Calcium supplements and cardiovascular risk?

On July 31, 2010, in Minerals, by Andrea

A prime example of how media will take a study and leave out key points in order to scare people.  Gotta love it.

All over, the news outlets are talking about how people should maybe lay off the calcium because there may be too much risk for a cardiovascular incident versus osteoporosis prevention.  What they conveniently forget to mention is that the calcium used did not contain any vitamin D, which is pretty much standard faire in the US.  Vitamin D is renowned for lowering cardiovascular risk.. perhaps this study highlights that now more than ever?  I can say fairly confidently that people are waking up to the need of vitamin D and post-WLS folks are some of the most educated in that realm.  WTG WLSers!

Additionally, it should be noted that the problem is with fluctuating serum calcium levels — something that doesn’t happen as often with post-WLS patients as our absorption does not work the same way.  Food for thought:  how many post-ops, people who routinely take 1500-2000mg of calcium citrate a day (or should be..) are dropping like flies with heart disease?  Not many.

Am I worried?  No.

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1 in 5

On February 6, 2010, in Uncategorized, by Andrea

That’s the number of kids that abnormal lipid numbers.

I’ll wait for some of you to, you know, wake up.  Need some smelling salts?

20% of kids have abnormal lipid numbers.  That’s scary, folks.  These are kids just waiting for RNYs, DS’s, VSG’s, and AGB’s — plus anything else we can think up and guinea pig on ourselves.  We need to get all of this down and understand it cause the next generation isn’t looking too healthy.

From Medscape:

One in Five Kids With Abnormal Lipids

Michael O’Riordan

February 3, 2010 (Atlanta, Georgia) — New data from the Centers for Disease Control and Prevention (CDC) shows that one in five youths aged 12 to 19 years has abnormal lipid levels [1]. Also, nearly one-third of these youths are obese or overweight and based on their body-mass index (BMI) are candidates for lipid screening, according to investigators.

In an editorial accompanying the new report [2], the CDC urges clinicians to be aware of the lipid screening guidelines so that interventions for overweight or obese children and youths can be recommended. “Healthcare providers can refer eligible youths to nutritional counseling, community fitness programs, and school-based lifestyle programs,” writes the CDC.

The new report, from a combined sample of four National Health and Nutrition Examination Survey (NHANES) surveys taken from 1999 to 2006, includes data on 9187 youths, of which 3733 provided fasting blood samples for lipid testing.

Among the sample, 20% had at least one abnormal lipid measurement, such as elevated LDL cholesterol (>130 mg/dL), reduced HDL cholesterol (<35 mg/dL), or elevated triglyceride levels (>150 mg/dL). Researchers also showed that compared with normal-weight youths, those who were overweight or obese were significantly more likely to have at least one abnormal lipid measurement.

In addition to these findings, the CDC report also showed that boys were more likely than girls to have low HDL cholesterol, while older youths, those aged 18 to 19 years, were more likely to have low HDL and elevated triglyceride levels than kids aged 12 or 13 years.

The researchers point out that, based on the American Academy of Pediatrics (AAP) screening recommendations, 32% of youths would be eligible for lipid screening based solely on their BMI. The AAP recommends screening based on family history of high cholesterol or premature cardiovascular disease or an unknown family history of high cholesterol or premature disease, as well as the presence of at least one major cardiovascular disease risk factor, including overweight/obesity.

Heart Disease to kill 400,000 in US in 2010

On February 1, 2010, in Uncategorized, by Andrea

Wow.  That’s sobering.

And we know what the number one cause for heart disease is, right?

(Don’t make me slap you silly.  Cause I will.)


Heart disease to kill 400,000 in U.S. in 2010

Experts: Progress against cutting cholesterol stalled by rising obesity rates

LONDON – Decades of progress in the United States on cutting cholesterol, blood pressure and smoking are being stalled by rising obesity rates, and heart disease will kill around 400,000 Americans this year, experts said on Monday.

A study by British scientists found that around half of those deaths could be averted if people ate healthier food and quit smoking, and experts warned there was no room for complacency when it came to heart health risks.

