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Re: [OM] Cardio Vascular Disease [was: Pungo Creek Butcher]

Subject: Re: [OM] Cardio Vascular Disease [was: Pungo Creek Butcher]
From: Chuck Norcutt <chucknorcutt@xxxxxxxxxxxxxxxx>
Date: Sat, 07 Sep 2013 08:42:11 -0400
What Moose said.  What Brian knows full well but fails to tell us is 
that, of all the physicians he has mentioned as recommending L-arginine 
for the treatment of CVD, only Dr. John P. Cooke 
<http://www.methodisthealth.com/john-p-cooke-md-phd>
has ever conducted ANY peer-reviewed clinical research on the use of 
L-arginine.  In 2002 Dr. Cooke wrote "The Cardiovascular Cure" wherein 
he recommends dietary and exercise regimens and also the use of 
L-arginine as a dietary supplement.

But Dr. Cooke did not stop doing research on L-arginine in 2002.  He and 
others continued research on longer term supplementation and discovered 
that long term supplementation had adverse effects.
For example: <http://jama.jamanetwork.com/article.aspx?articleid=202136>
I pointed this out to Dr. Cooke in a personal email to him and asked if 
he was still recommending the use of L-arginine and got this response.
-----------------------------------------------------------------------
Yes, the book needs to be updated to take into account the new data, one 
of which papers is mine(the one from Stanford published in Circulation 
in 2007, showing no benefit and potential vascular harm from chronic use 
of Arginine in patients with Peripheral arterial disease.
Accordingly I no longer recommend l-Arginine supplementation for heart 
and vessel health.
------------------------------------------------------------------------
Brian would do better to pay less attention to L-arginine peddlers and 
more attention to those who do clinical research such as Dr. Christopher 
Gardner mentioned below.  He's quite believable when he admits that his 
25 years of vegetarianism is contra-indicated by his own recent research.

