Tag Archives: death

Should You Avoid Saturated Fats If You Already Have Heart Disease?


Most heart attacks occur in folks with pre-existing coronary artery disease that’s been present for years

If you already have coronary artery disease, Dr. Axel Sigurdsson says that ongoing saturated fat intake probably doesn’t matter, in terms of future cardiac events (like heart attacks) or risk of death from any cause.

Dr. Sigurdsson is a cardiologist in Iceland.

Some quotes from his blog:

For decades, cardiologists have advised patients with heart disease to restrict the intake of saturated fats and dietary cholesterol. Many patients still believe this to be the cornerstone of their lifestyle modification.

The main reason for avoiding saturated fats is the assumption that they adversely affect the lipid profile of our patients.

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Recent studies suggest that the recommendation to avoid saturated fats may have been premature and not based on solid scientific evidence.

Now, a recently published Norwegian study shows that dietary intake of saturated fatty acids was not associated with risk of future events or death among patients with established coronary artery disease.

It is important to keep in mind that most of the patients were receiving secondary prevention drug therapy including aspirin, beta blockers and statins.

Anyhow, the results of the study certainly suggest that high intake of saturated fats is not a risk factor among patients with coronary heart disease receiving modern-day treatment.

These recent scientific data don’t imply hat we should urge our patients to consume high amounts of saturated fats. They only tell us that there is no association and accordingly, restriction won’t help.

So, it’s certainly a lifeline for those who believe red meat, whole-fat milk, cheese, cream, butter and eggs can be a part of a healthy diet.

On the other hand we must realise that scientific studies often provide contradictory results. A US study published last year suggested that greater adherence to a low carbohydrate diet high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality following acute heart attack.

It appears the jury is still out…


R.I.P.: A Horse Named Steve; and a Neurosurgeon Confronts His Own Death

The New York Times online has the story:

As soon as the CT scan was done, I began reviewing the images. The diagnosis was immediate: Masses matting the lungs and deforming the spine. Cancer. In my neurosurgical training, I had reviewed hundreds of scans for fellow doctors to see if surgery offered any hope. I’d scribble in the chart “Widely metastatic disease — no role for surgery,” and move on. But this scan was different: It was my own.

Well worth your time to read unless you’re in denial of death.

h/t Yoni Freedhoff.

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A pall hangs over the Parker Compound since one of our horses died of colic yesterday. Certainly not the same as a human death, but still….  

My wife and daughter rescued Steve from appalling conditions  eight or nine years ago when he was about seven years old. They named him after me for some reason—his original name was Wyatt. Sunny paid $200 (USD) for Steve, which is one cheap horse. Many horses are like boats and airplanes in that they may not cost all the much initially—it’s the maintenance and repairs that get you.

The seller in Apache Junction, Arizona, had him in a large pen with 20 or 30 other horses. At feeding time, the owner threw a few flakes of hay into the pen and then it was “survival of the fittest” time. Horses are not by nature sharing creatures. Steve was not high up on the pecking order. If she hadn’t bought him, he may well have ended up in a meat market.

Steve was originally my daughter’s first horse, not mine. For reasons forgotten, we got her another horse, Buckwheat. Steve was to be my wife’s horse then. Soon enough Sunny broke her leg and was out of commission for months. Horses, like people, need exercise. The most fun way to exercise them is to ride them. That’s when I first started riding Steve, to give him exercise. My daughter and a cowgirl named Angel Antan were my instructors.

I had an odd experience with him one time when my daughter and I were on a trail ride to the Verde River from our home in Rio Verde. If you don’t know how to ride, note that a horse isn’t supposed to move or stop unless the rider gives the signal. You can’t let the horse be in charge. We were in a dry wash when Steve suddenly stopped and started sniffing the ground. I had no idea what was up and thought I’d just sit there waiting to see what would happen. Soon and without warning, Steve knelt down on his front legs, then his back ones, and was on his belly, starting to roll over! I jumped off and pulled him up by the reins before he did the deed. You do NOT want a horse rolling over on you, or your saddle for that matter. He never did that again, nor have I heard of that happening to others.

One of the cool things about our trail rides is that you can get close to coyotes. When you’re on horseback, the coyotes don’t perceive you as much of a threat.

Steve always liked men more than women. It was only in the last few months that my wife and he became quite fond of each other.

My wife gave him a great home. He was a good horse who taught me how to ride. I always felt safe when I was around him and on him, regardless of the near roll-over.

He “colicked” every year for the last five years. I’d like to think that Steve’s in horse heaven with his buddy Buckwheat, running over grassy  hills and wading through clear streams. RIP, Steve. No more pain, ever. 

Steve is the palomino on the right

Steve is the palomino on the right

Sugar-Sweetened Beverages Kill Almost 200,000 Annually

…according to a Harvard-affiliated Ph.D. How could that be?  SSBs contribute to obesity, which in turn leads to diabetes, cardiovascular disease, and some cancers.

Reducing consumption of SSBs was one of the major points in the American Heart Association’s 2010 guidelines for reducing heart disease.

Read the details at MedPageToday.

High Calcium Intake Linked to Higher Risk of Death In Swedish Women

Six of every 10 middle-aged and older women in the U.S. are taking calcium supplements, hoping to keep their bones strong and thereby avoid osteoporotic fractures of the hip, spine, and wrist.  A new study in the British Medical Journal suggests that high calcium consumption, whether from food or supplements, increases the risk of death.

The researchers wrote: 

In this study of women in the Swedish mammography cohort, a high calcium intake (>1400 mg/day) was associated with an increased rate of mortality, including death from cardiovascular disease. The increase was moderate with a high dietary calcium intake without supplement use, but the combination of a high dietary calcium intake and calcium tablet use resulted in a more pronounced increase in mortality. For most women with lower intakes we observed only modest differences in risk.