Simon Capewell of the University of Liverpool said recent weight trends were “alarming,” with 1.5 billion adults worldwide expected to be overweight by 2015.

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“Although (heart disease) death rates have been falling in the United States for four decades, they are now leveling off in young men and women,” he wrote in a study in the World Health Organization’s weekly journal.

“Recent declines in total blood cholesterol have been modest, blood pressure is now rising among women and obesity and diabetes are rising steeply in both sexes.”

The researchers calculated the number of deaths based on lifestyle trends, taking the year 2000 as a base.

They found that almost 200,000 lives could be saved if certain heart risk factors were cut, even modestly, in particular, Capewell said, “if people ate healthier food and stopped smoking.”

Two-thirds of U.S. adults and nearly one in three children are overweight or obese — a condition that increases their risk for diabetes, heart disease and other chronic illnesses.

U.S. health officials last week introduced first lady Michelle Obama as their latest weapon in a fresh campaign against the increasingly-costly weight burden.

But Shanthi Mendis, an expert on chronic disease prevention at the Geneva-based WHO, noted that the United States was not alone in facing an obesity epidemic, and said lifestyle choices now directly affected the health of many of the world’s people.

“Worldwide, nearly one billion adults are overweight and, if no action is taken, this figure will surpass 1.5 billion by 2015,” she said in the study.

“By avoiding tobacco, eating a healthy diet and engaging in regular physical activity, people can dramatically reduce their risk of developing heart disease, stroke or diabetes.”

Lo Carb vs Diet/Drug Combo

On January 26, 2010, in Uncategorized, by Andrea

In the world of non-surgical weight loss (and let’s face it, we’ve all been there), there’s a new study out that proves that medications raise BP.  Especially in light that Meridia should not be used in heart patients, here’s even more proof that low carb diets are better for one’s heart health than medication and diet combos.

From Medscape:

Same Weight Loss, Better BP With Low-Carb Diet vs Drug/Diet Combo

Shelley Wood

January 25, 2010 (Durham, North Carolina) — A new randomized trial comparing a low-carbohydrate diet with a low-fat diet in combination with the weight-loss drug orlistat has found that both strategies produced meaningful weight loss among hospital outpatients over a one-year period [1]. Strikingly, however, the low-carb diet appeared to produce significant improvements in blood pressure.

According to Dr William S Yancy Jr (Duke University, Durham, NC), lead author on the study, this is the first time the low-carb diet has been pitted against a diet drug in combination with a different diet. It is also one of the first studies to compare weight-loss strategies in patients who also have other known medical problems, including high blood pressure, diabetes, arthritis, etc.

Yancy et al’s findings are published in the January 25, 2010 issue of the Archives of Internal Medicine.

Almost 10% Weight Loss at One Year

Yancy et al’s study randomized 146 overweight or obese outpatients (mean age 52, mean body-mass index [BMI] 39.3) to either a low-carbohydrate, ketogenic diet, or to orlistat (120 mg, three times daily) and a low-fat diet over 48 weeks, with regular group meetings to boost diet adherence. At the end of the study period, weight loss was similar in both groups, at roughly 10% (approximately 20 to 25 pounds). Of note, almost 80% of the low-carb group and almost 90% of the orlistat/low-fat group completed the full 48-week follow-up.

Improvements in HDL and triglycerides were seen in both groups, LDL levels improved in the orlistat/low-fat diet group only, while glucose, insulin, and HbA1c levels improved in the low-carb group only, although none of these differences were statistically meaningful. By contrast, both systolic and diastolic blood-pressure levels declined in the low-carb group only, a statistically significant difference between weight-loss groups.

“It’s not surprising that the blood pressure improved,” Yancy told heartwire , adding that improvements in blood pressure are common in weight-loss trials. “But it was surprising that, with similar weight loss, blood pressure would improve more in one group than the other.”

While there are a number of explanations for the blood-pressure differences between weight-loss strategies, Yancy speculated that it might be related to the known diuretic effect of low-carb diets.

