Category Archives: Opinion

Heart Attacks and Cholesterol – Public Policy That Makes No Sense

I have touted the book Overdosed America by Dr. John Abramson over and over. It is shocking to me that so few people, especially doctors, know that high cholesterol and heart attacks are only correlated through the age of 40. Lowering weight, eating right, not smoking and exercising have more benefits and reduce heart attack risk more than statin drugs by far. Too low cholesterol increases the risk of other fatal diseases and over use of statin drugs does little but enrich the pharmaceutical industry.

On his blog site, Dr. Abramson has reviews of his book listed which are well worth reading. Here is one such review from the San Diego Union Tribune:

“Abramson, who has a background in statistics and health policy, took the time to read the full 284-page version of the panel’s 2001 report, rather than the 11-page summary that most doctors saw. The results of his careful analysis are enough to shock a healthy heart into failure. He notes that data from the venerable Framingham study – a large, long-term study of risk factors for heart disease – show that elevated total cholesterol levels correlate with an increased risk of death only through the age of 40. Even more astounding is the finding that the risk of death from causes other than coronary heart disease increases significantly with lower total cholesterol levels for both men and women after the age of 50. And that doesn’t even touch on the question of the long-term side effects – both known and unknown – of the statins themselves.”

Buy two copies of the book which is in paperback and give one to your doctor. Physicians need to know that prescribing statin drugs to all but a small percentage of individuals is bad medicine, morally wrong and just plain harmful. Statin drug prescriptions is an industry not true medicine.

NFL Season Picks – Another Year of Cheer

As some of my readers know, I’m a BIG pro football fan. My favorite teams include the NY Jets, San Francisco 49ers, Seattle Seahawks and Pittsburgh Steelers (the Super Bowl two years ago was a dream game for me). Now that the new season is about to start tonight, it’s time for my prognostications for the upcoming season. Here goes:

AFC East – New England Patriots      AFC North – Indianapolis Colts      AFC South – Pittsburgh Steelers            AFC West – San Diego Chargers

AFC Wild Cards – Baltimore Ravens, New York Jets

NFC East – Dallas Cowboys             NFC North – Chicago Bears            NFC South – New Orleans Saints            NFC West – Seattle Seahawks

NFC Wild Cards – Philadelphia Eagles, San Francisco 49ers

AFC Champion – San Diego Chargers

NFC Champion – Seattle Seahawks

Super Bowl Champion – San Diego Chargers

Team with the first pick in the 2008 NFL Draft – Miami Dolphins

First team to fire their coach after the season – New York Giants

So, there you have it, my wild guesses. Take them as such.

Fascinating Book About Restaurants and Chefs

Anthony Bourdain is not just a pretty darn good chef, but he turns out to be a very good writer. After reading, Kitchen Confidential, I could never eat a seafood frittata again (or any seafood on a buffet on a Sunday). He writes with such bite and wit that I was thrilled to see he had written another book on food called The Nasty Bits.

While this isn’t related to health or nutrition, I really recommend it to everyone who likes to read. It is a nice book to read in bed, or by the fireplace. Be forewarned through, Anthony pulls few punches, especially in the chapter called “The Evildoers” where he skewers the fast food industry being one of the main reasons the world is becoming obese. The book is worth the price just for that chapter alone.

 The Nasty Bits: Collected Varietal Cuts, Usable Trim, Scraps, and Bones

The Hippocratic Oath – Do Doctor’s Today Even Read It Much Less Practice It?

The Hippocratic Oath is something that every physician who graduates from medical school presumably takes. While most physicians follow a great proportion of this important pledge, there is one passage in the modern version created by the late Dr. Louis Lasagna that is rarely followed by those physicians practicing allopathic medicine. It reads, “I will prevent disease whenever I can, for prevention is preferable to cure.” Is that the way medicine is really being practiced in today’s world?  I think not and here is why.

The purple pill NexiumTM helps people with severe esophogeal acid reflux. These people suffer greatly from their disorder but by prescribing the drug without first making the sufferers change obvious bad habits are we really preventing disease? By denying the healing benefits of nutrients and proper eating do they also fail to fulfill their oath. Having been to a number of physicians over the years I really believe that it is not that they don’t want to prevent disease but that they cannot spend the time necessary to help their patients stop doing things that harm their health. There is plenty of blame to go around and here are my big three.

First off we should point our finger at the pharmaceutical industry and its focus on profits and selling drugs to overcome issues that can often times be treated by lifestyle and habit changes as well as low side effect nutritional supplements (note that I say low side effect not no side effect). Restless Leg Syndrome, while a serious issue is often times better treated with magnesium and well formulated electrolytes instead of the drug RequipTM which has numerous serious side effects. The way the pharmaceutical industry markets their drugs is a major reason why people look for a short cut drug instead of slower lifestyle changes.

