Monday, May 2, 2011

Statin Statistics: Lies and Deception

In an independent meta-analysis (when a number of studies are put together to achieve more statistical power) of randomized controlled trials in patients without CVD, statin therapy decreased the incidence of major coronary and cerebrovascular events and revascularizations but not coronary heart disease or overall mortality.(1) Taking statins for a number of years will not reduce mortality: “Primary prevention with statins provides only small and clinically hardly relevant improvement of cardiovascular morbidity/mortality.”(2) “Hardly relevant” means there is virtually no clinical benefit; as the authors of these particular studies are independent, they gain nothing by stating this. Another review found that “current clinical evidence does not demonstrate that titrating lipid therapy (trying to lower cholesterol with statins) to achieve proposed low LDL cholesterol levels is beneficial or safe.”(3) In other words, lowering lipids has no real benefit and has the potential for adverse effects. Following up on this, in a major independent review of studies funded by the Ministry of Health of British Columbia (Canada) on statins and primary prevention, researchers reported that “statins have not been shown to provide an overall health benefit in primary prevention trials.”(4) This is a government report carried out by an independent university yet its findings are still ignored.

The problem really comes down to vested interests and the abuse of statistics. To overcome the limitations of small studies, vested parties combine many studies into a meta-analysis. The researchers themselves select the studies used in the meta-analysis. A fundamental problem is that researchers with direct links to drug companies have the authority to select the most positive studies and ignore the rest—including independent studies not funded by pharmaceutical companies. Despite this, they have still not been able to show any clinically significant findings.

As readers of the scientific journals, we should not be confused between statistical significance and clinical significance. For an outcome to be “statistically significant” means that the outcome was likely result of the treatment—whether the result was 100% effective or less than 0.1% effective. That is, if you treat 1,000 people to save one life (0.1%) it may be statistically significant but it is not clinically significant. “Clinical significance” means 20% to 30% or more. The drug companies’ most positive studies on statins for prevention of CVD report statistical significance, mostly 1% or less, and none have found any clinical significance.
Busy medical professionals don’t have time to review the statistics; few of them may be aware of the different ways the statistics are manipulated. So if the experienced professionals don’t understand the results of these studies, how do we expect the media or public to understand?


(1) Thavendiranathan, P., A. Bagai, et al. (2006). "Primary prevention of cardiovascular diseases with statin therapy: A meta-analysis of randomized controlled trials." Archives of Internal Medicine 166: 2307-2313.

(2) Vrecer, M., S. Turk, et al. (2003). "Use of statins in primary and secondary prevention of coronary heart disease and ischemic stroke. Meta-analysis of randomized trials." International Journal of Clinical Pharmacology and Therapeutics 41(12): 567-577.

(3) Hayward, R.A., T.P. Hofer, et al. (2006). "Narrative review: Lack of evidence for recommended low-density lipoprotein treatment targets: A solvable problem." Annals of Internal Medicine 145(7): 520-530.

(4) University of British Columbia (2003). "Do statins have a role in primary prevention? A review by the Therapeutics Initiative of the Department of Pharmacology & Therapeutics of the University of British Columbia." Therapeutics Letter (48).

WorkPlace Wellness

Something I have been working on for a long time, and currently writing on as part of an upcoming book, is Workplace Wellness (WW). WW is really about looking after the health and wellbeing of the workers and the research shows it pays off for employers. The cost of poor health on personal and professional productivity is high and includes stress, absenteeism, presenteeism, low morale, low productivity, poor concentration and focus, low output, and risks increase sick leave, disability and more.

Many factors influence employee productivity; the list includes family issues, work environment, relations with other employees, autonomy, perceived control and health. However it is possible to relate health to many of these issues and it could be inferred that having good health will assist people to overcome these problems. The level of health is one of the most important factors enhancing and maintaining productivity in the labor force, affecting both the quantity (working time) and quality (productivity) of employees. By investing in the health of the organizations human resources, employee services and the general workplace environment, a positive impact on productivity can be observed.

