This is an exploration of mortality rates associated with low cholesterol. The review was published in Circulation: Journal of the American Heart Association. In this review, the National Heart, Lung, and Blood Institute held a conference seeking to understand why lower total cholesterol (TC) levels are associated with some cancers, respiratory and digestive diseases, trauma, and residual deaths.
Apparently, men are more susceptible to this correlation than women. They examined 19 cohort studies from the U.S., Europe, Israel, and Japan. TC is a calculation of cholesterol measurements of LDL, HDL, and triglycerides. The review noted high rates of cerebral hemorrhage with lower average TC. The rate of cerebral hemorrhage decreased as average TC went up in prospective populations. This was true in the Multiple Risk Factor Intervention Trial (MRFIT) in addition to increased incidence of colon cancer with lower TC. This may be related to what I wrote in an earlier post.
For women, 6 of the 11 studies showed no variation in cancer death rates across all spectrum of TC levels. There was an increased cancer risk in men when their TC levels fell below 180 mg/dL. In non-cancer and non-cardiovascular death rates, both men and women had similar risk findings. When TC was below 160 mg/dL there was a 40% increase of mortality compared to 160-199 mg/dL levels. Risk was also reduced by 10% when TC levels were between 200-240 mg/dL compared to the reference class (TC between 160-199 mg/dL levels).
This increase in non-cardiovascular deaths raises the issue of the dangers associated with taking cholesterol lowering drugs. These dangers are real and should not be taken likely (as mentioned in the study). Once again, when the data was pooled together, TC below 160 mg/dL was associated with highest risk of mortality.
Unfortunately, some of the data did not differentiate between age or sex but we can assume that having TC this low for anyone is quite risky. The review did take into account people with diabetes, smokers, CVD, alcohol intake, and other possible factors that might skew the data. Some of the research also separated participants further by age and gender.
Findings for all-cause mortality (ACM [death from any cause]) for those with TC between 200-240 mg/dL had the lowest incidence. The rate of death increased the TC went down below 199 mg/dL (are you seeing a trend yet?). Interestingly enough, the American Heart Association, the journal’s parent organization, say that total cholesterol should be below 200 mg/dL. This is the range that has been demonstrated by the AHA to increase risk death from all causes. The standard protocol for primary care providers is to prescribe statin medication when TC is above 200 mg/dL which will place patients well within the range of increased risk of death.
There are also other health risks associated with direct effect of statin use in addition to health benefits not associated with TC lowering mechanisms. Statins act on many mechanisms in addition to reducing cholesterol synthesis in the liver. A benefit-risk analysis of statin use will be explored in a future post.
It is safe to say that total cholesterol levels appear safest when they remain in the range between 200-240 mg/dL. This is my target. Unless you have a very rare disease, it is completely controllable through diet which will be discussed later. Don’t forget exercise will increase your total cholesterol level (by increasing HDL) as it improves your health.
A woman living in the western Brazilian Amazon, Maria Lucimar Pereira, recently celebrated her 121st birthday. She has never lived in a city and is rooted strongly in her local culture.
Some of her pearls of wisdom:
What is her usual diet? Well, she only eats unprocessed local foods:
Another interesting point she made in her interview is that she walks regularly in her village visiting friends and relatives and does not use soap or any artificial products from the city.
Dare I say, this appears to be a very organic lifestyle.
Recently starting my MSN Ed, I quickly realized there is a newer and larger definition of advanced practice nursing or advanced nursing practice. I’ll just call it APN. Historically, APN stood for advanced clinically trained nurses in direct patient care such as nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse-midwives.
The current trending definition of APN includes all master’s and doctorate level educated nurses. According to the (AACN, 2004),
Any form of nursing intervention that influences health care outcomes for individuals or populations, including direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy.
This modern definition of APN includes nurse educators, public health nurses, nurse administrators, and nursing research. I was surprised to learn APNs are no longer limited to direct clinical care. As far as mandating doctorate level education to the definition of APN, direct clinical care (DNP) and nursing research (PhD) seem to be the only two defined terminal pathways.
