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Trump Tells GOP It's Now or Never, Demanding House Vote on Health Bill - New York Times
Fri, 24 Mar 2017 02:35:57 +0000   

New York Times

Trump Tells GOP It's Now or Never, Demanding House Vote on Health Bill
New York Times
WASHINGTON — President Trump issued an ultimatum on Thursday to recalcitrant Republicans to fall in line behind a broad health insurance overhaul or see their opportunity to repeal the Affordable Care Act vanish, demanding a Friday vote on a bill that ...
Trump Ultimatum: Vote on Health Care Friday or Obamacare
Trump Ultimatum For House GOP: Vote On Health Bill Or Affordable Care Act StandsNPR
Trump delivers ultimatum to House Republicans: Pass health-care measure on Friday or he'll move onWashington Post
Chicago Tribune -FiveThirtyEight -ABC News
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All-male White House health bill photo sparks anger - BBC News
Fri, 24 Mar 2017 02:04:06 +0000   

BBC News

All-male White House health bill photo sparks anger
BBC News
That's because one of the points under discussion was whether the new bill should mandate that health insurance plans provide "essential benefits" including maternity services. In January, the White House came in for some flak when President Trump ...
What's Missing From This Photo of Politicians Deciding the Future of Women's Health?Mother Jones

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Health care bill divides Trump supporters in Arizona - CBS News - CBS News
Thu, 23 Mar 2017 23:27:00 +0000   

CBS News

Health care bill divides Trump supporters in Arizona - CBS News
CBS News
CBS News spoke with ardent supporters of President Trump ahead of proposed changes that will have big effects in Arizona.

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What the GOP Doesn't Get About Who Pays for Health Care - The New Yorker
Thu, 23 Mar 2017 23:16:21 +0000   

The New Yorker

What the GOP Doesn't Get About Who Pays for Health Care
The New Yorker
I've been thinking about that conversation this week, as President Trump has cajoled and muscled House Republicans in an attempt to get the votes to pass the American Health Care Act, the Paul Ryan-produced bill that was meant to fulfill Trump's ...

Dropping Obamacare's 'essential' benefits impacts more than mammograms - USA TODAY
Thu, 23 Mar 2017 22:47:00 +0000   

CT Post

Dropping Obamacare's 'essential' benefits impacts more than mammograms
Eliminating required health insurance benefits, a move discussed as part of the Republican move to repeal the Affordable Care Act, also threatens to kill the ACA's annual and lifetime limits on patients' costs, which was enacted to prevent bankruptcies ...
Health care vote delayed, debate continuesCT Post
The Trouble With Killing Obamacare's 'Essential Health Benefits'The Atlantic
The Obamacare Fight Is About Way More Than Health CareFiveThirtyEight
NPR -CNN International -National Review -Congressional Budget Office
all 1,487 news articles »
Congressmen face growing pressure from voters on GOP health-care bill - CNBC
Thu, 23 Mar 2017 22:34:00 +0000   


Congressmen face growing pressure from voters on GOP health-care bill
Republican lawmakers are caught between a rock and a hard place: A White House that wants a health care win, and constituents who don't want changes to their health care. That debate is on fully display as House Republicans get closer to a vote on the ...

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CBO: New Health Care Bill Would Leave Millions More Uninsured and Save Less -
Thu, 23 Mar 2017 22:24:08 +0000

CBO: New Health Care Bill Would Leave Millions More Uninsured and Save Less
After a series of revisions, the House Republican health care bill would still leave 24 million more people without insurance while saving less money than before, according to the nonpartisan Congressional Budget Office. While the previous bill would ...
Revised Republican health care bill is more costly, but doesn't insure more peopleCNNMoney
This is the problem with delaying a vote on Republicans' health-care billWashington Post
CBO says latest GOP health care bill would cost more, not expand coverageUSA TODAY
Bloomberg -TIME -CBS News -Congressional Budget Office
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Cramer's best and worst case scenarios for the health-care vote - CNBC
Thu, 23 Mar 2017 22:11:54 +0000   


Cramer's best and worst case scenarios for the health-care vote
The House of Representatives' vote on the Obamacare replacement may have been delayed, but Jim Cramer's advice is to keep an even keel and have a game ...

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President Trump sits down with truckers to talk health care, jobs - CNBC
Thu, 23 Mar 2017 21:45:28 +0000   


President Trump sits down with truckers to talk health care, jobs
While Republican leaders were busy most of the day Thursday trying to rally House support behind the GOP-proposed American Health Care Act, President Donald Trump met with some of the trucking industry's biggest names, and their dialogue focused on ...

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Stocks close mostly lower after key health-care vote is delayed - CNBC
Thu, 23 Mar 2017 17:23:10 +0000   


Stocks close mostly lower after key health-care vote is delayed
U.S. stocks fell on Thursday after a key vote in the House regarding a Republican-led health care bill was delayed. The Dow Jones industrial average fell about 5 points, with UnitedHealth contributing the most losses. The 30-stock index had traded ...

