I got an email from Pamela Schoenfeld, R.D. the other day. She wanted to make me aware of a paper she and her colleagues (Hite, et al)published on Friday in the journal Nutrition. It’s a critique of the Report of the 2010 Dietary Guidelines Committee (DGAC) that recommended that we all go on eating the same low-fat, high-carb diet that has contributed to the epidemics of obesity, diabetes and heart disease (among others).

The paper is open-access, which means you can read the full text for free (PDF). Here’s the gist: the new dietary guidelines proposed by the DGAC aren’t based on scientific evidence. The authors criticize the DGAC for excluding recent research that contradicts their low-fat propaganda, and for conveniently ignoring the fact that disease rates have skyrocketed over the past 30 years in spite of Americans eating less fat and more carbs.

The DGAC report essentially said, “Hey Americans! You’re fat and sick because you haven’t done a good enough job following our advice. What you need to do is eat even less fat (and by extension more carbs), and then you’ll finally lose weight and maybe not die of a heart attack.

Obviously the DGAC has never heard Einstein’s definition of insanity, which is to do the same thing over and over again and expect a different result.

Hite et al start the paper off with this gem of a quote:

What is required is less advice and more information. – Gerald M. Reaven

Amen to that! There’s no doubt we’re in the midst of a serious nutritional crisis, but the DGAC is dead wrong about what’s causing it. Hite et al continue:

Nutritional health covers a wide range of concerns but first and foremost in the mind of the public are whether the standing recommendations for lowering fat intake and increasing carbohydrate intake were ever appropriate for the prevention of obesity, diabetes, and cardiovascular disease;

You took the words right out of my mouth!

The authors go on to dismantle the DGAC dietary recommendations by reviewing all of the available evidence (imagine that!), rather than just focusing on the studies that support their viewpoint. Real science! What a breath of fresh air.

If you’re interested in learning more about how we’ve been collectively duped into the idea that fat is bad and carbs are good, read the paper. It’s not highly technical and is intended, to some degree I think, for a lay audience. But for those of you who don’t have time to read it, I’m going to list a few of the section headings to give you the idea:

“Strong recommendations, weak evidence”

“Animal versus plant protein: Recommendations do not reflect limitations and uncertainties of the science”

This is an important paper. It’s one of the most comprehensive critiques of the mainstream dietary recommendations I’ve seen, and it’s all in one place. So please, share this with as many people as you can. Post it to Facebook. Tweet it. Print it and take it to your doctor. Send it to your Mom & Dad, who might still think butter is bad for them. Tape it on your refrigerator. Get the word out!

I imagine some of you have heard about the new study published in the Annals of Internal Medicine claiming that low-carb, meat-based diets raise the risk of heart attacks, other cardiovascular events and death. With headlines in the media like “Low carb, high meat diet has high risks” and “Low-carb diets might be deadly“, you might be (understandably) concerned.

Well, as they say in NYC, “fuggedah-bout-it.”

As many preposterous and poorly designed studies as I read (and let me tell you, I read a lot of them), I haven’t lost the ability to be shocked by a particularly bad one. I know the researchers who publish them aren’t stupid. And in general, I think their motivations are good. But it is truly astonishing to see how easily highly trained scientists can completely abandon reason and critical thinking.

And don’t get me started on the mainstream media. They’re hopeless. Do they even read the junk that comes across their desk before regurgitating it as a sensationalized and vapid news story? I know that news outlets have science reporters on staff. Where do they find these people? I could explain this study to a ten-year old in simple language, and they’d understand right away how ridiculous and worthless it is.

Maybe these researchers and reporters need to eat more meat and fat so their brains work better. Because stuff like this is pretty embarrassing for them.

When I saw this study, I knew I’d have to write about it. After all, a low-ish carb, meat-based diet is exactly what I advocate for optimal health. Fortunately, several of my esteemed blogger colleagues have already dissected, dismantled and otherwise disposed of this piece of scientific garbage. Rather than re-create the wheel, I’m simply going to link to their articles and provide a brief summary of the key points here.

The study claimed that a plant-based, low-carb diet (which we’ll call the Vegetable group) is associated with a lower risk of mortality and disease, while an animal-product based low-carb diet (which we’ll call the Animal group) is associated with an increased risk of mortality and disease.

