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from the ask-your-doctor-if-this-medicine-is-right-for-you dept.
Submitted via IRC for Fnord666
The recent news that stents inserted in patients with heart disease to keep arteries open work no better than a placebo ought to be shocking. Each year, hundreds of thousands of American patients receive stents for the relief of chest pain, and the cost of the procedure ranges from $11,000 to $41,000 in US hospitals.
But in fact, American doctors routinely prescribe medical treatments that are not based on sound science.
The stent controversy serves as a reminder that the United States struggles when it comes to winnowing evidence-based treatments from the ineffective chaff. As surgeon and health care researcher Atul Gawande observes, "Millions of people are receiving drugs that aren't helping them, operations that aren't going to make them better, and scans and tests that do nothing beneficial for them, and often cause harm."
Of course, many Americans receive too little medicine, not too much. But the delivery of useless or low-value services should concern anyone who cares about improving the quality, safety and cost-effectiveness of medical care. Estimates vary about what fraction of the treatments provided to patients is supported by adequate evidence, but some reviews place the figure at under half.
Naturally that carries a heavy cost: One study found that overtreatment — one type of wasteful spending — added between $158 billion and $226 billion to US health care spending in 2011.
The stunning news about stents came in a landmark study published in November, in The Lancet. It found that patients who got stents to treat nonemergency chest pain improved no more in their treadmill stress tests (which measure how long exercise can be tolerated)than did patients who received a "sham" procedure that mimicked the real operation but actually involved no insertion of a stent.
There were also no clinically important differences between the two groups in other outcomes, such as chest pain. (Before being randomized to receive the operation or the sham, all patients received six weeks of optimal medical therapy for angina, like beta blockers). Cardiologists are still debating the study's implications, and more research needs to be done, but it appears that patients are benefitting from the placebo effect rather than from the procedure itself.
(Score: 1) by pdfernhout on Saturday January 06 2018, @04:13AM (3 children)
When arteries are clogging in your heart, that generally means they are clogging elsewhere in your body like the brain and kidneys. Stents just temporarily help prop up the weak link of your heart. My father had stents put in and died less than a year later from a heart attack as the rest of his arteries continued to clog. Stents don't fix the underlying issue. If you want to reverse the ongoing arterial clogging throughout your body, look into a whole foods plant-based diet.
One resource for that is the work of Dr. Joel Fuhrman who regularly reverses heart disease in his patients via dietary interventions: https://www.drfuhrman.com/learn/health-concerns/31/cardiovascular-disease-cvd [drfuhrman.com]
"CVD is ultimately caused by oxidative stress and inflammation that leads to damaged arteries. With an intake of low nutrient, pro-inflammatory foods high in saturated and trans fat, as well as refined carbohydrates, cholesterol plaques begin to line the inner endothelial layer of the arteries. Other elements of excessive animal product intake also contribute, such as the iron and carnitine in meat and too much animal protein in general. These growing plaques can block the arteries and even rupture and promote a clot, causing rapid occlusion of the vessels. The same disease-promoting diet most Americans consume results in high blood pressure, high cholesterol, diabetes, insulin resistance, and obesity, all of which further contribute to an inflammatory environment that promotes atherosclerosis. Tobacco use, stress, sedentary lifestyle, poor sleep quality, and certain medications also increase risk of CVD. A Nutritarian diet, exercise, and tobacco cessation can remove plaque and reverse or eliminate the risk of CVD, as it has done in thousands of those following a Nutritarian diet worldwide."
Good luck! There are a lot more resources out there once you start looking.
The biggest challenge of the 21st century: the irony of technologies of abundance used by scarcity-minded people.
(Score: 2) by frojack on Saturday January 06 2018, @05:28AM (2 children)
And there it is. The obligatory Vegan pontification.
No, you are mistaken. I've always had this sig.
(Score: 2) by frojack on Saturday January 06 2018, @05:34AM (1 child)
www.independent.co.uk/news/science/vegetarian-diets-heart-disease-link-higher-risk-health-food-sweet-refined-grains-potato-a7845286.html
No, you are mistaken. I've always had this sig.
(Score: 1) by pdfernhout on Tuesday January 09 2018, @01:38AM
From that link: "When we examined the associations of the three food categories with heart disease risk, we found that healthy plant foods were associated with lower risk, whereas less healthy plant foods and animal foods were associated with higher risk."
Right, so if you eat a whole foods plant-based diet ( e.g. "The Whole Foods Diet: The Lifesaving Plan for Health and Longevity" by John Mackey, Alona Pulde, Matthew Lederman" https://www.goodreads.com/book/show/34837239-the-whole-foods-diet [goodreads.com] ) with even a modicum of sense, you will do better than people who subsist on vegan soda pop and vegan potato chips or alternatively eat a lot of animal products. And, at the edges, if you subsist *entirely* on one especially low-nutrient stable like plain potatoes (unlike sweet potatoes that are more nutrient rich), you probably won't do that well either.
It's a good point to make. And that is a point made by pretty much all of the advocates of a whole-foods plant based diet who all advocate for eating a diversity of whole foods, mostly plants. There indeed are a lot of junk-food-based vegans and vegetarians out there (e.g. eating vegan twinkies and fake processed meats and lots of soda or fruit juice), and their health can be terrible. They are ruining their health.Dr. Fuhrman says he has treated a lot of vegans who damaged their health by eating badly including avoiding B12 supplements or not eating enough foods with omega 3s or otherwise supplementing.
Still, overall, that study supports my point on the benefits of a whole foods plant-based diet being better for you. And just because vegans and vegetarians can screw up, that does not mean eating a lot of animal products (especially processed ones from CAFO lots) is good for you.
And incidentally, on "Vegan pontification", both Fuhrman and the authors of "The Whole Foods Diet" say it is OK to get up to 10% of your calories from animal products. So, they are not pure vegan diets. Even supposedly "vegan" gorillas get 5% or more of their calories from termites and other insects they eat incidentally. Even "vegan" deer eat birds (young nestlings) when they can find them (there is a youtube video on that). One can argue about how essential that small percent of animal products is -- especially if that 10% is fish with healthy fats or similar high quality animal products. It is when you go over that 10% of calories from animal products that they suggest problems tend to start (and 10% is a bit arbitrary -- maybe it is a bit lower for some people, maybe it is a bit higher for others). And if you already have a health condition like heart disease or diabetes, they say even that 10% may be problematical until the health issue is resolved.
Bottom line: If your car engine kept clogging up -- requiring expensive cleanouts -- when buying gas from a certain gas station, you'd likely pick a different gas station next time.
The biggest challenge of the 21st century: the irony of technologies of abundance used by scarcity-minded people.