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What Does Obamacare Uncertainty Mean For You?
Wed, 08 Mar 2017 21:33:00 +0000   
House Republicans unveil the American Health Care Act, their replacement for the Affordable Care Act. WebMD tells how your health insurance coverage may be affected.
How Does Daylight Saving Time Affect Your Health?
Wed, 08 Mar 2017 21:03:38 +0000   
Losing an hour of sleep may do more to your mind and body than you realize.
Americans With High BP Still Eating Too Much Salt
Wed, 08 Mar 2017 20:15:16 +0000   
Average sodium intake more than double the recommended daily limit for these patients, study finds
Depression May Hasten Death After Heart Diagnosis
Wed, 08 Mar 2017 20:15:13 +0000   
Mental health screening recommended over the long term, study suggests
Baby Boomers Get an 'F' for Hep C Testing
Wed, 08 Mar 2017 18:15:12 +0000   
Screening rates for the dangerous virus remain low despite recommendations, study finds
Violent Video Games May Not 'Desensitize' Players
Wed, 08 Mar 2017 18:15:07 +0000   
In small study, frequent players had empathetic responses similar to those who don't play much
5 Ways The GOP Health Bill Would Reverse Course
Wed, 08 Mar 2017 12:45:09 +0000   
From Medicaid funding to paying for over-the-counter drugs, the legislation offered by House Republicans offers a far different pathway to coverage than Obamacare.
1 in 4 U.S. Adults Disabled by Arthritis: CDC
Wed, 08 Mar 2017 02:12:37 +0000   
Agency recommends exercise, not opioids, to control pain, stiffness
Chrissy Teigen Shares Her Struggle With Postpartum Depression
Tue, 07 Mar 2017 20:41:26 +0000   
The model and author got candid about the painful time following the birth of her daughter last April.
More Sleep Time, Less Play Time in U.S. Bedrooms
Tue, 07 Mar 2017 20:15:27 +0000   
Biggest drop in sexual activity seen for those married or living together, survey finds
Soy May Be Protective for Breast Cancer Survivors
Tue, 07 Mar 2017 20:15:25 +0000   
Study of 6,200 women finds the food linked to lower risk of death after nearly a decade of follow-up
Obesity in Pregnancy Tied to Cerebral Palsy Risk
Tue, 07 Mar 2017 20:15:20 +0000   
But study authors stress that a cause-and-effect link wasn't proven
Poor Diet Tied to Heart Disease, Diabetes Deaths
Tue, 07 Mar 2017 20:15:18 +0000   
Study explores which foods and nutrients may be helpful or harmful
Evanger's Dog Food Recall Expanded
Tue, 07 Mar 2017 18:42:48 +0000   
The dog food may be contaminated with pentobarbital
Have Americans Given Up on Losing Weight?
Tue, 07 Mar 2017 18:26:04 +0000   
Study finds more are overweight, obese than 2 decades ago, but fewer are trying to shed pounds
House Republicans Unveil Their Rx for Obamacare
Tue, 07 Mar 2017 18:15:29 +0000   
It retains some portions of the health reform law, but axes some unpopular ones
Alzheimer's Death Toll Nearly Doubles in 15 Years
Tue, 07 Mar 2017 18:15:21 +0000   
Price tag hits $259 billion a year, projected to exceed $1 trillion by 2050, report finds
Some Migraines Tied to Artery Tears in Neck
Tue, 07 Mar 2017 00:15:16 +0000   
Problem also more likely in men and patients under 39, though chances are still low
RA Drug May Not Ease Chronic Fatigue After All
Tue, 07 Mar 2017 00:15:14 +0000   
With disappointing study results, there's still no cure for the mysterious disorder
Your Sex Life May Work Wonders for Your Work Life
Mon, 06 Mar 2017 22:15:18 +0000   
Employees in better mood the next day, leading to more work engagement and job satisfaction, study contends
Obesity May Raise Girls' Risk of Asthma, Allergies
Mon, 06 Mar 2017 20:15:14 +0000   
But same was not true for boys, study found
Can Social Media Leave You Socially Isolated?
Mon, 06 Mar 2017 18:24:26 +0000   
More time using apps and sites like Twitter, Instagram, Facebook linked to greater sense of isolation, study suggests
Patients Often Reject Drug-Only Psych Treatment
Mon, 06 Mar 2017 18:15:34 +0000   
Compliance more likely when doctors prescribe talk therapy, study finds
Secondhand Smoke Linked to Food Allergies in Kids
Mon, 06 Mar 2017 18:15:24 +0000   
Passive exposure tied to more egg and peanut sensitivity in study
Polluted Environments Kill 1.7M Kids Yearly: WHO
Mon, 06 Mar 2017 18:15:19 +0000   
The deaths stem from indoor and outdoor air pollution, secondhand smoke, unsafe water, lack of sanitation, and poor hygiene
Nasal 'Nerve Block' May Help Ease Kids' Migraines
Sun, 05 Mar 2017 18:15:15 +0000   
But one headache expert says procedure not without risks, pain relief not significantly better than meds
Can Mom's Vitamin E Head Off Child's Asthma Risk?
Sat, 04 Mar 2017 18:15:17 +0000   
Association only significant with type of nutrient found in highest amounts of safflower, sunflower oils