Does the study support those claims? Hardly. Here’s why:

• The so-called low-carb diet in the study wasn’t remotely low-carb. The participants got between 37% – 60% of calories from carbohydrates, which is what most low-carb experts would call, um, “high-carb.”
• People in the Animal group were more likely to smoke and be overweight than the Vegetable group. Smoking and overweight are risk factors for heart disease. This alone could explain the results, but it also suggests that the Vegetable group may have been more health conscious in other ways (like exercise, stress management, etc.) that were not accounted for in the study. This, of course, is the problem with attempting to draw conclusions from epidemiological research – as we’ve discussed several times here before.
• The Vegetable group didn’t exactly eat a vegetable-based diet. They got almost 30% of calories from animal products (vs. 45% from the Animal group).
• When you examine the data in the study closely, differences in death rates were unrelated to animal product consumption. That means something else (not eating meat) described the differences seen in the study.
• Epidemiological (observational) studies about meat intake are notoriously inaccurate, because people tend to lie (or forget) how much meat they actually eat. Since this study was based on nurses and doctors, who firmly believe the “meat is bad for you” hype, and are invested in the medical establishment, the participants may have been more likely to under-report their meat intake.

Of course Dean Ornish has jumped on the bandwagon claiming this study vindicates his completely unscientific claims that a plant-based diet is healthier than a meat-based diet. It does nothing of the sort, as you’ll see when you read the following articles. (I’ve lost all respect for the Dean Ornish’s integrity. I think his heart is in the right place, but he so clearly believes eating meat is bad and wrong that he entirely ignores any evidence that conflicts with his belief, and eagerly distorts any evidence that vaguely appears to support his belief.)

For a full analysis of the absurdity of this study, check out the following articles:

• Why the latest low carb scare study is flawed, by Jenny Ruhl at Diabetes Update
• Brand-spankin new study: are low-carb meat eaters in trouble?, by Denise Minger at Raw Food SOS: Troubleshooting on the Raw Food Diet
• The Atkins study (ahem, ahem) according to Ornish, by Tom Naughton at Fat Head
• New study shows that lying about your hamburger intake prevents disease and death when you eat a low-carb diet high in carbohydrates, by Chris Masterjohn at The Daily Lipid. (That headline says it all, doesn’t it?)

In a recent post, The Myth of Evidence Based Medicine, I explained that conventional medicine is based not on evidence, but on profit.

So how’s this working out for us?

The U.S. spends far more than any other country in the world on healthcare – a whopping $2 trillion per year. ¹

Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm.

But that’s not what’s happening at all. The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators. ²

Even worse, a study published a few years back in JAMA suggested that medical care may be the leading cause of death in the US. (For more on this, read my article The Failure of U.S. Healthcare).

Yes, you read that right. Medical care kills more people than heart disease, strokes or cancer.

How can it be that we spend nearly 16% of our GDP on healthcare, but have one of the worst health care systems in the industrial world?

The answer, in short, is that we don’t have healthcare in the U.S.. We have disease management. And there’s a world of difference between the two:

Wellness care is what we need. Disease management is what we have.

Wellness care would save insurance companies billions of dollars each year. But it would devastate the bottom lines of the pharmaceutical industry.

Wellness care is what I will offer my patients. And it’s the vision I have for what medicine could be here in the U.S. and elsewhere.

I’m just not holding my breath. Until we can lessen the influence of Big Pharma, disease management will rule.

Statins are the most popular drugs in history. Drug companies made $26 billion selling statins alone in 2008. 25 million Americans take them, and the number is growing each year.

One reason why statins are the best-selling drug category by far is that 92% of people taking them are healthy. The FDA has approved the prescription of statins to people at low risk for heart disease and stroke, who don’t even have high cholesterol. Two years ago the American Academy of Pediatricians recommended that statins be prescribed for kids as young as eight years old.

With sales statistics like this, you’d think statins are wonder drugs. But when you look closely at the research, a different story emerges. Statins have never been shown to be effective for women of any age, men over 65, or men without pre-existing heart disease. Early studies did suggest that statins are effective for men under 65 with pre-existing heart disease, but later, more rigorous clinical trials has not confirmed this benefit.

