Statins Don't Save Lives in People Without Heart Disease. To read more about heart disease and cholesterol, check out the. In the second article, I explained it’s not the amount of cholesterol in your blood that drives heart disease risk, but the number of LDL particles. In the third article, I discussed the five primary causes of elevated LDL particle number. In this article, I will. Researchers and pharmaceutical companies often use relative risk statistics to report the results of drug studies. For example, they might say “in this trial, statins reduced the risk of a heart attack by 3. But what they may not tell you is that the actual risk of having a heart attack went from 0. In other words, before you took the drug you had a 1 in 2. That’s not nearly as impressive as using the 3. With that in mind, let. In the medical literature, these groups are referred to as . Several large controlled trials including 4. S, CARE, LIPID, HPS, TNT, MIRACL, PROV- IT and A to Z have shown relative risk reductions between 7% on the low end in MIRACL and 3. S, with an average risk reduction of about 2. However, absolute risk reductions are much more modest. They range from 0. MIRACL on the low end to 9% in 4. S on the high end, with an average of 3%. An analysis by Dr. David Newman in 2. A heart attack or stroke can have a significant negative impact on quality of life, so any intervention that can decrease the risk of such an event should be given serious consideration. But even in the population for which statins are most effective. Dieting is the practice of eating food in a regulated and supervised fashion to decrease, maintain, or increase body weight. In other words, it is conscious control. Most studies have shown that while statins do reduce cardiovascular disease (CVD) events and deaths from CVD in women, they do not reduce the risk of death from all causes (. Statins do reduce the risk of heart attack and other CVD events in men over the age of 8. However, the bulk of the evidence suggests that statins don’t extend life in people over 8. However, this effect is more modest than most people assume. Newman also analyzed the effect of statins given to people with no known heart disease for 5 years (5): 9. Dietary factors that influence lipid levels include modification of nutritional components, consumption of specific foods, use of food additives and supplements, and. Read the latest Cardiology news, opinion, conference coverage, thought leader perspectives, medical journal articles and more from theheart.org and Medscape. Energy intake and body composition. A total of 36 studies were found. When an alternate-day fasting diet is implemented, overall calorie restriction and weight. Effects on Blood Pressure of Reduced Dietary Sodium and the Dietary Approaches to Stop Hypertension (DASH) Diet. Sacks, M.D., Laura P. These statistics present a more sobering view on the efficacy of statins in people without pre- existing heart disease. They suggest that you. These somewhat unimpressive benefits must also be weighed against the downsides of therapy, such as side effects and cost. During that hypothetical 5 year period, 1 in 6. This is true even when the risk of heart disease is high. In a large meta- analysis of 1. Kausik Ray, MD and colleagues published in the Archives of Internal Medicine, statins were not associated with a significant reduction in the risk of death from all causes. It was important because it was the first review that only included participants without known heart disease. Previous studies suggesting that statins are effective in reducing death in people without pre- existing heart disease included some people that did have heart disease, which would have skewed the results. The lack of significant effect on mortality is even more interesting in light of the fact that LDL cholesterol levels did decrease significantly in the statin group; the average LDL level in those taking placebo was 1. L and the average in the statin- treated patients was 9. L. Yet in spite of this marked reduction in LDL cholesterol in the statin group, there was no difference in lifespan between the two groups. This is yet another line of evidence suggesting that the amount of cholesterol in LDL particles is not the driving factor in heart disease. A meta- analysis of statin trials in people without heart disease by the prestigious Cochrane Collaboration came to a similar conclusion. This is significant because research clearly indicates that industry- sponsored trials are more likely than non- industry- sponsored trials to report favorable results for drugs because of biased reporting, biased interpretation, or both. But statins are not free, nor are they harmless. Statin use has been associated with a wide range of side effects, including myopathy (muscle pain), liver damage, cataracts, kidney failure, cognitive impairment, impotence and diabetes. Unfortunately, studies show that physicians are more likely to deny than affirm the possibility of statin side effects, even for symptoms with