Chuck Norcutt


On 9/7/2013 2:12 AM, Moose wrote:
> On 9/6/2013 2:10 PM, Brian Swale wrote:
>> Moose wrote about what I wrote
>>> .........
>> Michael C. Johnston seems to have just taken a broad-based look at the
>> range of diet books without going into important science.
>
> Agreed. I only linked to it because it is such a good summary of the range of 
> firmly held, 'correct' ideas about diet.
> In the world of nutrition science, the main difference seems to be that the 
> professionals don't have best selling books.
> I like the video I linked to in part because Christopher Gardner does not 
> take himself too seriously as some sort of
> expert who knows all the answers.
>
>> I watched about 20% of the video
>> http://www.youtube.com/watch?v=eREuZEdMAVo
>> ie, 16 minutes of the total 1 hour 16 minutes, and it seemed that what he is
>> on about is obesity and weight-loss.
>
> Impatience ... It's at minute 23 that he starts showing the effects of the 
> different diets on cardiovascular blood
> chemistry risk factors. From then on, it's a mixture of  stuff about losing 
> weight and the effect of diet on health and
> well being. Only an hour long, before a question period. You forced me to 
> watch it again - but I'm not sorry.
>
> If you watch the whole thing, I expect you will find it hard to support a 
> high carb diet for the majority of people.
> That is what you proposed in your post, and one of the things in it with 
> which I disagree. Gardner is too smart to
> explore the possibility in public, but there is the possibility that high 
> carb diets, as recommended by the
> medical/nutritional establishment, have contributed to the large increase in 
> incidence of diabetes. Can't likely be
> proven, but the differences in response to a high carb diet by people with 
> different insulin responses, near the end of
> the video, is suggestive.
>
>> Those are irrelevant to what interests me, which is the total obliteration of
>> the leading cause of premature death in the Western World; vascular
>> disease, caused by atherosclerosis and arterosclerosis. Currently,
>> somewhere around 35% of premature deaths are cause by heart attacks
>> and strokes, and nearly all are preventable; BUT most of the health advisers
>> seem to think these are not avoidable. Through knowledge of biochemistry
>> relating to artery health, these premature deaths ARE avoidable, and if a
>> person has arterial disease already, this can be reversed.
>
> The problem is that there are many conflicting opinions about how to 
> stop/reverse the course of the disease. Many are
> from important authorities who simply disagree.
>
>> Please look at this 10 minute video; the voice is that of Dr Joe Prendergast.
>>
>> http://www.youtube.com/watch?v=BDqLcblMyIY
>
> Well, that was a fairly slick piece of promotion, almost completely lacking 
> in anything substantive. I am not quite the
> uninformed tyro you might assume. When Dr. Myer Friedman was recruiting 
> subjects for a 10 year study of cardiovascular
> disease, he showed us what was then the most famous slide in cardiology, the 
> first slide showing a ruptured plaque and
> the resulting clot that had killed the patient.
>
> As the video says, up until an assistant of Dr. Friedman's found it, everyone 
> assumed that plaque buildup eventually
> slowed blood flow to dangerous levels. What no one knew until then was the 
> actual cause of the acute infarction. It
> doesn't really go with a very slow restriction, but no one had a cause of the 
> sudden event.
>
> So I've known about one of the great revelations of the video for well over 
> 20 years.  I did qualify for that study,
> which required NO evidence whatsoever of CV disease. I still had no signs at 
> the end of my participation ten years later.
>
> Dr. Friedman had followed up on his famous book, "Type A Behavior and Your 
> Heart" by conducting a series of increasingly
> ambitious studies of the effect of time urgency and unwarranted, chronic 
> anger on the course of CV disease.
>
> His immediate prior, five year, study tracked the lives of two groups of 
> people who had just had a first heart attack.
> It was stopped early, based on ethical grounds. The results were so 
> statistically strong that it was considered
> unethical not to offer the results to the control group, who were dying off 
> much faster.
>
> At that time, his protocol, which is entirely based on behavior modification, 
> was the single, most effective treatment
> for reducing subsequent mortality of survivors of first heart attacks.
>
> The study I was lucky enough to be a treatment subject in was a ten year 
> study of people between the ages of 45 and 65
> at the beginning who had no detectable CVD. It was going well, i.e. my group 
> was having fewer heart attacks and dying
> off more slowly, (we got periodic progress reports) when statins came on the 
> scene.
>
> It wasn't that they were more effective, or even whether they were effective 
> at all. The problem was that the sample
> size wasn't large enough to statistically separate any effect from statins 
> from the effects of the research protocol. So
> the study was never published. Unfortunate, as I believe it would be a major 
> treatment had the study been publishable.
> More info here. <http://www.youtube.com/watch?v=wxMopJ_eb3c>
>
> Research starting in 1840 has shown endlessly that morbidity and mortality 
> are closely linked with social status. The
> facts aren't in doubt. The question was always what the actual physiological 
> causes behind this are. Research carried
> out by Robert Sapolsky on the metabolisms of apes in Africa shows the vast 
> difference between dominant males and
> submissive males, and its health effects/implications. Friedman's research 
> and theory is similar, in that it posits
> metabolic and physiologic effects of long term chronic, as opposed to 
> occasional acute, 'fight or flight' bodily
> chemistry, as caused by certain common behavior patterns
>
> I bring all this up to point out that not all prominent, expert investigators 
> of CVD believe that the chemical magic
> bullet approach is even a useful path. And not all research points that way.
>
> As Chuck has pointed out, using the Nobel Prize for discovering the messenger 
> effect of nitric oxide in such a way as to
> seem as though it is also an endorsement of the L-A treatment is unethical, 
> to my mind. It isn't stated directly, but
> clearly implied, in the video. And didn't Dr. Prendergast later drop that 
> treatment, over concerns about side effects?
> Was this video made before that? If not, it's simply blatant 
> misrepresentation today.
>
> As to the claim of making no referrals to hospitals, I believe that is either 
> another misrepresentation, as presented in
> the video, in neglecting to say it's only no CV related referrals, or a good 
> reason to pull his license to practice
> medicine. My mother had diabetes, and I was her primary support through her 
> final years. Her primary care physician was
> an endocrinologist, very highly regarded, and he sent her to the hospital 
> several times, none CV related. Diabetes,
> especially in the elderly, is a serious disease, with many effects/symptoms, 
> a number of which may require
> hospitalization. People, especially the elderly, not uncommonly require 
> hospital treatment for other causes, as well.
>
> He is either a liar, in the video, or an incompetent physician, if he has 
> treated thousands of patients without a single
> hospital referral in 15 years.
>
> All of that aside, I believe, as someone with more than usual lay knowledge, 
> that the causes of CVD are too varied,
> complex and interactive to be fully understood to date. I also strongly 
> suspect that ingestion of large amounts of a
> single chemical is not likely to be a simple cure for everybody, or even a 
> majority.
>
> There is also the problem of placebo effect and Physician effects. The 
> promise of cure from a treatment and the effect
> of physician personality, especially empathy and compassion and/or an aura of 
> authority, on clinical outcomes is quite
> powerful, and one of the reasons for double blind studies, rather than 
> anecdotal evidence, which is what the video story
> is, at bottom.
>
> Sorry if this rains on your parade, but I believe my knowledge and experience 
> make my opinions in the matter the equal
> of yours. I doubt that Dr Prendergast is a huckster, per se, but it seems to 
> me that the video puts him in that light.
>
> A. Skeptical Moose
>
-- 
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