The number of wellness promotion programs in an occupational setting has positively increased over the past 20 years. These programs have the potential, if properly designed and correctly implemented, to simultaneously increase employee health and employer profitability; by preventing occupational disease and injury and promoting positive employee lifestyle behaviors. Health is an extremely important determinant of an employees capacity to work productivity as even a skilled employee who enjoys their job, has job autonomy, a pleasant work environment, good relations with colleagues and is well compensated can still have very low productivity levels when they are sick or injured at work (presenteeism) or if they are absent (absenteeism). Health should be seen as not only the absence of disease but the presence of physiological and psychological wellness, this is the key to a highly competent and productive workforce.

Many studies have shown the benefit of health programs in the workplace. There is an increasing awareness that these programs may play a significant role in achieving improved organizational productivity and, for commercial enterprises, increased profitability. Workplace Wellness Programs Can Generate Savings The Effects of Behavioral Risks on Absenteeism and Health-Care Costs in the Workplace

Just one percent improvement in productivity of a person on $40000 per year assuming their output is double the value of their income ($80000) would return to the company approximately $800 per employee.

Other benefits include
• improved morale
• Increased attraction/Retention of staff
• job satisfaction,
• satisfaction with supervision,
• increased organizational commitment
• increased productivity
• reduced time loss from work/disability
• short-term health benefit cost savings
• long-term health benefit cost savings
• quality of life
• lower insurance rates
• lower legal liability

The value of health promotion programs in support of employee attraction, retention, and morale was clearly demonstrated when Glaxo Wellcome was named the best place to work in North Carolina in 1999 by the North Carolina Business Journal. These programs were cited as among the reasons people viewed Glaxo Welcome as a terrific company. In 1999, Glaxo welcome received the Everett Koop National health award, the American College of Occupational and Environmental Medicine Corporate Health Award, the American Association of Occupational Nurses Business Recognition Award. By prescription: Glaxo Wellcome has all the right ingredients to be the best place to work in North Carolina.

Citibank (Financial Services Bank) initiated a comprehensive Health Management Program in 1994, and reported the program had a positive Return on Investment, ranging from $4.56 to $4.73 saved per dollar spent on the program. The savings were even higher when absenteeism-related savings were added to health related costs, at $6.70 savings per dollar invested. Ten studies of worksite health promotion programs documented an average of $3.93 of health care benefit for each dollar of cost. Six studies of worksite health promotion programs documented and average of $5.02 of absenteeism cost savings for each dollar of program cost. So why aren’t you doing it?
A return on investment evaluation of the Citibank, N.A. Health Management Program.

Power Lines and Electrical Devices

The ever-increasing use of electrical appliances, along with the consequent demand for electric power, have greatly increased awareness of possible risks from electric and magnetic fields at extremely low frequencies. In particular, concern has been raised about power lines. This concern has, in some cases, led to strong opposition to the installation of transmission facilities, which has delayed or even prevented their licensing. The proximity to power lines in suburbs usually means less demand for the properties and lower real estate values due to concerns about raising families near these powerful sources of electromagnetic radiation.

The idea that such fields might be deleterious has been seriously considered only since 1979, when researchers suggested, on the basis of a case-control study conducted in Colorado, that the fields associated with power lines and domestic electric wiring might cause cancer in children. At the time the idea seemed bizarre—power lines were such a normal part of everyday life and they had not been shown in laboratory experiments to have any effect that appeared to be even remotely connected with the development of cancer. During the past 25 years, however, numerous epidemiological studies have suggested a link between leukaemia and brain cancer in adults and exposure to similar and higher frequency fields at work places. Residential-based studies have found similar links. The findings are, however, difficult to interpret. One reason for this is that neither leukaemia, nor brain cancer, is a single entity; each consists of a variety of conditions that differ in childhood and adult life and may—and in some cases definitely do—have complex causes.

