OT - Cardiologists recommend wider use of statin drugs

[49er]

I know there has been controversy about posting OT topics but this is the first one I have posted in a while. Also, statins have been discussed on this list before and since this announcement could effect alot of people, I thought it would be of interest to forum members.

http://www.latimes.com/nation/la-sci-st ... z2kVrtNdrY

49er

[Lazer1234]

I already eat Atorvastatin, and that article would double the number of Americans who are going to eat it. I think it's important to avoid carbs, I myself have stopped, as best i can, to eat cereal, no bread, no sugar.
I notice in my body when I eat carbs now, that condition deteriorates. When I avoid carbs, I feel stronger and more energetic. I do not think it's all in my head.

[Todzo]

I already eat Atorvastatin, and that article would double the number of Americans who are going to eat it. I think it's important to avoid carbs, I myself have stopped, as best i can, to eat cereal, no bread, no sugar.
I notice in my body when I eat carbs now, that condition deteriorates. When I avoid carbs, I feel stronger and more energetic. I do not think it's all in my head.

I keep hearing mixed reports about statins. It seems that they are effective in only certian groups.

I think we need all kinds of food but getting the mix right with the rest of our lifestyle is the key.

Currently I try to "keep it moving" (walking, cycling, resistance training, considering some running) for at least two hours a day.

But I absolutely agree with you that carbs should be minimized. I think veggies should be maximized both in terms of portion and variety.

I very much notice that as the foods that I eat are balanced with my activity, as my stomach shrinks and my muscles grow, I feel much better.

I think it is very much better to put the body back in balance with things other than drugs if at all possible.

[Iowamv]

Interesting that the news media is zeroing in on statins as the big message. Here's the report that triggered the news:
http://content.onlinejacc.org/data/Jour ... /11003.pdf

Glance over it and count the number of times you see the words "diet" and "exercise." I know medication is important for a lot of people, but there is more to the story.

The search for solutions in the form of a pill, and solutions that require no modifications to behavior, continues.

[robysue]

The search for solutions in the form of a pill, and solutions that require no modifications to behavior, continues.

To be fair: I think the doctors get more than a bit tired of telling the same patients year after year after year, "You need to lose weight, get more exercise, drink less, and quit smoking."

The sad fact is: Changing behavior patterns in people is very, very difficult. Even when people are motivated, changing long term behavior is difficult.

The people on this board are atypical patients---not only are we atypical OSA patients, we're atypical across the board. We're more likely to question all of our doctors in an intelligent way and we're more likely to be willing to do the hard work to make long term life style changes than the run of the mill American happens to be.

And even so, it's difficult.

For example: Todzo has mentioned the need to get two hours of pretty hard core exercise/activity per day. If you are working full time (I am) and have a family to take care of, finding two hours to go off and exercise each and every day can be tough. I'm finding it hard to find the time to squeeze in the hour-long walk that I know I need each day. Part of it is time and part of it is motivation. Walking in cold, wet raining fall weather in Buffalo ain't anybody's definition of "fun" and it aggravates a pain of unknown orignin in my right butt/hip something fierce.

And lots of folks mention low carb diets. Fine in principle---but realistically I can stick with a genuinely low carb diet for about 2-3 days before I become a mean snarling bitch because I want some real honest (whole grain) bread or (whole grain, unsweetened) cereal because I really and truly don't like the taste and texture of most fruits or veggies.

So I do what I can and I try (hard) to NOT worry about how much more I should be doing because the stress of the disconnect between what I should[/b] be doing and what I can reasonably do feeds the insomnia monster.

[bwexler]

Some light reading before bedtime recommendations, The Cholesterol Conspiracy by Dr Ladd McNamara (a personal friend), Death By Prescription and Releasing Fat, by Dr Ray Strand.
These books are among those that shed a different light on how to approach health rather than disease management.

[Guest]

Glance over it and count the number of times you see the words "diet" and "exercise." I know medication is important for a lot of people, but there is more to the story.

The search for solutions in the form of a pill, and solutions that require no modifications to behavior, continues.

Then there are those of us that need a "pill" to help us take better care of our bodies. I am diabetic and recently diagnosed with sleep apnea. I have lost forty-four pounds in the past year to take more control of my body and be healthier but my triglycerides have gone out of control even with weight loss and a statin caused them to come down from 266 to 138 in a two month time. Will I continue to take a "pill" to help - you betcha.

[DoriC]

I read a similar long article in our paper but I'm concerned not only about the science but about 2 paragraphs..."Roughly half the panel members have financial ties to makers of heart drugs, but panel leaders said no one with industry connections could vote on the recommendations".
"It is practically impossible to find a large group of outside experts in the field who have no relationships to industry", said Dr. George Mensah of the Heart Institute.

I'll be very interested in the opinions of our Primary, Cardio and my son(The Doctor)!

[ems]

So I do what I can and I try (hard) to NOT worry about how much more I should be doing because the stress of the disconnect between what I should[/b] be doing and what I can reasonably do feeds the insomnia monster.