Asthma Much More Lethal for Black Children, Study Finds
Sat, 04 Mar 2017 18:15:14 +0000   
This group has 6 times the odds of dying from the illness compared to whites, Hispanics
More Teens Turning Their Backs on Tanning Beds
Fri, 03 Mar 2017 22:24:43 +0000   
Half as many high school students reported indoor tanning in 2015 versus 2009, survey finds
5 Morning Habits Health Experts Swear By
Fri, 03 Mar 2017 22:04:20 +0000   
Find out how doctors, trainers, and nutritionists start each day on a healthy note.
Baby Rattles Recalled: Possible Choking Hazard
Fri, 03 Mar 2017 20:16:40 +0000   
A clear plastic disc on the outside of the ball-shaped Kids II Oball Rattle can break and the small beads inside the disc pose a choking hazard to young children
Brain Training for Cancer Survivors' Nerve Damage
Fri, 03 Mar 2017 20:15:14 +0000   
Neurofeedback seems to offers relief from chemo-induced pain, research finds
Daffodils, Margaritas Among Surprise Skin Dangers
Fri, 03 Mar 2017 18:23:58 +0000   
There are many hidden hazards that can cause itch or rash, dermatologists warn
Urine Present in all Pools: Study
Fri, 03 Mar 2017 18:15:24 +0000   
Researchers tested 31 pools and hot tubs in Canada and found evidence of urine in all of them
Do 'Early Birds' Get the Healthier Worm?
Fri, 03 Mar 2017 18:15:22 +0000   
Late-to-bed types appear to have poorer eating habits, study says
Read Skin-Care Product Labels With Caution
Fri, 03 Mar 2017 18:15:17 +0000   
Terms like 'hypoallergenic' and 'fragrance-free' may not mean what you think they do, doctor says
DIY Teeth-Straightening: Don't Try This at Home
Fri, 03 Mar 2017 00:15:15 +0000   
Dangers lurk when rubber bands, paper clips and other tools are used to avoid the orthodontist
More Kids Ill From Drinking Hand Sanitizers: CDC
Thu, 02 Mar 2017 22:15:20 +0000   
Some children aged 6 to 12 may be intentionally consuming brands containing alcohol, researchers say
Exercise Helps Counter Cancer-Linked Fatigue
Thu, 02 Mar 2017 22:15:18 +0000   
Psychological treatment and education can be useful, too, more so than drugs, study finds
Risk of Birth Defects From Zika 20 Times Higher
Thu, 02 Mar 2017 22:15:16 +0000   
Finding highlights importance of preventing infection during pregnancy, researchers say
How to Stop Feeling Anxious Right Now
Thu, 02 Mar 2017 21:25:13 +0000   
When your mind starts to race, these tips can help you relax and regain control.
FDA Approves New Treatment for Dust Mite Allergies
Thu, 02 Mar 2017 20:18:38 +0000   
Odactra is a year-round treatment for reactions to the tiny bugs that share your home
Hearing Loss May Double in United States by 2060
Thu, 02 Mar 2017 20:15:18 +0000   
Those over 70 will be hardest hit, study finds
Nips, Tucks: Americans Reshaping Their Bodies
Thu, 02 Mar 2017 18:15:37 +0000   
Cosmetic procedures are on the rise and patients aren't shy about what they're tweaking, study finds
Finally, Proof That Hearing Aids Help
Thu, 02 Mar 2017 18:15:35 +0000   
High-quality digital devices provide 'significant benefit' to older Americans, study finds
Some Melanoma Survivors Still Seek Out the Sun
Thu, 02 Mar 2017 18:15:33 +0000   
1 in 5 had suffered a sunburn in the past year, study finds
Facebook Launches New Suicide Prevention Tools
Thu, 02 Mar 2017 18:15:30 +0000   
People watching a Facebook Live broadcast will now be able to report the video for an escalated response from Facebook
Hospital Room Floors May Harbor 'Superbugs'
Thu, 02 Mar 2017 18:15:26 +0000   
But that area often overlooked when it comes to infection control, researchers say
Insecticides May Be Tied to Kids' Behavior Issues
Thu, 02 Mar 2017 18:15:24 +0000   
Study can't prove cause-and-effect, but children exposed in utero to pyrethroids had more problems
New Eczema Drug Promising in Early Trial
Thu, 02 Mar 2017 18:15:18 +0000   
Nemolizumab significantly reduced the itch and improved appearance of skin
A Sample Menu for a Low-Fat Diet
Tue, 28 Feb 2017 17:20:00 +0000   
17 Worst Habits for Your Heart
Mon, 13 Feb 2017 16:10:00 +0000   
Here are the worst habits for your heart, and how to avoid them.
5 Facts to Know About Your Cholesterol
Fri, 10 Feb 2017 15:39:30 +0000   
How's your cholesterol these days? If you’re not sure, you’re not alone.
What Causes High Cholesterol? 4 Lifestyle Mistakes That Put You at Risk
Wed, 28 Sep 2016 20:22:41 +0100   
Take heart: Most cholesterol risk factors are avoidable. 
5 Foods That Lower Cholesterol Naturally
Tue, 27 Sep 2016 21:28:32 +0100   
Add these versatile foods to your diet for a healthier heart.
What Puts You at Risk for High Cholesterol?
Mon, 29 Feb 2016 16:56:37 +0000   
A bad diet is a sure way to spike your triglyceride reading.