“We’ve looked at that in the past, and it seems to occur in the first couple weeks of the diet and doesn’t seem to be a big factor after that, but that could contribute to the differences seen here. The other thing is that low-carb diets are thought to reduce insulin levels more so than a high-carb diet. There are several different mechanisms that insulin has with the vascular system that might cause increased blood pressure, so if you decrease insulin your blood pressure might decrease as well.”

No Significant Differences in Lipid Changes

Other low-carb diet studies have also reported improvements in lipid parameters compared with low-fat diets: something that was not seen in the current study to a statistically significant degree. Yancy attributes this in part to an aggressive attempt on the part of investigators to include as many patients as possible at the 48-week follow-up.

“A big criticism of other weight-loss trials is there are a lot of lost or missing data,” he explained. “We tried to avoid that as much as possible, and as a result, some of these folks who came back for their final measurements who hadn’t really been following their diets kind of watered down the results.”

For example, in the paper, the authors report differences in heart-disease risk factors at interim time points and note that, out to 36 weeks, the two interventions “appeared to have differential effects on fasting serum lipid and lipoprotein levels over the first 36 weeks,” but that “these differences converged by 48 weeks.”

In another important finding, Yancy et al point out that while a small number of study participants initiated hypertension or diabetes medications over the course of the study in both diet groups, a much higher number actually decreased or discontinued their dosages, with a higher proportion of patients discontinuing or lowering their dosages in the low-carb group.

Referring to the blood-pressure effects of the low-carb diet, Yancy pointed out that investigators “don’t really know the full effect of the diet intervention because patients were actually taking less medication.”

Options for Patients

The key message from the paper is not that one diet is superior to another, Yancy concluded. “Different interventions appeal to different people,” he told heartwire . “We have a big weight problem in our society, and this study gives us two different options, both of which worked quite well. And if you happen to have blood-pressure problems and you are trying to kill two birds with one stone, the low-carb option might be a better option than the orlistat option.”

Of note, he added, orlistat is not associated with increases blood pressure, although other diet drugs are, including sibutramine, for which the FDA recently released an updated warning on CVD risks.

Yancy, as well as second author Dr Eric C Westman (Duke University Medical Center) disclosed having received clinical research grants from the Robert C Atkins Foundation.

Cholesterol high in kids

On January 21, 2010, in Uncategorized, by Andrea

Not good.  I mean, what else can I say?  Really not good?  Horrible, tragic news?

Not surprising, I suppose.


1 in 5 teens has unhealthy cholesterol levels

Even 14 percent of teens with normal weight have poor levels, CDC says

WASHINGTON – One in five American teens has unhealthy cholesterol levels, a major risk factor for heart disease in adults, the U.S. Centers for Disease Control and Prevention said on Thursday.

The heavier teens were, the more likely they were to have high cholesterol but even 14 percent of teens with normal body weight were found to have unhealthy cholesterol levels, the CDC said.

CDC researchers studied data on 3,125 teens collected from the National Health and Nutrition Examination Survey for 1999 through 2006.

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They found that 20.3 percent of young people aged 12 to 19 and more boys than girls had unhealthy cholesterol levels.

The study found that, based on American Academy of Pediatrics guidelines, a third of teens would be eligible for cholesterol screening based on a family history of high cholesterol or premature heart disease.

The researchers analyzed measurements of low-density lipoprotein — LDL or so-called bad cholesterol; high-density lipoprotein, the HDL or “good,” cholesterol; and triglycerides.

Bad cholesterol can help clog arteries while good cholesterol carries away the bad stuff. People should aim for low LDL and triglycerides and high HDL.

Ashleigh May of the CDC, who led the study, said the results were “very concerning.”

“It’s a large proportion of the youth that have at least one abnormal lipid level. That is concerning given the long term implications for heart disease,” May said in a telephone interview.

Unhealthy cholesterol levels, which often begin during childhood and adolescence, are a big risk factor in heart disease, the No. 1 cause of death among adults in the United States.

“We really want to make sure that clinicians are aware of lipid screening guidelines and lifestyle interventions that are recommended, for youth, especially overweight and obese youth,” May said.

“For all youth, healthy eating habits and physical activity are good ways to reduce their risk for abnormal lipids and heart disease in the long term.”

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