I think it feeds insomnia and many other problems I/we have. I've also come to the conclusion that I can only do the best I can. I think constant "worrying" and guilt is a huge problem in and of itself.

Sure, the manufactures of statins stand to make even more money but I will continue to take mine. My numbers are down almost 80 points since I started a statin 7 years ago. For the other folks who are able to keep their numbers low by healthy eating and exercise, more power to them. There is also a middle line... which I find more appealing. Be smart, be aware and then have a low fat ice cream cone.

[ems]

I'll be very interested in the opinions of our Primary, Cardio and my son(The Doctor)!

Yes, please tell us what your son, the "Doctor", thinks about this.

[BlackSpinner]

And lots of folks mention low carb diets. Fine in principle---but realistically I can stick with a genuinely low carb diet for about 2-3 days before I become a mean snarling bitch because I want some real honest (whole grain) bread or (whole grain, unsweetened) cereal because I really and truly don't like the taste and texture of most fruits or veggies.

Think very carefully about this symptom because it is usually associated with addiction and addiction to foods is often associated with allergy and intolerance and inflamation. You might want to get tested.

[Iowamv]

Glance over it and count the number of times you see the words "diet" and "exercise." I know medication is important for a lot of people, but there is more to the story.

The search for solutions in the form of a pill, and solutions that require no modifications to behavior, continues.

Then there are those of us that need a "pill" to help us take better care of our bodies. I am diabetic and recently diagnosed with sleep apnea. I have lost forty-four pounds in the past year to take more control of my body and be healthier but my triglycerides have gone out of control even with weight loss and a statin caused them to come down from 266 to 138 in a two month time. Will I continue to take a "pill" to help - you betcha.

Absolutely. Diet and exercise won't fix everything. Not by a long shot. I'm right there with you. Good for you for being proactive about your health!

[robysue]

And lots of folks mention low carb diets. Fine in principle---but realistically I can stick with a genuinely low carb diet for about 2-3 days before I become a mean snarling bitch because I want some real honest (whole grain) bread or (whole grain, unsweetened) cereal because I really and truly don't like the taste and texture of most fruits or veggies.

Think very carefully about this symptom because it is usually associated with addiction and addiction to foods is often associated with allergy and intolerance and inflamation. You might want to get tested.

Perhaps. But I'm not sure where you're going with this. Perhaps you think I'm addicted to carbs???? Because I don't like the taste of most fruit and the texture of most veggies?

I can tell you this: Most fresh fruit tastes way, way too sweet to me. (As do many sugar filled "treats". But I do confess a weakness for almost all things chocolate.) And veggies? Cooked veggies are either very mushy (which I don't like) or very strong smelling (which can trigger a migraine ) or both. (And yes, I do mean I can get a migraine from things like the smell of cooked cabbage.) Raw veggies? As long as my TMJs are not acting up, I'll eat them. But salads and raw veggies get old if you eat them day after day without much break ....

At any rate, it is very, very difficult to eat food that you do not really enjoy eating day after day while surrounded by food that you do like, but has been made "forbidden" for you to eat.

Weight has never been an issue for me: I have been at more or less constant weight for my entire adult life (100-110 pounds since 8th grade, except for two pregnancies, a couple of (externally induced) stressful times when my weight dropped below 100, and a few times it's gone up to 115 in response to (short term) medication. I got into this whole "low carb diet" stuff because my triglerides were slightly elevated on the last blood test (about 6 months ago).

Now I don't mind working on adding the fruits and veggies to my diet. But I found out that I do mind being told give up carbs almost entirely. Which was what the first round of dietary advice was. And that proved ridiculously hard because my normal old, diet was NOT particularly filled with the really bad carbs. In other words, all the "easy" things to cut were already NOT a big part of my daily diet----In other words, thinks like sweetened soft drinks, desserts/sweets made with white flour and sugar, lots of potatoes did NOT make up a large part of my diet in the first place. So cutting carbs meant cutting the whole wheat (or other whole grain) bread and whole grain, unsweetened cereals which were a big part of my daily diet---I typically ate a lot these things at every meal. Without the decent quality bread/cereal it felt like I had not eaten anything. Adding additional salads (which I don't mind, but get tired of) and fruit and veggies (which I eat, but do not like) to my diet simply did not satisfy me. It's not that I was hungry all the time; it's that the pleasure of eating what tastes good had been replaced by the chore of eating what was on the low carb diet guidelines. That's what makes me bitchy after two or three days of a low carb diet: I get very sick of the chore of eating a whole bunch of food that just plain does not taste very good to me, and I miss the food that does taste good to me. (It doesn't help that we're also surrounded by a sea of ads talking about "heart healthy" aspects of "whole grains" when you've been told to cut down on the whole grain carbs too.)

After a long chat with my doc about the very real difficulties that I was having with the low carb diet guidelines, he told me I was trying to be far, far more compliant with the low carb diet than most patients---i.e. I was taking the guidelines way too seriously. He said that they hoped people would be 40% "compliant" and cut out some carbs and add at least a bit of fresh fruit and veggies to each meal. And that's now what I do: Rather than hold myself to a diet that I simply do not enjoy eating because it tastes bad to me, I try to be sensible: I make a serious attempt to replace at least one or two servings of carbs at every meal with the fruits or vegetables that I don't like, but I don't try to eliminate all or nearly all the carbs from my diet.

