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Cholesterol metabolism is a very complicated field. 

Lipids are the different forms of fat and cholesterol which perform a variety of functions within human physiology. There are many different types and subtypes of lipid particles, each with different yet interrelated functions and effects.  There is much basic science that’s not well understood. 

When this basic science is applied to the clinical care of patients, many more complicated issues arise.  The role of various lipid particles in contributing to atherosclerosis, the underlying cause of heart attacks and strokes, is still being determined.  It’s well-documented that many patients who have heart attacks or strokes have normal traditional lipid levels, which illustrates the fact that there are many other factors at work in determining whether your arteries become clogged with plaques and you subsequently suffer a heart attack or stroke.

The media coverage of cholesterol reflects this complexity, and is filled with confusing and conflicting reports of benefits and risks associated with cholesterol levels, as well as the diets, supplements, and (especially) the drugs used to modify lipid levels. The drug companies and supplement makers constantly run adds which sometimes seem contradictory.

For many people like yourself, it’s all very confusing.

Let me make it simple for you.  While there is much that’s not known when it comes to cholesterol, there is one statement that is as rock solid as any truth in all of medicine.  Write this down, and commit it to memory.  I promise, you can take it to the bank.

If your lipid levels are not ideal, you can dramatically lower your risk of heart attack, stroke, and death by optimizing your cholesterol numbers with diet, drugs, or both.

That statement has been proven over and over again.  There are so many large, powerful, well-designed studies Read the rest of this entry »

“Scientific studies have shown. . .”

“Recent research suggests. . .”

“A study presented recently reported. . .”

These types of phrases are used daily in the popular media to report on medical and scientific studies which produce results the general population may find interesting. They’re also used regularly by those trying to convince you to buy certain products (e.g., supplements), follow certain diet plans, or take prescription drugs. Unfortunately, such references to scientific evidence are frequently misleading.

In medicine, there are many different types of studies and reports that are used as evidence to support a given treatment recommendation. The thing that most people (especially those writing media reports) don’t seem to realize is that some types of evidence are considered much stronger than others. Many times the media doesn’t seem willing or capable of distinguishing very weak evidence from very strong. Those who’re trying to sell you snake oil are much worse, and will often mislead you by using such phrases while really referring to virtually nonexistent or at least extremely limited evidence.

Some general categories of clinical medical evidence, presented from weakest to strongest, are reviewed below.

Anecdotal evidence. This is literally when recommendations are just based on the experiences of a few patients. A Read the rest of this entry »

So says the media.

In this blog I plan to address mainstream medical news articles you might hear about or find interesting.  I’ll give you my own opinion and interpretation of the info, with an obvious interest in figuring out whether there’s relevant info in the article relating to what this site is all about:  trying to improve your odds of living a long, healthy life. 

It turns out the media is not very good at accurately presenting medical information for the most part.  What they generally are good at is using a bit of medical information, or even misinformation, to generate a compelling or sensationalistic story.  Now I’m not saying it’s always intentional; often I’m sure the media simply misunderstands or misses the point of what they’re trying to report on.  The frequency with which the media presents medical information in a misleading way however is frightening to me, since it makes me wonder how many other media reports on topics other than medicine that I’m reading are full of misinformation and I’m simply too ignorant to recognize it.

Here’s one from today.  An article from the AP regarding minute, trace amounts of prescription drugs which are detectable in some water supplies.  Sounds pretty scary, right?  I mean, after all, you don’t want to be taking any prescription drugs unless you really need them and they’re prescribed and monitored by your doctor, particularly not if they’re unknowingly mixed into your tap water.  The article focuses on the potential for possible toxic long-term effects on humans due to decades of such exposure. Read the rest of this entry »