In addition, statins have been shown to have serious side effects and complications in up to 30% of people who take them. Studies have also shown that the majority of these adverse events go unreported, because doctors are largely unaware of the risks of statins.

Watch the two videos below to learn the whole story. Or, you can read this article for a concise summary of the evidence.

Video Presentation

Handouts

• Statin research summary: lists the eight statin studies performed in 2008 – 2009, including the drugs and populations studied and the results. If you’re currently taking a statin, you might consider printing this out and taking it to your doctor as a springboard for a conversation about whether statins are right for you.

References

ENHANCE
KasteleinJJ, AkdimF, StroesES, for ENHANCE investigators. Simvastatin with or without ezetimibe in familial hypercholesterolemia. N Engl J Med 2008;358:1431-43

CASHMERE
O’Riordan M. CASHMERE: no IMT effect with atorvastatin over 12 months. (link)

ACHIEVE
O’Riordan M. ACHIEVE stopped: IMT study with Niacin/Laropiprant halted by Merck & Co. (link)

SEAS
Rossebø AB, Pedersen TR, Boman K, et al. Intensive lipid lowering with simvastatin and ezetimibe in aortic stenosis. N Engl J Med 2008;359:1343-56

GISSI-HF
GISSI-HF Investigators, Tavazzi L, Maggioni AP, Marchioli R, et al. Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomized, double-blind, placebo-controlled trial. Lancet 2008;372:1231-9

CORONA
Kjekshus J, Apetrei E, Barrios V, et al. Rosuvastatin in older patients with systolic heart failure. N Engl J Med 2007;357:2248-61

AURORA
Fellström BC, Jardine AG, Schmieder ME, et al for the AURORA study group. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med 2009;360:1395-407

JUPITER
Ridker PM, Danielson E, Fonseca FA, et al, for the JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-Reactive protein. N Engl J Med 2008;359:2195-207

Still think saturated fat is bad for you? Still think eating eggs raises cholesterol? Still think high cholesterol causes heart disease?

If you answered yes to any of those questions, you really need to watch these videos. (But hey, you might learn something even if you answered “no”.)

In this presentation I:

• debunk the myth that eating saturated fat and cholesterol causes heart disease.
• explain why LDL and total cholesterol are not useful markers for heart disease.
• present three markers that are useful markers for heart disease.
• demonstrate that low-fat, high carb diets promote – rather than protect against – heart disease.
• show you how eating saturated fat and cholesterol can prevent heart attacks
• tell you how to order a test that more accurately predicts your risk of heart disease

At the end of these two videos, you’ll be heading to the fridge for some extra butter or cheese on those veggies or a little extra cream in your coffee!

If you’ve been reading this blog for a while, you’ll know I’m not a big fan of supplements. I’ve always believed that it’s preferable to get the nutrients we need from whole foods, as they’re found in nature, rather than from isolated, synthetic sources (i.e. supplements).

Unfortunately, modern medicine is obsessed with isolated, synthetic nutrients and has convinced itself that they have the same beneficial properties as nutrients found in whole foods.

A gigantic dietary supplement industry has arisen from this misguided belief. A 2006 National Institute of Health (NIH) conference (PDF) revealed that 20-30% of Americans use a multivitamin daily, forking over $23 billion a year to supplement manufacturers for the privilege. Many more Americans effectively take a multivitamin by eating fortified grain products, like Shredded Wheat cereal and Wonder Bread.

Most supplements don’t work

With these statistics in mind, you might be surprised (or even shocked) to learn that clinical trials have shown that most of these supplements not only don’t work as intended, they actually make things worse. The NIH conference examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials.

First the positive results:

• A combo of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
• There was some evidence that selenium reduces risk of certain cancers.
• Vitamin E may decrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
• Vitamin D showed some cardiovascular benefit.

Um, not too impressive considering the near universal faith considering how many people are popping these pills on a daily basis.

Now for the negative results:

• Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
• There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
• High-dose vitamin E supplementation increased the risk of death from all causes.

Then there’s the now infamous JAMA meta-analysis on antioxidants. They looked at 68 trials with over 230,000 participants. Here’s what they found:

Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.

Oops!

(Re)-introducing the concept of food synergy

It’s crazy to me that so many health care practitioners – both conventional and alternative – tell their patients to take multivitamins and antioxidants when their is little support for that position in the medical literature.

