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"The role of blood cholesterol levels in coronary heart disease (CHD) and the true effect of cholesterol-lowering statin drugs are debatable. In particular, whether statins actually decrease cardiac mortality and increase life expectancy is controversial."
This is in a cardiology journal.
SuzyQ will always find some drug company research claiming a 45% reduction in mortality with statins, or something like that. Yes, you certainly can find them. And you can also find the opposite.
The authors conclude, "Coronary heart disease is an extremely complex malady and the expectation that it could be prevented or eliminated by simply reducing cholesterol appears unfounded."
I do not think anyone claims that the only way to reduce coronary heart disease is by "simply" reducing cholesterol. Lifestyle changes, including the Mediterranean diet, are the foundation of CHD prevention.
The article does not discuss the role of cholesterol crystals in plaque rupture. It does not mention the anti-inflammatory effect of statins, while mentioning inflammation.
They say, "Paradoxically, statins have gone on to become a multi-billion dollar industry and the foundation of many cardiovascular disease prevention guidelines while the Mediterranean diet has often been ignored."
The Mediterranean diet has not "often been ignored".
I know you have not read this even though I have posted it before.
"The first-line approach to primary prevention in individuals with lipid disorders involves the implementation of lifestyle changes including physical activity and medical nutrition therapy."
"Nutritional guidelines for the reduction of cardiovascular risk through lipid management recommend diets rich in fruits* and vegetables** (combined ≥5 servings/day; ≥1 of these servings/day of dark green or orange vegetables), grains*** (primarily whole grains), legumes****, high-fiber cereals, low-fat dairy products, fish, lean meats, and skinless poultry*****."
It then lists several references, including #396 [EL 1; RCT]).
That is:
396. de Lorgeril M, Salen P, Martin JL, Monjaud I, Delaye J, Mamelle N. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999;99:779-785.
Dang. Not only do the guidelines recommend diet - the Mediterranean diet, if not called that by name - they reference an article by de Lorgeril, who claims diet is "often ignored".
Eating primarily plant-based foods, such as fruits* and vegetables**, whole grains***, legumes**** and nuts
Replacing butter with healthy fats such as olive oil and canola oil
Using herbs and spices instead of salt to flavor foods
Limiting red meat to no more than a few times a month; Eating fish and poultry***** at least twice a week"
I think the authors of your link have tunnel vision and can only see diet.
You are very determined to always miss the point SuzyQ. I have linked articles from various mainstream sources that all say statins are very much over-prescribed.
You have continually denied that they are over-prescribed. You link articles that report relative risk reduction only, which as I have explained is misleading and not informative.
You ignore everything I say, and then pretend you have counter arguments. You don't, but some people here get fooled by your strategy.
Yes, there has been research showing the Mediterranean diet works better than drugs. There could be many other diets that also work, but have not yet been tested.
And the research often ignores physical activity, even though it is known to be a major factor in preventing heart disease.
The focus should be taken off of drugs, an put onto lifestyle modification. That has been one of my points all along. And every time I mentioned it you said lifestyle often is not enough. Well how do you know, when most of the research has been on drugs?
We can't expect the drug companies to do research on lifestyle. Maybe drugs are almost never needed -- we need research to find out.
You are very determined to always miss the point SuzyQ. I have linked articles from various mainstream sources that all say statins are very much over-prescribed.
You have continually denied that they are over-prescribed. You link articles that report relative risk reduction only, which as I have explained is misleading and not informative.
You ignore everything I say, and then pretend you have counter arguments. You don't, but some people here get fooled by your strategy.
Yes, there has been research showing the Mediterranean diet works better than drugs. There could be many other diets that also work, but have not yet been tested.
And the research often ignores physical activity, even though it is known to be a major factor in preventing heart disease.
The focus should be taken off of drugs, an put onto lifestyle modification. That has been one of my points all along. And every time I mentioned it you said lifestyle often is not enough. Well how do you know, when most of the research has been on drugs?
We can't expect the drug companies to do research on lifestyle. Maybe drugs are almost never needed -- we need research to find out.
And...as usual...you are missing the point.
In terms of diet...diet is hard to study because there are few if any ethical ways to force a random group of people to stick to a very specific diet for any period of time so results are often not as neat and tidy as with other more controlled research. This would get at the theoretical benefit of the diet - doctors can certainly make recommendations but what we'd likely find is that real-world impact is somewhat less than perfect-world.
So, if theoretically we could do this research and found a particular diet is helpful, that's great! Truly! But...a big but is that in PRACTICAL terms (I know you love the practical, clinical effect and not just statistical) to what degree will people adopt that diet and religiously keep to it for the rest of their lives? We could also study that group and find the true limitations. Maybe even when people only follow 50% of the recommendations it still can have a huge effect, maybe not.
