Fried food increases cardiovascular mortality risk – sorry KFC

fried foods

As part of my ongoing series of articles that review interesting new studies, this week, I’m going to look at a new study that shows that fried food may be linked to increased risks of death from cardiovascular disease.

Now, some of you may be scratching your head and saying, “I’m sorry ye old feathered dinosaur, but tell me something I don’t know.” That’s the thing about science, we may think we know that eating a bucket of fried chicken or fish and chips is “bad” for you, but we can’t be sure until we have published studies that give us statistically powerful results.

Despite the beliefs by nearly everyone, including physicians, that fried food is directly linked to cardiovascular disease, studies have been inconclusive in establishing that link. A recent large prospective cohort study in Europe showed no link between fried food and coronary heart disease. The link between fried food and anything is hardly settled science, despite the conventional wisdom.

And since nearly 25-36% of Americans consume fast food, which presumably includes a lot of fried food, researchers wanted to reduce as many confounders as possible by narrowing the study group to women of a certain age.

And that’s what we have from a new study published in January 2019. Let’s take a look at the study and discuss what it may mean. Continue reading “Fried food increases cardiovascular mortality risk – sorry KFC”

Salt and cardiovascular health – not as evil as we once thought

salt

If you are worried about your cardiovascular health, one of the things you want to avoid is salt. This was based on ancient research that seems to show even moderate salt intake could do all kinds of bad things for your cardiovascular system.

I was always skeptical of these claims because if you’ve got a healthy set of kidneys, the body has an amazing ability to regulate salt levels in the body. Of course, maybe there is some level of salt consumption that increases the blood pressure, cause retention of water, and other issues that lead to cardiovascular issues.

Recently, a very large prospective epidemiological study examined levels of salt consumption versus cardiovascular events. What did they find? Only high levels of salt consumption are linked to cardiovascular health. Continue reading “Salt and cardiovascular health – not as evil as we once thought”

Supplements for cardiovascular diseases – more evidence that they don’t work

supplements for cardiovascular diseases

I have been skeptical of supplements for a long time – not because I have some predisposition against them. My skepticism results from the relative lack of any robust evidence that supplements have any positive effect on human health other than in unique situations of chronic diseases or malnutrition. In fact, most of the high-quality evidence about supplements show that it does not work. And a recently published review shows that using supplements for cardiovascular diseases are expensive and useless.

Since many readers fail to read what I wrote above, let me repeat myself for clarity. Supplements are not completely useless – of course, they are important for those who have chronic diseases or conditions may require supplements of some or many micronutrients. Someone who has had bariatric surgery or other types of serious gastrointestinal surgery may not be able to consume enough vitamins and minerals from food, and they will require multivitamins.

Also, some individuals may be malnourished, which doesn’t mean just not eating enough, but not eating some foods that have specific nutrients. For example, avoiding certain foods that contain vitamin C could put you at risk for a disease called scurvy, which can be deadly. There are several other diseases that result from missing key nutrients. However, in the modern developed world, these diseases are extremely rare because of the varied diet we have – and the availability of supplements to treat those diseases.

However, several points have got to be made. Just because vitamin C can treat scurvy doesn’t mean that more vitamin C makes your immune system suddenly powerful enough to destroy the common cold or flu or cure cancer. Vitamin D, although there are many cases of deficiency in many countries, is not a miracle supplement. It cannot cure or prevent cancer. It does not impart superpower abilities to your immune system.

The whole supplement industry has an overreliance on logical fallacies (like appeal to popular belief or appeal antiquity) or anecdotes (which aren’t data) to convince customers to buy their nonsense. They do this because they are not required to undergo gold-standard clinical trials to convince the FDA to approve their claims. Real pharmaceuticals, on the other hand, take 10-20 years of research and clinical trials before they are approved for use.

