More on Treadmill Stress Tests...

Last month NBC’s Tim Russert suffered a fatal heart attack at age 58, shocking the country. He recently passed a stress test, so how could this happen? In a post Dr. Fuhrman explains why stress tests fail to determine heart attack risk. Here’s an excerpt:
A stress test is not an accurate test for determining the risk of a heart attack. A stress test only identifies obstructions, it doesn't identify vulnerable plaque—the plaque that is likely to throw a clot. A stress test can only detect a blockage of more than 80% and the propensity of plaque to rupture has nothing to do with the amount of obstruction…

…Stress tests are big money-makers for doctors. They identify those people with large blockages who qualify as candidates for costly angioplasty or bypass surgery. However, drugs and medical procedures reduce risk only slightly.
Now, Jane E. Brody of The New York Times talks to Dr. Todd D. Miller, a cardiologist and co-director of the Mayo Clinic’s Nuclear Cardiology Laboratory in Rochester, Minn., about the shortcomings of stress tests. Take a look:
Mr. Russert’s treadmill test may have put him in the low-risk category, Dr. Miller said, “but that doesn’t mean no risk.”

“Maybe 3 patients in 1,000 with a low-risk test will die from heart disease within a year,” he said. “Among those deemed at high risk, more than 3 patients in 100 would die within a year.”

Furthermore, when the stress test is used for people who are at low risk for heart disease, an abnormal finding is most often a false positive that prompts further testing that is far more costly, Dr. Miller said.

The stress test’s main advantages are its rapidity and low cost — one-fifth to one-quarter the cost of more definitive and often more time-consuming tests like a nuclear stress test, CT coronary angiogram or standard angiogram. Medicare pays about $150 for a standard stress test, though hospitals typically charge three to four times that when the test is done on younger patients.
Criticism for stress tests is not new. In 2007, Karen Dente, M.D., a medical journalist based in Brooklyn, New York, stated that as stress-testing and coronary angiograms may no longer be the true gold standard for detecting coronary stenosis. Via Medscape:
"Conventional stress-testing and angiogram gives you no information on whether a plaque is going to rupture," David DuBois, MD, an attendee at the symposium and emergency medicine specialist from Pinehurst, North Carolina, told Medscape. "[With these tests] there are a lot of false-positives and false-negatives," he said.


One of the hottest current discussions in the evaluation of acute coronary syndromes is centered around the use of computed tomography coronary angiography. "CT technology is advancing at a very fast rate," said Amal Mattu, MD, associate professor and program director of emergency medicine residency at the University of Maryland, explaining the technology's improved detection in plaque composition and remodeling compared with conventional diagnostic tests.

"If you have a radiologist that can give you an accurate reading with the new 64-head multidetector CT scans, you can detect occlusions better," according to Dr. Dubois. But we are still a long way from having the new technology replace standard coronary angiography for the detection of large coronary stenoses, he said. "It is not going to change the [current] practice any time soon."
Sadly, this information can’t help Tim Russert, but doctors and patients should now take note that traditional testing procedures might be lulling us into a false sense of security by not revealing crucial life-saving data.

Japan's Love of Fish, Keeps Arteries Clear

A new study in the Journal of the American College of Cardiology claims having high blood-levels of omega-3 fatty acids may reduce atherosclerotic plaque buildup. The research compared middle-aged men living in Japan to white men and men of Japanese decent living in the United States. More from Reuters:
Japanese eat about 3 ounces (85 grams) of fish a day on average, while Americans eat fish perhaps twice a week. Nutritional studies show that intake of omega-3 fatty acids from fish averages 1.3 grams per day in Japan, compared to 0.2 grams per day in the United States.

Earlier studies by Akira Sekikawa, assistant professor of epidemiology at the University of Pittsburgh, showed that Japanese men had significantly less cholesterol build-up in their arteries despite similar blood cholesterol and blood pressure readings, similar rates of diabetes and much higher rates of smoking…

…In this study, Sekikawa's team recruited 868 randomly selected men aged 40 to 49. Of these, 281 were Japanese from Kusatsu in Japan, 306 were white men from Allegheny County, Pennsylvania, and 281 were third or fourth generation Japanese-Americans from Honolulu, Hawaii.

