BTW, I’m 47 and have never smoked, and had a heart attack last year. (I’m only one person, but I remember you saying in another post that everyone you knew who had had a heart attack was a smoker, so I thought I should mention this.) Since then, I’ve been on an ACE inhibitor, a beta blocker, a statin, and aspirin. The possible side effects of the drugs concern me, but it requires some courage to reject the confident advice of one’s primary physician and cardiologist, and I figure that the positive effect, even if slight, on people under 65 with pre-existing heart disease, might well be worth it for me.

http://www.telegraph.co.uk/health/healthnews/5237700/Cholesterol-busting-statins-could-mask-signs-of-prostate-cancer.html

Interesting article. The law of unintended consequences strikes again.

I would agree that it has been difficult to prove mortality benefit in primary prevention. However, that is true for almost all preventative interventions including diet, exercise, vitamins, cancer screening, etc.

Here is 4S abstract:

Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)

Lancet 1994 Nov 19;344(8934):1383-9.

Drug therapy for hypercholesterolaemia has remained controversial mainly because of insufficient clinical trial evidence for improved survival. The present trial was designed to evaluate the effect of cholesterol lowering with simvastatin on mortality and morbidity in patients with coronary heart disease (CHD). 4444 patients with angina pectoris or previous myocardial infarction and serum cholesterol 5.5-8.0 mmol/L on a lipid-lowering diet were randomised to double-blind treatment with simvastatin or placebo. Over the 5.4 years median follow-up period, simvastatin produced mean changes in total cholesterol, low-density-lipoprotein cholesterol, and high-density-lipoprotein cholesterol of -25%, -35%, and +8%, respectively, with few adverse effects. 256 patients (12%) in the placebo group died, compared with 182 (8%) in the simvastatin group. The relative risk of death in the simvastatin group was 0.70 (95% CI 0.58-0.85, p = 0.0003). The 6-year probabilities of survival in the placebo and simvastatin groups were 87.6% and 91.3%, respectively. There were 189 coronary deaths in the placebo group and 111 in the simvastatin group (relative risk 0.58, 95% CI 0.46-0.73), while noncardiovascular causes accounted for 49 and 46 deaths, respectively. 622 patients (28%) in the placebo group and 431 (19%) in the simvastatin group had one or more major coronary events. The relative risk was 0.66 (95% CI 0.59-0.75, p < 0.00001), and the respective probabilities of escaping such events were 70.5% and 79.6%. This risk was also significantly reduced in subgroups consisting of women and patients of both sexes aged 60 or more. Other benefits of treatment included a 37% reduction (p < 0.00001) in the risk of undergoing myocardial revascularisation procedures. This study shows that long-term treatment with simvastatin is safe and improves survival in CHD patients.

I’m not against doctors per se (although I might sound like it sometimes)… It’s just that I am not willing to submit to the “tender mercies” of a statin pusher, nor to a low-fatter, etc.

Were I to suffer a broken leg, of course I would get myself to the nearest urgent care or ER ASAP, as the treatment would most likely be straightforward–cast the leg, etc.

But I don’t yet have the money, time, or inclination to have to fight with multiple doctors over every pat of butter, fish oil capsule, or egg… and I will not count calories.

Well, thanks again for your recommendations.

I read the blog comment by one lady which stated that after going to about 10 different doctors, she had found herself a “gem.”

Crikey, even if I had the money for 10 office visits (at how many dollars a pop?), I’m not sure I’d be eager to spend that amount of time in various doctors’ offices only to be disappointed.

Apparently doctors who are simpatico at all to low-carbing are just really hard to find.

A while back I was hanging out on the forums at Dr. Richard K. Bernstein’s website, and one of the frequently asked questions was for any kind of doctor recommendations. Sounded to me like most of the diabetics there were taking care of their condition themselves and just relying on the doctors for lab tests; it also sounded to me as if most of the “professional help” they received from their doctors, nutritionists, and other diabetic educators was the same-old ADA stuff which they basically ignored.

I like eating low-carb. I absolutely adore eating meat, and I also like vegetables. My significant other, fortunately, is willing to eat just about anything I cook, although he also is something of a carb addict… he drinks a lot of RC Cola and eats a lot of stuff that’s a no-no for me (sometimes it’s hard to keep away from the bread and taquito snacks).

