Skip to content

Are statins overprescribed? Currently many people without heart disease and at low risk of heart disease are taking them as a preventive, what is known as "primary prevention". Over the years, changes in medical guidelines have resulted in more and more lower risk older healthy people being prescribed statins. But there has been controversy over this: Are the statins really preventing heart disease and deaths in these low risk people? Also, do the benefits outweigh the harms (because all medications have side-effects, some more serious than others)? Finally, are the extra financial costs worth it?

recent study published in the prestigious British Medical Journal (BMJ) suggests that statins may be overprescribed in many such lower risk cases.  But please, keep in mind that for people with heart disease, statins are uncontroversial, where there are clear benefits. The controversy is regarding statins for low risk people without heart disease.

For example, the study researchers point out that studies find that statin use can be associated with an increased risk of diabetes, various muscle problems, and hemorrhagic stroke, as well as some  milder side-effects. Yet, looking at just one country (Ireland), with the latest medical guidelines it would take about 400 lowest risk healthy people taking statins to prevent one major cardiovascular event. And the statins would be taken for years. Is it worth it? Also, the studies being published are those favorable to the pharmaceutical industry, while under reporting harms.

From Medical Xpress: For most healthy people, benefits of statins 'may be marginal at best'   ...continue reading "Are Statins Overprescribed?"

A new large study found that eating a flavonoid rich diet is associated with a lower risk of death. Flavonoids are compounds found in abundance in plant derived foods and beverages, such as fruits, vegetables, dark chocolate, tea, legumes, and red wine. The study followed about 56,000 people in Denmark for 23 years and found that eating higher levels of flavonoid rich foods was associated with a lower risk of death from any cause (all-cause mortality), heart disease (cardiovascular disease), and cancer.

The researchers found that there was an inverse relationship (the more one eats, the lower the risk of death), and that this relationship was strongest among cigarette smokers and people who consume high amounts of alcohol (more than 20 grams per day). Bottom line: Make sure your diet includes lots of fruits, vegetables, legumes, and dark chocolate (yes!).

By the way, while other studies do find a lower incidence of heart disease and cancer in people eating a diet rich in flavonoids, in this study they were not looking at who got the diseases, but looked at deaths. Therefore the following title is misleading. It should instead say "... protects against cancer and heart disease deaths..." From Science Daily: Flavonoid-rich diet protects against cancer and heart disease, study finds  ...continue reading "Eating Foods Rich In Flavonoids Has Health Benefits"

Are we looking at vitamin D and sunlight the wrong way? Back in 2016 I posted about the results of a long-running Swedish study that made me rethink everything I knew about sunlight and health. (The prevailing view of dermatologists at the time and now is: to always use sunscreen if going outdoors in order to lower the risk of skin cancer. In other words, that sunlight is always harmful.)

The Swedish study followed women for 20 years and found that: Women who had more sunlight exposure experienced a lower mortality rate than women who avoided sun exposure. However, they were at an increased risk of skin cancer. But those with more sun exposure lived longer due to a decrease in heart (cardiovascular) disease and other noncancer reasons. And the most surprising finding: Nonsmokers who avoided sun exposure had a similar life expectancy as smokers with the highest sun exposure. In other words: avoidance of sun exposure = cigarette smoking when looking at life expectancy. And the results of sun exposure was dose-dependent, with the more, the better for longer life expectancy.

The researchers suggested that  a person's vitamin D levels might be just a marker of sun exposure, which other studies and articles now also suggest. So while we measure vitamin D levels in studies, maybe we should instead be looking at sunlight exposure.

Since then I read more studies that found other benefits of sunlight exposure, such as sunlight having low levels of "blue light" which energizes T cells. T cells are a type of white blood cell, are part of the immune system, and help protect the body from infection and cellular abnormalities (cancer). An earlier study found that exposing skin to sunlight may help to reduce blood pressure and thus cut the risk of heart attack and stroke.

This year I read the following two nicely written articles about this whole issue, both a little different - so worth reading both to get a good idea about the research and the debate.

1) From Outside: Is Sunscreen the New Margarine?

2) From Elemental Medium: What If Avoiding the Sun Is Bad for You?

And once again, a link to the 20 year Swedish study, from the Journal of Internal Medicine: Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort

The Paleo diet has been around for years and yet it continues to be controversial. The debate is whether following the Paleo diet long-term has health benefits or not? Supporters of the Paleo (Paleolothic) diet say it promotes gut health and is good for gut microbes, but recent research findings are a strike against this claim. The Paleo diet is based on the hypothesis that humans have not adapted to eating products of agricultural farming such as grains, dairy products, or legumes (beans), as well as all processed foods, so they should be avoided. Instead it stresses eating meat, fish, eggs, nuts, (some) fruits, and vegetables.

So what were the new research findings?  Australian researchers found that people who had been on a Paleo diet for more than a year ate lower amounts of resistant starch, and so had a different bacteria profile in the gut - with lower levels of some beneficial species. They also had high levels of a biomarker in the blood (trimethylamine-n-oxide or TMAO) that is linked to heart disease.