"Our study clearly demonstrated that whites and Japanese-Americans have similar levels of atherosclerosis, which are much higher than in the Japanese in Japan," Sekikawa said.
Outstanding news for omega-3’s, but fish is not your only source of these beneficial fats. Foods like soybeans, tofu, and flaxseed are also rich in omega-3 fatty acids. Here’s some info from Dr. Fuhrman:


When we have insufficient omega-3 fat, we do not produce enough DHA, a long-chain omega-3 fat with anti-inflammatory effects. High levels of arachidonic acid and low levels of omega-3 fats can be a contributory cause of heart disease, stroke, autoimmune diseases, skin diseases, depression, and possibly increased cancer incidence.1 Most Americans would improve their health if they consumed more omega-3 fats and less omega-6 fats. I recommend that both vegetarians and nonvegetarians make an effort to consume one to two grams of omega-3 fat daily.
I eat flaxseed and walnuts everyday, but I also eat fish—like salmon and steelhead trout—so I think I’m covered in the omega-3 department—are you?
Continue Reading...

Study: High Apoprotein B Not Good

Dr. Fuhrman talks about the new research on lipids, lipoproteins, and apolipoproteins as risk markers for myocardial infarction—via The Lancet.

This study reveals that the ApoB/ApoA1 ratio is more predictive of heart attack occurrence compared to cholesterol levels or cholesterol ratios. That means that a high ApoB (Apoprotein B) is not good and a better indicator of risk compared to LDL cholesterol.

Keep in mind that a calculated LDL is not as accurate as a direct LDL and the type of LDL measured in Apoprotein B is even a better predictor. Also the LDL particle number is still likely the most accurate test for heart attack risk.

In spite of all these numbers and their potential to predict risk, the bottom line is that all of them go down with a vegetable-based diet and go up with sloppy eating habits. But not only that, the high-nutrient diet, contains positive benefits to reduce risk of heart disease not reflected in these numbers, so the numbers are not as predictive compared to a qualitative index of one’s diet such as the proportion of the diet made up of high-nutrient plant food and a tape measure around ones’ waist.

In summary, to predict one’s risk of heart disease, or to give someone assurance they are not at risk, it is important to consider:

  • Waist measurement or waist fat accumulation (body fat)
  • Nutrient density of the diet
  • Exercise tolerance
  • Non-medicated systolic blood pressure
  • The blood risk markers noted above

Vytorin, Going Down the Toilet


A clinical trial has determined that the cholesterol-lowering drug Vytorin fails to help people with heart disease AND increases their risk of cancer. Alex Berenson of The New York Times reports:
The scientists who reported on the trial, called Seas, cautioned against panicking over the cancer findings, saying that even well-designed clinical trials sometimes produce chance results. A review of two other, much larger trials did not find a similar risk, they said.

Vytorin and Zetia, a companion drug, are prescribed each month to almost three million people worldwide and are among the world’s top-selling medicines.

But other cardiologists and epidemiologists said that the cancer risk could not be so easily dismissed.

The findings of the Seas trial will heighten concerns about Vytorin’s safety and effectiveness, said Dr. Steven Nissen, a former president of the American College of Cardiology and a longtime critic of Vytorin. Six months ago, a fourth clinical trial, called Enhance, also failed to show that Vytorin benefited patients, leading a panel of top cardiologists to recommend using Vytorin and Zetia only as a last resort.

Since that recommendation, Vytorin and Zetia prescriptions have plunged, though the drugs remain among the largest sellers for Merck and Schering- Plough, which jointly sell them. The drugs had combined sales of $5 billion last year.
These drugs have been sinking for months. Take a look:
Oh no. Without that $5 billion, how will all the fat cat executives pay for their yachts and facelifts!

Men's Health, All Screwed Up...


Mike Howard of Diet Blog investigates why men’s health is in the crapper. Here are some disturbing snippets from the post:
Compared to women, men...
  • Have higher death rates for all 15 leading causes of death (except Alzheimer's disease) and die more than five years younger.
  • Represent 50% of the work force, yet account for 94% of all on-the-job fatalities.
  • Know less about health and take less responsibility for it.
  • Are less likely to see themselves as ill or susceptible to disease or injury.
Why Men Die Younger than Women
  • They have less-healthy diets
  • They have higher blood pressure and do less to control it
  • They sleep less
  • They smoke more
  • They engage in more criminal activity
  • They have smaller social networks and less intimate and active social relationships
Listen, go to the mall on a busy day and just count ALL the middle-aged guys with big bellies and handfuls of mall food.

Flavonoids, Protecting Your Heart...