strong evidence in the scientific literature. Naveed Sattar and colleagues published in The Lancet in 2. They found that statin use was associated with a 9% increased risk in developing diabetes. Note that this is a relative risk, so the absolute risk of developing diabetes while taking a statin is very low. That said, observational data from the Women. A heart attack or stroke can have a significant, negative impact on quality of life. The decision whether to take them should be based on whether you have pre- existing heart disease, what your overall risk of a heart attack is, how healthy your diet and lifestyle is, what other treatments you’ve already tried, and your own risk tolerance and worldview. It’s clear that statins reduce heart disease as well as the risk of death in those that have already had a heart attack, so if you’re in this group and you’ve already tried diet and lifestyle interventions without much impact on your lipid or inflammatory markers, you are more likely to benefit. In the next and final article of this series, I? Sign up for FREE updates delivered to your inbox. I hate spam too. Your email is safe with me. Dieting - Wikipedia. Dieting is the practice of eating food in a regulated and supervised fashion to decrease, maintain, or increase body weight. In other words, it is conscious control or restriction of the diet. A restricted diet is often used by those who are overweight or obese, sometimes in combination with physical exercise, to reduce body weight. Some people follow a diet to gain weight (usually in the form of muscle). Diets can also be used to maintain a stable body weight and improve health. In particular, diets can be designed to prevent or treat diabetes. Diets to promote weight loss can be categorized as: low- fat, low- carbohydrate, low- calorie, very low calorie and more recently flexible dieting. In his 1. 86. 3 pamphlet, Letter on Corpulence, Addressed to the Public, he outlined the details of a particular low- carbohydrate, low- calorie diet that had led to his own dramatic weight loss. He himself was tremendously overweight and would constantly eat large quantities of rich food and drink. He began a meatless diet, taking only milk and vegetables, and soon regained his health. He began publicly recommending his diet for everyone suffering from obesity. In 1. 72. 4, he wrote An Essay of Health and Long Life, in which he advises exercise and fresh air and avoiding luxury foods. It described the benefits of a meat diet for those suffering from diabetes, basing this recommendation on Matthew Dobson's discovery of glycosuria in diabetes mellitus. In 1. 86. 3, he wrote a booklet called Letter on Corpulence, Addressed to the Public, which contained the particular plan for the diet he had successfully followed. His own diet was four meals per day, consisting of meat, greens, fruits, and dry wine. The emphasis was on avoiding sugar, sweet foods, starch, beer, milk and butter. Atkins used the study to resolve his own overweight condition and went on to popularize the method in a series of books, starting with Dr. Atkins' Diet Revolution in 1. In his second book, Dr. Atkins' New Diet Revolution (1. Low- fat. Calorie consumption is reduced because less fat is consumed. Diets of this type include NCEP Step I and II. A meta- analysis of 1. Low- carbohydrate diets are sometimes ketogenic (i. Low- calorie. Some of the most commonly used low- calorie diets include DASH diet and Weight Watchers. The National Institutes of Health reviewed 3. They found that these diets lowered total body mass by 8% in the short term, over 3. Men should have at least 1,8. Very low- calorie. They subject the body to starvation and produce an average loss of 1. These diets are not recommended for general use as they are associated with adverse side effects such as loss of lean muscle mass, increased risks of gout, and electrolyte imbalances. People attempting these diets must be monitored closely by a physician to prevent complications. Many of these use herbs or celery and other juicy low- calorievegetables. Religious. The Daniel Fast resembles the vegan diet in that it excludes foods of animal origin. Examples include Lent in Christianity; Yom Kippur, Tisha B'av, Fast of Esther, Tzom Gedalia, the Seventeenth of Tamuz, and the Tenth of Tevet in Judaism. Eastern Orthodox Christians fast during specified fasting seasons of the year, which include not only the better- known Great Lent, but also fasts on every Wednesday and Friday (except on special holidays), together with extended fasting periods before Christmas (the Nativity Fast), after Easter (the Apostles Fast) and in early August (the Dormition Fast). Members of The Church of Jesus Christ of Latter- day Saints (Mormons) generally fast for 2. Sunday of each month. Like Muslims, they refrain from all drinking and eating unless they are children or are physically unable to fast. Fasting is also a feature of ascetic traditions in religions such as Hinduism and Buddhism. Mahayana traditions that follow the