Obese dying awaiting operations

Dr Nicholas Christou, a bariatric surgeon, claims that obese people are dying for lack of bariatric surgery. Do you ask a barber if you need a haircut? There is not a single randomized, sham-operated, controlled trial proving that gastric bypass or banding has saved even one life. Morbidly obese people are not dying from lack of bariatric surgery but from junk food addiction . Before the discovery of drugs for reducing stomach acid, many thousands of gastric bypasses were done to treat peptic ulcer disease but they were never associated with major weight loss. But now stomach surgery is touted to be the cure for obesity. If “diet and exercise” don’t work then why do patients after bariatric surgery still have to “stay on their diets”? Quite likely, bariatric surgery “works” only because patients are convinced that they must control their addiction or suffer abdominal pain. Eventually they discover they can eat as before and, if they haven’t mastered their addiction, regain the weight. Before we spend many billions of dollars on this unproven “treatment” a controlled trial is essential.

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Obese dying awaiting operations
SHARON KIRKEY CANWEST NEWS SERVICE
The Gazette
03 Jun 2009

Patients in Canada are dying while waiting their turn for obesity surgery, according to new research that says wait times for bariatric surgery are the longest of any surgically treated condition in the country. In 2007, 6,783 patients were waiting…read more…

Related:
Canadians wait more than five years for obesity surgery
Canadians wait more than five years for obesity surgery

Tech Tags: The Gazette newspaper Nation

Once-a-day trap

Not mentioned is the moral hazard effect of taking any pill that one thinks will obviate the need for constant vigilance in lifestyle choices. The deceptive hype behind multivitamins and “cholesterol” pills has been largely responsible for the pandemic of obesity and Type 2 diabetes.

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Once-a-day trap
BY JULIE BEUN-CHOWN Canwest News Service
National Post
30 Mar 2009

Joe Schwarcz is known for his blunt, take-noprisoners style when he gets fired up. For the past 25 minutes, the erudite director of McGill University’s Office for Science and Society and outspoken star of the Dr. Joe Show on Toronto’s CFRB radio has…read more…

Tech Tags: National Post newspaper Body & Health

Eat less, live long

On the average North Americans are eating at least 30% too many calories. Calorie restriction is relative. If we cut our calories by 30% we wouldn`t be restricting calories, just eating enough without gaining weight and we could cut medical costs by $many billions. But you will never hear a office-holding politician say “Eat less”; he/she would never be elected again.

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Eat less, live long
BY EVRA TAYLOR LEVY AND EDDY LANG Canwest News Service
National Post
16 Mar 2009

As the world faces an ageing population with a rapidly growing segment that will require nursing home care for Alzheimer’s disease, more and more scientific energy is being directed at stemming the “Silver Tsunami.” One intriguing possibility is that a…read more…

Tech Tags: National Post newspaper Body & Health

The wrong food fight

Very well written. But the biggest nutritional problem is not finding cheap brown rice but obesity, too many calories from all sources, resulting in many disastrous consequences, like Type 2 diabetes. If the population cut calorie intake by an average of 20% we could save $billions in food, waste disposal and medical costs. And the best way to do that is to ditch the junk food. However, I note that Becel margarine is a “founding sponsor” of the HSF. If there is any food junkier than margarine I would like to know. So the HSF can’t risk condemning junk food and losing it’s main sponsor.

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The wrong food fight

National Post
11 Feb 2009

We feel awkward questioningthe judgment of the Heart and Stroke Foundation (HSF) when it comes to cardiac health issues, but their new and much-trumpeted report about the supposed costs of healthy eating seems deranged. The foundation blasts grocers…read more…

 

 

Tech Tags: National Post newspaper Editorials

The Atherogenic Football Diet

Who are the coaches and “nutritionists” that advise football players to eat atherogenic, obesogenic , diabetogenic, hypertensogenic diets just so they can trample the opposing team? They should be banned from the game.

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By Madison Park
CNN

(CNN) – Football players guzzle protein shakes, down steaks and lift weights. They train and gain weight, hoping to build mass under the careful eye of the team’s coaches, nutritionists and gurus.

“It was a scripted lifestyle where they tell you how to eat, how to take care of yourself, how much body fat you should have,” said Chuck Smith, a former defensive end for the Atlanta Falcons and the Carolina Panthers.

But once their glory days are over, they have the same problem as millions of other Americans: They’re fat.

Football Team

“When I trained, they told us to eat all you can eat,” said Smith, who played in Super Bowl XXXIII with the Falcons. “Drink beer, eat peanut butter to gain weight. All those eating habits were great for football. But when I got done, no question I had to make adjustments.”

Without scheduled practices, meals, and games on Sunday, it became tougher to keep in shape.

When players were younger, they had the opposite problem.

Many tried to gain weight, believing that bigger is better. But as they age and retire from football, many are seeing that “big” is causing problems.

Smith, who weighed 274 pounds during his professional days, often had four plates of food in one sitting “to keep my weight up.” After retirement, Smith had to unlearn those habits.

“I had to retrain my thinking,” he said. “I don’t need to be full. I don’t have to stuff myself to feel comfortable. That took a long time. You stuff yourself to gain weight, then you get out of shape.”

Smith learned he had high cholesterol (he had to take Lipitor), and his blood pressure was climbing, too.

“I had to take the bon-bons out of my mouth,” said Smith, 39. “I had to empower myself. Strength coaches, nutritionists aren’t going to take care of me. Guys have to empower themselves to take care of themselves.”

Smith is now a fitness trainer at Defensive Line Incorporated, where he works with football players. Through healthy foods and workouts, he trimmed his body fat, lowered his cholesterol and shed 50 pounds.