Big Supplement (yeah, it’s a huge industry, over US$100 billion annually, worldwide) also pushes the trope that if a little helps, a lot is better. This is not good science. The millions of years of human evolution (following up a billion years of immune system evolution) has led to a rather powerful immune system that is exceedingly complex and has always been able to do its job without the addition of supplements (unless early Homo sapiens had access to a GNC someplace).

But let’s take a look at supplements for cardiovascular diseases (stroke, heart attacks, and other cardiovascular conditions) – a new review shows us, once again, that there’s nothing there. Continue reading “Supplements for cardiovascular diseases – more evidence that they don’t work”

Omega-3 supplements have little effect on cardiovascular disease and mortality

omega-3 supplements

I have been skeptical of supplements for a long period of time. Supplements are generally of low quality, they don’t prevent or cure cancer, they don’t prevent colds, they can’t boost the immune system, and they don’t prevent heart disease. Now there is a powerful review of omega-3 supplements that shows that it has little effect on cardiovascular disease.

Unless one has a chronic disease or is chronically malnourished, there are precious few instances where supplements are necessary. A couple of cases where supplements may be critical include prenatal folic acid supplements to prevent neurological defects in the developing fetus, vitamin C to prevent scurvy, and vitamin D supplements for individuals who do not produce enough endogenous vitamin D. In each of these cases, however, supplements are necessary to counteract a micronutrient deficiency that results from a chronic deficiency in the diet.

The benefits of omega-3 supplements have always been intriguing to me because it is a supplement that I thought might be useful for improving cardiovascular health. But as I reviewed before, the evidence seemed awfully weak. With this new study, there may be no evidence whatsoever supporting the use of omega-3 supplements, at least for cardiovascular disease. Continue reading “Omega-3 supplements have little effect on cardiovascular disease and mortality”

Mediterranean diet and cardiovascular diseases study retracted – “aw nuts”

mediterranean diet

Although I think that most diets are bogus and healthy outcomes are not very well supported by scientific research, I have been a proponent of the so-called Mediterranean diet. It seems to have been linked to lower risks of cancer, cardiovascular disease, and some other chronic health conditions.

The claims of researchers who stated that the so-called Mediterranean diet, rich in plants, olive oil, fish, nuts, and other foods, was linked to lower risks of cardiovascular disease. It was a pivotal and robust cohort study, a powerful form of epidemiological study that sits near the top of the hierarchy of medical research, that influenced a lot of recommendations about the proper diet for people. The study was so powerful that I switched to that diet personally.

But lucky for the planet, science is self-correcting, and some aspects of the original study caused concerns, and the Mediterranean diet study was retracted and republished with corrections.

Does this mean that the Mediterranean diet was and is bogus? No, but let’s take a look at the whole story. Continue reading “Mediterranean diet and cardiovascular diseases study retracted – “aw nuts””

Dietary supplements make costly urine – not helpful for CVD

dietary supplements

I have never been a fan of dietary supplements pushed by Big Supplement, the less regulated, less evidence-based, more pseudoscientific mirror image of Big Pharma. Recently, a meta-review published in a respected journal examined whether there were any causal links between various dietary supplements and cardiovascular disease (CVD). They only found one, folic acid, that might have an effect on CVD, but, in that case, causality might not be so clear.

Just to be perfectly clear, no one on the side of real science-based medicine would dismiss using dietary supplements to treat chronic medical conditions. Many people have had surgeries, illnesses, and other medical conditions where certain supplements are necessary for the patient to survive. But these are highly specific requirements, not general quack claims that taking supplements will somehow miraculously treat colds and flues, prevent cancer, or some other nonsense.

Essentially, if you’re taking dietary supplements for no medical reason other than you believe it makes you healthier, let’s stick to facts – all that you are doing is having your kidneys create some very costly urine. Human physiology, based on a couple of billion years of evolution, automatically regulates its needs for micronutrients – excess amounts do not stick around to make you healthier, it just becomes a component of your pee.