The problem seems to be the lower intake of resistant starch - which is a carbohydrate that resists digestion in the small intestine and ferments in the large intestine. As the fibers ferment they act as a prebiotic and feed the beneficial bacteria in the gut. More than one type of resistant starch can be present in a single food. And what foods contain resistant starches? Precisely some foods avoided in the Paleo diet: grains, rice, beans, peas, lentils, plantains, and green bananas. A number of studies find health benefits (e.g. gut health) from eating foods with resistant starches.

From Medical Xpress: Heart disease biomarker linked to paleo diet

People who follow the paleo diet have twice the amount of a key blood biomarker linked closely to heart disease, the world's first major study examining the impact of the diet on gut bacteria has found.  ...continue reading "Problems With Paleo Diet?"

Once again research is finding effects on health from nanoparticles and air pollution - this time the heart. Tiny air pollution particles less than 100 nm (nanometers) in size are typically called "ultrafine  particles", but actually they are so small that they are nanoparticles. They are NOT regulated in the United States, even though many researchers feel that they are the most dangerous particles found in air pollution. This is because their small size means they are easily inhaled and then get into human lungs and organs, and even cells. Where do they come from? They get into the air from industry (e.g. metal processing, power generation plants), from the exhaust of vehicles (from vehicle combustion), and from friction when using vehicle brakes.

The researchers write that the air in polluted urban areas and next to roads have a lot of these iron-rich nanoparticles from vehicle combustion and friction. And also that these particles are "strongly magnetic". Earlier research in the urban Mexico City area found that these nanoparticles were found in the brains of all people, starting at young ages (they had died suddenly in accidents, which is why the brains could be analyzed). Keep in mind that Mexico City has high levels of air pollution, but so do many other urban areas throughout the world.

This latest study from a team of international researchers analyzed both the hearts of young people who died suddenly, as well as animals - and they compared the results from those exposed to high levels of urban air pollution (Mexico City metro area) and those from areas with low amounts of air pollution (the "controls"). The results were not good: all hearts from the Mexico City area (high air pollution) had lots of the same iron-rich magnetic nanoparticles ("in abundance") that are found in the air. Billions of nanoparticles in each heart, even in the youngest 3 year old child!

These nanoparticles are inhaled, then enter the person's circulatory system (carried by blood cells), and then into cardiac cells. As the researchers stated: the magnetic nanoparticles were "highly abundant in left ventricular samples from young subjects exposed to high concentrations of particulate air pollution above current US EPA standards. The organelles and structures containing abundant nanoparticles displayed substantial abnormality". Hearts from low pollution areas appeared normal.

This could explain why people living in polluted urban areas, including in the United States, have a greater risk for heart disease (cardiovascular disease), including heart attacks and strokes, as well as premature death. This research also highlights why we need to regulate these tiny particles in the air. As the researchers said: "This is a serious public health concern".

Excerpts from The Guardian: Billions of air pollution particles found in hearts of city dwellers   ...continue reading "Pollution Nanoparticles Found In Human Hearts"

1

Do you routinely work more than 10 hours a day at your job? Uh-oh. A large study conducted in France found that individuals working long hours had a 29% greater risk of stroke, and those working long hours for 10 years or more had a 45% greater risk of stroke. What exactly are long working hours? The study defined long working hours (LWH) as working more than 10 hours daily for at least 50 days per year.

The researchers looked at people who had full-time jobs, and did not separate out types of strokes - both ischemic and hemorrhagic strokes were lumped together in this study. Another interesting finding was that the risk for stroke was greater among people under the age of 50 who reported long working hours for more than 10 years. And this association had a "lower effect for owners, chief executive officers, professionals, and farmers" - all occupations where people had greater control over decisions during their days.

Studies from other countries found a similar association. For example, in Japan, 60% of death from over-work (called karoshi) cases who received worker compensation died of stroke.

From Science Daily: Long work hours associated with increased risk of stroke  ...continue reading "Long Work Hours Associated With Increased Stroke Risk"

What's with the blueberry obsession in medical studies? Another study finding health benefits with frequent eating of blueberries was recently published in the American Journal of Clinical Nutrition. Researchers at the Univ. of Anglia in the United Kingdom found that eating one cup of blueberries daily for 6 months reduced risk factors for cardiovascular disease (e.g. improvements in endothelial function, systemic arterial stiffness, and HDL cholesterol concentrations). They predicted that this would result in 12 to 15% reductions in heart (cardiovascular) disease risk.

The nicely done study was conducted on 138 overweight or obese men aged 50 to 75 years, all with Metabolic syndrome (e.g. hypertension, low levels of HDL cholesterol, impaired fasting glucose) - thus a group at risk for heart disease. Interestingly, ingesting 1/2 cup of blueberries a day did not have health benefits  - only 1 cup of blueberries a day did. So it was dose dependent -the more, the better. However, the study did not find any improvements in blood pressure or insulin resistance (glucose control) at the end of 6 months.

