibiotics, and antibacterial disinfectants to practically sterilize homes has significantly added to the number of childhood asthma and allergies cases. This is referred to as the “hygiene hypothesis.”

The following simple tips can protect you and your family from adding to your body burden when you clean your home:

- Dilute cleaning supplies with water, either as directed on the label or until you are happy with the results.

- Clean with windows and doors open so you don’t trap air pollution inside.

- Use gloves: cleaners and solvents can harm or penetrate skin.

- Never mix bleach with ammonia, vinegar, or other acids: these combinations can produce deadly gases.

- Avoid pine and citrus oil cleaners: they may smell pleasant, but these cleaners can react with ozone in the air, particularly on smoggy days, to produce cancer-causing formaldehyde.

- Skip acidic toilet bowl and drain cleaners: use a simple paste made out of water and baking sodas and when necessary use a mechanical snake to unclog the drain.

- Wipe down showers after each use to prevent mold and mildew growth.

- Forget air fresheners: they only disguise odors while pumping toxic chemicals into the air.

- Sweep and use a vacuum with HEPA filter frequently to remove dust, which often harbors household toxins.

- Dust with a soft or microfiber cloth and don’t use toxic dusting sprays.

Natural Cleaning Options:

- Baking soda: Absorbs odors and chemicals and can be used as a mild abrasive. It can remove stains from the bathtub or toilet and remove grime from a dirty oven.

- Borax: A mineral compound (sodium borate) that is a disinfectant, deodorizer, mold inhibitor, and mild abrasive.

- White vinegar: Cuts grease, deodorizes, and dissolves sticky buildup and mineral deposits.

- Lemon juice: Cuts grease, dissolves sticky buildup, and has a bleaching effect.

-    Vegetable-based dish soaps: Use a vegetable based soap that is made out of olive oil, such as castile soap.

Are toxic particles in your office air making you sick?

DrJoe's BLOG — Wed, 02 May 2012 16:12:00 GMT

In a first-of-its-kind study, scientists are reporting that the indoor air in offices is an important source of worker exposure to potentially toxic substances released by carpeting, furniture, paneling, paint and many other items that “out gas” their fumes. Their report, which documents a link between levels of these so-called polyfluorinated compounds(PFCs) in office air and in the blood of workers, appears in ACS' journal Environmental Science & Technology.

Michael McClean and colleagues explain that PFCs, used in water-repellent coatings on carpet and furniture, may have adverse effects on human health. The substances are widespread in the environment and in humans around the world.

Scientists know that potential sources of exposure include food, water, indoor air, indoor dust and direct contact with PFC-containing objects. But the link between levels in air and blood had not been explored previously, so McClean's group set out to fill that gap with a study of 31 office workers in Boston.

They found concentrations of a PFC called fluorotelomer alcohol (FTOH) in office air that were 3-5 times higher than those reported in previous studies of household air, "suggesting that offices may represent a unique and important exposure environment." In addition, the study found a strong link between concentrations of FTOH in office air and perfluorooctanoic acid (a metabolite of FTOH) in the blood of office workers. The results also suggested that workers in newly renovated office buildings may receive considerably higher doses of PFCs than workers in older buildings.

So, yes…toxic particles in the office air can and does make you sick. But, there’s something very simple you can do to combat this in your office, your home, your classroom, even in your RV.

In the late '80s, NASA and the Associated Landscape Contractors of America studied houseplants as a way to purify the air in space facilities. They found several common plants that filter out common volatile organic compounds. Print this article and take it with you when you go to visit your local nursery so you can see what they look like or simply search them on the Internet.

By the way, “silk plants”, you know, the pretty but fake flowers and “plants” that you might have in your home, well, they’re pretty much non-functional other than collecting lots of dust which is loaded with toxic things that could be causing your allergies or poor health. If you do have health problems you’ll want to replace them with real plants that do real work to make you healthier:

The aloe vera plant easy-to-grow, sun-loving succulent helps clearformaldehyde and benzene, which can be a byproduct of chemical-based cleaners, paints and more. Aloe is a smart choice for a sunny kitchen window. Beyond its air-clearing abilities, the gel inside an aloe plant can help heal cuts and burns. Every home needs one or several of these.