Secondly, we need to blame our society as a whole where we eat bad foods and enormous supersized meals, cut back on funding physical education in our schools and take a laisse faire attitude towards health. This societal degredation is so reminiscent of the fall of the Roman Empire that it is just history repeating itself. So many physicians feed into this societal illness that they refuse to make their patients change their habits in fear of losing them.

Thirdly, we need to lay the ultimate blame on the individuals who allow themseslves to get caught up in the “blame others but not me” syndrome. From the moronic ex-judge who sued the dry cleaner for losing a pair of pants to the people who demand that their children get an antibiotic prescription for the flu. Each of us, and I am guilty at times, look for shortcuts, ways not to pay the required price for real health, not just the lack of disease. We all need to look in the mirror and assess what we need to do to get better and then do it. We need to follow our own personal Hippocratic Oath, something I will propose in my next blog.

Breast Feeding For Babies – Lobbyists Fall to New Lows in Ethics

Just when you thought things couldn’t get much more unethical, the baby formula lobby, forced the U.S. Department of Health and Human Services (HHS) to “tone-down” their advertising campaign targeted towards improving the percentage of mothers who breast feed their babies. Political appointees changed the ads so that they were kinder and gentler and not hard hitting like they were initially designed and needed to be. This is just another example of the present Administration injecting politics and money into science.

There is little doubt in the medical and scientific community that breast feeding a baby markedly lowers the risk of developing asthma, becoming obese, becoming diabetic and scads more childhood diseases. American’s, according to this article on MSNBC.com are far behind other countries when it comes to breast feeding their babies. Maybe this is another reason our health care system is stressed. Still, to think that lobbyists have such an influence on scientific and medical issues like this makes me more than ill, it truly disgusts me.

The advertising agency that originally created the ads that would have startled mothers into understanding that by not breastfeading their babies, they could potentially harm them, said that by just emphasizing the positives of breastfeeding, the message would not work. Despite that, this is what the HHS did. So how did it work? Exactly like the ad agency said it would, by bombing. During the time the ads were on the air, 2003-2005, the percentage of mothers breastfeeding their babies went DOWN, from 33.2% to 30%. To increase the disgust factor it turns out that the lobbyists even convinced the president of the American Academy of Pediatrics Carden Johnston to help them convince then director of HHS Tommy Thompson to tone down the pro-breastfeeding ads.

This Administration has shown no compunction to make their friends richer regardless of the effects on the citizens of this country. How many children could have led healthier lives had their parents received hard hitting messages that breast feeding is the right thing to do? How many hundreds of millions of dollars have we wasted in treatment of asthma, diabetes, and heart disease that could have been prevented? To allow lobbyists from the baby formula industry to do what they did and to have buckled under the pressure they used is one step up from depravity. Shame on the lobbyists who have no compunction to do what they did. Shame on the political hacks at the Department of Health and Human Services for changing the ads. Shame on Dr. Carden Johnston for betraying his profession and his Hippocratic Oath. Most of all, shame on this Administration for allowing this pervasive assault on the American people to continue. A sad day in our country’s history.

A National Shame – The Lack of Healthcare Coverage in America

How is it that the most affluent country in the world has 44 million of its citizens lacking health care coverage? How do we as a people allow our fellow Americans to lack something so basic as commonly available health assistance? Are we as a people so lacking compassion that we allow children to be forced to avoid medical treatment because their families lack the financial ability to afford health care?

My feelings here run deep as I feel that the lack of such a basic and fundamental right is a blemish on our nation. We spend billions on fighting a war in Iraq, yet we see no problem in cutting back on services to our growing population of poor and middle class citizens who flat out cannot afford the spiralling out of control health care costs. Why do we do this? Greed. Since the 1980s our country’s focus has been on making money, making rich people richer and cutting back on services to our citizens all the while wasting money on pet projects that do nothing more than enrich the few at the expense of the many.

Our country grows lazy, obese and uncaring. The percentage of people who volunteer time to their community is shrinking. We have focused on our own personal pleasures at the expense of others. Unless we have a fundamental change in what we want in life, our health care system will continue to flounder and more people will have to do without.

It is the will to change our ways that will make a change in health care. If we get away from the pharmaceutical, treat the symptom, not the cause model, we will begin to make the first step towards real health. The FDA also needs to regulate their approval program so they can stop pharmaceutical companies from introducing new drugs at higher costs with only minimal benefits over cheaper drugs. We need to cut back on the mountains of paperwork and bureaucracy that fuels medical care expenses. We need to take the stance in health care that prevention, through the use of alternative and complementary means are much cheaper and preferable than emergency care medicine which is the mind set of today’s health care community.

