On board for this week’s edition of Twitter Thursday is Devon Schuyler of the Los Angeles Times, Dr. Michael Eades from ProteinPower.com and Martha Rose Shulman of the New York Times. At first glance, some of the issues addressed may seem more serious than others. An example is an examination of statin-induced side effects vs. a recipe for a creamy cucumber salad. But if you view food as medicine, then the comparison changes considerably. That’s one of the shifts I’d like to see more in modern medicine. This is my latest contribution toward that end.

A few days ago, a Twitter message courtesy of LATimesHealth laid out a fairly balanced account of what doctors and patients are discovering about statin medications. In short, the side effects reported in a real world setting are often much higher than those documented in previously published studies. For instance, the piece explains that only about 5% of study participants noted muscles aches (myalgia) attributable to statin use. However, in general practice that figure may be as high as 20%. This has potentially far reaching ramifications when you consider that roughly 24,000,000 Americans are currently using this class of cholesterol-lowering drugs. In closing, the article makes a cursory mention of the possible benefits of using Coenzyme Q10 supplements to reduce statin-related adverse reactions.  But, a recent review in the Cleveland Clinic Journal of Medicine was considerably more optimistic about CoQ10’s potential and more in line with my point of view. (1,2,3)

The safety and value of medications that lower cholesterol is a matter for substantial debate. However, if you find yourself in a situation where you need or want to lower your LDL (“bad”) cholesterol but wish to avoid medications, you may want to consider using fiber instead:

• A study published in April 2010 noted a 19.26% decline in total cholesterol and a 25.51% reduction in LDL cholesterol in a group of 29 men and women using a patented fiber complex known as PolyGlycopleX or PGX. The study participants took 5 grams of PGX about 5 – 10 minutes prior to meals for 14 weeks. Other benefits noted were an average 12.79 lbs weight loss, a -12.07% change in waist circumference and -2.43% lower body fat. (4)
• The addition of 20 grams of stabilized rice bran/day resulted in a significant decline in blood sugar, LDL (-13.7%) and total cholesterol (-9.2%) in 28 type 2 diabetics. The study in question lasted a total of 12 weeks and also exhibited a reduction in plasma free fatty acids and an elevation in adiponectin concentrations – both of which are highly desirable for those with combined blood sugar and cardiovascular risk factors. (5)
• Foregoing supplements and focusing on a very high fiber diet also promotes lower lipids. This was most recently illustrated in the March 2010 issue of the American Journal of Clinical Nutrition. An intervention involving 264 children found that those given a higher fiber diet had lower cholesterol. In fact, “serum cholesterol concentrations decreased with increasing fiber intakes”. (6)

I don’t know if Dr. Michael Eades has a nickname or not. If he doesn’t, I’d like to propose this one: The Fructose Sheriff. This is one physician who refuses to let any bad news about fructose go unnoticed and I commend him for it. A current tweet by Dr. Eades highlights a presentation recently given at the The Endocrine Society’s 92nd Annual Meeting. The presentation described a laboratory experiment funded by Diabetes UK in which children’s fat cells were exposed to fructose. They found that this combination “makes more of these (young) cells mature into fat cells in belly fat and less able to respond to insulin in the both fat and fat located below the skin”. This lends more strength to the theory that increased dietary fructose is partially responsible for the modern rise in obesity and overweight. Furthermore, this new data and a recent experiment in rats bolsters my view that so-called healthy sweeteners which contain a large percentage of fructose, such as agave syrup, should be avoided. (7,8,9)

It’s a shame, but I think many people think of cucumbers as insignificant or trivial vegetables. The truth is that they’re not devoid of any substance. Within the green peel lies a considerable quantity of magnesium, potassium and Vitamin K. Cucumbers are also relatively low in carbohydrates and a great way to ensure proper hydration. After all, they are 95% water! (10)

The current recipe posted on the New York Times website features a refreshing concoction for any hot summer’s day. It builds on the goodness of cucumbers by adding healthy sources of fat and protein: small-curd cottage cheese and Greek yogurt. The best part is that the nutritional composition yields an impressive 11 grams of protein and only 4 grams of “net” carbohydrates per bowl. Moreover, each serving registers in at a surprisingly slim 85 calories. This qualifies as a good candidate for virtually any menu plan. That includes carbohydrate restricted diets which have recently been in the news for outperforming low fats diets with respect to two important cardiovascular health markers – blood pressure and HDL (“good”) cholesterol. (11,12,13)

In medicine and in life, there is almost always a story behind the story. In the background of the LA Times statin article, a Dr. Mark A. Hlatky suggests that living a healthy lifestyle will reduce the likelihood of “needing” a cholesterol lowering medication in the first place. But why don’t more doctors make a bigger point of that? I think it’s primarily because they don’t think most of their patients want to hear it or won’t act upon such guidance if given. In some instances, that’s clearly true. However, I still think the information needs to be put forth, front and center. Until that happens, allow me to play the imaginary role of a doctor in this identical circumstance. I’d say something like this: “Most people can dramatically improve their risk factors for heart disease by adopting a healthy diet, exercise routine and stress management techniques. In my opinion, that’s the best way to go because it will almost certainly improve your overall quality of life and well being. To be blunt, that’s what I practice myself and what I suggest to those I care about. If you decide that making such lifestyle changes isn’t for you, I can prescribe any number of medications. But please bear in mind that there is a real possibility of side effects with that approach. Be assured that whatever you ultimately decide, I’ll offer you the best possible care available. I just want you to know where I stand on this issue before you make your decision”.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP