For Cascade Discovery April 2002

Health & Medicine Journal

By Paul Van Camp MD

Welcome to the first edition of Cascade Discovery. For some time I have edited medical news and recent research selected to be of interest to consumers, professionals and business persons for the Cascade Business News. I am pleased to offer more reports in Cascade Discovery. While this publication is created for "seniors", I will use this term to mean everyone over 50. In Central Oregon that means people living life to the fullest: a healthy lifestyle, active in outdoor sports and recreation, business, travel, family, church, etc. My main medical specialty is laser skin surgery, yet I have a broad medical background and these reports are selected from a review of over 50 journals. If you would like to submit questions or topics for future articles, this would be most welcome. My address and web site are provided at the end. This issue focuses on preventing heart disease, the number one health risk for all adults (men and women) over 50 in America.

Eat Fish and Fish Oils for a Healthy Heart.

Certain special fats found in abundance in cold water fish such as salmon, halibut, herring, and mackerel have been shown to reduce the risks of heart disease. These fatty acids are known as omega-3 fatty acids and include: EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid), and ALA (alpha linoleic acid). An article in Archives of Internal Medicine reviewed the studies showing their benefits. This was seen in the U.S. physicians who ate fish the most had the lowest risk of heart disease. This benefit was seen again in the Nurses Health Study, and other studies of Eskimos and Greenlanders who eat a lot of fish. Recovering heart attack patients who took fish oil capsules or ate fish regularly had lower death rates than those who did not. The benefits are obtained by eating fish once or twice per week, or by taking fish oil capsules containing 1000 mg. EPA plus DHA daily. Added benefits of fish oils may include a reduction in the risk of prostate cancer and decreased rates of depression. Salmon anyone?

And more on the Amazing Statins.

The statins are the most effective and most commonly prescribed medicines for reducing unhealthy cholesterol levels. (They include Lescol, Lipitor, Zocor, Mevacor and Pravachol.) These are so effective for reducing the LDL or "bad" cholesterol and reducing heart attack risks that the guidelines for prescribing them have recently been expanded to include more people at intermediate risk. The criteria from the National Cholesterol Education Program include other risk factors as well as cholesterol levels. So, be sure to have a blood lipid profile done for your next health evaluation and discuss it with your physician. The benefits may be too good to miss. What is more: a recent study showed that the benefits may extend beyond their cholesterol lowering effect. A protein associated with arterial inflammation (CRP or C-Reactive Protein) was reduced and heart attack risk was reduced even in those with below-average LDL cholesterol levels.

Testing an Alternative Treatment: Chelation Therapy.

Having studied acupuncture and herbal medicine before attending medical school, I am open-minded towards effective non-conventional methods of treatment. Yet, we must insist upon careful research to prove both the safety and effectiveness of any treatment. Chelation therapy is a treatment advocated by some practitioners for several conditions including coronary artery disease. It is theorized to work by removing calcium from the arteries and excess iron from the body. This study, published in the Journal of the American Medical Association, is the best and fairest test yet of this method. 80 patients in Canada who had proven coronary artery disease received either chelation treatments (with EDTA) or placebo (false treatments) twice weekly for 15 weeks then monthly for 3 months. Both groups continued their regular medicines such as aspirin, statins, and blood pressure medicines. There was no difference seen between the groups for heart pain, exercise tolerance, heart attacks, deaths or any other measure. In this well designed study, there was unfortunately no benefit seen from chelation therapy. Therefore, it cannot be recommended for coronary disease.

Moderate drinking has benefits: Should non-drinkers start?

Numerous studies have shown that regular moderate drinking (one to two drinks per day for men, one for women) protects against heart disease and stroke risks. But an important question remains: Should middle aged non-drinkers start drinking? A study published in the January 2002 journal Heart looked into this. 7200 British men in their 40s and 50s were followed for 5 years. Occasional drinkers (less than 2 drinks per month) were compared to regular moderate drinkers who had less heart attacks, but slightly more accidental deaths. However, for those who started moderate drinking during the study, there was no lower heart attack death risk. The only group that benefited from starting moderate drinking were those that had proven heart disease. Generally, patients should not start drinking to protect themselves from heart disease.

Resistant Training in Older Adults.

The health benefits of moderate intensity aerobic exercise (such as walking and cycling) are well established. But what about lifting weights and other forms of "resistance training"? The American College of Sports Medicine recently published recommendations for adults 65 and over. The benefits of adding resistance training include preserving or increasing muscle mass, strength, endurance and increased bone density. They suggest that older adults should train two to four days per week for 20 to 45 minutes per session. Each exercise should involve more than one joint movement and weight machines are recommended over free weights. The program should include the chest, shoulders, arms, back, abdomen and legs. Use one to two exercises per group and exercise large muscles before smaller muscles. Two sets of 10 to 15 repetitions is suggested for each exercise with 2 to 3 minutes of rest between sets. Intensity need not be more than 65 to 75% of your maximal effort. Your physician should give clearance before starting a new resistance program. A personal trainer will get you off to a good start and prevent injuries due to incorrect technique. Resistance training for strength: use it or lose it.

Margarine’s Dangerous Fatty Acids.

Margarines, especially the hard margarines sold like butter cubes, contain modified vegetable fats containing 50% "trans fatty acids". While these do not contain any cholesterol, they may be far more unhealthy than butter or the soft spreadable margarines. A study published in Lancet followed men in a Dutch town and determined the effects of trans fatty acids from margarines on their heart disease risk. They determined that just a 2 percent increase in trans fatty acid intake (as a percent of their diet) caused a 30% increase in the risk of heart disease. Over time these men saw a 24% drop in heart disease from just a 2.4% decrease in trans fatty acids. Stick with the soft spread-able margarines or butter, and those in moderation.

The above summaries are presented for education purposes and not to recommend treatment for any individual or condition. Dr. Paul Van Camp is a physician and medical director of Aesthetics MD. 115 SW Allen Road Bend 97702. Further information is available at www.aesthetics-md.com References to original publication of the studies discussed is available upon request.