Some players understand the risks, said Dr. Archie Roberts, a former National Football League quarterback and retired cardiac surgeon.

“They understand that if they stay 250, 300, 350 pounds as they age, that’s going to shorten their life span and cause them more health problems,” he said. “Others don’t get it and they’re unable — for whatever reason — to lose the weight, and they will suffer the consequences, just like anybody else in the general population carrying too much weight.”

Diabetes, hypertension and high cholesterol are all cardiovascular risks associated with obesity.

Roberts heads the Living Heart Foundation, a nonprofit promoting health for former football players. For five years, he has conducted research to determine whether former football players are at added risk for heart problems (they’re not).

After left tackle Bob Whitfield retired from the New York Giants in 2007, he gained 20 pounds. The 37-year-old Pro-Bowler is trying to lose 40 pounds, which would bring him to 290 pounds, the lowest he has weighed since ninth grade.

“You don’t want to be the person at the buffet and people look at you crazy,” Whitfield said. “Overall, you want to have a healthier lifestyle. It doesn’t mean you want to be muscled up. … I don’t want to be the biggest man in the room anymore.”

Looking back at his career, Whitfield doesn’t think his size made him a better player.

“When that mass gets too heavy, you decline, you can’t accelerate, you don’t have as much force,” he said. “I never felt that being bigger gives you a competitive advantage. I put it on flexibility, the explosive nature of your movements.”

Several decades ago, 300-pound players were a rarity; now, the league has more than 500, Roberts said.

Decades ago, the Washington Redskins’ offensive line was known for its size and dominance.

“They had the largest line in the NFL, called the Hogs, 20 years ago,” said Dr. Ben Levine, director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital in Dallas, and professor of medicine. “If you go back and look at their size, they’re about the size of the running backs today. The impression was these guys were massive, huge. They couldn’t play in the NFL today. They’re too small.”

Smith said he wasn’t forced to gain weight, but perceptions exist on how a player should look based on his position. That “needs to change in the NFL,” he said.

Being faster, stronger and more aggressive is more important than size, Smith said. He drew an analogy to airline stewardesses: “We want her to be tall and slim so she can walk down the aisles. Now is there really a difference between a 135-pound woman and a 150? Well, maybe a little bit different in the hips, but the same effectiveness happens when she does her job.”

He added, “I’m a classic example that size doesn’t matter.”

But that’s not what young, aspiring players think.

Jackie Buell, director of sports nutrition at Ohio State University, said she encounters players who seek to gain as much as 30 pounds by next season and seldom care whether it’s fat or muscle.

Buell’s research examined 70 college linemen and found that nearly half have metabolic syndrome, meaning that the players have at least three of the five risk factors of developing diabetes and heart disease. Her next project is to explore whether junior high and high school football players are developing metabolic syndrome.

“My fear is, these young men have this metabolic profile, what happens when they stop working out intensively?” Buell said. 

Every disease is “genetic”. So what?

Every disease is caused by some combination of nature and nurture, genetic susceptibility and the environment, especially nutrition. Fortunately, most of the common fatal diseases and those costing the most to the disease care system are mostly environmentally caused. Attempts to find a simple genetic cause for atherosclerosis, hypertension, obesity and Type 2 diabetes were and are unscientific fishing expeditions driven by the analogy that we could immunize the population against these chronic diseases of lifestyle, as we can immunize against acute infectious diseases like polio or smallpox. As this paper makes clear the four-billion year old genetic code is a highly refined, self-referential system that is unlikely ever to be completely understood.

Unfortunately, changing the environment, aka lifestyle, necessitates conquering legal addictions to junk food, tobacco and alcohol. We would much rather spend $many billions on a futile attempt to find a magic genetic bullet to obviate the destructive consequences of addiction than face the painful necessity of eliminating them. 

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Genetic diseases may be tougher to crack, new research suggests 

Last Updated: Friday, December 26, 2008 | 4:07 PM ET 

CBC News

Finding a cure for many genetic diseases — including some cancers and neurodegenerative ailments — may be much more complicated than previously thought, new research indicates.

An international team’s work on alternative splicing, the process that produces 75,000 of the proteins in human cells, found that small changes in the environment near an alternative splice could produce a large change in the proteins produced.

That’s important, because mutations in DNA sequences in alternative splicing cause more than half of all genetic diseases.

If the materials used in splicing are seen as forming a long sentence, then the individual parts can be considered words, said Tim Nilsen, director of the Case Western Reserve University School of Medicine’s Center for RNA Molecular Biology in Cleveland.

“Adding or deleting one word,” he said “can radically change the meaning of the sentence.”

Biologists believe that rules hidden in the DNA code control alternative splicing, so once the code is broken, cures can be found for genetic diseases.

But the finding by Nilsen’s team on the importance of the environment means the code is much more complicated than thought. That will likely delay that progress of scientists who hope to amend the code to cure genetic diseases, said Joseph Nadeau, chair of the medical school’s genetics department.

“It’s context, not [genetic] code, that’s important,” he said.

The study, Dynamic regulation of alternative splicing by silencers that modulate 5′ splice site competition, was published in the Dec. 24 issue of Cell.

Nilsen led a team from three U.S. institutions — Case Western, Columbia University and the Memorial Sloan-Kettering Cancer Institute — and the Max Planck Institute for Biophysical Chemistry in Germany.

