Tuesday, November 11, 2008

Cholesterol JUPITER link

For an absolute, all singing, all dancing excellent review of the JUPITER trial go read Sandy Szwarc over at Junkfood Science.

Don't expect to be done in 2 minutes!

Peter

19 comments:

gunther gatherer said...

Actually just knowing that the trial was sponsored by AstraZeneca saves us the trouble of even having to read the Jupiter study.

Though I did anyway, just for the laugh.

Ok, not so funny for those who are going to have this poison pushed on them, and who will have to pay for it to...

Sven said...

Peter, what do you think about the (JunkfoodscienceBlog-) "Obesity Paradox"-articles?

Peter said...

Sven, just flicked through a few (not read all of them by any means) and I think she is basically correct. To my mind the poo poo hits the fan when you STOP getting fatter. Once the fat cells say no to calories those calories then slosh around in your blood stream as elevated glucose and trigs. My only problem with obesity is that you are eating a diet that will eventually, at some point, lead your fat cells to say no to calories. Then you are in trouble. For some people this may be at BMI 25, for others at BMI 40. It's not the obesity that is the problem, more the eating style which promotes it.... And of course throw in plasticisers and anything else which might put a spanner in your metabolic works (stains, beta blockers and thiazide diuretics all spring to mind as glucose elevators, see JUPITER and diabetes incidence). I'd even accept genetics as a factor!

Being overweight with normal glucose and insulin is fine by me, though I think it gets harder to maintain this as you get heavier and your adipocytes overfill.

You get stuck in the rut of vanity though and I like weighting 64ish kgs.... This is not obligatory for health. Hee hee, you reading Windmill?

Peter

mtflight said...

I haven't gone to that link yet, but Dr. Eades got to it too:

http://www.proteinpower.com/drmike/cardiovascular-disease/1853/

gunther gatherer said...

MTflight, thanks for that link. I didn't know JUPITER is actually an anagram for "Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin".

How dare they call it a study at all...

Sven said...

Peter,

"My only problem with obesity is that you are eating a diet that will eventually, at some point, lead your fat cells to say no to calories."

According to the studies Sandy cites this doesn´t seem to be a big problem overall. Beeing overweight is associated with longevity in elderly. Do the researcher miss something or is there a causal relationship between overweight and longevity? What could that be? Or is it just an association?
Probably more telling than BMI would be hip/waist-ratio. Maybe quite a lot in the "normal BMI group" are thin with huge "beer bellies".

Peter said...

I think I would phrase it as "people who are able become overweight and carry it in to old age without becoming diabetic (ie without exceding their enregy storage ability) do well". Whether they do better than people of "normal" weight who HAVE exceeded their abilty to store energy is very probable. But then what about people of normal weight and normal glucose/insulin metabolism. Do they do worse that a metabolically similar heavy person? Not aware that anyone has checked this but, if the study is out there, it would make very interesting reading.

Peter

Paul said...

Heh, someone brought in the marketing guy to make a catchy acronym
for the public - Justification for the Use of Statins in Primary Prevention: an
Intervention Trial Evaluating Rosuvastatin -instead of doing real work. Come to think of it, that may sum up all you need to know about statins,

Paul.

_flo said...

News on the eastern front: TK announced he had been asked by JK to write and publish a book on cholesterol. He mentioned something about writing in English - I doubt it, though. Anyway, can't wait...! Statins are scarily in vogue in PL too.

Gyan said...

Peter,
Since April, we have stopped consuming vegetable oils except for some rapeseed oil and using the bulk of cooking in ghee.
We eat mostly wheat with lentils.
I have lost about 4 kgs from 76 to 72.
However, I have having problems with weakness and had a fainting spell about a couple of weeks ago.
Yesterday I got some tests done (for insurance purposes).
The total cholesterol was 125 compared with 215 in August this year.
HDL 40 (57 in August)
LDL 77 (130 ")
Fasting sugar 72 (83.5)

Post-dinner I frequently feel a sharp urge to sleep (passes in a few minutes) and is accompanied by some mental confusion (during telling a bedtime story to my 3 yr old daughter).

I am somewhat apprehensive that something is wrong somewhere but not able to fix and wondering if the doctors can help.
Could you give some advice?

Stan (Heretic) said...