The exceptions to the current proposed mandate of doctorate level educated nurses by 2015 appear to be limited to clinical nurse leaders and nurse educators. These two professional arenas are generally accepted at the master’s level due to the combination of didactic training and practical experience (Barker, 2009).
AACN, (2004). AACN Postion Statement on the Practice Doctorate in Nursing, October 2004. American College of Association of Nurses. Retrieved November 21, 2011 from http://www.aacn.nche.edu/publications/position/DNPpositionstatement.pdf
Barker, A. (2009). Advanced Practice Nursing: Essential Knowledge for the Profession. Sudburry, Ma: Jones and Bartlett.
I recently read an article proposing an alternative theory to increased incidence of melanoma. It isn’t what I expected. Basically it argues that people working indoors have a higher incidence (up to 9 times more) than people working outdoors.
Here is the abstract from Medical Hypothesis at Elsevier:
Cutaneous malignant melanoma (CMM) has been increasing at a steady exponential rate in fair-skinned, indoor workers since before 1940. A paradox exists between indoor and outdoor workers because indoor workers get three to nine times less solar UV (290–400 nm) exposure than outdoor workers get, yet only indoor workers have an increasing incidence of CMM. Thus, another “factor(s)” is/are involved that increases the CMM risk for indoor workers. We hypothesize that one factor involves indoor exposures to UVA (321–400 nm) passing through windows, which can cause mutations and can break down vitamin D3 formed after outdoor UVB (290–320 nm) exposure, and the other factor involves low levels of cutaneous vitamin D3. After vitamin D3 forms, melanoma cells can convert it to the hormone, 1,25-dihydroxyvitamin D3, or calcitriol, which causes growth inhibition and apoptotic cell death in vitro and in vivo. We measured the outdoor and indoor solar irradiances and found indoor solar UVA irradiances represent about 25% (or 5–10 W/m2) of the outdoor irradiances and are about 60 times greater than fluorescent light irradiances. We calculated the outdoor and indoor UV contributions toward different biological endpoints by weighting the emission spectra by the action spectra: erythema, squamous cell carcinoma, melanoma (fish), and previtamin D3. Furthermore, we found production of previtamin D3 only occurs outside where there is enough UVB. We agree that intense, intermittent outdoor UV overexposures and sunburns initiate CMM; we now propose that increased UVA exposures and inadequately maintained cutaneous levels of vitamin D3 promotes CMM.
Since UVB sunlight exposure of 15-30 minutes can produce between 15,000 to 30,000 IU of vitamin D3 which is protective against melanoma. We should get outside more frequently. Protect your face and neck with a hat (since this is the most susceptable area of the body due to chronic, long-term exposure), and get an adequate dose of sunlight on a regular basis. DO NOT put on sunscreen when you want to get vitamin D since it blocks UVB exposure of the skin and subsequently vitamin D synthesis.
Vitamin D has been found to act on approximately 2,000 genes in our body and every single cell has at least one vitamin D sensitive receptor/activator in the phospholipid bilayer (cell wall) as noted in ScienceDaily. Think about what that can mean for a moment. Do we really want to be deficient with this hormone? Yes, vitamin D is not a vitamin. It is a hormone that has action in our endocrine system regulating more than we realize. Since vitamin D is one of my personal pet study projects, I plan to study it further.
Okay. Here’s a controversial one. . . what happened to our milk? A larger and more salient question concerning our diet, nutrition, and physical health may be what happened to our food supply? Let’s look at dairy products.
Dairy, glistening milk, savory butter, thick cream, and satiating cheese. How about the cultured variety, yogurt and keifer? Then, there are fermented curds and whey and don’t forget cottage cheese. I eat dairy raw as much as possible with the exception of the occasional heavy whipping cream dosed for my Starbuck’s coffee. Did you know that you can leave raw milk out on the counter for three days, consume it, and gain health benefits? I didn’t until a few months ago when I learned how to make homemade cottage cheese. The separated whey can be used for fermenting vegetables like sauerkraut.