Men, not women, out of work

The real issue here is the proliferation of moral rot in American society which will inevitably spread to all capitalist economies, Canada included. At present the only growing American industries are junk food and “health care”, industries that employ mostly women. Obese, junk-food addicted Americans are obsessed with the mirage that diseases caused by self-destructive habits can be prevented and death can be delayed indefinitely if they take enough pills for “cholesterol”, hypertension and diabetes and have enough operations, like gastric and coronary bypasses. Such societies cannot compete against less self-indulgent economies eventually implode and are unable to defend themselves. Unless there is a major change in US society the terrorists just have to wait until it self destructs and they can walk in and create a totalitarian Islamist state. As long as Americans can get their BK Quad Stackers and Lipitor they will not resist.

 

 

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Men out of work
BY ROBERT GAVIN
National Post
10 Dec 2008

The careers of Neal Boyle and Scott Hacker couldn?t be more different. Boyle, whose education ended with high school, worked 20 years crushing rocks at the U.S. Gypsum plant in Charlestown, Mass. Mr. Hacker, who holds an MBA, changed firms several…read more…

 

 

 

 

Tech Tags: National Post newspaper Fp Working

Taliban’s super success: opium

If it weren’t for heroin addiction the Taliban would not exist and we would not be fighting a war in Afghanistan. Until we conquer the problem of addiction in our society there will always be criminals, terrorists and drug companies preying on the misery of addicts. Another example: instead of dealing with junk food addiction we would rather spend $many billions on drugs to treat its symptoms. The recent report of the JUPITER trial, funded by AstraZeneca and really an infomercial for Crestor, is a good example. No attempt was made to treat the addiction of the mostly overweight or obese subjects in trial. Only a drug was tested to treat the metabolic manifestations of the addiction, like “dyslipidemia” and CRP. Consequently many of the subjects became diabetic.

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Taliban’s super success: opium
KIRK KRAEUTLER NEW YORK TIMES
The Gazette
28 Nov 2008

UNITED NATIONS  Afghanistan has produced so much opium in recent years that the Taliban are cutting back poppy cultivation and stockpiling raw opium to support prices and preserve a major source of financing for the insurgency, says the head of the…read more…

Tech Tags: The Gazette newspaper WORLD

Cardiac disease threatens diabetics

Dr. Terrence Ruddy, chief of cardiology at the University of Ottawa Heart Institute, says the increasing number of people with diabetes is a major concern across the medical profession.

“The increasing number with diabetes is directly related to the increasing number with obesity,” he says. “We have an epidemic of obesity in young and older people. In older people, that is giving them diabetes now. In younger people, it will give them diabetes in the next 20 to 40 years.” It’s vital to reduce obesity, “not just for 40- to 50-year-olds but in 10 to 20-year-olds,” he says. “We need more money flowing into educational programs focused on lifestyle changes — increased activity, appropriate diet and weight loss in young people. Decrease obesity to decrease diabetes.”

Yet at least 500 cardiologists around the world were paid by AstraZeneca to take part in JUPITER, a clinical “trial” of Crestor in which most subjects were overweight or obese and NO attempt was made to reduce their weights. 1.5% per year became diabetic due to their inflamed excess visceral fat. Probably at least US$500 million flowed into this “trial” with NO “educational programs focused on lifestyle changes”.

Doctors pay lip service to the need to fight obesity but money talks. Those cardiologists probably received at least $1000 per subject to enroll them in the JUPITER “trial”. Why would they dare to insist upon lifestyle change first before enrolling the subject and forgo this income? Members of the “JUPITER Study Group” presumably overseeing the “trial” for AstraZeneca were probably paid $100,000 each for their “consultation”. Why would they insist on lifestyle change first before agreeing to participate?

 

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Cardiac disease threatens diabetics
IRIS WINSTON CANWEST NEWS SERVICE
The Gazette
26 Nov 2008

Just one year after Dale Frayling was diagnosed with type 2 diabetes, he suffered his first heart attack. Four months later, he had a second, more severe attack followed by bypass surgery. That was 11 years ago. The Saskatoon resident, now 57, has…read more…

 

Also blogged here: 1, 2

Tech Tags: The Gazette newspaper Healthy Living

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Here is the list of the cardiologists paid to participate in the JUPITER study who care more about money than advising patients on the best way to prevent atherosclerosis and diabetes.

Paul M Ridker, M.D., Eleanor Danielson, M.I.A., Francisco A.H. Fonseca, M.D., Jacques Genest, M.D., Antonio M. Gotto, Jr., M.D., John J.P. Kastelein, M.D., Wolfgang Koenig, M.D., Peter Libby, M.D., Alberto J. Lorenzatti, M.D., Jean G. MacFadyen, B.A., Børge G. Nordestgaard, M.D., James Shepherd, M.D., James T. Willerson, M.D., Robert J. Glynn, Sc.D., for the JUPITER Study Group