That’s why I was so happy to come across a study in the American Journal of Clinical Nutrition addressing this issue. It’s called “Food synergy: an operational concept for understanding nutrition” and it’s one of the most encouraging pieces of research I’ve seen in a while. I’m relieved to learn that their are researchers working in the nutrition field that don’t buy into the synthetic nutrient hype, and understand the importance of whole food.

Since it’s such a great article, I’m going to quote from it and riff off of a few passages.

A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference Intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health. This review argues for the primacy of food over supplements in meeting nutritional requirements of the population.

This is the crux of the authors’ argument, which I’m 100% behind. They congratulate science on the discovery of fundamental nutrients such as vitamin C, and clarifying their role in health and disease. The realization that scurvy is caused by vitamin C deficiency has saved a lot of lives. But, the approach to nutrition that is fundamentally guided by nutrients has a dark side:

The aspect of science that reduces to fundamental principles, however, can lead to oversimplification and ultimately stifle understanding and progress.

Translation: reductionistic thinking can get us in trouble if we’re not careful.

The concept of food synergy is based on the proposition that the interrelations between constituents in foods are significant. This significance is dependent on the balance between constituents within the food, how well the constituents survive digestion, and the extent to which they appear biologically active at the cellular level.

Yes! It makes me so happy to see this in a major, peer-reviewed journal. The authors go on to define several aspects of food synergy:

• A buffer effect, i.e. the effect of a large intake of a particular nutrient may vary depending on if it is taken in concentrated form or as part of a whole food.
• Nutrients can affect each other’s absorption, such as copper-inc and magnanese-iron. These interdependent nutrients tend to appear together in foods, but not necessarily in isolated supplements.
• It matters whether the nutrients have been produced by technologic or biological processes. Trans fat produced in ruminant animals (such as conjugated linoleic acids in dairy products) are beneficial to health, whereas trans fats produced in the processing of industrial seed oils are highly toxic.

Then they provide evidence that whole foods are more effective than supplements in meeting nutrient needs:

• Tomato consumption has a greater effect on human prostrate tissue than an equivalent amount of lycopene.
• Whole pomegranates and broccoli had greater antiproliferative and in vitro chemical effects than did some of their individual constituents.
• Free radicals were reduced by consumption of brassica vegetables, independent of micronutrient mix.

Should we all take a daily multivitamin as “insurance” against a nutrient deficiency? Here’s how the authors respond to that question:

In our view, the better “insurance” would be to eat food with a broad coverage of nutrients and take no supplements at all, unless they are deemed necessary to fix a specific medical problem.

Hallelujah! I’d like to buy these researchers a beer.

Okay, not all supplements are bad

Now that I’ve made my point (or at least I hope I have), I need to add a qualifier or two.

There are a few supplements that I do recommend – in certain situations.

Vitamin D may be necessary for those who live in northern latitudes, especially during the winter months. Low vitamin D is associated with so many diseases that it’s probably a good idea to keep levels up. The first choice would be to do this by eating seafood, but that’s not always practical or desirable for a number of reasons. Cod liver oil is my second choice for maintaining D levels. But note that this is more of a whole food than it is a supplement. In some cases when people are very deficient, i.e. under 25 ng/ml, I may suggest adding a D3 supplement in addition to the cod liver oil.

Fish oil has been shown to provide great benefit for cardiovascular disease and other inflammatory conditions. My preference here is that people reduce their intake of omega-6 fats and simply eat cold-water, oily fish a couple times a week to meet their omega-3 needs. Unfortunately, people have been scared away (unnecessarily, which is a topic for a future post) from eating fish, or perhaps it’s difficult for them to find or afford wild fish on a regular basis. In this situation I may recommend a fish oil. My favorites are whole-food based oils such as Green Pasture’s Fermented Cod Liver Oil and Vital Choice Wild Salmon Oil.

Magnesium is one of the most crucial nutrients in our diet, and many people are deficient. It protects against nearly every modern disease, and can be therapeutic for difficult to treat inflammatory conditions such as fibromyalgia, irritable bowel syndrome, arthritis, etc. Seaweed and various nuts and seeds are high in magnesium, but occasionally supplementation may be useful. I suggest using a highly-absorbable form such as magnesium glycinate.