So, knowing that people are flawed...THEN what do you advise? Do you say - you are BAD - you didn't do what the doctor told you to do and we stopped doing drug research because that first study showed how well diet could work! It didn't work for YOU? YOUR problem...no drugs for YOU!
So - why don't you plan both of these studies and get them funded- mmmm hmmmmmm? Now, I KNOW you know exactly what the results would be so let's hear it.
In terms of diet...diet is hard to study because there are few if any ethical ways to force a random group of people to stick to a very specific diet for any period of time so results are often not as neat and tidy as with other more controlled research. This would get at the theoretical benefit of the diet - doctors can certainly make recommendations but what we'd likely find is that real-world impact is somewhat less than perfect-world.
So, if theoretically we could do this research and found a particular diet is helpful, that's great! Truly! But...a big but is that in PRACTICAL terms (I know you love the practical, clinical effect and not just statistical) to what degree will people adopt that diet and religiously keep to it for the rest of their lives? We could also study that group and find the true limitations. Maybe even when people only follow 50% of the recommendations it still can have a huge effect, maybe not.
So, knowing that people are flawed...THEN what do you advise? Do you say - you are BAD - you didn't do what the doctor told you to do and we stopped doing drug research because that first study showed how well diet could work! It didn't work for YOU? YOUR problem...no drugs for YOU!
So - why don't you plan both of these studies and get them funded- mmmm hmmmmmm? Now, I KNOW you know exactly what the results would be so let's hear it.
You seem to think drugs are just as good as preventing heart disease (and the other modern diseases) with lifestyle.
You don't think it's possible to study diet and exercise -- but in fact there is plenty of research showing their benefits, especially of exercise.
But this gets over-shadowed by the loud proclamations from the drug industry, echoed by the medical industry, and blasted all over the internet.
I don't know why you think I should do the research, just because I think it should be done. I am here very carefully pointing out why the wrong direction has been taken, trying to help people see a different perspective. That doesn't mean I should change my whole life and suddenly become a medical researcher.
You don't make sense, but I guess that's obvious.
Last edited by Good4Nothin; 08-13-2018 at 11:58 AM..
You seem to think drugs are just as good as preventing heart disease (and the other modern diseases) with lifestyle.
You don't think it's possible to study diet and exercise -- but in fact there is plenty of research showing their benefits, especially of exercise.
But this gets over-shadowed by the loud proclamations from the drug industry, echoed by the medical industry, and blasted all over the internet.
I don't know why you think I should do the research, just because I think it should be done. I am here very carefully pointing out why the wrong direction has been taken, trying to help people see a different perspective. That doesn't mean I should change my whole life and suddenly become a medical researcher.
You don't make sense, but I guess that's obvious.
No - I'm asking what you would do in a situation where diet does not alleviate all issues associated with whatever condition you'd like to discuss. You seem to think that diet is just as good at preventing disease as drugs (across the board). I'm asking you to consider what people are supposed to do if diet doesn't work.
Clearly diet can be researched but it's not as easy to do as drugs - didn't you READ?
And I'm not talking about anyone making proclamations - I'm just talking straight results.
No - I'm asking what you would do in a situation where diet does not alleviate all issues associated with whatever condition you'd like to discuss. You seem to think that diet is just as good at preventing disease as drugs (across the board). I'm asking you to consider what people are supposed to do if diet doesn't work.
Clearly diet can be researched but it's not as easy to do as drugs - didn't you READ?
And I'm not talking about anyone making proclamations - I'm just talking straight results.
You don't make sense but that is obvious.
I have already said here, many times, that there are people whose cholesterol is extremely high because of genetic defects, and they need cholesterol-lowering drugs. They are only a small minority of the population. If I were a doctor with a patient like that, I would give them drugs.
For most other patients, lifestyle will fix the problem. Not just diet -- exercise is extremely important. And it has to be a lot more than 120 minutes a week.
Exercise is being researched a lot, so it can't be all that hard to research.
Instead of the loud drug industry marketing propaganda, we need loud information about lifestyle. People do not have nearly enough awareness. Especially people who don't spend time reading about health, and expect their doctors to tell them everything in a 15 minute appointment.
We desperately need the public to be educated. They learned from the anti-smoking publicity and now smoking has gone way done from where it was. The same can be done for diet and exercise. But the drug industry has too many people brainwashed. That is what we have to fight against.
The public has been educated. It does not listen, which is what reneeh just explained to you. You think if people are just told to fix their diets, they will. They don't.
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