Blood cholesterol is a risk factor for coronary artery disease and heart attack, so reducing your risk of high cholesterol is a worthy goal. However, the next time you brag that your cholesterol is nice and low—or lament that your number is in the mid-200s—know this: "Your total cholesterol is a pretty meaningless number," says Maureen Mays, MD, a preventive cardiologist and lipid specialist at Oregon Health & Science University in Portland. "Not only does the general public not know this, some doctors don't either."

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Here's why "the number" is so misleading. Total cholesterol is calculated by adding LDL (bad cholesterol), HDL (good cholesterol), and one-fifth of your triglyceride total. "We have been using this formula of adding a bad thing to a good thing and factoring in one-fifth of a bad thing, and it's not useful," Dr. Mays says.

That's one reason 50% of people who have a heart attack have normal cholesterol readings.

Effects of diet and exercise
A smarter way of looking at cholesterol risk is by component. LDL, or bad cholesterol, is very responsive to good nutrition and exercise. The target number is less than 100 mg/dL. It's not uncommon for LDL to swing up by 40% in response to a sedentary lifestyle and a diet high in saturated and other unhealthy fats, according to Dr. Mays.

It can also drop by up to 40% in response to a heart-healthy diet and regular exercise.

One in 500 people has an inherited risk of extremely high LDL and should be put on statins to control their risk of heart disease.


[ pagebreak ]Being overweight can also raise your triglycerides, for which the goal is 150 mg/dL or under. High triglycerides put you at risk for type 2 diabetes, which is a coronary heart disease risk equivalent; this means that if you have diabetes, you have the same risk of dying from cardiovascular problems as someone who already has coronary heart disease.

While increasing age and stress will slightly change your cholesterol panel, "stopping smoking is the best way to raise your good cholesterol," says Dr. Mays.

10 Simple Food Choices for a Healthy Heart
Read how a well-rounded diet full of leafy greens and healthy fats can help lower your risk for heart disease  Read more

It is critical for women nearing menopause to maintain a healthy diet and exercise plan to counteract the effects of estrogen loss. Because estrogen suppresses LDL levels, women who reach menopause may notice a surge of bad cholesterol, says Denise Janosik, MD, a cardiologist and professor of internal medicine at Saint Louis University School of Medicine.

Effect of drugs and alcohol
Certain medications, including the steroid prednisone and HIV drugs, can affect your cholesterol panel negatively, so much so that people who are on protease inhibitors for HIV need to be concerned about developing heart disease, and not just AIDS, according to Dr. Mays.

One to two drinks a day is fine for keeping your cholesterol in check. More than that may raise triglycerides because of the high sugar and calorie content of alcoholic drinks. Alcohol also raises HDL slightly, but this increase in good cholesterol isn't as great as that caused by a healthy lifestyle.

Hypothyroidism, too, can result in skewed cholesterol numbers. "If you are fatigued and have sudden weight gain, it is good to have a thyroid screening," says Dr. Mays. "If your thyroid isn't working properly, your lipid panel will make no sense."

Cholesterol in Eggs May Not Hurt Heart Health After All
Wed, 17 Feb 2016 11:40:10 +0000   
The once-maligned egg may not be a heartbreaker after all, new research suggests.
'Obese' May Not Always Equal Unhealthy, Study Says
Fri, 05 Feb 2016 15:30:03 +0000   
Many overweight and obese Americans might be perfectly healthy when it comes to blood pressure, cholesterol, and blood sugar levels—while many thin folks may not be the picture of good health.
1 in 8 American Adults Still Have High Cholesterol
Wed, 02 Dec 2015 15:00:03 +0000   
About one in every eight American adults continue to have high levels of total cholesterol.
'Silent' Heart Attacks are More Common Than You Might Think
Tue, 10 Nov 2015 12:45:08 +0000   
New research suggests that many Americans suffer "silent" heart attacks -- events that go unnoticed but are serious enough to leave scars on the heart.
22 Heart-Smart Salmon Recipes
Sat, 25 Jan 2014 14:20:00 +0000   
Use these healthy and easy recipes to grill and bake delicious salmon dishes.
Heart Trouble? 15 Herbal Remedies to Avoid
Wed, 22 May 2013 16:15:00 +0100   
Though widely viewed as safe, herbal remedies can cause serious interactions in people taking prescription drugs for heart problems. Check out the following guide to herbal products that heart patients should avoid.
Happy National Nut Day!
Mon, 22 Oct 2012 11:30:13 +0100   
It's National Nut Day, a time to celebrate the heart health benefits of nuts and nut butters.
A Doctor Heals Himself, But Still Battles Culture of Disease
Wed, 25 Jul 2012 14:00:07 +0100   

Dr. Ed James draws inspiration from his personal experiences with healthy lifestyle changes, having overcome prediabetes and obesity several years ago. In 2011, he founded Heal2BFree to focus on helping individuals and organizations to develop and implement action plans that help close the health disparities gap between blacks and whites.

As a medical student in the late 1980's, I recall being lectured on the importance of medical research. We were told the results of such work would occasionally lead us in directions that were not anticipated. We were also reminded of the importance of analyzing the results critically and comprehensively without bias and following them wherever they might lead. At the time the advice seemed obvious, but in the years since I have come to appreciate such action is not always easy.

I believe that my personal health journey has relevant public health implications and reinforces why we must pay attention to research, even when such results may bring into question current dogma, and even implicate our culture.

