November 6, 2013

Over the past two weeks the ABC aired a two-part documentary entitled “Heart of the Matter” on their Catalyst science show. If you did not see them, the links are at the bottom of this post. There’s also been discussion on the ABC Radio Health Report.

The first episode questioned what’s known as the “lipid hypothesis”. It goes like this:

  1. If your diet is high in saturated fat – it might raise your cholesterol.
  2. If your cholesterol is raised – it might raise your heart risk.
  3. If your heart risk is raised – you might die earlier of heart disease or stroke.

It reminds us of the famous question about whether “Ice cream sales increase shark attacks”. Whether you agree with the above statements, the Catalyst show certainly encourages you to think about the issues. Now, more than ever, consumers are able to access more and more health information from sites like PubMed and Medscape. Of course we all have to be careful of biased and misleading information.

The saturated fat question is important for our members. We’ve learnt that weight loss is not a physics problem “It’s just calories in versus calories out. Just eat less and exercise more.” It’s a biological problem “How your body absorbs and uses calories from foods and their macronutrients – protein, carbohydrate and fat, varies with each individual.” In the last 30 years the western world has been advised to limit fats, as well as sources of saturated fats mainly from red meat and dairy. For many, this has led to a subsequent increase in carbohydrate containing foods, especially as they are cheaper.  For many, the amount of carbohydrate has exceeded their individual tolerance and this has lead to fat cell dis-regulation – causing hunger, cravings, fat storage and a decline in energy levels and the desire to be physically active. And so the fear of saturated fat may have contributed to our rising obesity levels – as an unintended consequence.

Before we say any more, Healthy Inspirations encourages members who have questions to raise them with their GP. We feel for the time-starved GP who is under huge pressure to ensure that the advice they give is up to date and evidence-based. Next time you visit your GP there is no reason why you cannot ask for copies of your previous blood tests for your own files. At the same time it is good to ask your doctor to explain them.

If your age is getting on, or you have some heart risk (like family history) your doctor may want to assess your risk factors. Risk factors fall into two categories:

  1. Not modifiable – age, sex, family history of heart disease or stroke
  2. Modifiable – like carrying extra weight (especially around the midsection), lack of exercise, high cholesterol, high triglycerides, high blood pressure, and high or unstable blood sugar. These aren’t just risk factors for heart disease, but most are also risk factors for diabetes, asthma, arthritis, dementia and many cancers.

This is exciting as it means that each us can make lifestyle choices to reduce our risk factors. Some of these (or a combination) may have as great an effect as does taking a statin to reduce total cholesterol. Be aware, that because you do one, it does not follow that you shouldn’t do the other. It’s horrifying to hear about people with heart disease or elevated risks who rely on the “heart pills” for cholesterol and blood pressure, but continue smoking, eating junk food and not exercising.  It’s equally horrifying to hear of people who should be on medication, decide to cease their medication without discussing it with their doctor.

At Healthy Inspirations we’re delighted to get reports from members who have lost weight (score 1), reduced waistline fat (score 2), decreased blood pressure (score 3), increased physical activity (score 4), decreased triglycerides (score 5), increased “good” HDL (score 5) and even eventually decreasing total cholesterol (score 6).

When it comes to total cholesterol and weight loss, we do pre-warn members and their doctors that any weight loss program (low fat, vegetarian, Mediterranean, low carb or fasting) that yields just half a kilo weight loss per week, will require the body to metabolise around 70 extra grams of fat a day and this sometimes creates a temporary elevation in total cholesterol, even though “good” HDL goes up and triglycerides go down. Total cholesterol generally settles a few months after weight loss is stabilised.

The bottom line is that you and your doctor should work as a team to keep you as healthy as you can possibly be. Feel free to discuss any of the above with your doctor.

Here are the links:

ABC- Catalyst – Healthy of the Matter – Episode 1

ABC- Catalyst – Healthy of the Matter – Episode 2

ABC – Health Report – Low carb Diet to Manage Diabetes – Type 1

ABC Health Report  – The Cholesterol and Statin Debate

There has been a lot of chatter about the experts on all the shows above having undeclared conflicts of interest. This does not mean that their comments were not valid, but their conflicts should have been disclosed so that we can make a fair judgement, especially when the conflict affects the topic about which they are commenting. Read what lawyer David Gillespie writes. Click here.

Facebook fans may wish to read the comments from the CEO of The Heart Foundation and the comments regarding her comments.

PS: In regard to statins, we’d be interested to know:

  1. What is the the annual total cost to the Pharmaceutical Benefits Scheme (PBS), for statin medications – paid for by all tax-payers?
  2. Is there is any unwarranted prescription of statins? If so, how much?
  3. The answer to a hypothetical question: If there was no PBS funding for statins, how much might they cost a patient per month?
  4. The answer to a 2nd hypothetical question: If there were no statins, would more people take more lifestyle steps to minimise their own risks?