Remember, one should not focus on individual foods (e.g. blueberries), but should strive for a good dietary pattern, such as the Mediterranean diet. That means a diet rich in fruits and vegetables, whole grains, seeds, nuts, and legumes. These foods have lots of fiber and feed the beneficial microbes in the gut. Eating one beneficial food such as blueberries won't overcome an entire unhealthy dietary pattern, such as the Western one (lots of highly processed foods, low in fiber, lots of fast food, sugary drinks, etc).

BOTTOM LINE: While this study focused on blueberries, research shows that eating all types of berries (blueberriesblackberries, raspberries, lingonberries, bilberries, strawberries, etc.) have health benefits. One should actually try eating a variety of berries, if possible, because they all have different nutrients, microbes (to feed beneficial bacteria in the gut), and different health benefits.

From Medical Xpress: Eating blueberries every day improves heart health   ...continue reading "Eating Blueberries Frequently and Heart Health"

Eat real foods, not supplements. Study after study has found beneficial health effects from eating real foods, but not from taking supplements. Now another large study found similar effects - eating real foods was linked to a lower risk of death for any reason (all cause mortality) and death from heart disease (cardiovascular), which was not found with supplements. The only dietary supplement that was associated with a lower risk of death and cancer was lycopene.

In fact, the Tufts University researchers also found that excess intake of calcium from supplements (exceeding 1,000 mg/day) was associated with a 62% increased risk for dying from cancer, but this was not found with foods. And even in persons with a low intake of nutrients from foods, the use of dietary supplements had no effect on the risk of death.The study conclusions were that: "Use of dietary supplements is not associated with mortality benefits among U.S. adults."

From Medical Xpress: Nutrients from food, not supplements, linked to lower risks of death, cancer

...continue reading "Getting Nutrients From Food (But Not Supplements) Linked to Lower Risk of Death"

Many, many people wind up taking numerous courses of antibiotics at some points in life. Think of recurrent sinus infections or urinary tract infections or other infections. Or some conditions (e.g. dental or skin conditions) are treated with really long courses of antibiotics  New research (from 36,429 women participating in the long-running Nurses' Health Study)  found that women who take antibiotics over a long period of time during middle-age (40 to 59 years old), but even more so in late adulthood (60 years and over), are at increased risk of heart attack or stroke within the next 8 years.

How increased a risk for cardiovascular diseas? 28% or higher risk (compared to those who didn't take antibiotics)! But looking at the actual numbers it means: Among women who take antibiotics for two months or more in late adulthood, six women per 1,000 would develop a cardiovascular disease, compared to three per 1,000 among women who had not taken antibiotics.

Eight years was the length of the study, so it is unknown if the increased risk persists longer. The authors give a number of possible reasons for these results, but think it might be because antibiotic use results in gut microbial alterations. And the longer the antibiotic use, the more persistent the gut microbiome (microbial community) alterations. Other research studies supports this link (antibiotic use - gut microbe disruptions - increased cardiovascular disease). Another reason to eat in as healthy a manner as possible to feed beneficial gut microbes: a diet rich in fruits, vegetables, whole grains, seeds, and nuts.

From Medical Xpress: Antibiotic use linked to greater risk of heart attack and stroke in women

Women who take antibiotics over a long period of time are at increased risk of heart attack or stroke, according to research carried out in nearly 36,500 women. The study, published in the European Heart Journal today, found that women aged 60 or older who took antibiotics for two months or more had the greatest risk of cardiovascular disease, but long duration of antibiotic use was also associated with an increased risk if taken during middle age (aged 40-59). The researchers could find no increased risk from antibiotic use by younger adults aged between 20-39.  ...continue reading "Link Between Antibiotics, Heart Attacks, and Stroke Risk In Older Women"

How many times have you heard to eat lots of fruits, vegetables, whole grains, nuts, legumes (beans), and seeds? Study after study finds that eating a diet rich in these foods is linked to all sorts of health benefits. A big reason is that they have lots of fiber - which feeds beneficial microbes in our gut. A recently published review of studies in the prestigious journal Lancet examined studies done over the past 40 years and found numerous health benefits.

The researchers found that people consuming high levels of dietary fiber and whole grains have a lower risk of death from heart disease (cardiovascular mortality) and death from any cause. They also have a lower incidence of heart disease, stroke, type 2 diabetes, and colorectal cancer (as compared to those eating less fiber). There was a dose-response effect - in other words, the more fiber eaten daily, the lower the incidence of these diseases and deaths. They also found that a high fiber diet is also linked to lower cholesterol levels, lower weight, and lower blood pressure.

This study viewed 25 to 29 grams per day as a high fiber diet, but said the findings suggest that higher levels of fiber would be even more protective. Which means put down that delicious white bread and sugary cereal and start eating whole grain foods! Nowadays the average person eats less than 20 grams of fiber per day, but guidelines say to eat at least 30 grams per day. The researchers pointed out that getting fiber from real food is best.

From Science Daily: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

People who eat higher levels of dietary fiber and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycaemic load and low glycaemic index diets are less clear. Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fiber a day, according to a series of systematic reviews and meta-analyses published in The Lancet.  ...continue reading "Eating Lots of Fiber Has Health Benefits"