A doctor at risk
Several years ago, at the time of my routine physical exam, my doctor informed me that I was prediabetic and my LDL (bad) cholesterol was elevated. I was also obese. As a physician in my mid-40’s at the time, I was quite aware that these were risk factors for premature death. I was feeling much more like a patient--quite vulnerable, concerned, and helpless.

When my doctor gave me the prescription, it was simply for healthy lifestyle changes. He suggested I read The China Study by T. Colin Campbell, Ph.D., which I promptly did, and which thankfully changed my life......for the better. It also provided me with a different lens through which to view some of the greatest challenges that face the medical profession.

Adopting a plant-based, whole foods diet as advocated by Dr. Campbell, and a regular exercise and stress reduction program (as described in publications by Dr. Dean Ornish), I was able to lose more than 50 pounds, "cure" my prediabetes, lower my LDL cholesterol to the normal range, and lower my total cholesterol by approximately 40 mg/dL to under 150. My body inflammation (a risk factor for heart attack), as measured by a lab test called C-reactive protein (CRP), also improved significantly. I was sold.

Changing his health fate
In my family, obesity, type 2 diabetes, hypertension, heart disease, and stroke are frequent co- morbidities and have resulted in much premature death. "The China Study" research clearly demonstrates that these diseases and many others, including cancers that frequently occur in Americans, are preventable in most cases, since diet and lifestyle generally "trump genes." In my opinion, we doctors, although well-intentioned, spend considerable time evaluating patients’ family medical histories, often leaving them with the misconception that their genes hold their likely destinies. Simply put, the diseases that are responsible for the deaths of most Americans can be prevented by a healthy diet and lifestyle in the majority of cases.

The New York Times has referred to "The China Study" as the largest and most comprehensive ever undertaken on the relationship between dietary patterns and development of disease. In rural areas of China, the mean total cholesterol was 127 mg/dL. Rates of chronic disease were generally much lower than in the United States. Interestingly, when these rural Chinese populations migrate to Western countries and adopt our diet and lifestyle, their rates of chronic disease soar to Western levels.

The diet of the rural Chinese in the study consists of mainly plant-based, low-fat, whole foods with some fish, while our Western diet is high in animal-based foods, including milk and dairy, refined carbohydrates, sugar, salt, and saturated fats. The "China Study" research strongly supports that these dietary differences are largely responsible for the much higher rates of heart disease, diabetes, stroke, many cancers, and other chronic diseases in Western cultures, including the United States.

Armed with Dr. Campbell’s research, and that of other researchers, including Drs. Dean Ornish and Caldwell Esselstyn, I set out to "scream from the rooftops" how my personal experience with lifestyle changes strongly supported the China Study research, beginning with my physician colleagues. But......not so fast. While none contested the validity of these studies, most were reluctant to change their personal diets significantly. The research and clinical experience of Dr. Caldwell Esselstyn at the Cleveland Clinic has clearly demonstrated that a total cholesterol of less than 150 reduces one’s risk of a heart attack to virtually zero. Yet most of my physician friends (including cardiologists) do not consider this a reasonably attainable goal for themselves or for their patients.

Why? It is "culturally impossible." It would require a departure from the animal-based foods, high in saturated fats and cholesterol, that comprise the Standard American Diet (SAD). At recent medical conferences that I’ve attended, bacon, sausage, pastries and doughnuts were consumed. In my anecdotal experience over the last 20 years, we doctors generally suffer and die from the same "preventable" chronic diseases as our patients (heart attacks, strokes, diabetes, etc.). I once saw a cartoon of a doctor eating breakfast. In one hand, he held a medical journal whose research concluded that meat contributes to chronic disease. In the other hand, he held a fork with sausage.

The cartoon summarizes the disconnect which I have anecdotally observed. It is my personal observation and conclusion that our reluctance as a medical profession to embrace a plant-based, whole foods diet reflects a general unwillingness to re-examine and critically evaluate our dietary patterns, which are embedded in our culture. Reflecting on our societal imperfections is uncomfortable.

Yet I am optimistic looking towards the future that our approach to chronic disease will change. Continuing medical education programs such as Healthy Kitchens, Healthy Lives (Harvard School of Public Health) and Food as Medicine (Center for Mind-Body Medicine) are now educating more and more physicians and other health professionals about the impact changes in the kitchen can have on chronic disease prevention. When our medical schools begin to engage proactively and impress upon future physicians the need to "walk the talk" with regard to leading healthy lifestyles, we will become better suited as a profession to address the preventive health needs of our patients.
10 Heart-Healthy Rules to Live By
Mon, 04 Jun 2012 14:15:00 +0100   
10 Ways to Lower Cholesterol
Fri, 09 Dec 2011 14:25:00 +0000   
How Cholesterol Affects Your Heart's Health
Wed, 13 Jul 2011 14:10:00 +0100   
Too much LDL (bad cholesterol) can lead to fatty deposits in the blood vessels, which can cause a heart attack or stroke.

When most people hear "cholesterol" they think "evil." Like most things in life, the reality is more complex; cholesterol can be very bad and very good. On its own, cholesterol is a crucial body component. That's why you make the white, waxy substance (about 75% of the cholesterol in your blood is made by the liver and cells elsewhere in your body). Cholesterol insulates nerve cells in your brain and provides structure for cell membranes.