Weeping fig (Ficus benjamina). A ficus in your living room can help filter out pollutants that typically accompany carpeting and furniture such as formaldehyde, benzene and trichloroethylene. Caring for a ficus can be tricky, but once you get the watering and light conditions right, they will last a long time.

Heart leaf philodendron (Philodendron oxycardium). This climbing vine plant isn’t a good option if you have kids or pets — it's toxic when eaten, but it's a workhorse for removing all kinds of VOCs. Philodendrons are particularly good at battling formaldehyde from sources like particleboard.

Spider plant (Chlorophytum comosum). One of my favorites. Even if you tend to neglect houseplants, you’ll have a hard time killing this resilient plant. With lots of rich foliage and tiny white flowers, the spider plant battles benzene, formaldehyde, carbon monoxide and xylene, a solvent used in the leather, rubber and printing industries. Great plant to give as a “house warming gift”!

Peace lily (Spathiphyllum). Another one of my favorites. Shade and weekly watering are all the peace lily needs to survive and produce blooms. It topped NASA’s list for removing all three of most common VOCs — formaldehyde, benzene and trichloroethylene. It can also combat toluene and xylene.

Gerber daisy (Gerbera jamesonii). This bright, flowering plant is effective at removing trichloroethylene, which you may bring home with your dry cleaning. It’s also good for filtering out the benzene that comes with inks. Add one to your laundry room or bedroom — presuming you can give it lots of light.

Snake plant (Sansevieria trifasciata 'Laurentii'). Also known as mother-in-law’s tongue, this plant is one of the best for filtering out formaldehyde, which is common in cleaning products, toilet paper, tissues and personal care products. Put one in your bathroom — it’ll thrive with low light and steamy humid conditions while helping filter out air pollutants. A great plant if you don’t have a “green thumb”.

Golden pothos (Scindapsus aures). Another powerful plant for tackling formaldehyde, this fast-growing vine will create a cascade of green from a hanging basket. Consider it for your garage since car exhaust is filled with formaldehyde. (Bonus: Golden pothos, also know as devil’s ivy, stays green even when kept in the dark.) Very hardy plant!

Chrysanthemum (Chrysantheium morifolium). The colorful flowers of a mum can do a lot more than brighten a home office or living room; the blooms also help filter out benzene, which is commonly found in glue, paint, plastics and detergent. This plant loves bright light, and to encourage buds to open, you’ll need to find a spot near an open window with direct sunlight.

Red-edged dracaena (Dracaena marginata). The red edges of this easy dracaena bring a pop of color, and the shrub can grow to reach your ceiling. This plant is best for removing xylene, trichloroethylene and formaldehyde, which can be introduced to indoor air through lacquers, varnishes and gasoline.

Azalea (Rhododendron simsii). Bring this beautiful flowering shrub into your home to combat formaldehyde from sources such as plywood or foam insulation. Because azaleas do best in cool areas around 60 to 65 degrees, they’re a good option for improving indoor air in your basement if you can find a bright spot.

Chinese evergreen (Aglaonema Crispum 'Deborah'). This easy-to-care-for plant can help filter out a variety of air pollutants and begins to remove more toxins as time and exposure continues. Even with low light, it will produce blooms and red berries.

English ivy (Hedera helix). A study found that the plant reduces airborne fecal-matter particles. It has also been shown to filter out formaldehyde found in some household cleaning products.

Warneck dracaena (Dracaena deremensis 'Warneckii'). Combat pollutants associated with varnishes and oils with this dracaena. The Warneckii grows inside easily, even without direct sunlight. With striped leaves forming clusters atop a thin stem, this houseplant can be striking, especially if it reaches its potential height of 12 feet.

Bamboo palm (Chamaedorea sefritzii). Also known as the reed palm, this small palm thrives in shady indoor spaces and often produces flowers and small berries. It tops the list of plants best for filtering out both benzene and trichloroethylene. They’re also a good choice for placing around furniture that could be off-gassing formaldehyde.

Whatever time you spend in your home, classroom, office or RV, make it a toxic free zone with God’s wondrous working plants that clean the air you breathe to make it life-giving…don’t allow the air you breathe to be life-robbing.