Residential studies do not always directly measure exposure, but frequently use surrogates. These surrogates might include the distance of the residence from overhead power lines or electrical transmission stations or the wiring configurations in the vicinity of the residence, which could be classified as “high” or “low” according to the presence or absence of transformers and the characteristics of the local electricity supply cables. However, in three Scandinavian studies in 1993, children who lived in houses within broad corridors around power lines had higher than normal rates of leukaemia and brain cancer. Other studies have shown similar results: the incidence of leukaemia with residential exposure equal to or greater than 0.2 uT (or 0.25 uT in the Danish series) was 2.1 times that in the unexposed population. A recent study in Canada, in which participants wore personal monitoring devices, supports a link between magnetic field exposure and an increased risk of childhood leukaemia. Evidence of a carcinogenic effect in adults has been supported by studies that have suggested occupational hazards for leukaemia and cancer of the brain. Magnetic fields and childhood cancer—a pooled analysis of two Scandinavian studies

In a three-year study of some 570 people in Auckland, New Zealand researchers found that people living within 20 metres of high-tension power lines were three times as likely to have asthma, twice as likely to experience major depression, twice as likely to suffer from immune deficiencies (including allergies and dermatitis) and more likely to have diabetes than those who did not live within such proximity to power lines. http://aktinovolia.net/wp-content/uploads/Evidence-that-EMFs-are-hazardous.pdf

Researchers have also found significant evidence that occupational exposure to electromagnetic fields may reduce melatonin levels. Melatonin levels appear to be affected by the intensity and length of exposure as well as time of day it occurred; levels did not return to normal when workers were away on weekends. Melatonin, produced by the body, regulates sleep cycles and is a potent antioxidant that protects us from cancer. http://aje.oxfordjournals.org/content/150/1/27.short

The magnetic field strength produced by overhead lines depends mainly on the current flowing and distance from the line. Unlike the voltage, the current may change considerably during the day according to the demand for energy and, therefore, the magnetic field from power lines will be highly variable, reaching its maximum values when the load is highest—that is, when many people are using electrical appliances. Objects and buildings provide little or no screening for the magnetic field. In other words, even though it is safer to be farther from power lines, buildings don’t block out the magnetic field.

Exposure to electromagnetic radiation from appliances in buildings is also an area of growing concern. The results from measurements in some offices show that magnetic induction levels are within the range 0.2 3.2 uT close to typical office devices such as personal computers and photocopiers, while at the writing desks and in usual conditions the mean value is equal to 0.37 uT, with a maximum value of 1.4 uT. Most new computers have a screening device on the front but unfortunately not behind the computers so don’t sit behind a computer. In a few buildings we have investigated, wiring ran inside internal columns in the buildings, with people working right next to the columns. The exposure was extremely high and resulted in many health complaints. Devices to measure electromagnetic radiation are relatively cheap and can be obtained from some electrical stores.

In the home environment, the most significant exposure is likely to come from electrical equipment, clocks and lights in the bed head or near where people sleep. In addition, exposure can be considerable if the bed backs onto a wall that has a circuit board behind it. In general the bedroom should not have too many electrical devices in it and none near the area where one’s head is during sleep.

Non-ionising Electromagnetic Radiation

There is so much confusion nowadays about the pros and cons of radiation I thought it best to try and clarify it as best I could. People are exposed to non-ionising radiation through natural sources such as the sun as well as human-generated sources: computers, microwaves ovens, mobile phones, radar systems and power lines. From the sun, UV radiation is a major concern related to sunburn, skin damage and skin cancer. Too much sun can have a negative effect on one’s immune system. On the other hand, without enough exposure to the sun, the body does not produce vitamin D. But more on that at a later date.

Microwave radiation or Microwaves are extremely high frequency radio waves on the electromagnetic radiation spectrum. While some microwaves and radiofrequency radiation occur naturally—the sun, the earth and the ionosphere create natural sources of low-level RF and MW radiation fields—the incidence of non-naturally occurring radiation has increased dramatically with the advance of technology. Microwaves can be used to carry satellite signals for communication in televisions, AM and FM radio, computers, global positioning systems and mobile phones. Microwaves can also be used to generate heat through the extremely rapid reversal in the polarity of electrons affected by magnetic and electric fields via a tube called a magnetron—this occurs in almost every kitchen and restaurant throughout the industrialised world, with the ubiquitous microwave oven.