Vitamin K2 has recently been revealed as an important nutrient in protecting against heart disease. It does this by telling the body to put calcium in the bones and teeth where it belongs, and not in the arteries and soft tissue. K2 is found in the fat of grass-fed animals and certain fermented foods like natto and hard cheese. I recognize that not everyone eats these foods for various reasons, so if someone has heart disease or is at risk for it I may recommend either Fermented Cod Liver / Butter Oil from Green Pastures, and/or an MK-4 supplement. For more on vitamin K, see my post Vitamin K2: The Missing Nutrient.

But even in these cases, I only suggest that people take these if they need them, and if they can’t (or won’t) get the nutrients from foods.

Dr. John Briffa wrote a post worth reading on his blog today about the significant side effects of statin drugs, and the considerable effort pharmaceutical companies and the medical establishment spend trying to convince people that these drugs are safe.

Sadly, they’ve been largely successful. Some time ago a physician in the UK by the name of Dr. John Reckless (you can’t make this stuff up) suggested that statins are so safe that they should be put in the water supply!

That’s ridiculous, of course. Statins are dangerous drugs. What’s more, they don’t reduce the risk of total mortality (death from any cause) for 95% of the population. See my articles The Truth About Statin Drugs and More Statin Shenanigans for more on this.

If you’re wondering why you haven’t heard more about the danger of statin drugs, check out another great post Dr. Briffa wrote a couple of weeks ago called Adverse effects of drugs are “neglected, restricted, distorted or silenced”.

There’s big money in the drug business, folks. The total pharmaceutical industry is worth hundreds of billions, and drug companies make $25 billion on statin sales alone. Do you think they’re going to go out of their way to tell everyone about the side effects and risks of these drugs? They’re legally obligated to maximize profits for their shareholders, as are all corporations, and maximizing profits means selling as many pills as they can.

That’s just the way it works. Unfortunately, people like you and I and our families are the victims of this profit-driven health care system.

I want to get some Juno-inspired T-shirts printed up for researchers that say “What other kind of shenanigans can I get into?” Seriously. I cannot believe the stuff that gets published in medical journals these days. I don’t know which is the scarier possibility: that the researchers are really so poorly trained that they consistently violate the most basic principles of medical research (that you probably learned in your 8th grade science class), or that they are so dishonest that they intentionally and blatantly lie about their results.

A prime example of this is an article that came across my newsfeed a couple of days ago. The headline read “High fat diet during pregnancy leads to severe liver disease“. I’m always very, very suspicious when I see articles like this because of my previous experience evaluating such studies. All too often researchers make basic (and frankly, inexcusable) mistakes like lumping all fat types together (i.e. combining saturated fat with polyunsaturated fat, although the two fatty acids have completely different effects on human physiology).

I didn’t have time to review the study and write about it, so I emailed Chris Masterjohn, a researcher pursuing a PhD in Nutritional Sciences with a concentration in Biochemical and Molecular Nutrition at the University of Connecticut. Chris has a blog called The Daily Lipid where he writes about the benefits of saturated fat and the dangers of polyunsaturated fat. Turns out Chris had seen the article on ScienceDaily too and was planning to write a critique. Here’s what he wrote. I encourage you to check out his blog, and also his website, both of which have some great information about the health benefits of cholesterol and saturated fat.

ATTN: Bay Area Healthy Skeptic readers!

I am once again offering my free public talk in Berkeley, CA which debunks the myth that cholesterol causes heart disease. We’ll also explore the true causes of heart disease as well as simple dietary and lifestyle changes you can make to protect yourself and your loved ones.

If you have family or friends that live in the area that might benefit from this information, please let them know about the talk.

Tuesday, October 27th from 7:00 – 9:00 PM

Acupuncture & Integrated Medicine College, Berkeley (AIMC Berkeley)
2550 Shattuck Avenue (at Blake)

510.666.8248 ext. 106

www.aimc.edu

For over 50 years, the medical establishment has vigorously promoted the notion that high cholesterol is a primary risk factor for coronary heart disease, and that a diet high in saturated fat and cholesterol causes heart disease. These hypotheses are widely accepted as fact by physicians and the general public alike, despite the overwhelming body of evidence that suggests otherwise.