Bisphosphonates vs. Nutrition for Osteoporosis? Part III

Here is the wrap-up of the three part series on osteoporosis by Dr. R. Keith McCormick whose Chiropractic practice can be found at 145 Old Amherst Rd. Belchertown, MA  01007 – Telephone # (413) 253-9777.  Enjoy the final installment of what I think is an important issue and should be shared with all of your friends and relatives, especially females who might be taking bisphosphonate drugs.

WHY USE NUTRITIONAL THERAPY BEFORE RESORTING TO DRUGS? Strategic nutritional therapy can reduce a patient’s fracture risk without the risks for adverse effects posed by drug therapy. It therefore makes clinical sense to first use nutritional therapy before resorting to pharmaceuticals. There are, of course, situations where a patient may have already sustained one or more fragility fractures or has been determined to be in imminent fracture risk and may require a combination of drug (such as teriparatide, the 1-34 amino acid segment of parathyroid hormone) and nutritional therapy. But in the clinical setting, there is often a window of time where the use of nutritional therapy can be used as a first choice.

Specific biomarkers shown to be related to bone health can be used to identify metabolic dysfunction that can be improved through nutrition. In addition, because osteoporosis is a catabolic disease with high correlation to diabetes, Alzheimer’s, and cardiovascular disease, improving these indicators may reduce etiopathologic mechanisms of other disease processes. Drug therapy as a first choice does nothing to improve a person’s overall health. It can only reduce fracture risk and that only possibly for a limited time period.

WHAT FACTORS MUST BE CONSIDERED PRIOR TO PRESCRIBING A BISPHOSPHONATE?  All too often, physicians look at improving bone density with a bisphosphonate as being the means to an end, when in fact the bone loss is just one symptom within a system struggling against a catabolic tide of inflammation-induced destructive forces. Before a person is placed on bisphosphonates as a panacea for bone loss, many factors should and must be ruled out. These include vitamins D and K deficiency, hypercalcemia, mineral deficiencies, high oxidative stress, chronic systemic inflammation, chronic low-level metabolic acidosis, malabsorption syndromes such as celiac disease, food allergens leading to chronic systemic inflammation, and heavy-metal toxicity. Artificially increasing bone density with a bisphosphonate while leaving the catabolic fires of destruction to burn on is both shortsighted and irresponsible.

Because there are currently no adequate guidelines available, it is difficult to assess an individual’s true fracture risk. The best we can do is to assess the patient’s lifestyle and superimpose upon this their level of bone mineral density to make a judgment call as to their risk for fracture.  But laboratory tests can also be used to improve our assessment of risk and guide the application of a nutritional treatment program. These lab values include the resorption markers N-telopeptide and deoxypyridinoline, but other indirect markers such as morning urine pH, urine organic acids, chemistry screen, CBC, 24-hour urine calcium, TSH, anti-tissue transglutaminase, antigliadin antibodies, glucose, 25-hydroxyvitamin D, homocysteine, hsCRP, and others can also be used to assess fracture risk and overall health. When biomarkers are abnormal, they may reflect a rise in the patient’s risk for fracture. Prescribing a bisphosphonate before laboratory tests are obtained is not an optimal approach to improving a patient’s bone health.

In summary, when bisphosphonates are used before adequate laboratory evaluation and before appropriate strategic nutrition is used to reduce fracture risk, we have lost not only an important opportunity to normalize bone remodeling but a chance to reduce the catabolic forces of chronic inflammation and further disease.

USDA Bastardizing the Word Raw – The Battle Over the Definition of Raw Almonds

In a astonishingly bad decision, the United States Department of Agriculture has decided to force almond producers to pasteurize their product. One of the approved methods uses propylene oxide which is considered by the European Union as a carcinogen. It is also a highly toxic flammable chemical compound, once used as a racing fuel, but that usage is now prohibited under the US NHRA rules for safety reasons. Safety reasons! Yet the USDA wants almond growers to spray it on their crop?

The Organic Consumers Association is sprearheading a campaign to role back the rules. Please go to this site and make your opinion known. We, as consumers, need to stop this madness. Don’t take this sitting down because if you do, what next?

Bisphosphonates vs. Nutrition for Osteoporosis? Part II

Here is part II of the three part series on Bisphosphonates versus Nutrition in the treatment of osteroporosis by Dr. R. Keith McCormick whose practice can be found in Belchertown, Massachusettes.

MICROFRACTURE RISK FROM LONG-TERM BISPHOSPHONATE USE?  Bisphosphonates interrupt the tightly coupled bone-renewing synchrony of osteoclasts that get rid of the old, worn, microfractured bone and the osteoblasts that form strong renewed bone. This reduction in bone turnover leads to skeletal ageing, and there are concerns that long-term bisphosphonate use (> 3 years) may lead to brittle bones and an increase in microfractures. This brittleness is due to altered mineralization properties such as a rise in mineralization homogeneity, which is not a feature of normal healthy bone.