Microwaves and radiofrequencies represent one of the most common and fastest growing environmental influences about which anxiety and speculation are spreading. Yet very little is known about the results of exposure to microwaves; even less is known about the relative dangers of different sources of microwaves. We do, however, know that microwaves can be reflected, transmitted or absorbed by matter in their path. Absorption occurs in matter that contains moisture, including human beings.

Living organisms absorb microwaves and radiofrequency energy at the molecular, cellular, tissue and whole-body levels. Heating of internal organs is a consequence of the absorption of energy. The energy is absorbed by water within the tissue; therefore, tissues with high water density and low blood density—such as the eyes and testes—are particularly vulnerable.

Scientists have known for a long time about the capacity of RF radiation to cause this type of heating and have discovered that prolonged exposure to RF radiation can lead to health problems such as fatigue, reduced mental concentration and, in the case of very high levels, cataracts. These effects are similar to subjecting a person to an extremely warm environment. Other possible thermal effects include foetal abnormalities, decreased thyroid function, cardiovascular mortality, impaired ability to perform complex tasks and the suppression of behavioural responses, gonadal function and natural killer cell activity. Studies have shown that environmental levels of microwaves and radiofrequency energy routinely encountered by the general public are far below levels necessary to produce significant heating and increased body temperature. However, there is concern for whole body heating amongst the elderly and those on specific medications that affect thermoregulatory function. Also of concern are people with cardiac and circulatory problems, those with implanted medical electronic devices (e.g., heart pacemakers), fever sufferers, infants and pregnant women.

The majority of studies in this area are concerned with cataracts, arguably the major hazard associated with microwave radiation. A cataract is a clouding of the lens within the eye. Authorities concerned with producing safety standards agree that little is known with any real certainty about the effects of microwave radiation beyond its thermal effects. However, microwave studies contain too many shortcomings to rule out the possibility that microwaves cause adverse health effects.

The recognition of non-thermal effects has been highly controversial, due to conflicting and inconclusive studies. Studies are complex, investigating possible effects of microwave radiation—from cancer to effects on the operation of all systems and parts of the human body. Cancer studies have examined cancers of the breasts, lungs, testicles and brain, as well as ocular melanoma and leukaemia. Other studies have included assessments of the relationships between radiation and cardiovascular disease, birth defects and hormone secretion rates. Research has also shown the effect of microwaves on reducing a cell’s ability to perform apoptosis, that is when the cell terminates its own life as a part of the life cycle of the cell, increasing the risk of spontaneous mutations, including cancer.

An example of the controversy surrounding microwaves occurred with a 1990 leaked draft EPA report in the USA, recommending that radiofrequency microwave radiation be considered a “possible human carcinogen.” The White House moved quickly to suppress the draft and commissioned another report, which stated that there was no EMF cancer risk. Unfortunately, politics has its influence in too many places it should not.

Wednesday, March 2, 2011

Selenium reduces prostate cancer

Selenium is known as the anti cancer mineral and is an essential trace element involved in several key metabolic activities via enzymes that are essential to protect against free radical (oxidative) damage and to regulate the immune system. Selenium is an essential part of glutathione peroxidase, an enzyme found to remove one of the major free radicals, hydrogen peroxide.

A number of very large studies on selenium supplementation, such as those in China and Finland have found significant reductions in cancer rates. In support of this a study just last week found that supplementation with 200 micrograms of selenium glycinate for 6 weeks increase the activities of blood enzymes such as glutathione, and reduces the levels of PSA, prostate-specific antigen, a marker for prostate cancer. It was only a small study of 30 middle-aged US men but the authors of the study said “If selenium could lower PSA [prostate-specific antigen] in healthy, middle-aged men, then it could be proposed that selenium can lower prostate cancer risk in some men, especially as part of an overall dietary plan,” (Zhang et al 2011).

Other studies have shown that high levels of selenium in the body have been linked with lower levels of lung, prostate and colorectal cancers. Selenium is thought to reduce the risk of developing cancers in two ways. Firstly, as selenium is an anti¬oxidant it helps protect the body from dangerous free radicals. Secondly, selenium has been known to prevent or slow down tumour growth. It does this in such a way that selenium enhances immune cell activity and suppresses the development of the blood vessel leading to the tumour resulting in reduced or no cancer growth. Studies have also shown that people with low levels of selenium have a greater incident of heart disease.