Brahma's Net Sutra may recommend that the laity fast . Members of the Baha'i Faith observe a Nineteen Day Fast from sunrise to sunset during March each year. Nutrition. They also agree on the importance of reducing salt intake because foods including snacks, biscuits, and bread already contain ocean- salt, contributing to an excess of salt daily intake. It offers a wide array of personalized options to help individuals make healthy food choices. It also provides advice on physical activity. It is important to know the amount of energy your body is using every day, so that your intake fits the needs of one's personal weight goal. Someone wanting to lose weight would want a smaller energy intake than what they put out. There is increasing research- based evidence that low- fat vegetarian diets consistently lead to healthy weight loss and management, a decrease in diabetic symptoms. The first source to which the body turns is glycogen (by glycogenolysis). Glycogen is a complex carbohydrate, 6. It is created from the excess of ingested macronutrients, mainly carbohydrates. When glycogen is nearly depleted, the body begins lipolysis, the mobilization and catabolism of fat stores for energy. In this process, fats, obtained from adipose tissue, or fat cells, are broken down into glycerol and fatty acids, which can be used to generate energy. The former include Weight Watchers and Peertrainer. The latter include Overeaters Anonymous and groups run by local organizations. These organizations' customs and practices differ widely. Some groups are modelled on twelve- step programs, while others are quite informal. Some groups advocate certain prepared foods or special menus, while others train dieters to make healthy choices from restaurant menus and while grocery- shopping and cooking. Food diary. A 2. 00. During prolonged fasting or very low calorie diets the reduction of blood glucose, the preferred energy source of the brain, causes the body to deplete its glycogen stores. Once glycogen is depleted the body begins to fuel the brain using ketones, while also metabolizing body protein (including but not limited to skeletal muscle) to be used to synthesize sugars for use as energy by the rest of the body. Most experts believe that a prolonged fast can lead to muscle wasting, although some dispute this. The use of short- term fasting, or various forms of intermittent fasting have been used as a form of dieting to circumvent this issue. While there are studies that show the health and medical benefits of weight loss, a study in 2. Finns over an 1. 8- year period showed that weight loss from dieting can result in increased mortality, while those who maintained their weight fared the best. The Nurses' Health Study, an observational cohort study, found that low carbohydrate diets based on vegetable sources of fat and protein are associated with less coronary heart disease. A long term study that monitored 4. Swedish women however suggests that a low carbohydrate- high protein diet, used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins, is associated with increased risk of cardiovascular disease. A more recent meta- analysis that included randomized controlled trials published after the Cochrane review. These results can be understood because weight loss is mainly governed by daily caloric deficit and not by the particular foods eaten. The diet based around this research is called the Low GI diet. Low glycemic index foods, such as lentils, provide a slower, more consistent source of glucose to the bloodstream, thereby stimulating less insulin release than high glycemic index foods, such as white bread. Thus the authors concluded that the high- carbohydrate, low- glycemic index diet was the most favorable. A meta- analysis by the Cochrane Collaboration concluded that low glycemic index or low glycemic load diets led to more weight loss and better lipid profiles. However, the Cochrane Collaboration grouped low glycemic index and low glycemic load diets together and did not try to separate the effects of the load versus the index. Retrieved 2. 9 November 2. The American Psychologist. In sum, there is little support for the notion that diets . The American Journal of Clinical Nutrition. Retrieved 2. 2 December 2. Obesity (Biographies of Disease). Westport, Conn: Greenwood. Retrieved 1. 7 December 2. Joslin's Diabetes Mellitus: Edited by C. Lippincott Williams & Wilkins. ISBN 9. 78- 0- 7. Retrieved 2. 0 June 2. Chalem (5 September 2. Essential Diabetes Leadership. ISBN 9. 78- 1- 4. Retrieved 2. 0 June 2. Retrieved 2. 6 December 2. Retrieved 2. 6 December 2. USA: New York: Cosimo Classics. ISBN 9. 78- 1- 5. Retrieved 2. 8 December 2. Candy: A Century of Panic and Pleasure. New York: Faber & Faber, Incorporated. Counsels on Diet and Foods(PDF). Lipids in Health and Disease. Retrieved 2. 6 July 2. Archived from the original on 2. May 2. 01. 0. Retrieved 2. July 2. 01. 0. Current Diabetes Reports. The Lifestyle Heart Trial. Lancet (London, England). British Medical Journal. Cochrane database of systematic reviews (Online) (2): CD0. Retrieved 2. 