It’s time to take a look at this article about dietary supplements and cardiovascular disease. Maybe I’ll convince you to save some money each month, and spend it on something like investing in a better diet. Continue reading “Dietary supplements make costly urine – not helpful for CVD”

Statins prevent cardiovascular deaths – a new systematic review

statins prevent cardiovascular death

Now for something completely different, let’s not talk about vaccines – we’re going to discuss statins! There have been more and more robust studies that statins prevent cardiovascular events, including death. Nevertheless, statins have been controversial, and are used by the alternative medicine (not medicine) lovers as an example of all kinds of medical malfeasance.

As I’ve mentioned before, I hang out on Quora answering questions about a lot of topics, mostly vaccines and cancer. But I also occasionally answer questions about statins, and I regularly state that statins prevent cardiovascular events. And just as regularly, I’ll get nasty comments (see Note 1) claiming everything from my being a Big Pharma shill to I don’t know anything about anything.

So let’s take a look at this new systematic review, and try to put to rest the nonsensical dismissal of the claim that statins prevent cardiovascular events, including death. Continue reading “Statins prevent cardiovascular deaths – a new systematic review”

Coffee health effects – what does the best science say

coffee health effects

Coffee is one of the most consumed beverages worldwide, with tea being number one. And as I have mentioned previously, I am an unrepentant coffee lover. Over the years, there have been a number of claims about coffee health effects, both positive and negative, many without any solid scientific evidence in support.

Claims about coffee health effects goes back centuries. These claims were often confusing and contradictory. How many “studies” have we read about that said drinking it was good for your heart. Or bad for your heart. Or it prevented cancer. Or it increased your risk of cancer.

Part of the confusion is that the popular press, with its strange dependence on false equivalence, often presents two contradictory scientific studies as equivalent, even if they aren’t. Well, we’re going to look at a powerful new study that examined health outcomes that can be related to coffee. Let’s see what they say. Continue reading “Coffee health effects – what does the best science say”

Measles infections prevent heart disease – an anti-vaccine trope

measles infections prevent heart disease

Here we go again, another anti-vaccine trope based on one paper without adequate scientific criticism of said paper. What is this trope? Mumps and measles infections prevent heart disease and stroke. Let me jump right to the conclusion – wrong.

Although I’ve seen this story before, like most zombie tropes in the anti-vaccine world, this one has come back from the dead. In the pseudoscientific website, Health Impact Newsthe author writes:

By my calculations, natural infection with the measles and mumps will prevent millions of heart attacks and strokes. Why is this information not all over the TV and internet? I will tell you why. Because mainstream media is in bed with Big Pharma who pay their bills. The politicians are slaves to their corporate masters. Our children should be exposed to every virus and bacteria for which a vaccine exists.

The author’s shrill claim is based on a 2015 article published in the lower impact factor journalAtherosclerosis. The authors concluded that “measles and mumps, especially in case of both infections, were associated with lower risks of mortality from atherosclerotic CVD (cardiovascular disease).”

Now, it’s time to turn a critical and skeptical eye towards that article.

 

Mumps and measles infections prevent heart disease – the paper

The study evaluated lifestyle questionnaires from 43,689 men and 60,147 women who were aged 40-79 years at the baseline period of 1988-1990. Individuals of that age probably were not vaccinated against measles or mumps, since that vaccine wasn’t available for children until the late 1960s, when the individuals in the study would have been 20-50 years old. The questionnaire included history of measles and mumps, and were followed until 2009.

The authors then determined hazard ratios (HR, see Note 1) for mortality from cardiovascular disease (CVD) between groups with history of measles and/or mumps infection versus those who did not have those infections. Here are some of the results of the analysis:

  • Men with history of measles had an HR for all CVD deaths of 0.92.
  • Men with history of both measles and mumps had an HR for CVD deaths of 0.80.
  • Women with both infections had an HR for all CVD deaths of 0.85.

The researchers also looked at comparisons between infected and non-infected groups for various types of CVD, but these data probably are the most important.