Why do the vast majority of us avoid raw dairy? Is it because milk has undergone demonization by the dairy industry, FDA, and other authoritative entities under the premise of public health? Is it really that dangerous? Maybe we should ask the Masai tribe. There is plenty of research on these people consuming large amounts raw milk and meat “with little or no evidence of atherosclerosis or heart disease“. However one chooses to view this controversy, changing the way humans have consumed dairy for tens of thousands of years has a causal relationship wtih our health.
Milk consumption has undergone dramatic changes in composition and production in the last 200 years. We have moved from milking our own cows and goats to strict oversight of production from the feeding of cattle to dispensing at the store front. Current mechanisms of dairy mass-production may very well be antiquated and more hazardous to our health than consuming raw and unprocessed dairy from small family farms. Yes, one can drink contaminated milk (raw or processed) and get acutely ill. The media coverage is enough to scare anyone into thinking raw milk is akin to poison. Just review the recent news about FDA approved monitored food products 1, 2, 3 and see the inherent dangers associated with governmental regulation of food products in general. A lot of this is new to me and may require revision in the future. In the mean time, I hope to describe some of the basics I’ve discovered and attribute my newly found health.
How does raw dairy differ from processed dairy (pasteurized, homogenized, or ultra-homogenized)? Here are some of the differences.
1. Pharmaceutical and genetic influences: Coming from pasture raised cows, diary is absent of contaminants from low-grade antibiotic therapy given to feed-lot cows. Recombinant bovine growth hormone (rBGH) and its cumulative effects, in addition to genetically modified feed is also absent. The hormone rBGH stimulates insulin-like growth factor-1 (IGF-1), which is associated with breast, colon, and prostate cancer.
2. Nutritional Attributes: Pasteurization destroys vital enzymes. Many people complain of being lactose intolerance. Milk contains a disaccharide (milk sugar) called lactose. There is an inherent inability in some people breakdown lactose as we age. This may be due to our decreased dependence on milk in early development or there may be other explanations such as a genetic predisposition. What ever the cause, with lactose intolerance our intestinal villi do not secrete enough lactase (an enzyme) to breakdown lactose into monosaccharides, glucose and galactose. Once broken down, glucose gets absorbed into the bloodstream and galactose continues to break down further into glucose for transport, again to the blood.
3. Raw milk also contains bacteria-friendly lactobacilli to that breaks down lactose. Pasteurization destroys this bacteria altering milk composition. So, people who are lactose intolerant are in reality pasteurization intolerant. They can often consume raw dairy products without difficulty, especially fermented dairy since the bacteria digests lactose during fermentation.
4. Phosphatase, an essential enzyme utilized in calcium absorption in conjunction with vitamin D (found in raw cream) is destroyed during pasteurization contributing to decreased mineralization processes needed for continued osteogenesis.
5. Catalase, an anti-oxidizing enzyme is also destroyed in pasteurization. Catalase is used to deactivate hydrogen peroxide and toxins including phenols and alcohols. Combine this with the increased bioavailability resulting from the the activating process (from fractured lipid globules) of Xanthine oxidase (XO), a reactive oxygen species (ROS) synergized in the presence of testosterone has been shown to be atherosclerotic especially for men and the soup for heart disease is beginning to be prepared. During homogenization, fractioning lipid globules can trigger a free-radical cascade potentially stimulating allergic responses, inflammation, and atherosclerosis.
6. Perhaps the least known and most profound benefits come from application of its anti-oncogenic properties. Dr. Burzinski, a physician and scientist, currently doing multiple FDA phase II clinical trials extracted four antineoplaston (ANP) ingredients from whey, milk, feta and farmer’s cheese that have been shown to deactivate oncogenes and activate tumor suppressor genes. They are 3-phenylactylamino-2, 6-piperidinedione, phenylacetylglutamine, and phenylacetylisoglutamine. If you want to learn about his research of treating cancer a documentary can be found here. This anti-cancer therapy is generally considered more effective and less toxic than both chemotherapy and radiation treatment.
