I’m always amazed at the number of comments this blog gets from readers who are worried about discussing health issues with their doctors.  Most are a variant of this composite of many comments I’ve read:

I’ve been on a low-carb diet, and I’m afraid my cholesterol is going to be up a little and my doctor will want to put me on a statin.  How can I show him/her that I’m really on the right track?

Another common variant:

I want to go on a low-carb diet, but I’m sure my doctor will be against it.  What should I tell him/her?

Read more »

The sugar hypothesis of heart disease triumphs yet again over the lipid hypothesis. A study presented recently in Rome and published in the New England Journal of Medicine demonstrates that efforts to lower blood sugar pay off better in lower rates of heart disease and longer life than do efforts to lower cholesterol.  In fact, to be ruthlessly honest about it, efforts to lower blood sugar do seem pay off whereas efforts to lower cholesterol don’t much at all.

Researchers presented data from a long-term study (almost 30 years long) showing that subjects who lowered their blood sugar levels with drugs for a period of 10 years reaped large rewards in terms of reduced incidence of heart attack and reduced incidence of all-cause mortality long after the end of the study.

Here is how the study was done:

Read more »

As I was going through all the comments that had stacked up while I was away, I came across one about the Ornish program that I thought might be of interest to the group. Here is the gist of it:

after my 3rd heart attack dec 04 I quit the veggie/ornish just plant food eating and now with type 2 this yr am still doing great with no carbs. also off BP drugs and since May have stopped all lipitor and crestor (7 days of crestor was enough) still getting stronger and no more brain fog feeling, wish I knew then what I know now

This comment reminded me of one I read in the long list of comments after Ornish’s response to John Tierney’s blog post about Taubes’ comments on the Israeli low-carb study. Said a commenter who states that he works in a clinic that uses the Ornish regimen:

I too, happen to work in a clinic that espouses the Ornish program. In practice, however, as long as patients do the stress relief, engage in exercise, and quit smoking, they seem to do fine. The diet doesn’t seem to do very much one way or the other, especially since most people give it up quickly. They seem to dislike it.
The diet does wreak havoc with our diabetic patients, however. They are put on the diet because diabetics are prone to heart disease, but the huge quantities of starch required by the Ornish program (whole grain or not) makes make blood sugar control almost impossible. There’s a lot of internal argument about this now.

Read more »

Earlier this year I posted about the ACCORD study that was discontinued because more subjects in the intensive-glucose-control arm of the study were dying than were those whose glucose was less strictly controlled. In this post I made the case that one of the reasons this might be happening is that the strict-glucose-control was brought about by various drug regimens, none of which address the underlying problem of too much insulin. If insulin resistance and hyperinsulinemia are the real problems here (and my bet is that they are), drug combinations deal only with one of the symptoms – the elevated glucose of type II diabetes – and not the underlying problem. The underlying problems continue to chug along causing more disease, disability and death. (Another possibility is that the drugs themselves are causing the increase in death.) All of which doesn’t really make the outcome all that surprising.

And even less surprising is the horde of diabetes ‘experts’ who are stampeding over the cliff with the idea that careful glucose control isn’t the panacea they had hoped it would be. Unfortunately, it isn’t they who will be splattered on the rocks below; it will be their patients instead.

Last week’s New England Journal of Medicine published the ACCORD study (full text here), and the authors concluded: Read more »