Another dodgy paper alert:

http://cancerres.aacrjournals.org/cgi/content/abstract/68/22/9274

This is weird because previous population study of that kind (Willett's) found a correlation with processed meat but not with fat. This one found the opposite: saturated fat but not meat itself. It would be nice to dissect the full text like the previous one. 8-:)

Regards,
Stan

Anna said...

gyan (We eat mostly wheat with lentils.
I have lost about 4 kgs from 76 to 72.)

Are you getting enough protein? How about high quality protein ( non-plant) that doesn't rely on amino combinations, like eggs? How about eliminating wheat in case it is damaging your gut lining?

Have you calculated your lean body mass? Perhaps the weight you have lost isn't fat but muscle, bone, and tissue, perhaps due to protein insufficiency.

Peter said...

Hi Gyan,

Just back on line after 5 days working. Your lipid parameters look to be quite typical of someone on a starch based diet, something like Ornish. Classically saturated fats raise HDL, you either don't follow this pattern of biochemistry or you have accidentally reduced your fat intake when you switched to ghee... The drop in weight would fit with decreased calories, in fact that seems like the only way you could loose weight on a wheat/lentil based diet.

The low LDL would be appropriate for someone on a high fibre, carbohydrate based diet. This seems quite plausible on a whole food diet based on wheat and lentils. The lower fasting blood glucose would fit with this too, as on Kitava.

The question then is whether you can live on a Kitava style diet and stay healthy. As you know, I doubt it is possible to stay healthy on a wheat based diet....

If your insulin sensitivity is good your post prandial glucose figures may be reasonable and if you can stay that way you might be okay. An HbA1c or a few glucometer readings over a couple of hours following a wheat/lentil meal would be interesting.

Bare in mind that I haven't eaten wheat or lentils in a very long time, so really you are way out of my personal experience. But that's how the lipid/glucose numbers look to me.

Best wishes and good luck

Peter

BTW this could be of interest too, just depends really on you ghee intake vs wheat/lentils and I guess on how wrong my suggestions might be!

Gyan said...

Peter,
Should I eat less wheat and more potatoes?
Are sweet potatoes a betetr option than potatoes?
(as they contain pre-vitamin A).
I forgot to mention I stopped eating eggs in August as the egg quality in my town has gone to pits. And the eggs seemed to give me stomach achs.

Peter said...

Hi Gyan,

Well the not eating eggs fits in with the posts on G's blog about the benefits they provide vs your lipid numbers... As for potatoes vs grains vs sweet potatoes, you are well beyond what I have any idea about, bearing in mind I live on butter, dripping, egg yolks, cream and some meat with enough root vegetables to just keep out of ketosis... At a guess I'd go for the most paleo, which is sweet potatoes. I don't know what constrains you are under for food choices, personally I'm still living as cheaply as practically on UK supermarket food... Seem to be doing OK on 50g of carbs per day.

Good luck

Peter

Stan (Heretic) said...

Hi Peter, hi everybody,

In case if you have some spare time and an inclination, please have a look at the following list of papers posted by Jeff N. proving (?) that eating more whole grains is protective against cancer etc. Regards,
h:) [hysterical laughter]

http://drmcdougall.com/forums/viewtopic.php?t=9386&postdays=0&postorder=asc&start=18

Peter said...

Hi Stan,

The message I get from epidemiology is that well educated health conscious people get less cancer despite whole grain consumption. Until you do an intervention study that's all epidemiology can tell you. Intervention gives you WHEL and PPT. The only intervention to show benefit was the Lyon Heart study and that was a multivariable intervention. Did do some good though.

BTW back in the real world some time next week...

Peter

Stan (Heretic) said...

I agree. Almost every time I look at an epidemiological study I find something wrong. For example this one "proving" that fruit and veg are good for BP had 3 times as many smokers in the low veg group and 3 times as many men than women:

http://www.ncbi.nlm.nih.gov/pubmed/18957815?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

I suspect that one can find similar blatant biases in all of them, since if they were true I and you would be dead 8-:)

In this case I didn't have a time to go through all Jeff's list, but it could be an educational experience.

Stan

O Primitivo said...

http://michel.delorgeril.info/dwnl/JUPITER/2010_Answers-to-Ridker-by-de-Lorgeril.pdf