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"If you want to see what it looks like in a solidified form, go get yourself a can of Crisco at the grocery store," says Gregory Dehmer, MD, director of the division of cardiology at the Texas A&M College of Medicine. "If you open up a can of Crisco, its this white, lard-like substance."

His Heart Almost Stopped
Heart Disease Thinking Every Day Doctor-Patient Video
"I almost didn't wake up"  Watch video

When it comes to heart disease, though, some types of cholesterol are too much of a good thing.

How cholesterol can clog arteries
Not all cholesterol is created equal. It's a fatty substance, so cholesterol can't dissolve in the blood to be carried to where it's needed in the body. "Your body is mostly water, and fat and water don't mix," says Dr. Dehmer.

So cholesterol is packaged into proteins that can shuttle the fatty stuff around your body. One is high-density lipoprotein (HDL, or good cholesterol) and another is low-density lipoprotein (LDL, or bad cholesterol).

What's the difference? LDL can stick to the smooth lining of the blood vessels, where it is absorbed. HDL appears to do the opposite—it actually mops up excess cholesterol and removes it from the blood vessels.



[ pagebreak ]The amount and type of cholesterol in your blood are determined by genetics, age, diet, and exercise. When you eat a diet that's rich in saturated and trans fats, or dietary cholesterol (which is found in animal products such as eggs, milk, and meat), LDL cholesterol levels go up.

"The problem is that many individuals—and probably including myself—eat a diet that is very excessive in all the wrong kind of fats, of which we are talking about animal fats and dairy fats, and therefore we get our cholesterol up too high," says Dr. Dehmer.

But when you exercise, HDL cholesterol goes up—and that's a good thing. "The bottom line is that there are some people out there who have fairly high levels of HDL cholesterol," says Stephen Nicholls, MBBS, PhD, a research cardiologist at the Cleveland Clinic. "That may drive their total cholesterol to look higher than it actually is in terms of how bad that level is."

How cholesterol affects the heart
If LDL cholesterol is too high, some is absorbed into the artery walls, where it acts like an irritant that triggers inflammation in the body. White blood cells crawl into the artery wall and start "gobbling up fatty particles" in a fruitless effort to heal the damage, says Dr. Dehmer.

The end result is big, fatty deposits in the blood vessels. This causes the vessels to become stiff, narrow, and less responsive to triggers to expand and constrict, a process that ensures a steady flow of life-giving oxygen to the body's tissues. (While you may think of blood vessels as akin to the plumbing in your house, they're more dynamic; they constantly adapt to meet the body's needs.)

open quoteIf you want to see what cholesterol looks like, go get yourself a can of Crisco at the grocery store.close quote
—Gregory Dehmer, MD, Cardiologist

This process can happen all over your body. If the fatty buildup is in the blood vessels in the legs (a condition known as peripheral arterial disease), you may experience cramping and have difficulty walking; if it's in the penis, you can develop erectile dysfunction; and if it's in the neck arteries, it can cut off the blood supply to the brain and cause a stroke.

The biggest danger, however, is to the heart. The arteries that cover the surface of the heart are particularly prone to clogging. Once fatty plaques clog these blood vessels, blood flow to the heart tissue is reduced. This can cause chest pain, or angina.

If plaque ruptures, a clot can form and cause a heart attack—a dramatic decline in the blood supply that causes heart tissue to die. (To find out if youre at risk for having a heart attack, take this test.)



[ pagebreak ]What you can do about bad cholesterol
The artery-clogging process can start early in life. A 2008 autopsy study of adults ages 16 to 64 who died of non-heart-disease-related causes found that 83% had signs of heart disease and 8% had advanced disease. "We're seeing evidence of abnormality of blood vessels and obvious plaque in teenagers," says Dr. Nicholls.

Luckily, there are many things you can do to help prevent this process. "We know that lowering LDL cholesterol, the bad form, is clearly a good thing," says Dr. Nicholls. "The other thing we would highlight is the emerging role of HDL, or good cholesterol, the other player here."

Diet and exercise are critical for lowering LDL and raising HDL, notes Dr. Nicholls. (Click here for specific lifestyle changes that can lower heart disease risk.)

Cholesterol-lowering medication can also help, but you still need to watch your diet and exercise. "You can't just say, 'I'm being treated, so I can therefore not exercise and eat whatever I want,'" says Dr. Nicholls. "It doesn't work that way."


Bone Drug May Boost Statin's Heart Benefits
Thu, 28 Apr 2011 21:00:28 +0100   
A bone-strengthening drug sometimes used to treat osteoporosis may boost the cholesterol-lowering power of statins, according to preliminary research presented today at an American Heart Association meeting in Chicago.
Study Suggests C-Reactive Protein Doesn’t Cause Heart Disease
Tue, 30 Jun 2009 18:00:52 +0100   

(Getty Images)

By Anne Harding

WEDNESDAY, June 30, 2009 ( — High levels of C-reactive protein (CRP) in the blood probably don’t cause hardening of the arteries or heart disease, according to the largest study of its kind to focus on the long-suspected culprit.

People with heart disease have high levels of CRP in their blood because it’s released by cells during inflammation, the immune system’s attempt to defend against disease or infection. For this reason, blood tests for CRP levels have become a valuable tool in determining a person’s cardiovascular risk. But there’s a hot debate under way about whether CRP itself hurts the heart or whether it’s just an innocent bystander.