The study also attempted to show that there was no difference in infected and non-infected groups for a series of confounding variables. They include:

  • Age
  • Body mass index
  • Hypertension
  • Diabetes
  • Previous history of CVD
  • Smoker
  • Exercise level
  • Education
  • Stress level

Taken at face value, the research does seem to support the contention that we shouldn’t get the MMR vaccine to protect ourselves against measles and mumps, because catching those diseases may protect us against cardiovascular disease when we get older. But really, does it really gives us evidence to quit vaccinating? Let’s take look.

 

The critique

  1. This is a one-off primary study that has not been confirmed by any other researchers. This places it at the lower end of the hierarchy of scientific research.
  2. The authors did not propose a biologically plausible explanation. If one is to propose a correlation between two events, especially when the temporal difference is over 50-70 years, one must also propose a plausible reason why you might assume there is correlation. Is there a plausible reason for anyone to believe that a mumps or measles infection will protect someone from cardiovascular disease? I have a scientific bias towards plausibility, otherwise we can propose inane scientific hypotheses that waste the time of everyone involved.
  3. There is simply little evidence that measles or mumps is correlated with CVD –  a review of PubMed for any articles that might establish a relationship between mumps and/or measles with CVD provided me with two articles. The first is the one we are discussing herein. The second, also published in Atherosclerosis, seems to indicate that mumps and measles is related to higher rates of CVD. This is why cherry picking is bad – you seek out articles that support your pre-conceived conclusion rather than let all of the evidence lead you to a conclusion.
  4. The use of questionnaires for epidemiological studies is frowned upon by many researchers. The reasons for this are many, but they include a reliance upon the memory of the participant for events that may be 50 or 60 years in the past. For a highly infectious disease like measles, it’s hard to believe that 50% of the participants in this survey caught neither mumps or measles as a child. It’s more likely that they actually had caught the disease but forgotten about it. A properly designed study would have measured measles and mumps antibodies then determined the HR. Or used actual medical records (like a lot of vaccine studies use for case control studies of vaccine effectiveness and safety).
  5. The hazard ratios were tiny. Yes, it appears that mumps and measles infections prevent heart disease – the data seem to show a 8-20% reduction in CVD risk. But is that clinically significant? If being vaccinated against measles and mumps showed a 200-300% increase in the risk of CVD, I would be impressed and troubled by the results. But such a tiny reduction in the risk could be explained by anything. A missing confounder. Other infectious diseases. Nutritional levels. In fact, I can go on and on. Furthermore, is an 8% reduction in risk of CVD, if it is valid, worth the risk of death or disabling conditions from contracting measles or mumps? Although the question is rhetorical, it’s actually necessary to come to a conclusion based on the results provided.
  6. Speaking of vaccines, why wasn’t vaccine status asked (although the same memory issues that would plague this questionnaire would still bother me here)? Even though most of the participants probably would have missed the vaccine, some may have gotten it.
  7. The results also showed a 5-20% increase in risk of CVD for women who had either mumps or measles. That result alone throws into question the whole study, because the results are all over the place.

Can one use this article to claim that mumps and measles infections prevent heart disease and stroke? Not really. The best I can say, and I’m doing this with a lot of trepidation, is that this study provides us with observational data, not a confirmation or refutation of a hypothesis about mumps and measles infections. It certainly does not give us any reason whatsoever to change public health priorities in vaccinating against mumps and measles despite the anti-vaccine tropes.

 

Notes

  1. A hazard ratio describes a ratio of hazard rates between two events. In the case of this study, if the rate of cardiovascular disease mortality for the mumps infected group is 1.0 and it’s 2.0 for the non-infected group, then the hazard ratio is 0.5. That is the mumps infected group is only 50% as likely to have died of cardiovascular disease as the non-infected group.

 

Citations:

Poll: what’s scarier than Ebola

ebola-virus-disease

There are actually more worrisome public health issues than Ebola.

What worries you?