I’ve tried to tell him that giving up the carbs would help with his blood pressure control (he’s not fat like me yet… he’s still densely muscular from the time when he used to be buff). He does have a problem with reflux, and he uses both famotidine and antacids on a regular basis.

I really enjoy reading your blog. I hope that someday I will find a doctor who is more simpatico with your approach.

I checked with Jonny Bowden, a nutritionist friend of mine who deals with many physicians in the greater LA area. He tells me that two very good ones are Prudence Hall and Howard Leibowitz, who practice at The Hall Center (www.thehallcenter.com) in Santa Monica. Hope this helps.

Right now I’ve been going to a county clinic, because that’s what I can afford right now; but in the future I would like to upgrade my medical care, as it were.

Unfortunately, I don’t know anyone in the Lancaster or Southern Cal area that practices low-carb nutrition. I’m sure there are a few practitioners, I just don’t know them.

1. Buy a used freezer if you can. In about 2001, I got a used, 12-cubic-foot, upright freezer for about $50 plus the cost of hauling it. This has saved me a lot of money over the years. The regular refrigerator I have is also fairly good-sized (with a fairly large top freezer), and was also bought used.

2. Regularly peruse the grocery ads for your area. See what’s on sale. Visit the grocery stores and see which ones you like. I follow the grocery ads fairly closely, especially for meat and produce. I don’t buy much canned food, except for tuna. At some point in the next couple of years, I might be able to get more of my meat at Sam’s Club or Costco.

3. I’m in Southern California. We often have California-grown whole chickens on sale for about 77 cents per pound (used to be down as low as 59 cents a while back). Learn to cut them up yourself. Sometimes leg/thigh quarters are on sale for as low as 59 cents per pound. We do eat mostly chicken at the current time, but I make sure that we have some other stuff around for variety.

4. Ground hamburger is another option… however, right now it’s up around $3.00 per pound or more. A cheaper way is to buy such cuts as round steak, London Broil, etc. and grind your own. We regularly get London Broil on sale for under $2.00 per pound.

5. Pork is often on sale, in various cuts, with and without the bones, for under $2.00 per pound, sometimes a lot less.

6. I have seen tri-tip cuts of beef on sale for $2.49 per pound or less.

7. Turkeys are often on sale after the holidays. Some stores have them at give-away prices just after Thanksgiving and others wait until after the New Year. I’ve still got about four of them in my freezer, just waiting to be made delicious.

8. Eggs… cheap at Wal-Mart, but they are the supermarket variety. Trader Joe’s also has acceptable eggs (better than Wal-Mart, but not as good as free-range, pastured eggs) for about $1.48 per dozen (also some more expensive types of eggs). Sometimes feed stores also have locally-produced eggs on sale (free-range?) in the $2.00 to $3.00 per dozen range. If you save your egg cartons and recycle them, sometimes you can get a bit of a discount. Also check Craigslist for your area.

9. For good-tasting water, if that is a problem for you: Get a water filtration unit. I have the large Pur unit which sits in the refrigerator, plus a Pur pitcher (both on sale or at discount stores). I have found that Wal-Mart sells the two-stage filters (newer kind) for cheaper than other stores around here. And you can use those filters for a bit longer than the instructions state.

10. It may or may not pay you to become a member of a warehouse club such as Sam’s ($40 per year) or Costco ($50 per year). You can buy, for instance, big blocks of cheese, which you can then divide up and freeze.

11. We have the 99 Cents Only Stores (now $1.00 for most items) here. When in stock, they are a good source for Danish Creamery butter… $1.00 for 1/2 pound, which works out to $2.00 per pound, which is a lot less than the regular retail for this brand. You can freeze butter for several months at a time.

12. See if there are any outlet stores in your area. We had a Grocery Outlet here for a long while, which was a source for some bargains.

13. I guess my basic advice would be to become aware of what things generally cost, and also become aware of when something is on sale at a good price, which is when it’s time to stock up.

Thanks for the definitive list. I’m sure many people can profit from your suggestions. Thanks for taking the time to write them.