Appendix. JUPITER Clinical Sites

Argentina 253: Altamirano J, Berrizbeitia M, Boskis P, Colombo H, Cuadrado J, Cuneo
C, Diaz M, Esper R, Fernandez A, Foye R, Hershson A, Kuschnir E, La Greca R,
Lorenzatti A, Lozada A, Luciardi H, Luquez H, Maffei L, Majul C, Marin M, Muntaner
J, Nul D, Paolasso E, Rey R, Rodenas P, Rodriguez P, Rojas C, Telsolin P, Vita N,
Belgium 487: Adrianes G, Argento O, Bacart P, Baeck L, Baguet J, Balthazar Y, Battello
G, Behets J, Beke P, Bemden S, Berwouts P, Boermans P, Bolly F, Borms J, Boulad M,
Boulanger L, Bous J, Boxstael R, Brands Y, Buyse L, Calozet Y, Camps K, Capiau L,
Celis H, Coucke F, D’Argent F, De Beeck G, De Meulemeester M, De Praeter K, De
Rouck S, Delcourt A, Delvaux J, Demanet E, Derijcke M, Deruyck C, Devaux J, Dupont
C, Duyse J, Erpicum L, Gilio C, Gillet A, Grosjean J, Heeren J, Henry G, Heyvaert F,
Hollanders G, Hutsebaut A, Janssens P, Lannoy H, Ledoux C, Legros P, Leliaert R,
Martens R, Maury O, Mehuys G, Michaux J, Migeotte A, Mortelmans J, Mulders N,
Parijs P, Peer W, Pieters E, Reynders P, Riet D, Robert P, Stee J, Teheux J, Teuwen J,
Timmermans B, Tshinkulu M, Vantroyen D, Veevaete M, Vercruysse K, Vereecken G,
Vermeersch L, Vernijns J, Verspecht E, Vinck G, Vrancken F, Watte G, Weymans J,
Windmolders S, Ziekenhuis J, Ziekenhuis P, Brazil 327: Albuquerque D, Barbosa E,
Bertolami M, Blacher C, Brasileiro A, Eliaschewitz F, Esteves J, Feitosa G, Filho H,
Filho R, Fonseca F, Forti A, Francischetti E, Franco R, Gomes M, Gross J, Jardim P,
Kohlmann O, Loures-Vale A, Magalhaes M, Maia L, Moriguchi E, Nogueira P, Oigman W,
Repetto G, Saraiva J, Xavier H, Bulgaria 197: Balanescu S, Benov H, Chompalova B,
Donova T, Gocheva N, Goudev A, Grigorov M, Gruev T, Hergeldjieva V, Marchev S,
Mihov A, Pasheva V, Penev A, Popov A, Raev D, Sirakova V, Slavcheva A, Stoikov A,
Stoilov R, Tisheva S, Todorov G, Torbova S, Uzunangelov J, Canada 2020: Achyutna G,
Akhras R, Arun N, Barriere G, Bartlett J, Behiels S, Bell A, Bergeron J, Berlingieri J,
Bhamjee H, Bodok-Nutzati R, Booth W, Boyd C, Brault S, Bruckswaiger D, Bukovy B,
Campbell G, Carlson B, Cha J, Chehayeb R, Cheng W, Chilvers M, Chouinard G,
Chow W, Conter H, Conway J, Craig D, Dattani I, Del Grande R, Dharamshi S,
Dickson M, Dion D, Dowell A, Drexler J, Dube S, Dupont A, Dworkin B, Fields L,
Filteau P, Gardiner E, Gervais B, Gillis G, Girard R, Goldman H, Gorfinkel I, Goulet S,
Greenspoon A, Gritter R, Gupta A, Gupta M, Habib R, Harding R, Hart R, Henein S,
Henry D, Hirsch A, Ho K, Hoag G, Houde D, Howlett E, Ing G, Jadd J, Janes J, Jardine F,
Johnston T, Kanani S, Kazimirski M, Kelly A, Klajner F, Kooy J, Lalani A, Lam S,
Laranjeiro J, Larose D, Leiter L, Leung W, Li J, Lowe D, Luces K, Ma P, MacKinnon R,
Martinho V, Matangi M, McCrossin M, McIsaac J, McMullen W, Mehta P, Meunier M,
Misik K, Ng A, Nigro F, Noronha L, O’Mahony W, Pandey S, Papp E, Patel V , Patrick L,
Peddle C, Pinsky N, Poirier P, Powell C, Price J, Rolfe A, Saliba N, Sawkiw R, Senior R,
Shu D, Smith R, Somani R, Soowamber M, Stakiw K, Talbot P, Taliano J, Tan K,
Teitelbaum I, Threoux P, Tremblay G, Turcotte C, Tytus R, Walsh P, Webb G,
Willoughby P, Woo V, Woodland R, Yee G, Chile 83: Blanco M, Cardenas N,
Dominguez J, Gutierrez M, Jalaf M, Olivares P, Rodriguez B, Saelezer C, Stockins B,
Colombia 345: Ardila W, Aschner P, Botero J, Botero R, Calderon C, Casas L,
Castellanos R, Chaves A, Cure C, Escobar I, Fortich A, Garcia L, Hernandez E, Isaza D,
Jaramillo N, Kattah W, Marin M, Matiz C, Quintero A, Rizcala A, Rodriguez N, Ruiz A,
Urina M, Valenzuela A, Costa Rica 270: Cob-Sanchez A, Gutreiman-Golberg M,
Lainez-Ventosilla A, Ramirez-Zamoraa L, Slon-Hitti C, Vinocour-Fornieri M, Denmark