To look at the issue, Paul Elliott, FRCP, of Imperial College London, used a technique called Mendelian randomization, which is based on the arbitrary assignment of genes from parent to child—a bit like assigning someone either a placebo or a real drug.

Some people are genetically predisposed to having high levels of CRP, while others have genes that help keep their levels low. If the same genes associated with lower or higher levels of CRP were found to also influence heart disease risk, it would suggest that the protein does indeed help to cause heart disease.

But in the study, published this week in the Journal of the American Medical Association, Dr. Elliott and his team found the opposite. Their study isn’t the first to look at the CRP–heart disease question in this way, but it is the biggest.

“The power of the new study is its size,” says Mark Pepys, the head of medicine at the Royal Free Campus of the University of London Medical School. “It’s a very compelling null result which tells us that almost certainly CRP does not cause atherosclerosis and does not cause heart attacks.” The findings are consistent with animal studies, he adds, and “should help resolve the controversy.”

Another leading CRP researcher isn’t so sure. “A null Mendelian randomization may not mean very much,” Paul M. Ridker, MD, the director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, in Boston, says. “While it does not support causality, I don’t think most genetic statisticians believe it excludes a causal pathway either.”

Either way, the findings don’t mean that blood tests to measure CRP levels should be excluded when taking into account a person’s risk of heart disease or need for treatment, Dr. Ridker says. (The study didn’t consider this issue.)

“We should still measure it because, A, it predicts vascular risk even when cholesterol is low and other risk factors are absent, and, B, because we have clinical trial data demonstrating that if you have an increased level of [reactive protein], you will live longer and have fewer heart attacks and strokes if you take a statin," he says.

In the study, Dr. Elliott and his colleagues first looked at the genomes of 17,967 people to identify chromosome regions that were related to CRP levels. They checked their findings by genotyping an additional 13,165 people. Then they tested an additional 28,112 people with heart disease and 100,823 healthy subjects to see if any of the five gene variants most closely tied to CRP levels were linked to an increased risk of heart disease.

People who had the gene variants had 20% lower CRP levels. Based on observational studies of CRP levels and heart disease risk, this should have translated to a 6% reduction in heart disease risk—but it didn’t.

The current findings, as well as past research that used similar techniques, “strongly challenge” a causal role for CRP in heart disease, Svati H. Shah, MD, of Duke University Medical Center, and James A. de Lemos, MD, of the University of Southwestern Medical Center in Dallas, wrote in an editorial published with the new study.

But this doesn’t mean CRP tests should be tossed, according to Dr. Shah and Dr. de Lemos. “If CRP increases in response to other inflammatory triggers, it may still be a useful tool for personalizing selection of anti-inflammatory therapies, including statins,” they wrote.

Dr. Ridker agrees. “I have always felt that CRP is a good clinical biomarker of inflammation (and high vascular risk) but that it is inflammation that is likely to be causal for atherosclerosis, not CRP itself,” he says.

Dr. Pepys, however, worries that CRP might be too “nonspecific” to be a useful test for heart disease risk. “Anything that’s wrong with you will put up your CRP values, a little or a lot," he says.

He also points out that most variation in CRP levels is accounted for by well-known, modifiable risk factors for heart disease—such as being overweight and having type 2 diabetes. “Those things we know actually cause heart attacks," he explains.
More Heart Patients Getting Cholesterol Levels Under Control
Mon, 22 Jun 2009 18:48:11 +0100   
After years of rising cholesterol levels due to fatty diets and pudgy waistlines, experts have finally announced some good news. More people around the world who are taking cholesterol-lowering medication are getting their low-density lipoprotein (LDL) cholesterol, or bad cholesterol, down to healthy levels than they have in the past.
Eating to Control Your Cholesterol: Everyday Diet Strategies to Lower LDL
Fri, 05 Sep 2008 07:02:07 +0100   
It's National Cholesterol Education Month, and clearly, many of us need a refresher: About half of Americans have high or borderline blood cholesterol levels, a major risk factor for heart disease and a serious threat to overall health.

I'm a strong believer in trying dietary solutions before—or, if needed, in conjunction with—pharmaceutical approaches. Compared with a daily pill, lifestyle changes can be cheaper and just as effective, without the fear of unwanted side effects. This is especially relevant now, as scientists speculate on the safety and effectiveness of Vytorin, a popular cholesterol-lowering drug. 

Some of my clients come to me thinking that diet and lifestyle changes are just too difficult or not worth the hassle. But I learned firsthand the impact of sudden death from a heart attack when my father passed away at the age of 62—and you've likely had a personal experience with the disease, considering the following:

•    One American dies every 37 seconds from heart disease
•    In the United States, someone has a heart attack every 26 seconds
•    The annual U.S. health-care costs to treat heart disease are more than $450 billion

That's why I'm passionate about daily, drug-free adjustments you can make to help lower your cholesterol. I've written about these changes as part of's in-depth cholesterol center. Check out my tips here, and let me know your own heart-healthy strategies.

By Julie Upton, RD
Cholesterol Drug Confusion: Is the Cancer Risk Real?
Thu, 04 Sep 2008 17:36:24 +0100   
THURSDAY, Sept. 4 ( — The news hit this week that a cholesterol-lowering drug called Vytorin was linked to a possible risk of cancer. If you’re one of millions of Americans who take a cholesterol-lowering drug—and possibly even unsure which type you are taking—you may be concerned.