Do Eggs Cause Heart Attacks and Premature Death?

At the beginning of my 30-year medical career, egg consumption was condemned as a cause of heart attacks.  Heart attacks can kill.  How did eggs kill?  It was thought to be related to the cholesterol content – 200 mg per egg – leading to higher serum cholesterol levels, which clogged arteries (atherosclerosis), leading to heart attacks.

Fifteen years ago the pendulum began to swing the other direction: Egg consumption didn’t seem to matter much, if at all.

The evidence is usually collected in observational, epidemiologic studies of large groups of people.  The groups are analyzed in terms of overall health, food intake (e.g., how many eggs per week), healthy lifestyle factors, etc.  Egg consumption of the group is broken down, for example, into those who never eat eggs, eat 1-4  eggs per week, eat 5-10 per week, or over 10 eggs weekly.  A group is followed and re-analyzed over 10-20 years and rates various diseases and causes of death are recorded.  Researchers don’t follow just 25 people like this over time.  You need thousands of participants to find statistically significant differences.

The debate about eggs was re-opened (although never really closed) by the publication in April, 2008, of an article in The American Journal of Clinical Nutrition.  Scientists of the Physicians’ Health Study suggest that consumption of seven or more eggs weekly is associated with significantly increased risk, over 20 years, of all-cause mortality.  Interestingly, this level of consumption did not cause heart attacks or strokes.  Study participants, by the way, were 21,327 Harvard-educated male physicians.  5,169 deaths occurred during 20 years of follow-up.  If you’re not a Harvard-educated male physician, the study results may not apply to you.

When physicians with diabetes  – type 2’s mostly, I assume –  were analyzed separately, consumption of even less than seven eggs per week was associated with higher all-cause mortality.

Several other observational studies looking at this same issue have found no association between egg consumption and cardiovascular disease, heart attacks, and all-cause mortality.

Bottom line?  If you worry about egg consumption, limit to 7 or less per week.  If you have type 2 diabetes, consider limiting to 4 or less per week.

I wouldn’t be surprised if a study were published next week saying “eat as many eggs as you want; they don’t have adverse health effects.”

Remember, all the cholesterol is in the yolk.  Try making an omelet using the whites only.  But in our lifetimes you’ll never see an observational study looking at egg white consumption and mortality rates.

I’m still not convinced egg consumption is worth losing sleep over.  “More studies are needed…”

Steve Parker, M.D.References:

Djousse, L. and Gaziano, J. M.  Egg consumption in relation to cardiovascular disease and mortality: the Physicians’ Health Study.  American Journal of Clinical Nutrition, 87 (2008): 964-969.

Dawber, T.R, et al.  Eggs, serum cholesterol, and coronary heart disease.  American Journal of Clinical Nutrition, 36 (1982): 617-625.

Nakamura, Y., et al.  Egg consumption, serum cholestrol, and cause-specific and all-cause mortality: the National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged, 1980.  American Journal of Clinical Nutrition, 80 (2004): 58-63.

22 Things To Do Before You Die

From Staci, who died too young.


h/t WhiteCoat

Olive Oil Protects Against Death and Heart Disease

Olive oil consumption is linked to lower risk of death and heart disease in a Spanish population, according to the American Journal of Clinical Nutrition.

Olive oil figures prominently in my Ketogenic Mediterranean Diet and Low-Carb Mediterranean Diet.


Alcohol Consumption Linked to Lower Rates of Death and Heart Attack

Canadian and U.S. researchers report that moderate alcohol consumption seems to reduce 1) the incidence of coronary heart disease, 2) deaths from coronary heart disease, and 3) deaths from all causes. Reduction of death from all causes is a good counter-argument to those who say alcohol is too dangerous because of deaths from drunk driving, alcoholic cirrhosis, and alcohol-related cancers such as many in the esophagus.

Remember, we’re talking here about low to moderate consumption: one drink a day or less for women, two drinks or less a day for men. That’s a max of 12.5 alcohol for women, 25 g for men. No doubt, alcohol can be extremely dangerous, even lethal. I deal with that in my patients almost every day. Some people should never drink alcohol.

The recent meta-analysis in the British Medical Journal, which the authors say is the most comprehensive ever done, reviewed all pertinent studies done between 1950 and 2009, finally including 84 of the best studies on this issue. Thirty-one of these looked at deaths from all causes.

Compared with non-drinkers, drinkers had a 25% lower risk of developing coronary heart disease (CHD) and death from CHD. CHD is the leading cause of death in develop societies.

Stroke is also considered a cardiovascular disease. Overall, alcohol is not linked to stroke incidence or death from stroke. The researchers did see strong trends toward fewer ischemic strokes and more hemorrhagic strokes (bleeding in the brain) in the drinkers. So the net effect was zero.

Compared with non-drinkers, the lowest risk of death from any cause was seen in those consuming 2.5 to 14.9 g per day (one drink or less per day), whose risk was 17% lower. On the other hand, heavy drinkers (>60 g/day) had 30% higher risk of death.

In case you’re wondering, the authors didn’t try to compare the effects of beer versus wine versus distilled spirits.

On a related note, scientists at the Medical University of South Carolina found that middle-aged people who took up the alcohol habit had a lower risk of stroke and heart attack. Wine seemed to be more effective than other alcohol types. They found no differences in overall death rates between new drinkers persistent non-drinkers, perhaps because the study lasted only four years and they were following only 442 new drinkers.

This doesn’t prove that judicious alcohol consumption prevents heart attacks, cardiac deaths, and overall deaths. But it’s kinda lookin’ that way.

Steve Parker, M.D.

Reference: Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, & Ghali WA (2011). Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ (Clinical research ed.), 342 PMID: 21343207