Good sources of selenium in the diet are whole grains, asparagus, garlic, eggs, mushrooms, lean meats and seafood's but the best known source is brazil nuts.

Zhang. W, E. Joseph, C. Hitchcock, R.A. DiSilvestro. 2011. Selenium glycinate supplementation increases blood glutathione peroxidase activities and decreases prostate-specific antigen readings in middle-aged US men. Nutrition Research, doi: 10.1016/j.nutres.2010.10.012

Nutrition science and the common Cold

Time to go back to some basics and take a few supplements when the next cold (flu) comes around. Here is the latest update from the Cochrane review.

In a major study of 13 therapeutic trials and two preventative trials with almost 1400 participants Zinc supplements significantly reduced the severity of cold symptoms, as well as the length of illness (Singh and Das, 2010). They reported a significant difference between the zinc and control group for the proportion of participants symptomatic after seven days of treatment . The authors concluded that zinc administered within 24 hours of onset of symptoms reduces the duration and severity of the common cold in healthy people. When supplemented for at least five months, it reduces cold incidence, school absenteeism and prescription of antibiotics in children. One of the actions of zinc is to inhibit rhinoviral replication and has been tested in trials for treatment of the common cold.

In a review of studies on Vitamin C (Hemilä 2007) the researchers found it useful for people exposed to brief periods of severe physical exercise. In five trials with participants exposed to short periods of extreme physical stress (including marathon runners and skiers) vitamin C halved the common cold risk.

In a review of 16 controlled clinical trials (Linde et al 2006) investigating the effectiveness of Echinacea preparations (a herb) for preventing and treating common colds, the researchers found taking Echinacea preparations after the onset of cold symptoms shortens the duration or decreases the severity of symptoms when compared with a placebo.

In summary when you get the flu take Zinc, Echinacea and if you are exercising take vitamin C. That is what the science shows so forget the flu vaccine with its very questionable benefits, high cost and serious side effects. Last year in the UK they spent more than 2 billion pound on the swine flu without a single reduction in symptoms or disease.
It should also be mentioned that vitamin C and zinc work hand in hand for lots of other things in the body including healthy skin and arteries. They have lots of positive side effects.

Hemilä H, Chalker E, Douglas B. Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD000980. DOI: 10.1002/14651858.CD000980.pub3. Cochrane Acute Respiratory Infections Group.

Linde K, Barrett B, Bauer R, Melchart D, Woelkart K. Echinacea for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000530. DOI: 10.1002/14651858.CD000530.pub2. : Cochrane Acute Respiratory Infections Group

Singh M, Das RR. Zinc for the common cold. Cochrane Database of Systematic Reviews 2011, Issue 2. Art. No.: CD001364. DOI: 10.1002/14651858.CD001364.pub3. Cochrane Acute Respiratory Infections Group.

Wednesday, February 9, 2011

Omega 3 Not Drugs For Diabetics

In a recent study by Dr Sapicha and her colleagues, building on their earlier research on the same topic, found that a simple and cheap supplement of omega 3 oils is effective in reducing "pathological retinal neovascularization". That is the damage done to the blood vessels which can lead to an array of complications culminating in blindness. It is a serious condition in diabetes. They reported that their studies on mice suggests "that _-3 PUFAs (omega 3s) may be profitably used as an alternative or supplement to current anti-vascular endothelial growth factor (VEGF) treatment for proliferative retinopathy and points to the therapeutic potential of _-3 PUFAs and metabolites in other diseases of vasoproliferation. She was quoted on ABC radio as saying that the drugs for diabetic retinopathy cost around $4000 a month or $10 for the omega 3 supplements.

This builds on a large amount of research on the benefits of omega 3 oils for both the prevention and treatment of diabetes. For those interested all the details of the study are provided below.

Sci Transl Med 9 February 2011: Vol. 3, Issue 69, p. 69ra12 DOI: 10.1126/scitranslmed.3001571.