So what is Vytorin? You’re probably familiar with the drug from TV ads (you get your cholesterol from your Grandma Barbie and barbecued ribs). Check out this YouTube video for a refresher or see our previous blog for a picture. If you don’t remember seeing one of those ads lately, it’s because they stopped running.

Vytorin’s troubles started in January, when a study found that the drug—a combination of a new medication, ezetimibe, and an older statin drug, simvastatin (Zocor)—was no more effective than simvastatin alone for treating patients with high cholesterol.

Although the difference was not statistically significant, patients treated with the pricier Vytorin had more narrowing of the arteries than the group treated with Zocor, which is sold in a cheaper generic form.

It’s not like other cholesterol drugs
Vytorin is not like other cholesterol-lowering drugs. It’s a relatively new way of lowering cholesterol that was first approved by the Food and Drug Administration (FDA) in 2004. (Ezetimibe on its own is sold under the name Zetia, which was first approved in 2002.)

Vytorin lowers LDL, or bad, cholesterol by blocking its absorption in the intestines, while other drugs work in different ways. So Vytorin’s issues don’t necessarily apply to other classes of drugs.

Researchers are concerned about Vytorin right now because study results released in July had an unexpected finding. Known as the SEAS trial, it looked at whether Vytorin could reduce heart attack, strokes, and heart-valve surgery in 1,873 people with aortic stenosis. It didn’t. However, they also found that Vytorin-treated patients seemed to have a greater risk of getting certain cancers—such as prostate, gastrointestinal, and skin cancers—than those treated with a placebo.

In response, the FDA announced it was taking a closer look at the drug. And a group of researchers at Oxford University analyzed early data from a couple of other big studies (20,000 patients, combined), called SHARP and IMPROVE-IT, which are ongoing.

While there were slightly more cancer deaths in the Vytorin-treated patients in these two trials, it was not statistically significant and most likely due to chance, according to the report in The New England Journal of Medicine. However, other experts are not so sure. When data from all three trials are combined, it looks like there may be a real increase in cancer mortality.

So that means the jury is still out on the issue. The results were not strong enough to halt the trial and the FDA did not remove the drug from the market, notes Gordon F. Tomaselli, MD, a Johns Hopkins University professor of medicine, and program chair of scientific sessions for the American Heart Association.

“I still think there’s a signal there, and I think it’s a signal we need to pay very careful attention to,” says Dr. Tomaselli. “I certainly don’t think it should stop patients who are in the two other trials from being in those trials, or from enrolling new patients.”

Fewer people taking Vytorin than in the past
Don’t know what drug you’re taking? Don’t be embarrassed, it’s not uncommon. But it’s probably not Vytorin.

In the United States, the “vast majority [of heart patients] are taking statins and statins alone,” says Douglas Zipes, MD, past president of the American College of Cardiology, and a distinguished professor at Indiana University School of Medicine in Indianapolis.

Statins include drugs such as Lipitor, Zocor, and Crestor. Other cholesterol-lowering, non-statin drugs include niacin, a type of vitamin, and fenofibrate, which is a fibric-acid derivative.

In the past, cancer-risk questions were raised about statins too. But an analysis of long-term data from 90,000 patients found it wasn't true.

And when statins debuted more than a decade ago, it was feared they might raise the risk of suicide or mental instability, because cholesterol is important for normal brain function, says Dr. Zipes. Those fears didn't turn out to be true, either.

Statins now have a long safety record (though some people have to stop taking them due to muscle aches). In fact, it has been suggested in recent year that statins are safe enough to be sold without a prescription, although that hasn’t happened yet.

”It was felt that statins were so safe that indeed they should go over-the-counter,” says Dr. Zipes.

It is possible that future research will show that Vytorin is no more likely to cause cancer than statins or any other drug. However, experts don’t really have enough information at this point to say one way or another.

“It’s not entirely settled by all of the data,” says Dr. Zipes. It’s been raised as a “very important issue but it has to be addressed more prospectively,” he says.

If you are taking Vytorin
Given the attention to the drug this year, it’s not surprising that sales have slumped; you’re probably less likely to be prescribed this drug if you have high cholesterol.

“It’s dropped off significantly,” says Dr. Zipes.  “Many of the cardiologists with whom I interact are no longer prescribing it.”

If you are taking Vytorin, your course of action depends on why you were given the drug, says Dr. Tomaselli. He says most patients with elevated cholesterol should be given a statin first, and if that doesn’t do the trick, they should try a higher dose of statins.

If they can't tolerate higher doses of statins, and need a different type of medication, there are many other options besides Vytorin, including niacin and fibrates.

“I would say to those folks, for the time being, if you’re on Vytorin for the reason of intolerance to higher-dose statins and/or failing to get to target on other drugs, then they should just stay on the drug for now,” he says.

Dr. Zipes also says, “There may be reasons why Vytorin might be used in a very small percentage of people.”

If you are taking the drug, experts recommend—as always—that you consult your doctor and don’t decide to stop taking it on your own.

“The number of deaths of coronary artery disease and stroke will be far greater if people stop their [medication] than if they continue on Vytorin in my opinion," says Dr. Tomaselli.

By Theresa Tamkins

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