Researchers believe that flavonoids—antioxidants found in plant foods—improve heart-health in numerous ways. Of HealthDay News reports:
Health benefits associated with flavonoids have been reported for decades, but it's still difficult for experts to make specific recommendations about which flavonoids to eat for specific health effects because of a lack of data. Antioxidants slow or prevent the oxidative process caused by substances called free radicals, which can cause cell dysfunction and the onset of heart disease and other health problems.

In the new study, Dr. Lee Hooper, a lecturer at the University of East Anglia in Norwich, U.K., and colleagues sifted through the 133 studies to look at the links between different flavonoid subclasses and flavonoid-rich foods on different risk factors for cardiovascular disease, such as unhealthy cholesterol, high blood pressure and blood flow.

Among the findings:
  • Eating chocolate or cocoa increased a measure called flow-mediated dilation, which is a good indication of blood flow in the veins. It also reduced blood pressure, both systolic (the upper number, reflecting the maximum pressure exerted when the heart contracts) by about 6 points, and diastolic (the bottom number, reflecting the maximum pressure when the heart is at rest), by about 3.3 points. But it didn't seem to have an effect on so-called "bad" LDL cholesterol.
  • Soy protein reduced diastolic blood pressure by almost 2 points of mercury and improved bad cholesterol but didn't improve so-called good HDL cholesterol. But those effects were found just for isolated soy protein, not for other soy products.
Not exactly new news, but still cool. For more on flavonoids, check out: What's a Flavonoid?

Ways to Lower Your Cholesterol...


I was reading That’sFit and found this link to Jonny Bowden’s Simple Ways to Improve Your Cholesterol—Now, on Remedy Life. Here are Jonny’s 5 tips:
  1. Eat more fiber.
  2. Lose weight.
  3. Exercise.
  4. Choose cholesterol-lowering foods.
  5. Take your supplements.
I was a little skeptical at first because Jonny has popped up on low-carb blogs—we all know how kooky those are—but his tips are right on point; especially when he suggests eating healthy foods like fruits, vegetables, nuts, seeds, cereals, and legumes.

As for taking supplements, Dr. Fuhrman sells his own, so that’s a good place to start. Also, Jonny recently provided the Well blog with his list of super foods. If you skip the canned sardines and canned pumpkin, it’s pretty good too. Via Well:
  • Beets
  • Cabbage
  • Swiss chard
  • Cinnamon
  • Pomegranate juice
  • Dried plums
  • Pumpkin seeds
  • Turmeric
  • Frozen blueberries
You should also check out Dr. Fuhrman’s Ten Super Foods and his Seven Best and Seven Worst Foods for Health and Longevity.

My Thoughts on Giving Children Cholesterol Drugs


Dr. Fuhrman responds to The American Academy of Pediatrics’ recommendation to give young children cholesterol-fighting drugs.

Clearly the medical profession and the drug companies form a coalition that economically monopolizes the health delivery to Americans. The effect is a health care system dependent on drugs, instead of encouragement of rationale lifestyle habits. When you consider that most antibiotics (which are highly toxic and already linked to later life cancers in scientific studies) prescribed to children are given for inappropriate reasons and viral illnesses in which they have no value, you could almost say that most pediatricians spend a large portion of their time delivering toxic medications to fragile children without justification. The harm they do may be much greater than anyone ever imagines. Now it gets even worse.

We have a nation of overweight parents, addicted to processed foods and convenience foods, who are poisoning themselves and creating a nation of overweight, diabetic and cancer-prone children, and the answer of the American Academy of Pediatrics and the American Heart Association is to recommend a more aggressive use of cholesterol-lowering drugs. Why don’t we just give all these kids gastric bypass surgery instead? Besides nobody knows the long-term risks of statins taken since childhood. This is just another example of the failure of health care in this country and that things will continue to worsen in the future as we continue to place drugs as the focal point of health care interventions.

I say—our health is tied to our country’s fertile soils with access to micronutrient rich produce never so available in recent human history; fresh fruits, vegetables, beans, seeds, nuts and other natural foods that are infinitely more effective than drugs. We have an unprecedented opportunity to be healthier than ever before and we can better use our resources educating and motivating our country to eat healthier and utilize less medical care and drugs, not more.

Kids on Cholesterol Drugs: American Academy of Pediatrics Goes Bonkers!

Why bother teaching kids to eat right. Let them eat all the junk they want and then prescribe them meds just like their fat parents. Get this. The American Academy of Pediatrics is now recommending giving children as young as 8 cholesterol-fighting drugs. The Associated Press reports:

Several of these drugs are approved for use in children and data show that increasing numbers are using them.