And being sensible about carbs does NOT drive me crazy and make me bitchy. There are some days that I actually do manage to eat a genuinely low carb diet all day long; but there are seldom more than 2 of them in a row. But even on my highest carb days, I'm usually eating fewer carbs and a lot more fruit and veggies than I was a year ago. Overall, my new diet would not qualify as "low" carb, but I do believe it's probably "good enough" and it's certainly "lower in carbs" than my old diet was.

[Janknitz]

And lots of folks mention low carb diets. Fine in principle---but realistically I can stick with a genuinely low carb diet for about 2-3 days before I become a mean snarling bitch because I want some real honest (whole grain) bread or (whole grain, unsweetened) cereal because I really and truly don't like the taste and texture of most fruits or veggies.

What Black Spinner said and this: One of the reasons a low carb diet works is that it depletes your stores of excess glycogen. Each gram of glycogen carries about 4 grams of water. So the initial weight loss is water loss (first week or so). Around day 3 people start to feel HORRIBLE if you don't replace fluid and have adequate sodium and potassium to avoid dehydration. It's referred to as "low carb flu" or "Atkins flu". Drinking plenty of fluid and supplementing potassium and sodium can get you over the hump. A common "prescription" for those days is salty broth, leafy green veggies and avocados for the potassium. Once you get past that "bump" (usually by day 7) you start feeling FANTASTIC. Energy soars, real fat loss occurs, health issues start to improve and you feel better and better.

Most people simply don't give low carb enough of a chance. They don't read up and aren't expecting this transition, and when it occurs they don't quite know what to do. Kind of like adjusting to CPAP--it doesn't happen overnight, and you have to do a little self-education to understand what's happening and how to get through it. Once you get through it, your body adjusts and you can feel great.

RobySue, you identify yourself as thin, and you may not NEED a low carb diet (although there are probably tweaks to your current diet that might improve health). But for those who do, understanding this adjustment period and working through it are crucial. I hate to see people give up because they aren't expecting or prepared to deal with this metabolic change. Too many people give up far too soon. A low carb diet is so much easier and better than a pill, when it comes right down to it.

As for these new statin guidelines, what a lot of BUNK! There's NO evidence that women benefit from statins. Male or female, lower cholesterol does NOT prevent cardiovascular events--50% of people who have heart attacks have LOW cholesterol already. Multiple studies have found this. And our body makes cholesterol for a reason, we NEED it and we'd die without it. Low cholesterol doesn't translate to better health. For example, a study in Lancet (A.W. Weverling-Rijnsburger, et al., "Total Cholesterol and the Risk of Mortality in the Oldest Old," Lancet 350, no. 9085 (October 18, 1997): 1119 - 23) found that each 39 point increase in total cholesterol corresponded to a 15% decrease in mortality risk. But other causes of death were dramatically associated with lower cholesterol--deaths from cancer and infection "were significantly lower among the participants in the highest total cholesterol category than in the other categories." Dr. David Perlmutter writes "when you compare the lowest- and highest-cholesterol groups [in this study], the risk of dying during the study was reduced by a breathtaking 48% in those who had the highest cholesterol. High cholesterol can extend longevity." In the Framingham study they found that post-menopausal women who had the highest total and LDL cholesterols lived longer and healthier.

Meanwhile, statins are associated with serious side effects from muscle weakness and pain, to diabetes and dementia. When you look closely at the studies purporting to "prove" that statins are beneficial, you find that the "numbers needed to treat" are huge, and there is NO real benefit to anyone except a very small segment of the population--men under 65 who have already had one heart attack. Even that benefit is modest.

More and more the medical community is beginning to recognize that total cholesterol and LDL numbers don't really represent the risk for cardiovascular disease, it's inflammation which is the root cause. Our bodies manufacture excess cholesterol in response to inflammation, but squelching the cholesterol production is about as effective as killing off the firefighters responding to the fire--it's treating the symptom and not the cause, and doing so INTERFERS with the body's protective response. The root causes of inflammation are diet, infection, toxic exposure in our environment, and stress. Some people claim that there are anti-inflammatory properties of statins, but there are much better and more effective approaches to reduce inflammation including avoiding inflammatory oils like transfats and polyunsaturated Omega 6 oils--canola and soy oil chief among them--keeping blood sugar in the low normal range, eating a nutrient dense diet to improve immunity, reducing environmental toxins, and stress reduction. If you don't have insulin resistance, a low carb diet may not be necessary, but you should certainly understand what excess sugar and gluten containing grains may be doing to your body over the long run. And treating apnea is key to getting adequate sleep and reducing those stress hormones we all were bathing in each night. So all of us here are at least on the right path.

[Julie]

Just a reminder - fruit and most veggies ARE carbohydrates. I think when people refer to carbs they think only of bread, pasta, potatoes, etc., but you can't live realistically without some carbs... not unless you're a pure carnivore!