1 September 2. Written at University of Sydney, Children's Hospital at Westmead, CEBPGAN (Centre for Evidence Based Paediatrics Gastroenterology and Nutrition. Cochrane database of systematic reviews (Online). USA: John Wiley & Sons, Ltd. American Journal of Clinical Nutrition. USA: The American Society for Clinical Nutrition, Inc. Written at Human Nutrition Unit, School of Molecular and Microbial Biosciences, University of Sydney, Sydney, NSW, Australia. The Journal of Nutrition. USA: The American Society for Nutritional Sciences (published September 2. Written at Human Nutrition Unit, University of Sydney, Sydney, Australia. Archives of Internal Medicine. USA: American Medical Association (published 2. July 2. 00. 6). Cochrane database of systematic reviews (Online) (3): CD0. Cheraskin Emmanuel (1. Journal of Orthomolecular Medicine. Dansinger, M. L., Gleason, J. L., Griffith, J. L., et al., . Never Satisfied: A Cultural History of Diets, Fantasies, and Fat. New York: Free Press/Macmillan, 1. Paleo diet carbohydrate list and carb counter(If you would like these carbohydrate charts as a PDF, simply donate via paypal – at right – to get my paleo book sent to you – it also has omega 3& 6 charts and protein charts, plus 5. One recurring theme in the paleo world is carbohydrate confusion. Should I eat carbohydrates if I want to lose weight, and if so how much? There are a couple of contributing factors to this confusion: 1. The paleo diet has become viewed as a low carbohydrate diet. This stems from the work done by Cordain, Eaton and others whose research found that the majority of paleo and hunter gatherer diets are lower in carbohydrates and higher in protein and fat than today’s diet. However it needs to be noted (again) that this may be because of the dietary availability of carbohydrates, and the higher availability of protein sources. The Kitavan diet is a widely used example of a high carbohydrate paleo diet. Kitavan people are lean and healthy. Very low carbohydrate diets are widely promoted for weight loss, and the low carbohydrate trend has become entwined with paleo eating. We are taught / or under the impression by very low carbohydrate advocates that any amount of carbohydrate which causes even the slightest rise in blood sugar, will raise insulin, and will cause us to turn carbs into fat and store it. A diet high in refined carbohydrate diets is not healthy – especially the standard western diet, where carbohydrates are eaten far in excess of requirements. The sources of carbohydrates are mostly from grains and sugar / fructose, all of which contribute to health issues. As a result of our highly disordered eating – we are eating crappy carbohydrates in obscene amounts that are contributing to metabolic disease, inflammation, overeating and obesity – we’ve put most of the blame on carbohydrates, and consequently we’ve made all carbohydrates baddies. Most feel better on a moderate carb diet, which is still a lot lower in carbs than the standard western diet, and more importantly if you eat a paleo diet, you will be cutting out the damaging carbohydrates. Quality carbohydrates eaten in the context of a paleo diet will be less that the standard diet. I’ve been working with a moderate carb diet for years – people still lose weight easily. How much carbohydrate do you need to feel / perform your best? I like the work of Paul and Shou- Ching Jaminet, who recommend about 4. Barry Sears, who recommends approx 1 – 1. I’ve worked with hundreds of people, and in my observation most people feel best at around these amounts, they have good energy, sleep well, have good appetite control and lose weight, and don’t get any of the long- term problems that many people report on very low carb diets (less than 5. It takes around 3 cups of cooked sweet potato to get 1. I regularly see people eat far less than this, and wonder why they don’t feel great. I also see many Cross. Fitters eating low carb diets and suffering – low energy, poor recovery, sleep problems, adrenal fatigue. Cross. Fit and other high intensity workouts deplete glycogen fast. If you don’t replace it you wont perform at your best. I’ll leave it up to you to experiment on what works best for you. But I’d recommend no less than 8. If you are smaller, more sedentary, and prone to an apple shape, around the 8. The bigger you are, the more exercise you do, eat more. If you are lean, or tend to a pear shape – you will probably feel better with more – i. To make it easy for you to get enough paleo carbs – I’ve done some charts with carb counts. All portion sizes are approximately 1. Easy. Of course you don’t need to count carbs, but in my observation, many in the paleo world do not eat enough carbs. This is because they eat lots of volume of vegetables, but not enough of the carbohydrate containing ones. I’ve used cup measurements as portion sizes, you can easily translate this to a volume that you can.
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