336: Hansen H, Nordestgaard B, Steffensen R, Stender S, El Salvador 162: Abrego H,
Renderos J, Rivera-Ochoa L, Estonia 85: Eha J, Jaanson E, Kaasik U, Keba E, Maetos E,
Petersen M, Reinmets S, Roostalu U, Vahula V, Veidrik K, Germany 222: Bellmann R,
Hanefeld M, Horacek T, Klein C, Knels R, Koenig W, Laus S, Meibner G, Mondorf C,
Schell E, Schuster H, Sehnert W, Stahl H, Szelazek G, Winkelmann B, Witczak E, Israel
143: Avishay E, Gavish A, Grossman E, Haratz D, Hussein O, Keider S, Levy Y, Shapiro
I, Shveydel E, Wolfovitz E, Yogev R, Zeltser D, Mexico 741: Escarcega J, Galvez G,
Gonzalez J, Guajardo S, Gutierrez-Fajardo P, Ibara M, Leon J, Lozano F, Munoz E, Pina
J, Romero-Zazueta A, Sanchez R, Takahashi H, Villalpando C, Villegas E, Netherlands
987: Agous I, Bak A, Bartels G, Basart D, Cornel J, De Schipper L, Holwerda N, Kose
V, Koster Y, Lok D, Lokhorst B, Mosterd A, Nierop P, Oude Ophuis A, Somer S, Tiebesl
J, Trip M, Van Hessen M, Van Kempen W, Wassenaar M, Norway 204: Andresen M,
Berz A, Bjurstrom M, Bo P, Brunstad O, Daae-Johansen T, Elle S, Fauske J, Fossdal B,
Gjefsen O, Hallaraker A, Haugen J, Helberg S, Holm-Johnsen S, Istad H, Jacobsen T,
Johansen R, Jorstad T, Jorum I, Kjorlaug K, Kontny F, Langaker K, Larsen B, Lonning
S, Loraas A, Mansilla-Tinoco R, Medhus R, Meyer I, Nasrala S, Ofjord E, Ose L, Palmas
J, Risberg K, Sandberg A, Sirnes P, Skjegstad E, Skjelvan G, Solnor L, Storm-Larsen A,
Tandberg A, Tomala T, Torkelsen A, Ursin A, Valnes K, Walaas K, Panama 202: Binns
R, Delgado A, Lombana B, Noriega L, Trujillo R, Poland 804: Artemiuk E, Asankowicz-
Bargiel B, Banas I, Baranska E, Baranski M, Bijata-Bronisz R, Sikorska A, Blasszczyk B,
Bolanowski J, Brokl-Stolarczyk B, Brzecki K, Buczkowski K, Chmielewski T, Chojnowska-
Jezierska J, Chwist-Nowak A, Cygan W, Czajkowska-Kaczmarek E, Dargiewicz A,
Dluzniewski M, Dudka C, Fares I, Flasinska J, Gadzinski W, Gaszczyk G, Golebiowski G,
Gozdur W, Grudzien K, Kalamarz J, Kalinowska A, Kornacewicz-Jach Z, Korol M,
Korycka W, Kostka T, Kostrzewska A, Kot A, Kowalczyk-Kram M, Kowalska-Werbowy B,
Krupinska G, Lotocka E, Luberda-Heynar Z, Lukas W, Lysek R, Machyna-Dybala A,
Mlynarczyk-Jeremicz K, Mocarska-Gorna B, Niedbal-Yahfouf I, Pasternak D, Potakowska I,
Ramian U, Roleder M, Rosinska-Migda J, Sidorowicz-Bialynicka A, Skierkowska J,
Skorinko I, Slaboszewska J, Sleziak-Barglik K, Sobieska E, Stachlewski P, Superson-Byra E,
Tissler-Nahorska G, Turbak R, Uzunow A, Wasowicz D, Wodniecki J, Wojnowski L,
Wrzol A, Zdrojewska J, Zurakowska-Krzywonos A, Zurowska-Gebala M, Romania 32:
Ablachim T, Abobului M, Bobescu E, Bojinca M, Cristea M, Gaita D, Stoicovici R, Tataru R,
Tudose A, Russia 273: Ardashev V, Arutyunov G, Azarin O, Barbarash O, Bondarev S,
Borisov M, Boyarkin M, Burova N, Chazova I, Dovgalevsky P, Duplyakov D, Egorova L,
Goloshchekin B, Gratsianskiy N, Ivleva A, Karpov R, Karpov Y, Khokhlov A, Khokhlov R,
Khrustalev O, Konyakhin A, Kostenko V, Libov I, Lukyanov Y, Mezentseva N, Panov A,
Repin M, Shabalin A, Shalaev S, Shilkina N, Shulman V, Sidorenko B, Smolenskaya O,
Starodubtsev A, Talibov O, Titkov Y, Tsyba L, Uspenskil Y, Vishnevsky A, Yarokhno N,
South Africa 2497: Ahmed S, Ashtiker H, Bester A, Bhorat Q, Biermann E, Boyd W, Burgess L,
Dindar F, Dulabh R, Engelbrecht I, Erasmus E, Fouche L, Furman S, Govind U, Herbst
L, Jacovides A, Kahanovitz C, Kruger C, Lakha D, Lombaard J, MacLeod A, Makan H,
Manuel E, McDonald M, Mitha E, Mitha I, Moola S, Nell H, Nieuwoudt G, Olivier P,
Padayachee T, Pillai P, Pillay S, Ranjith N, Reyneke S, Routier R, Sandell P, Sebastian P,
Skriker M, Smit J, van Rensburg D, van Zyl L, Vawda Z, Wellman H, Switzerland 15:
Stahl M, United Kindom 2873: Adbulhakim E, Angus M, Balmer F, Balmer J, Barrat R,
Blair D, Blyth A, Brodie R, Brydie D, Campbell C, Campbell I, Church M, Clark C,
Clements R, Donnachie H, Fitpatrick P, Godley C, Hill J, Jarvie F, Kieran W, Langridge S,
Leslie R, Liddell A, MacKenzie J, MacKintosh C, Mair R, Marshall G, Martin R,
McCann C, McKibbin C, McLachlan B, McLean F, Murray S, Norris A, Pawa R, Pexton
N, Ramage A, Reid S, Robertson A, Rourke E, Sarmiento R, Shaw H, Shaw R, Sheil L,
Spence G, Stewart E, Thomas H, Thomson J, Thomson W, Travers J, Ward R, Williams
L, Wooff D, Young W, Uruguay 14: Belzarena C, Huarte A, Kuster F, Lluberas R,
Speranza-Sanchez M, United States 4021: Abarikwu C, Abate L, Abbott R, Ackley C,
Adams G, Adkins S, Albakri E, Albarracin C, Allison J, Alvarado O, Alwine L, Amin K,
Amin M, Anderson J, Anderson M, Anderson W, Andrawis N, Andrews C, Angles L,
Aquino N, Ariani M, Armstrong C, Aronoff S, Arora N, Atri P, Baker J, Baker K, Balli
E, Banish D, Bardenheier J, Barnett G, Bartkowiak A, Basista M, Beliveau W, Bell G,
Benchimol G, Bennett B, Bennett N, Bermudez Y, Bernstein J, Berroya A, Bhargava M,
Biaggioni I, Bimson S, Bittar N, Bleser S, Blumberg M, Bobson C, Boeren J, Bogan R,
Boling E, Booras C, Borge A, Brady J, Brandon D, Bredlau C, Brideau D, Brobyn T,
Brodowski M, Broker R, Broussard C, Brown C, Browning D, Brusco O, Bryant J,
Buchanan P, Bueso G, Burgess G, Burke B, Buynak R, Byrd L, Camilo-Vazquez E,
Campbell J, Cannon L, Capo J, Carmouche D, Castaldo R, Castilleja J, Caudill T, Caulin-
Glaser T, Champlin J, Chardon-Feliciano D, Cheng T, Cherlin R, Cheung D, Chodock A,
Christensen J, Christian D, Christiansen L, Ciemiega R, Clark J, Coble S, Cohen K,
Colan D, Cole F, Cole R, Colleran K, Collins G, Conard S, Cook J, Cooperman M,
Cooze D, Copeland T, Corder C, Courtney D, Cox W, Crump W, Cruz L, Cuellar J,
Cunningham T, Daboul N, Dailey R, Dallas A, Dansinger M, Dao L, Darwin C, Dauber
I, Davidson M, Davis P, Degarmo R, Degoma R, Dempsey M, Denny D, Denyer G,
Desai V, Despot J, Dewan M, Dickert J, Diederich C, Doben S, Dobratz D, Douglas B,
Drehobl M, Dresner J, Dreyfus J, Drummond W, Dunbar W, Dunlap J, Dunmyer S,
Eaton C, Ecker A, Edris M, Egbujiobi L, Elkind A, Ellis J, Ellison H, Engeron E, Erdy G,
Ervin W, Eshowsky S, Estock D, Fang C, Fanning J, Feinberg B, Feld L, Fenton I,
Fernandez E, Ferrera R, Fiacco P, Fierer R, Finneran M, Fintel D, Fischer M, Flippo G,
Flores A, Folkerth S, Forbes R, Fowler R, Francis P, Franco M, Frank A, Fraser N,
Fuchs R, Gabriel J, Gaddam S, Gaffney M, Gamponia M, Gandhi D, Ganzman H, Gaona
R, Gaona R Jr, Garibian G, Garofalo J,, Gatewood R, Gazda S, Geiger R, Geller M,
Germino W, Gibbs R, Gifford C, Gilhooley N, Gill S, Gillespie E, Godwin D, Goldberg
M, Goldberg R, Goldstein M, Gonzalez-Ortiz E, Goodman D, Gordon G, Gordon M,
Goswami A, Gottlieb D, Gottschlich G, Graham D, Gray J, Gray W, Green S, Greenberg
R, Greenspan M, Greenwald M, Grover D, Gupta, R, Gupta-Bala S, Guthrie R, Gutmann
J, Gvora T, Habib G, Hack T, Haidar A, Hamdy O, Hansen M, Hanshaw C, Hargrove J,
Harris H, Harris H, Harrison B, Hart T, Heacock J, Head D, Headley D, Henderson D,
Herman L, Herrera C, Hershberger V, Hershon K, Heym H, Hill G, Hippert R, Hirsch A,
Hnatiuk G, Hoekstra J, Holt W, Homan J, Honsinger R, Howard J, Howard V, Howard
W, Huling R, Imburgia M, Isajiw G, Ison R, Iverson W, Jacks R, Jackson B, Jackson K,
Jacobs J, Jacobson E, James A, Jayanty V, Johary A, Johnson G, Jones P, Jones T, Joseph
J, Julien C, Kahn Z, Kalvaria I, Kang J, Kaplan I, Karns R, Kashi K, Kaster S, Kaufman
A, Kawley F, Keller R, Kenton D, Kerlin J, Kern J, Kerwin E, Kerzner B, Ketchum J,