During this two-hour talk, we’ll review scientific studies demonstrating that:

1. High cholesterol is not the primary of cause heart disease..
2. Diets high in saturated fat and cholesterol don’t cause heart disease.
3. Consumption of so-called “heart healthy” vegetable oils is linked to heart disease, cancer and many other conditions.
4. Statin drugs don’t reduce the risk of death for most people, and have dangerous side effects and complications.

You’ll also learn the latest theories on what causes heart disease and a truly “heart healthy” approach to diet and lifestyle that is supported by both modern science and centuries of traditional wisdom.

The presentation draws on more than 150 peer-reviewed studies published in major journals and the work of an impressive list of physicians, scientists and researchers who question the connection between cholesterol and heart disease.

Download a PDF flyer for the event here.

THS reader Christopher Lane brought this article to my attention, and asked me to forward it on to my readers. Yet another tragic consequence of dangerous and overused psychiatric drugs.

Mary Weiss, a mother in Minnesota, was one such person who wrote me last month. I’d been on the radio, talking about issues tied to my book. Ms. Weiss wrote an email afterwards, telling me about her son, Dan Markingson, who’d been diagnosed with schizophrenia, though she herself has serious doubts that the diagnosis was accurate.

Her son was encouraged to participate in a clinical trial at the University of Minnesota and other campuses comparing Seroquel, Risperdal, and Zyprexa for schizophrenia, schizoaffective disorder, and schizophreniform disorder, a loosely defined diagnosis for people suffering from “mood disorders with psychotic features.” The trial was sponsored by AstraZeneca, maker of Seroquel, which put the researchers and university in an obvious conflict of interest. Dan was given 800 mg of the drug.

Over 70% of patients in the trial dropped out. But Dan was strongly dissuaded from doing so and remained in it for five months. He’d been given a directive warning that if he failed to continue in the trial, he would be put in a regional treatment center. His mother did not know about the directive until it was too late.

Follow this link to read the full story.

A new report due to be published in the May issue of the American Journal of Psychiatry shows that antidepressants aren’t all they’re cracked up to be.

But, faithful readers, you already knew that. Right?

The report is part of the National Institute of Mental Health-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) project – the largest study of the treatment of depression conducted in the United States. It showed that findings from clinical studies used to gain FDA approval of antidepressants are not applicable to most patients with depression.

Researchers at the University of Pittsburgh Graduate School of Public Health compared symptoms and outcomes in depressed patients who met phase III study inclusion criteria to those who did not. Phase III studies for antidepressants determine the effectiveness of the drug in comparison to a placebo.

The inclusion criteria for these studies aren’t standardized or subject to any federal guidelines. Typically this means that patients with milder forms of depression, chronic depression, or other psychiatric or medical conditions in addition to short-term depression are excluded from studies.

In other words, the majority of “real world” patients with depression who end up taking antidepressants are excluded from clinical studies. It should be obvious why this is a problem. In a normal, clinical setting many patients with depression do also have other illnesses, such as diabetes, chronic fatigue syndrome or irritable bowel syndrome (IBS). It’s not unusual for them to have anxiety and insomnia, as well. In fact, it wouldn’t be presumptuous to expect that a depressed person might be suffering from a number of conditions that are either contributing to or caused by their illness.

Yet the only people that “qualify” for the clinical trials which determine whether antidepressants get approved by the FDA are those with short-term depression, no history of depression, no other psychiatric conditions such as anxiety, and no physical illnesses like heart disease or diabetes. This is the only subgroup of the general population for which we have any data on the efficacy of antidepressants.

By the same token, this means is that we have almost no clinical data on how antidepressants work for the “real world” patients who are most likely to be taking them. Indeed, after assessing 2,855 patients treated with citalopram (Celexa), the study authors found that fewer than one in four, or 22.2%, of the patients met the usual criteria for inclusion in phase III clinical trials.

According to study lead author, Stephen Wisniewski, Ph.D., professor of epidemiology and co-director of the Epidemiology Data Center, University of Pittsburgh Graduate School of Public Health, “This raises major concerns about whether results from traditional phase III studies can be generalized to most people with depression, who also often suffer from anxiety, substance abuse and other medical and psychiatric problems.”