Owning car, TV linked to heart attacks: study

DrJoe's BLOG — Wed, 25 Apr 2012 16:12:00 GMT

Car owners with a television are 27% more likely to suffer heart attacks than people who have neither, according to a global study on physical exercise and heart disease published in January, 2012.

More broadly, the study - covering more than 29,000 people in 52 countries - showed that working up a light sweat may be the best preventative medicine against heart failure.

Until now, surprisingly little research has focused on how physical exertion at work and play influences the incidence of heart attacks, and even less has directly compared this data across nations at all income levels.

"This study shows that mild to moderate physical activity at work, and any level of activity during leisure time, reduces the risk of heart attacks," said lead researcher Claes Held, a professor at Uppsala University in Sweden.

It also "extends previous findings of the protective effect of leisure-time physical activity ... to low- and middle-income countries."

Held and colleagues poured over data collected from 1999 to 2003 for the so-called Interheart Study.

They compared one group of more than 10,000 middle-aged men and women who had had a single heart attack with an even larger cohort with no history of cardiovascular disease.

Physical activity at work and during leisure time was divided into four levels of exertion: being completely sedentary at one extreme, and, at the other, doing hard physical labor on the job or heart-pounding aerobic exercise while at play.

Not surprisingly, the study, published in the European Heart Journal, found that exercise is good for the heart.

But the effectiveness of physical activity varied depending on the setting and intensity, according to the research.

Any kind of workout during leisure time was shown to be a plus, with heart attack risk - compared to doing almost nothing - dropping 13% for mild activity and 24% for moderate or strenuous exercise.

The advantages were similar for light and moderate levels of physical activity on the job. Unexpectedly, however, heavy physical labor did not reduce risk at all.

Held and colleagues also investigated whether owning an automobile, motorcycle, stereo, TV, computer, land or livestock influenced health outcomes.

"Subjects who owned a car and a TV" – 25% of the respondents in poorer and middle-income nations, and two-thirds in rich ones - "were at higher risk of myocardial infarction," the medical term for a heart attack, the researchers concluded.

Diabetes and high blood pressure was also more common, but only in the developing world, the researchers found.

What accounted for the link? Another set of figures from the study points to a common-sense explanation.

Possessing these coveted consumer items made it about four times more likely in poorer and middle-income countries - and twice as likely in wealthy ones - that people would be sedentary, especially at work.

The implication, in other words, is that TVs breed couch potatoes, and motor vehicles discourage walking.

"If we want to support healthy longevity, we should put a stop to the pandemic of sedantism," Emiline Van Craenenbroeck and Viviane Conraads, both of Antwerp University Hospital Belgium, noted in a commentary in the same journal.

"Staying physically fit throughout life may well be one of the easiest, cheapest and most effective ways to avoid the coronary care unit."

Overall, the portion of people whose pulse did not speed up during leisure time was nearly twice as high - almost 70% - in less wealthy nations.

"Since the main burden of heart disease now lies in developing countries, this information should inspire a shift in healthcare strategy in low-income regions," Van Craenenbroeck and Conraads said.

How to Limit Your Exposure to Phthalates

DrJoe's BLOG — Wed, 18 Apr 2012 16:12:00 GMT

Toxin ALERT: That new car smell, which becomes especially pungent after the car has been sitting in the sun for a few hours, is partly the pungent odor of phthalates (pronounced thowl-ates) volatilizing from a hot plastic dashboard. In the evening's cool they then condense out of the inside air of the car to form an oily coating on the inside of the windshield.

Intentional uses of phthalates include softeners of plastics, cosmetics, nail polish, lotions, oily substances in perfumes, additives to hairsprays, air sprays, lubricants, wood finishers, and coatings in some time released medications.

Researchers from the Children’s Environmental Health Center at The Mount Sinai Medical Center in New York have found an association between phthalates and obesity in young children – including increased body mass index (BMI) and waist circumference. While poor nutrition and physical inactivity are known to contribute to obesity, a growing body of research suggests that environmental chemicals – including phthalates – could play a role in rising childhood obesity rates. Phthalates are endocrine disruptors which are also linked to reproductive and genital abnormalities.

Also, children chewing on soft polyvinyl chloride toys and patients receiving intravenous medication through polyvinyl chloride equipment may lead to very high exposures (polyvinyl chloride contains phthalates).

“Research has shown that exposure to these everyday chemicals may impair childhood neurodevelopment, but this is the first evidence demonstrating that they may contribute to childhood obesity,” said the study’s lead author Susan Teitelbaum, PhD, Associate Professor in the Department of Preventive Medicine at Mount Sinai School of Medicine. “This study also further emphasizes the importance of reducing exposure to these chemicals where possible.”

The percentage of obese children ages six to 11 in the United States has grown from 7% in 1980 to more than 40% in 2008, according to the U.S. Centers for Disease Control and Prevention. More than 15% of American children between the ages six and 19 are characterized as obese. In New York City, more than one in five children in public schools is obese.

How to Limit Your Exposure to Phthalates

Read all labels on foods, clothing, fragrances, furniture…everything. Synthetic fragrances contain phthalates, therefore use products with organic or natural fragrances or choose “unscented”. Unscented products can also contain phthalates.

Eat less processed food. Food, especially when fatty, is a major source of phthalate exposure, and processing can up the concentration. One study showed that prepared lunches had high levels of phthalates because food workers wore plastic gloves during prep.

Ventilate. Studies show indoor air tends to have higher loads than outdoor, most likely because countless household items and building materials contain phthalates that can end up in dust and air. Also, keep phthalate-containing materials, such as vinyl tiles and imitation leather furniture, out of kids' rooms. Behavioral studies discovered that phthalates exposures are found in children clinically diagnosed with conduct or attention deficit hyperactivity disorders.

Shop wisely. Avoid air fresheners, vinyl products, cooking or microwaving in plastic containers, vinyl shower curtains, and vinyl plastic toys. Again, read those labels. Many companies have introduced phthalate-free toys and baby products. You can find updated product reviews at websites like http://safemama.com/?s=phthalate-free+

Check your cosmetics. Products such as nail polish, hair spray, and deodorant can contain phthalates. The ingredients list may identify them—or mention only "fragrance," which may contain them.

Why Women Should Stop Their Cholesterol Lowering Medication

DrJoe's BLOG — Wed, 11 Apr 2012 16:12:00 GMT

If you are a post-menopausal women with high cholesterol, your doctor will almost certainly recommend cholesterol lowering medication or statins. And it just might kill you.

A new study in the Archives of Internal Medicine found that statins increase the risk of getting diabetes by 71 percent in post-menopausal women. Since diabetes is a major cause of heart disease, this study calls into question current recommendations and guidelines from most professional medical associations and physicians. The recommendation for women to take statins to prevent heart attacks (called primary prevention) may do more harm than good.

Statins have been proven to prevent second heart attacks, but not first heart attacks.

Take it if you already have had one, but beware if your doctor recommends it for you if have never had a heart attack.

This current study adds to an increasing body of literature questioning the benefits of statins, while highlighting their potential risks.

New Study Shows 48 Percent Risk of Diabetes in Women Who Take Statins

This study examined the data from the large government sponsored study called the Women’s Health Initiative, the same study that disabused us of the idea that Premarin prevented heart attacks in postmenopausal women.

In fact, based on this randomized controlled trial, estrogen replacement therapy, once considered the gold standard of medical care for the prevention of heart disease, was relegated to the trash bin of history joining medicine’s many other fallen heroes including DES, Thalidomide, Vioxx, Avandia, and more.

In this new study researchers reviewed the effect of statin prescriptions in a group of 153,840 women without diabetes and with an average age of 63.2 years. About 7 percent of women reported taking statin medication between 1993 and 1996. Today there are many, many more women taking statin medications, thus many more are at risk from harm from statins.

During the 3-year period of the study, 10,242 new cases were reported – a whopping 71 percent increase in risk from women who didn’t take statins. This association stayed strong at a 48 percent increased risk of getting diabetes, even after taking into account age, race/ethnicity, and weight or body mass index. These increases in disease risk were consistent for all statins on the market.