I started this draft last December. Since I have decided to give blogging another shot, I think it is appropriate to post this and add follow ups as time allows. I am starting my MSN/Ed next week and will probably incorporate some of the study topics in order to keep the blog alive during the school year. Perhaps I should have added my BSN journey into the blog, but I was too busy reading other people’s blogs in my off time and lost interest. Anyhoo, here is the beginning of the story that recently changed my life’s direction, revived my dreams, and awakened new goals.
On June 1st 2010, topping the scale at 305-310 pounds, my BMI was over 40. Feeling exhausted all the time, having difficulty breathing, a poor view of myself, I had had enough. A friend told me about a book, The Belly Fat Cure by Jorge Cruise. I read it, put it to work, and lost 8-10 pounds the first two weeks. Fascinated, I continued down this path and began studying fat metabolism, I discovered Good Calories Bad Calories written by Gary Taubes. It is a premier critical analysis of the last two centuries questioning the scientific method and resulting policies of diet, health, and exercise. In it he argues quite convincingly how insulin is a primary driver behind obesity and western diseases.
Needless to say, I severely restricted any source that increased my serum glucose and the pounds kept coming off. I weighed myself every day and noticed weight coming off almost a pound a day for the first two months. The next two months averaged under a half pound a day.
My hunger cravings for sugar and flour had subsided after eliminating wheat one month into the weight loss. The weight keeps coming off, even now. It is effortless, albeit much slower. My BMI is just over 25 and will be in the normal range in early 2011. Energy levels have increased significantly and my brain fog has lifted.
I just completed my B.S.N. and am about to begin my M.S.N., Ed. so, I had a moment to read some science (really write about it) for fun and personal reasons. Actually, I have been reading more health oriented research/data than my college assignments over the last year. This is due in part to my fascination of how I have been able to lose 130 pounds without exercise or combating hunger. Our bodies are truly amazing machines. More about that subject later . . .
Reading a post on a great cooking blog recently, the subject of discussion was a recent meta-analysis’ findings regarding the benefits of whole grains in our diet. Here is the link to the BMJ article. Buy and large, the findings indicate a linear risk reduction of colorectal cancer associated with increased dietary fiber from whole grain intake (up to 60% risk reduction with 90 grams of fiber daily). Now this raised a huge flag especially since the study did not show any risk reduction associated with vegetable and fruit fiber intake.
90 grams! That’s a lot of fiber. The USDA (mind you, I am hesitant about some of their recommendations) suggests daily fiber intake of 35 grams. I did a little research and compared carbohydrate intake associated with study’s findings of fiber intake. Using nutritiondata I took a common whole grain item most health-conscious people would consider eating without question unless they are gluten intolerant or suffer from a gastrointestinal disorder. One average serving (26 gm) of this whole grain contains 11 gm carb/2 gm fiber. In order to get your 90 gm fiber from whole grains such as this, one would consume 495 gm carbohydrates (@ 2,000 calories). When broken down metabolically, this equals approximately 495 grams of sugar in our gut. This sugar (glucose) goes straight to our bloodstream in addition to competing with vitamin C receptors. The human body’s normal fasting glucose level equates to less than one teaspoon of sugar in our circulating blood. Here is a breakdown of fasting glucose levels.
Call me a doubting Dolly but literally taking the meta-analysis’ conclusion to consume 90 grams of fiber daily may be suggestive of a diet that does contribute to cancer, diabetes, obesity, AND heart disease. Subjecting our bodies to nearly 500 grams of sugar a day is not something I or anyone should be doing. Pancreatic burnout and chronic inflammation are two obvious conclusions of dietary recommendations such as this.
Eating this much whole grain may indeed reduce our risk of colorectal cancer, but one must consider the risk/benefit analysis (we really should do this much more closely with everything we do). The problem with this type of research is that it gets published in a variety of news outlets such as this, the general public swallows it hook, line, and sinker, and continues meandering down the collective path of obesity and disease.