When Wisniewski and his colleagues looked at the efficacy of antidepressants in those who did not meet phase III inclusion criteria – meaning the majority of people who take the drugs in real life – they found that their outcomes were much worse than those who did qualify for the trials. The depression remission rate in the patients who met the criteria was 34.4 percent, compared to only 24.7 percent in the ineligible group.

So, here’s the bottom line: antidepressants are nowhere near as effective as research suggests.

And that is really bad news for the drug companies, because research already suggests that antidepressants aren’t very effective at all. In fact, as I explained in a previous article, antidepressants are no more effective than placebo for most people. If antidepressants are no more effective than placebo in the patients that do meet phase III criteria, and we know that antidepressants are less effective for patients who don’t meet phase III criteria (the vast majority of “real world” depression patients), then couldn’t we assume that antidepressants are less effective than placebo for most patients?

Yes, we could.

For more information on this topic, check out this index of my articles (as well as selected off-site resources) on depression and antidepressants.

Drugs comprise the major treatment modality of scientific medicine. A recent article in the New York Times revealed that over half of Americans regularly take prescription drugs for chronic health problems. Sadly, many people don’t realize that the drugs they’re taking could be making their condition worse.

Most drugs don’t cure illness. They just suppress symptoms. Unfortunately, drugs also suppress functions. Though drugs provide symptom relief in the short term, over time they may worsen the underlying condition because they interfere with our body’s self-healing mechanisms. For example, many people take ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) to cope with arthritis and inflammatory conditions. While NSAIDs are effective in reducing pain and inflammation in the short-term, they are also known to reduce blood flow to cartilage. Since blood carries all of the nutrients and immune substance necessary for tissue repair, NSAIDs can actually worsen the original problem when taken chronically.

The second problem is that, by definition, drugs correct a specific imbalance by causing at least one other and often several other imbalances. When a drug is introduced into the body to address a malfunction in one biochemical pathway, that drug inevitably interacts with many other pathways.

The mapping of these pathways in recent genetic research underscores the danger of pharmaceutical drugs. The diagram below shows the interactions among a small set of cellular proteins found in a fruit fly. Proteins encased in ovals are grouped according to specific pathway functions. Connecting lines indicate protein-protein interactions. Protein interconnections among the different pathways reveal how interfering with one protein may produce profound “side effects” upon other related pathways.¹

Complicating the phenomenon of so-called “side effects” is that biological systems are redundant. The same protein molecule may be used in several different systems of the body, but it has a completely different function in each of them.

Histamine is a perfect example of this. Histamine is a chemical that initiates the cell’s stress response. When histamine is present in the bloodstream of the arms and legs, it starts a local inflammatory reaction in those tissues. But if histamine is present in the blood vessels of the brain, it enhances the growth and function of specialized neurons there.

One of the most amazing features of the body’s signaling system is its specificity. When you have a poison oak rash on your arm, histamine is released in that specific area only to activate an inflammatory response to the allergen. Likewise, if you’re under significant stress, histamine is released only in the brain to enhance the function of neurons.

Unfortunately, pharmaceutical drugs have no such specificity. When you take an antihistamine to deal with the itchiness of an allergic rash, the drug is distributed systemically. It affects histamine receptors wherever they are located throughout the whole body. So, while the antihistamine will curb the blood vessels’ inflammatory response and reduce the allergic symptoms of the rash, it will also enter the brain and affect nerve function – which causes drowsiness.

The recent hormone replacement therapy (HRT) debacle is a tragic example of the inherent risks of pharmaceutical drugs.  Estrogen is best known for its function on the female reproductive system.  However, more recent studies have shown that estrogen also plays an important role in the normal function of blood vessels, the heart and the brain.  That ‘s why synthetic estrogen hormones that were prescribed to alleviate menopausal symptoms ended up causing cardiovascular disease and neural dysfunctions such as strokes.

No matter how “targeted” drugs are, they are still relatively crude, blunt instruments when compared to the body’s highly sophisticated immune system. Prescription drugs are are much more like sledgehammers or shotguns than the “magic bullets” they are made out to be.

In the next article, we’ll take a closer look at the consequences of side effects caused by prescription drugs. Until then, I welcome your questions and comments!

The U.S. spent 16 percent of its Gross Domestic Product (GDP) – a cool $2 trillion – on health care in 2005.¹ Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm. However, careful and objective review shows the opposite.