Khan J, Khan S, Khawar M, Khera A, Kinstrey T, Klein B, Klein E, Klein S, Klein T,
Kleinsteuber K, Klementowicz P, Knopp R, Knutson T, Koch S, Kramer M, Krause R,
Krisciunas V, Krueger C, Kruszewski D, Kumar R, Kunst E, Kuo D, Kuritsky L,
Kushner P, Kutner M, Kwiterovich P, Kwong S, Lanese J, Lang B, Lary J, Lasalle J,
Lasater S, Lasser N, Laughlin D, Lawless J, Lawlor D, Ledbetter J, Ledesma G, Lee D,
Lemanski P, Levinson G, Levinson L, Lewis D, Lewis L, Lewis S, Linden D, Loh I,
Look M, Lopez D, Loskovitz L, Lubin B, Lucas M, MacAdams M, Madden B, Magee P,
Maggiacomo F, Magier D, Magnuson S, Mahaffey R, Makowski D, Maletz L, Mally A,
Maloney R, Mancha V, Manolukas P, Marple R, Martin R, Masri A, Masri B, Mattingly
G, Mayer N, McCain A, McCall Bundy J, Mccartney M, Mcclain D, McConn M,
Mccullum K, Mcdavid R, Mcgettigan J, McIvor M, Mcneff J, Mendolla M, Mercado A,
Mersey J, Milam J, Milko T, Miller M, Miller R, Miller S, Mobley D, Modi T, Modiano
M, Mollen M, Montgomery R, Moran J, Morelli J, Morin D, Moskow H, Moursi M,
Mueller N, Mullins M, Myers E, Nadar V, Naiser J, Nash S, Natarajan S, Neft M,
Neuman D, Nevins B, Newman J, Newman R, Newman S, Nolen T, Nwasuruba C,
Oberoi M, Odom A, Ong Y, Oppy J, Owen S, Pampe E, Pangtay D, Parker R, Patel B,
Patel J, Patel M, Patel R, Paul A, Pearlstein R, Penepent P, Peniston J, Perlman M,
Persson D, Peters P, Peterson G, Peterson J, Pettyjohn F, Phillips A, Phillips D, Piel M,
Pillai T, Pi-Sunyer F, Pollack A, Pond M, Pongonis J, Porras C, Portnoy E, Potos W,
Powers J, Prasad J, Pritchett K, Pudi K, Pullman J, Purdy A, Quinones Y, Raad G,
Radbill M, Radin D, Rai K, Raikhel M, Raine C, Ramanujan R, Ramirez G, Ramos-
Santana Z, Rapo S, Ravin S, Rawtani P, Reeves R, Reeves W, Reiter W, Rendell M,
Resnick H, Reynolds W, Rhudy J, Rice L, Rictor K, Ringrose R, Riser J, Rizvi M, Rizzo
W, Robinson J, Robison W, Rogers W, Rohlf J, Rosen R, Ross, E, Roth E, Rovner S,
Rucki P, Runde M, Ryan W, Rybicki J, Saleem T, Salvato P, Santram D, Scharf B,
Schear M, Schectman G, Schmidt J, Schneider A, Schneider P, Schneider R,
Schoenfelder S, Schussheim A, Schwartz R, Schwartz S, Schwarze M, Scott C, Segal S,
Settipane R, Shah M, Shamim T, Shanes J, Shapero P, Shapiro J, Shealy N, Shepard M,
Shepherd A, Sheta M, Shrivastava R, Shusman R, Siddiqi M, Sidney A, Silvers D,
Simek C, Simpson C, Sinatra L, Singh S, Singson D, Slabic S, Smith D, Smith K, Smith
S, Smith T, Snell P, Specter J, Speer J, Spees R, Sperling M, Spuhler W, Staab P,
Stafford J, Stanton D, Stein E, Stern S, Stocks T, Stone A, Strader W, Strout C, Strzinek
R, Subich D, Suen J, Sugimoto D, Sulman S, Suresh D, Sweeney G, Szatkowski A, Szeto
J, Szewczak S, Szulawski I, Taber L, Taghizadeh B, Tague R, Tambunan D, Tannoury G,
Tavarez Valle J, Thieneman A, Thigpen D, Thompson P, Tidman R, Tilton G, Tokatlian
E, Topkis R, Torelli M, Tortorice F, Toth P, Touger M, Treat S, Trevino M, Trupin S,
Turner A, Turner M, Tweel C, Ugarte J, Ulmer E, Urbach D, Vacker M, Vallecillo J, van
de Beek M, Vargas L, Vazquez Tanus J, Verma, A, Vijayaraghavan K, Wade P, Wade T,
Wagner S, Wahle J, Walker J, Walker M, Weinstein R, Weisbrot A, Weiss R, West P,
White A, Wickemeyer W, Wieskopf B, Wiggins M, Williams H, Wilson M, Wiseman J,
Yataco A, Yates S, Zamarra J, Zamora B, Zawada E, Zemel L, Zigrang W, Zusman R,
Venezuela 209: Aguiton M, Arroyo-Parejo M, Beaujon Sierralta J, Carrizales de Marlin
Y, Colan Parraga J, Fernandez C, Fuenmayor N, Giesen G, Gonzalez Gomez C, Guaipo
A, Herrera Rivera C, Lopez de Montoreano N, Lopez Nouel R, Marturet L, Marulanda
M, Mata L, Morr I, Nass A, Palmucci G, Ponte C, Rivas I, de Roa E, Figarella Salazar G,
Sanchez F, Sirit U, Viloria A.