"If we are more aggressive about this in childhood, I think we can have an impact on what happens later in life ... and avoid some of these heart attacks and strokes in adulthood," Daniels said. He has worked as a consultant to Abbott Laboratories and Merck & Co., but not on matters involving their cholesterol drugs.

Drug treatment would generally be targeted for kids at least 8 years old who have too much LDL, the "bad" cholesterol, along with other risky conditions, including obesity and high blood pressure.

For overweight children with too little HDL, the "good" cholesterol, the first course of action should be weight loss, more physical activity and nutritional counseling, the academy says.

Pediatricians should routinely check the cholesterol of children with a family history of inherited cholesterol disease or with parents or grandparents who developed heart disease at an early age, the recommendations say. Screening also is advised for kids whose family history isn't known and those who are overweight, obese or have other heart disease risk factors.

Well, if it wasn’t official before. It sure is now! American medicine has gone nucking futs! No doubt, drug companies have their hands in this—it reeks of their stink. Now, I also read about this on the Well blog. Check this out:

The guidelines give no guidance on how long a child should stay on drug treatment. But they do say the first goal should be to lower bad cholesterol levels to less than 160 milligrams or possibly as low as 110 milligrams in children with a strong family history of heart disease or other risk factors like obesity.


Because statins have been around since only the mid-1980s, there is no evidence to show whether giving statins to a child will lower the risk for heart attack in middle age.

Clearly there is plenty of merit behind this recommendation—give me a break!

UPDATE: More from Dr. Fuhrman: My Thoughts on Giving Children Cholesterol Drugs.

Wednesday: Healthy Points


Denmark is the happiest nation and Zimbabwe the the most glum, he found. (Zimbabwe's longtime ruler Robert Mugabe was sworn in as president for a sixth term Sunday after a widely discredited runoff in which he was the only candidate. Observers said the runoff was marred by violence and intimidation.)

The United States ranks 16th.

The results of the survey, going back an average of 17 years in 52 countries and involving 350,000 people, will be published in the July 2008 issue of the journal Perspectives on Psychological Science. Researchers have asked the same two questions over the years: "Taking all things together, would you say you are very happy, rather happy, not very happy, not at all happy?" And, "All things considered, how satisfied are you with your life as a whole these days?"
The study, researchers say, suggests that CKD should be added to the list of conditions that are associated with weight gain, including diabetes and high blood pressure.


Obesity is a known risk factor for CKD, but the impact of weight gain in normal-weight individuals without high blood pressure or diabetes is unknown, Dr. Seungho Ryu, at Kangbuk Samsung Hospital in Seoul, and associates note in their report.

In Korea, workers are required to undergo periodic health examinations. Using these data, Ryu's team followed 8792 healthy men ages 30 to 59 years with no known risk factors for CKD between 2002 and 2007. The prevalence of obesity was about 33 percent.

For example, for apricots, a cup of fresh halves is 86 percent water, with 74 calories, and a half cup of dried fruit is 76 percent water, with 212 calories. Fresh apricots have 3.1 grams of fiber versus 6.5 for dried; 0.6 milligrams of iron versus 2.35 milligrams; 15.5 milligrams of vitamin C versus 0.8 milligrams; and 149 retinol activity equivalents of vitamin A versus 160.


A cup of fresh Thompson seedless grapes is 80 percent water, with 104 calories, and a half cup of raisins is 15 percent water, with 434 calories. The grapes have 1.4 grams of fiber, versus 5.4 grams for the raisins; 0.54 milligrams of iron versus 2.73 milligrams; 288 milligrams of potassium versus 1,086 milligrams; and 16.3 milligrams of vitamin C versus 3.3 milligrams.
At a meeting of the Codex Alimentarius Commission, a joint body of the WHO and the Food and Agriculture Organisation (FAO), officials also set benchmarks for producing gluten-free foods.


Peter Ben Embarek, a scientist in the WHO's food safety division, said the adoption of the "landmark" code of hygienic practices for powdered formula could reduce contamination from two bacteria that can cause severe illness and death in babies.

People with wheat allergies would also be protected by the standards for gluten-free food that countries pledged to work into their national legislation, and to meet in food exports under World Trade Organisation (WTO) rules.