The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators.²

40 million people in this country do not have health insurance. The exorbitant cost of health care seems to be tolerated based on the assumption that better health results from more expensive care, despite studies that as many as 20% to 30% of patients receive contraindicated care.³

Even worse, a recent study by Dr. Barbara Starfield published in 2000 in the prestigious Journal of the American Medical Association demonstrated that iatrogenic incidents (events caused by medical intervention) are the 3rd leading cause of death in this country, causing more than 250,000 deaths per year. Only heart disease and cancer kill more people.

Dr. Starfield estimates that, each year, medical errors and adverse effects of the health care system are responsible for:

• 116 million extra physician visits
• 77 million extra prescriptions
• 17 million emergency department visits
• 8 million hospitalizations
• 3 million long-term admissions
• 199,000 additional deaths
• $77 billion in extra costs

As grim as they are, these statistics are likely to be seriously underestimated as only about 5 to 20% of iatrogenic incidents are even recorded⁴, and outpatient iatrogenic statistics only include drug-related events and not surgical cases, diagnostic errors, or therapeutic mishaps⁵ . Other analyses which have taken these oversights into consideration estimate that medical care is in fact the leading cause of death in the U.S. each year.

Starfield believes that a major contributor to the poor performance of the United States on health indicators is the high degree of income inequality in this country. Countless studies in the medical literature document the adverse effects of low socioeconomic position on health. New research suggests the adverse effects not only of low social position but, especially, low relative social position in industrialized countries.⁶

Perhaps the words “health care” have given us the illusion that medicine is about health. In fact, western medicine is not a purveyor of healthcare but of disease-care. When the number one killer in a society is the health care system, that system has no excuse except to address its own urgent shortcomings. Unfortunately, until this happens partaking in allopathic medicine itself is one of the highest causes of death as well as one of the most expensive ways to die.

I’d like to bring your attention to two recently published studies which highlight the dangers of antidepressant drugs and maintaining low cholesterol levels.

Low Serum Cholesterol May Be Associated With Suicide Attempt History

I’ve written before about the association of low cholesterol with aggressive and violent behavior as well as an increased risk of suicide. A recent study published in the Journal of Clinical Psychiatry adds weight to the already considerable body of evidence suggesting that low cholesterol is dangerous to your health.

In this study ‘low cholesterol’ was defined as less than 160mg/dL (4.16 mmol/L). This level has been noted several times in the medical literature as a level below which suicide is more likely. And you should note that this level is well within what is considered ‘healthy’ by a cholesterol-lowering, drug pushing health industry.

This is consistent with studies showing that low blood cholesterol levels are associated with suicide and that cholesterol levels in certain areas of the brain are lower in those who commit suicide by violent means than in those who commit suicide by non-violent means.

Cholesterol is a health-promoting substance. It is a critical component of cell membranes, the precursor to all steroid hormones, a precursor to vitamin D, and the limiting factor that brain cells need to make connections with one another called synapses, making it essential to learning and memory.

If you understand the vital role cholesterol plays in health – especially in the brain – it’s not difficult to figure out why low cholesterol could increase the risk of suicide and violent behavior.

This is yet another reason to avoid cholesterol-lowering statin drugs. If you haven’t read it already, you might want to check out my post called Cholesterol Doesn’t Cause Heart Disease.

(J Clin Psychiatry October 21, 2008: e1-e8; pii: ej07m03866)

Two Antidepressants Taken During Pregnancy Linked To Heart Anomalies In Babies

In another disturbing study, researchers from Israel, Italy and Germany found that pregnant women taking two popular antidepressants, paroxetine (Paxil) and fluoxetine (Prozac), were three and four times more likely to give birth to children with heart problems.

Researchers have advised women taking the drugs to continue unless they are advised to stop by their doctor or consultant.

I’ve written extensively here about the risks of antidepressant drugs, especially for pregnant women. In my recent post Statins For Pregnant Women and Kids? I presented evidence that statin drugs can cause birth defects and changes in the brain that predispose the child to emotional problems later in life. Here’s a brief excerpt:

If you’re pregnant or considering getting pregnant, please – for the sake of your baby – speak to your psychiatrist or doctor about getting off antidepressant drugs before you conceive.