This effect also occurred in those with and without heart disease. Surprisingly disease risk was worse in thin women. Minority women were also disproportionately affected. The risk of diabetes was 49 percent for white women, 57 percent for Hispanic women, and 78 percent for Asian women.

But in a typical “my mind’s made up, don’t confuse me with the facts” statement by the medical establishment, the researchers said we should not change our guidelines for statin use for the primary prevention of heart disease.

In a large meta-analysis published in the Lancet last year, scientists found that statins increased the risk of diabetes by 9 percent. If current guidelines were followed for those who should take statins, and people actually took them (thank God only 50 percent of prescriptions are ever filled by patients), there would be 3 million more diabetics in America. Oops.

Other studies have recently called into question the belief that high cholesterol levels increase your risk of heart disease as you get older. For those over 85 it turns out having high cholesterol will protect you from dying from a heart attack, and, in fact, from death from any cause.

Low Cholesterol May Kill You

A recent study showed that in healthy older persons, high cholesterol levels were associated with lower non-cardiovascular-related mortality. This is extremely concerning because millions of prescriptions are written every day to lower cholesterol in the older population, yet no association has been found between higher cholesterol and heart disease deaths for those aged 55 to 84; and for those over 85, the association seems to be inverse — higher cholesterol predicts lower risk of death from heart disease.

The pharmaceutical industry, medical associations, and academic researchers whose budgets are provided by grants from the pharmaceutical industry continue to preach the wonders of statins, but studies like these should have us look good and hard at our current practices. Are we doing more harm than good?

Cardiologists recommend putting statins in the water and giving them out at fast food restaurants and having them available over the counter. They believe in driving cholesterol as low as possible. Statin prescriptions are handed out with religious fervor, but do they work to prevent heart attacks and death if you haven’t had a heart attack already?

Bottom line: NO! If you want to learn why this is true, read on.

Statins Don’t Work to Prevent First Heart Attacks

Recently, the Cochrane Group did a review of all the major statin studies by an international group of independent scientists. The review failed to show benefit in using statins to prevent heart attacks and death. In addition, many other studies support this and point out the frequent and significant side effects that come with taking these drugs.^[i] If scientists found that drinking two glasses of water in the morning prevented heart attacks, even if the evidence was weak, we would jump on board. Big up side, no down side.

But this is not the case with statins. These drugs frequently cause muscle damage, muscle cramps, muscle weakness, muscle aches, exercise intolerance^[ii] (even in the absence of pain and elevated CPK – a muscle enzyme), sexual dysfunction, liver and nerve damage and other problems in 10-15 percent of patients who take them.^[iii] They can also cause significant cellular, muscle, and nerve injury as well as cell death in the ABSENCE of symptoms.^[iv]

There is no lack of research calling into question the benefits of statins. Unfortunately, that research doesn’t get the benefit of billions of dollars of marketing and advertising that statins do. One big trial was touted as proving statins work to prevent heart attacks, but the devil is in the details.

It was the JUPITER^[v] trial that showed that lowering LDL (or bad cholesterol) without a reduction in inflammation (measured by C-reactive protein) didn’t prevent heart attacks or death.^[vi] Statins happen to reduce inflammation so the study has been touted as proof of the effectiveness of these medications. Mind you it wasn’t lowering the cholesterol that helped (which is the intended purpose of statins), but the fact that they lower inflammation. What is ignored by people who use this study to “prove” that statins work is the fact that there are so many better ways to lower inflammation than taking these drugs.

Yet other studies have shown no proven benefit for statins in healthy women^[vii] with high cholesterol or in anyone over 69 years old.^[viii] Some studies even show that aggressive lowering of cholesterol can cause MORE heart disease. The ENHANCE trial showed that aggressive cholesterol treatment with two medications (Zocor and Zetia) lowered cholesterol much more than one drug alone, but led to more arterial plaque and no fewer heart attacks.^[ix]

Other research calls into question our focus on LDL or the bad cholesterol. We focus on it because we have good drugs to lower it, but it may not be the real problem. The real problem is low HDL that is caused by insulin resistance (diabesity).

