17 November 2007
The Great Diet Debate
Cardiovascular disease is one of the major killers in today’s society. There are many risk factors that contribute to cardiovascular disease, some that are modifiable and others that are not. One of the major factors that are modifiable is obesity and hypercholesterolemia. Prevention and treatment for heart disease are very important and sometimes go hand in hand. The South Beach Heart Program is a diet that claims to ‘detect, prevent and even reverse heart disease.’ Studies of this program however did show that LDL levels did not go down and with that in mind high LDL levels is a major factor for cardiovascular disease. So what do the people on this diet do if the diet is not lowering there LDL levels, they take statins, cholesterol lowering drugs. Here is were I believe the problem lies, and that is with the idea that we as a society want a drug or pill to take to help us when there is a cheaper and just as effective way to obtain our optimal health and that is diet and exercise. Diet and exercise can help an individual so much to achieve a healthy life but they need to be done together and be a part of a lifestyle. People who have made intensive changes to their lifestyle with diet and exercise for a year have dropped their LDL levels 40 percent and that is equal to the statin Lipitor. I have no problem with statins and I know that the results that statins get are desired ones, yet I think this falls in line with us as a society being lazy and wanting pill to help us and us not wanting to do physical labor as exercise. Diet and exercise can do so much more than just a pill can do and just help with LDL levels; it can help with the other risk factors for cardiovascular disease as obesity, which can lead to many other problems like diabetes and hypertension. The underlying factor that I believe is and should be is that diet and exercise are vital for us to live and maintain a healthy life as individuals.
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6 comments:
An intersting argument about obesity and lifestyle issues in our society. However, what link does this issue have to Immunology?? :)
Hi Marybethm7630,
I'm going to answer for my student (but I'd love it if he'd respond as well)...but in our course on Inflammation and Disease, it's become clear that obesity (and its associated diseases including type 2 diabetes) have a strong inflammatory component and that perhaps instead of treating these diseases using varying anti-inflammatories, the smartest bet would be to have people alter their lifestyles before it became an issue. At least I think that was the point he was making here! : )
On a side note, it seems that statins actually have an anti-inflammotory affect along with all their other amazing functions!
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=59622
I appreciate the idealistic nature of the posting but statins are useful for the reality that we are, on average, a sedentary and obese society. Until we can affect true wide spread lifestyle changes (the most difficult public health task known to man) statins are a necessary band aid. One of my colleagues recently asked when statins are going to replace Fluoride in the drinking water.
Funny you should talk about replacing Fl- in drinking water with statins;
Ternes, R. Water Sci Technol. 2007;55(12):327-32.
Vieno, NM. et al. Environ Sci Technol. 2007 Jul 15;41(14):5077-84
Long story short:
Waste-water treatment plants are not designed to filter pharmaceuticals out of the water stream, so whatever statins you ingest and don't metabolize...will end up in everyone's drinking water, at some very low but apparently real rate. Ozone treatment effectively prevents this, but currently only "high risk" source water (industrial or agricultural run-off) is typically ozone-treated. So in a very real sense, Viagra, ASA, Ibuprofen etc are already replacing fluoride in the drinking water.
FritzJ7630...TERRIFYING!
DanielO495, you've made very relevant comments to our societal "Lay Perception of Illness View," (1,2) the idea that our current health care environment promotes an external locus of health control. This is part of the reason why people would rather take a pill than change their lifestyle, i.e., the message sent is 'why should I change my lifestyle when I can take a pill instead?' This is a theory of human behavior, which I can reference below for you. As far as the South Beach Diet, it does closely ressemble a Mediterranean Diet, which is higher in monounsaturated fats. There is some evidence that diets higher in these fats have beneficial effects on insulin sensitivity, which could ultimately positively impact LDL cholesterol. The problem is that there are not longitudinal well-done studies to help us better understand these diets...most are short-term and in very small samples. One interesting study to see is (3) if you'd like to have a look. TLH
1)Clarke, V.et al (1997). The lay epidemiological perspective in cholesterol testing: Implications for health promotion. Sci in Health: International J. Res. Prac., 3, 213-221.
2)Coutu, M. F.,et al (2001). The impact of cholesterol lowering on patients' mood. J Behav.Med., 24, 517-536.
3)Ryan, M, et al. (2000). Diabetes and the Mediterranean diet: A beneficial effect of oleic acid on insulin sensitivity, adipocyte glucose transport and endothelium-dependent vasoreactivity. Q J Med, 93:85-91.
Your post, Daniel 0495, reminded me of the "National Weight Control Registry," which is maintained by the University of Colorado's Center for Human Nutrition. It is a registry of people who have lost a signficant amount of weight and have maintained this weight loss for an extended period of time. (I'm sorry I don't know how long.) I believe all of the data are self-reported data, so there's no blood data such as cholesterol levels. I think there would be some incredibly interesting analyses if blood data were collected on these folks...especially since it's a registry. There's something about this group of people that allows them to lose weight and keep it off...wonder how that affects the other aspects of their life? Cholesterol levels? Drug interventions?
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