In addition to altered mineralization from long-term use of bisphosphonates, adverse changes also occur within the bone’s non-mineral organic matrix, specifically within the collagen fibers. The “material properties” of collagen give it its strength, and this, in part, is dependent upon the formation through enzymatic mechanisms of structural cross-linking. These enzymatic cross-links hold the collagen fibers together and give them strength and also impart flexibility and toughness to bone. When cross-links are formed from non-enzymatic sources, such as through advanced glycation end products (AGEs) seen with chronic elevation of blood glucose in diabetes or in chronic oxidative stress, collagen integrity is sacrificed, bone becomes more brittle, and fracture risk increases. Bisphosphonate therapy, with reduced osteoclastic activity and bone turnover, leads to the accumulation of these non-enzymatic cross-links and may be of great concern to patients using bisphosphonates long term, especially those, such as diabetics, who are most susceptible to the formation of AGEs.

The extent to which these property changes, induced by long-term bisphosphonate use, influence fracture risk is, as yet, unresolved. But one can easily foresee that ageing bone, especially in a young individual who started taking bisphosphonates when he or she was 30, 40, or even 50 years old, may not end up as “healthy” bone.

WHAT IS THE MOST SERIOUS POTENTIAL CONSEQUENCE OF BISPHOSPHONATE USE?  Concerns over the side effects from bisphosphonate use are obvious and valid. But serious side effects are relatively rare and they pale in comparison to another potentially devastating drawback from the unscrutinized, premature use of bisphosphonates for the treatment of osteoporosis. That is the failure to therapeutically address the chronic inflammation and metabolic dysfunction that is often not only the major underlying cause of bone loss but may also be a potential contributor to other disease processes not yet manifested. By using bisphosphonates to improve bone density, only one aspect of osteoporosis is being addressed. The underlying inflammation, a consistent contributor to all chronic degenerative disease processes, continues untreated.

Bisphosphonates vs. Nutrition for Osteoporosis? Part I

Dr. R. Keith McCormick, DC of Belchertown, MA, gave an insightful talk at the recent Boulderfest 2007 in which he described the realities of osteoporosis and the problems with the family of drugs being purveyed by the pharmaceutical industry known as bisphosphonates. In part one of a three part series, Dr. McCormick has been gracious enough to explain to my blog readers why bisphosphonates are NOT the right thing to do to prevent or treat osteoporosis.  Here is part 1.

Osteoporosis is a disease process characterized by skeletal weakening from low bone mass and a deterioration in micro-architectural quality. The physical and financial burden of this disease is substantial with over 50 percent of women and 13 percent of men in America destined to sustain an osteoporotic-related fracture within their lifetime. With these high-stakes costs it is important that our method of treatment is not only efficacious but also conducive to the patient’s over-all good health.

Bone health is naturally maintained in a person’s body by a balanced remodeling system that ensures continued replacement of old worn-out bone with strong new bone. During normal bone remodeling, the bone-forming cells (osteoblasts) produce enough new bone to replace that which was resorbed by the osteoclasts. It is when this coupled remodeling process is in balance that bone health is maintained. When the osteoclasts resorb excessive amounts of bone, remodeling becomes uncoupled and there is a net decrease in bone tissue. Drug therapy has therefore concentrated on reducing osteoclastic activity in an attempt to correct this imbalance that leads to bone loss. The antiresorptive agents, bisphosphonates, have become the most commonly used pharmaceuticals for this task. With less osteoclastic activity, remodeling slows and there is less bone loss. Most physicians and millions of patients who have taken bisphosphonates view them as harmless drugs that increase bone mineral density and reduce the risk of fractures. But after decades of use, concerns are now rising over the safety of bisphosphonates.

HOW DO BISPHOSPHONATES WORK?  Bisphosphonates are synthetic analogs of inorganic pyrophosphates (commonly used antiscaling or water-softening chemicals) that bind to the divalent calcium ion (Ca2+) in the hydroxyapaitite crystal of bone. It is here that nitrogen-containing bisphosphonates are able to decrease excessive osteoclast activity. They do so by repressing farnesyl diphosphate synthase, an enzyme important for the synthesis of osteoclast cell regulatory proteins. Without these proteins, osteoclasts can no longer function and bone resorption is substantially reduced. With decreased osteoclastic activity, resorption sites are reduced, which lessens the risk that a minor external mechanical load could impart a breakpoint strain leading to trabecular buckling and catastrophic structural failure. It is from this reduction in resorption sites that bisphosphonates are able to reduce fractures. From a glance, and from statistics showing that bisphosphonates reduce both vertebral and nonvertebral fractures, this seems a very positive therapeutic outcome. But is this mode of therapy improving the actual “health” of bone? And, are there drawbacks to these powerful drugs that must be considered before prescribing their use?

Tune in tomorrow for part II and Wednesday for the completion of this important series.