In fact studies show that if you lower the bad (LDL) cholesterol in people with low HDL (good cholesterol) that is a marker of diabesity – the continuum of obesity, prediabetes and diabetes — there’s no benefit.^[x]

Most people simply ignore the fact that 50-75 percent of people who have heart attacks have normal cholesterol.^[xi] The Honolulu Heart Study showed older patients with lower cholesterol have higher risks of death than those with higher cholesterol.^[xii]

Some patients with multiple risk factors, or who have had previous heart attacks do benefit, but when you look closely the results are underwhelming. It’s all in how you spin the numbers. For high-risk males (those who are overweight and have high blood pressure, diabetes, and/or a family history of heart attacks) and are younger than 69 there is some evidence of benefit, but one hundred men would need to be treated to prevent just one heart attack.

That means that 99/100 men who take the drug receive no benefit. Drug ads say the risk is reduced by 33 percent. Sounds good, but that just means the risk of getting a heart attack goes down from 3 percent to 2 percent.

Despite the extensive data showing that statins are a questionable therapy at best, they are still the number one selling drug in the US. What isn’t so well known is that 75 percent of statin prescriptions are written for people who will receive no proven benefit. The cost of these prescriptions? Over $20 billion a year.

Yet somehow the 2004 National Cholesterol Education Program guidelines expanded the previous guidelines to recommend that even more people without heart disease take statins (from 13 million to 40 million)^[xiii] What are we thinking?

Why would respected scientists go against the overwhelming research that statins don’t prevent heart disease in people who haven’t already had a heart attack?

You can find the answer if you follow the money. Eight of the nine experts on the panel who developed these guidelines had financial ties to the drug industry. Thirty-four other non-industry affiliated experts sent a petition to protest the recommendations to the National Institutes of Health saying the evidence was weak.

What Should Women Do?

It is time to push the sacred cow of statins overboard.

But first let me say this. If you have had a heart attack, or have heart disease, the evidence shows they do in fact help protect against a second heart attack, so keep taking them.

However, you should be aware that most prescriptions for statins are given to healthy people whose cholesterol is a little high. For these folks the risk clearly outweighs the benefit.

The editorial that accompanies the recent study on women taking cholesterol-lowering medication that I opened this article with was quite clear. Dr. Kirsten Johansen from the University of California, San Francisco said that the increased risk of diabetes in women without heart disease has “important implications for the balance of risk and benefit of statins in the setting of primary prevention in which previous meta-analyses show no benefit on all-cause mortality.”

In plain English, she said that we shouldn’t be using statin drugs for women without heart disease because:

The evidence shows they don’t work to prevent heart attacks if you never had one.
They significantly increase the risk of diabetes.

Treating risk factors like high cholesterol is misguided. We must treat causes – what we eat, how much we exercise, how we handle stress, our social connections and environmental toxins are all more powerfully linked to creating health and preventing disease than any drug on the market.

Remember what you put at the end of your fork is more powerful than anything you will ever find at the bottom of a pill bottle.

My new book The Blood Sugar Solution, which comes out at the end of February, gives exact details on what you should put at the end of your fork to prevent and reverse diabesity. It provides a comprehensive solution to the health problems facing our nation today.

Mark Hyman, MD

[i] Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based? Lancet. 2007 Jan 20;369(9557):168-9

[ii] Sirvent P, Mercier J, Lacampagne A. New insights into mechanisms of statin-associated myotoxicity. Curr Opin Pharmacol. 2008 Jun;8(3):333-8.

[iii] Kuncl RW. Agents and mechanisms of toxic myopathy. Curr Opin Neurol. 2009 Oct;22(5):506-15. PubMed PMID: 19680127.

[iv] Tsivgoulis G, et. al, Presymptomatic Neuromuscular Disorders Disclosed Following Statin Treatment, Arch Intern Med. 2006;166:1519-1524

[v] Mora S, Ridker PM. Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER)–can C-reactive protein be used to target statin therapy in primary prevention? Am J Cardiol. 2006 Jan 16;97(2A):33A-41A.

[vi] Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ; JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008 Nov 20;359(21):2195-207.