Most trade shows are the stuff of, if not nightmares, then at least a sleepwalk from one charmless kiosk to the next. Not so at the 54th Summer Fancy Food Show, where 20,000+ gourmet retailers, restaurateurs, chefs, media folks and plain ol' food fans spend three days chomping their way through a fever dream of some 180,000 specialty foods. The throwback "Fancy" is a bit of a misnomer by now, as there's a very wide slice of products on offer, ranging from swankity wines, oils, cheeses and caviar to humble chewing gums, ketchups, chili seasonings and snack mixes.
Most commercial brands of mayonnaise contain vinegar and other ingredients that make them acidic — and therefore very likely to protect against spoilage. When problems occur, they usually result from other contaminated or low-acid ingredients (like chicken and seafood), improper storage and handling, or homemade versions that contain unpasteurized eggs.


One prominent study published in The Journal of Food Protection found, for example, that in the presence of commercial mayonnaise, the growth of salmonella and staphylococcus bacteria in contaminated chicken and ham salad either slowed or stopped altogether. As the amount of mayonnaise increased, the rate of growth decreased. When temperatures rose to those of a hot summer day, the growth increased, but not as much as in samples that did not contain mayonnaise.

After following over 5,700 men for 23 years, researchers concluded that the faster your rate drops after exercise, the lower your risk of dying of a heart attack. To perform the calculation, first take note of your heart rate at exactly one minute after you've finished your workout. Then, take that number and subtract it from the maximum heart rate you reached during the workout. If the difference is more than 35bpm, there's a good chance you do not face an increased risk.


If, however, it is less than 35bpm, the study suggests there's need for caution. Specifically, if the difference is between 31-35bpm, your risk is increased by 40 percent; 25-30bpm, risk increase is 30 percent; less than 25bpm, risk increase is 110 percent.
In Berlin, where a ban took effect on January 1, smokers were granted a six-month period of grace that expired on Tuesday and those who breach the ban now face fines of 1,000 euros (1,575 dollars).


In the eastern state of Saxony, fines can run up to 5,000 euros but in the northern port of Hamburg and Thuringia, in eastern Germany, the highest fine authorities can issue is 500 euros.

The wealthy southern state of Bavaria is considered to have the country's toughest public smoking ban because it prohibits restaurants from opening separate smoking sections -- a practice allowed in other states.

Low HDL Linked to Poor Memory, So Go Nuts!


A new study associates HDL cholesterol—good cholesterol—with bad short-term memory in middle-aged adults. Reuters reports:
The researchers examined the relationship between blood fats and memory using data on 3673 individuals, who were an average of 55 years old when tested between 1997 and 1999.

Short-term verbal memory was assessed at the outset with a 20-word free recall test. Memory deficit was defined as recalling no more than four words. Memory decline was defined as a reduction of two or more words between the first test and a second test, performed in 2002-2004.

The results are reported in the medical journal Arteriosclerosis, Thrombosis and Vascular Biology.

Compared with a high HDL level, low HDL was associated with memory deficit during both tests. After adjusting for sociodemographic factors, illnesses, and medication use, those with low HDL were 27 percent and 53 percent more likely to have a memory deficit on the first and second test, respectively.
Fret not, nuts and seeds are a great natural way to boost your HDL cholesterol. Dr. Fuhrman explains in Nuts & Seeds Protect Against Heart Disease. Here’s a bit:
Perhaps one of the most unexpected and novel findings in nutritional epidemiology in the past five years has been that nut consumption offers such strong protection against heart disease. Several clinical studies have observed beneficial effects of diets high in nuts (including walnuts, peanuts, almonds, and other nuts) on blood lipids.1 A review of 23 intervention trials using nuts and seeds demonstrated convincingly that eating nuts daily decreases total cholesterol and LDL cholesterol.2 Not only do nuts and seeds lower LDL (bad) cholesterol and raise HDL (good) cholesterol, they can help normalize a dangerous type of LDL molecule (the small, dense LDL particles that damage the endothelial cells that line the blood vessels).3


Ellagitannins (ETs) are dietary polyphenols with potent antioxidant and other cancer chemopreventive activities that are found in berries, nuts (especially walnuts), and seeds.4 Walnuts can reduce Creactive protein and harmful plaque adhesion molecules, two significant markers of inflammation in arteries. The result is improved, and even restored, endothelial function (which includes the elastic property of arteries that allows dilation when necessary to meet an increased demand of blood).According to the researchers, walnuts are the first food to show such cardiovascular benefits.5
See, going nuts is a good thing!
Continue Reading...