JUPITER is a gas giant

An excellent article by André Picard in today’s Globe and Mail, the only story on JUPITER I have seen in the lay press that reveals the massive fraud behind the reporting of this “study”.

JUPITER is aptly named. It’s gigantic. Probably the largest, most expensive drug trial in history. When one looks below the surface of the publication in the NEJM, the results are about as exciting as the Jovian composition. A lot of gas. I would conservatively estimate that this “study” cost at least $500 million. But if you are AstraZeneca and stand to sell $many billions worth of Crestor because of this paper that’s small change. And junk food addicts, who comprise most of the subjects of JUPITER have one more excuse, however deceptive, to continue their self-destructive habits.

Here is my opinion posted in the NEJM blog on the paper.

A more detailed analysis of the marketing driven deception and lack of professionalism in the paper by Sandy Szwarc.

Another perspective by John McDougall similar to mine on the big lie behind the claim that many “healthy” people need Crestor.

For an insightful analysis of the obfuscation in the reporting of mortality data in JUPITER see here.

Another devastating critique of Jupiter by the Michel de Lorgeril who many years ago proved that simple diet changes could dramatically prevent heart attacks and prolong life after a heart attack with NO statins.

When all of these criticisms are considered it turns out that JUPITER is nothing more than a thinly disguised  infomercial for Crestor and should never have been published in a presumably high quality journal like the NEJM. But in being able to make this paper freely available on the web (and not wait 6 months like other papers) the NEJM must have received a large payment from AstraZeneca.

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Lead “investigators” of JUPITER

Paul M Ridker, M.D., Eleanor Danielson, M.I.A., Francisco A.H. Fonseca, M.D., Jacques Genest, M.D., Antonio M. Gotto, Jr., M.D., John J.P. Kastelein, M.D., Wolfgang Koenig, M.D., Peter Libby, M.D., Alberto J. Lorenzatti, M.D., Jean G. MacFadyen, B.A., Børge G. Nordestgaard, M.D., James Shepherd, M.D., James T. Willerson, M.D., Robert J. Glynn, Sc.D., for the JUPITER Study Group

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When it comes to statins, don’t believe the hype

November 20, 2008
The Globe and Mail
André Picard”Cholesterol drug causes risk of heart attack to plummet” – Fox News.

“Cholesterol-fighting drugs show wider benefit” – The New York Times.

“Cholesterol drug cuts heart risk in healthy patients” – The Wall Street Journal.

The New York Times article summarized the exciting news in a front-page story saying that “millions more people could benefit from taking the cholesterol-lowering drugs known as statins.”

That’s big medical/business news, because statins are already the bestselling drugs in the world, with sales in excess of $20-billion (U.S.).

Quoting some of the world’s top heart researchers, media reports touted the importance of a blood test for C-reactive protein. That’s because those benefiting from statins had high levels of CRP (a marker for inflammation) rather than high levels of LDL cholesterol, which is usually the criterion for statin prescription.

The news stories were based on research published last week in the prestigious New England Journal of Medicine and presented, with much fanfare, at the annual convention of the American Heart Association.

Like much reporting on medical research (and drug research in particular), however, there is more (or, more accurately, less) to these stories than meets the eye.

The principal finding in this study was that participants who took a statin pill recorded a 50-per-cent reduction in the risk of heart attack, stroke, surgery and death compared with those who took a placebo (a sugar pill).

Who wouldn’t be wowed by those numbers? Who wouldn’t want that miracle drug?

But the benefits are relative risk reductions.

When you look at the raw data in the study, they reveal that 0.9 per cent of statin users had cardiovascular problems. By comparison, 1.8 per cent of those taking a placebo had heart problems.

There were 17,802 participants in the study, yet there were only 83 cardiac events among statin users, compared with 157 in the placebo group. That’s 50 per cent fewer.

Are those really “dramatic” findings? Do statins really make heart attack risk “plummet”?

According to a cautionary editorial in the New England Journal of Medicine (which received virtually no mention in news reports), 120 people in this study needed to be treated with a statin for two years to see a benefit in one person.

That’s a lot of people taking a pricey drug ($3 Canadian a day) for no benefit – not to mention that there are risks.

While researchers (and journalists who report on studies) love to highlight benefits of drugs, they too often gloss over risks.

Like all drugs, statins have side effects. The drug used in the study, rosuvastatin (brand name Crestor), has been associated with muscle deterioration and kidney problems.

In the study, those taking statins had a higher risk of developing Type 2 diabetes – 3 per cent compared with 2.4 per cent of those taking a placebo. That’s a 25 per cent higher relative risk among people with very little heart disease to begin with.

As noted earlier, researchers (and news stories) suggested that, based on the findings, the number of patients taking statins could and should expand dramatically.

But is that really what the research tells us, even in its most optimistic interpretation?

The study involved exclusively men older than 50 and women older than 60 who did not have high cholesterol or histories of heart disease or inflammatory illness. All the people in the study needed to have low cholesterol and high CRP.

Initially, researchers recruited 90,000 people in those age groups, but more than 80 per cent of them were deemed ineligible. This is a very select population.

To say, by extrapolation, that these “dramatic” (read: modest) benefits apply to the general population is erroneous.

Similarly, while it is true that about half of all heart attacks and strokes occur in people whose cholesterol is not considered high, does that mean everyone should get a blood test to measure levels of C-reactive protein? Hardly.

Yes, there is more heart disease among people with high levels of CRP, but the jury is still out on what this means.

Some scientists believe that because CRP – secreted in response to inflammation – is present in plaque, it increases the risk that the plaque will burst, leading to blood clots that cause heart attacks. But other researchers think that CRP levels are, at best, a telltale sign of heart disease, a bit like grey hairs are a sign of aging – not its cause.

The CRP test is expensive at almost $50. And it’s worth noting that one of the principal authors of the new research holds the patent on the test and makes money every time it is used.

When you cut through all the hype and the self-interest, what we know is this: Statins reduce levels of [LDL] cholesterol. This is beneficial to people who have had a heart attack or other serious heart problems.

But for otherwise healthy people, high CRP levels or not, the potential benefits of taking statins are marginal, and the risks are not insignificant.

Hardly the stuff of dramatic newspaper headlines.

What typical JUPITER subjects would look like. These are "apparently healthy" people?

Nowhere in the JUPITER paper will you see it mentioned that CRP can be markedly reduced with cost-free lifestyle change alone, no statins, as shown in this paper in the Journal of Applied Physiology in 20006, results of which are summarized below. The subjects in the JAP paper were just the same as in the JUPITER study, obese people, many with metabolic syndrome but the authors did not call them “apparently healthy”. They had nothing to sell.