[vii]Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based? Lancet. 2007 Jan 20;369(9557):168-9

[viii] IBID

[ix] Brown BG, Taylor AJ Does ENHANCE Diminish Confidence in Lowering LDL or in Ezetimibe? Engl J Med 358:1504, April 3, 2008 Editorial

[x]Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, Kastelein JJ, Bittner V, Fruchart JC; Treating to New Targets Investigators. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007 Sep 27;357(13):1301-10.

[xi] Hansson GK Inflammation, Atherosclerosis, and Coronary Artery Disease N Engl J Med 352:1685, April 21, 2005

[xii] Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet. 2001 Aug 4;358(9279):351-5.

[xiii] http://www.nhlbi.nih.gov/about/ncep/index.htm

How to Ease Neck Pain

DrJoe's BLOG — Fri, 06 Apr 2012 16:12:00 GMT

Do your neck and shoulders feel stiff when you awake in the morning? Or do they seize painfully with no warning? If so, you have plenty of company. Doctors estimate that seven out of 10 people will be troubled by neck pain at some point in their lives, often causing daily aching in the neck and shoulder area.

Sometimes pain starts with the bang of a rear-end collision, but more often, the neck and its surrounding structures begin to ache after years of normal use, overuse, and misuse. Without knowing it, you may be encouraging neck and shoulder pain by the way you perform everyday activities. In general, try to keep your neck in a neutral position, which means your head balances directly over your shoulders and is not leaning forward or cocked to one side. Here are eight hints for achieving a healthy neck posture while performing everyday activities.

At the computer or desk. When working at the computer or at a desk, keep your head balanced directly over your spine as much as possible. That means setting your chair height so both feet rest on the ground, and sitting with your buttocks far back in your chair, using a small pillow to support your lower back if needed. Properly adjusting the keyboard and monitor may be difficult or impossible with a laptop computer.

You can plug a separate, full-size keyboard into a laptop to help you achieve better positioning. But no matter how perfect your office-chair posture, it’s important to get up, stretch, and move around every half hour. If you tend to get lost in your work, program your computer to flash a reminder.
Telephone use. If you spend a lot of time on the phone, try to avoid leaning your head to one side. This is also important when you use a cell phone and aren’t sitting at your desk while you speak. A headset or speakerphone is a good option to help keep your head in a neutral position for hands-free talking. Headsets are available for both your desk phone and cell phone.
Reading at home. If you are sitting in a chair, try to maintain an upright posture. Hold the book so that you don’t have to lean down or forward to see it. A pillow on your lap may help. If you must read in bed, sit up straight or use a specially designed wedge pillow. Or lie on your side with your neck straight and hold the book in front of you.
Walking. Avoid high heels, which change the alignment of your body from the ground up, characteristically ending in a head-thrust-forward position that stresses neck muscles. This may be one reason women have neck pain more than men do.
Carrying a bag. Choose a lightweight purse or backpack, and don’t overload. Don’t sling a backpack over one shoulder. Try switching to a fanny pack or a backpack designed to put weight on the hips instead of just the upper back. With heavier loads, use a wheeled pack or briefcase. If you must hoist a purse on your shoulder, alternate which shoulder you use.
Driving. Posture is a factor in whether a collision will cause whiplash. Your headrest should be high enough and close enough to catch your head in a rear-end collision. Position the seat so you can sit up straight with your head no more than two to four inches in front of the headrest. Adjust the headrest so its upper edge is level with the top of your head: the back curve of your skull should meet the cushion of the headrest.
Lifting. Improper lifting techniques put stress on the neck as well as the lower back. Bend your hips and knees instead of your back. Keep the object close to you while straightening your legs. When lifting something over your head, don’t tilt your neck backward. Strengthen your arms to make proper lifting easier.
Watching TV. Sit far enough from a TV or movie screen that you can watch without tilting your head back. Don’t sit off to the side, forcing you to turn your neck for long periods.

Isometric neck strengthening

This exercise can also be done in a sitting position—at the office, for example, or lying down with your knees bent and feet flat on the floor. Place your palm on your forehead and press gently as you try to bring your chin to your chest—your neck muscles will tighten without your head moving. Hold for a count of 3 to 5 seconds. Repeat 10 times.