Be a vegetarian and live longer

I am a vegetarian. I continue as a vegetarian. My father was a vegetarian. That is how I became one. Sufferings of animals at the hands of  butchers  shocked me. During my primary school days, while going to school, I used to see how  animals are getting killed by  butchers in their wayside shops. Throughout the day, the carcasses will remain hung in their shops till the meat is sold in retail to their customers. 

The worst scene was the killings of pigs. Occasionally they escape from the stroke of the pickaxe and run for their life wailing. Such scenes left a lasting impression on me. I believe if  nonvegetarians have to kill  the animals before they collect the meat  they eat they may prefer to be vegetarians. 

The provocation for writing this blog is a news item titled " Analysis of more than 1.5 million people finds meat consumption raises mortality rates" which I received from an international  news service.

The news item referred to a review  of large-scale studies involving more than 1.5 million people that found that all-cause mortality is higher for those who eat meat, particularly red or processed meat, on a daily basis. The Journal of the American Osteopathic Association published the review titled "Is Meat Killing Us?" conducted by physicians from Mayo Clinic in Arizona,

You may, if you desire, access the original paper at:

http://jaoa.org/article.aspx?articleid=2517494

The authors analyzed six studies that evaluated the effects of meat and vegetarian diets on mortality with a goal of giving primary care physicians evidence-based guidance about whether they should discourage patients from eating meat. Their recommendation was clear:  physicians should advise patients to limit animal products when possible and consume more plants than meat.

"This data reinforces what we have known for so long - your diet has great potential to harm or heal," the news story quoted  Brookshield Laurent, DO, assistant professor of family medicine and clinical sciences at New York Institute of Technology College of Osteopathic Medicine.

 "This clinical-based evidence can assist physicians in counseling patients about the important role diet plays, leading to improved preventive care, a key consideration in the osteopathic philosophy of medicine," he added

The findings for U.S. and European populations differed somewhat. Red meat was the focus of attention; the data found the steepest rise in mortality at the smallest increases in intake of total red meat.

The 2014 study  was very extensive. It followed more than one million people over 5.5 to 28 years and considered the association of processed meat (such as bacon, sausage, salami, hot dogs and ham), as well as unprocessed red meat (including uncured, unsalted beef, pork, lamb or game).

A 2014 meta-analysis examined associations with mortality from cardiovascular disease and ischemic heart disease. In that study of more than 1.5 million people, researchers found only processed meat significantly increase the risk for all-cause mortality.

Combined, the findings of these studies are statistically significant in their similarity, the reviewers noted. Further, a 2003 review of more than 500,000 participants found a decreased risk of 25 percent to nearly 50 percent of all-cause mortality for very low meat intake compared with higher meat intake.

They also found a 3.6-year increase in life expectancy for those on a vegetarian diet for more than 17 years, as compared to short-term vegetarians.

One constant worry I have is the quality of life when life is extended. Modern medicine can extend life. What is the advantage if the quality of life is not preserved.?

Also, there is a general feeling that a plant- based diet may not contain some of the essential nutrients. These are all legitimate points.

Japan’s biggest curry chain now offers a true vegetarian curry

Japan’s biggest curry chain now offers a true vegetarian curry

Watch what you eat; there may be bristles in your burger

At times, one gets a feeling that physicians and specialists do not get proper subjects for detailed research. But we must not be extremely critical on such matters as mundane research which just collates and lists observations is very useful; it may contain life-saving messages

Research that examines the incidence of injuries caused by ingesting wire bristles from grill brushes, and prompts physicians and consumers to take notice before the summer grilling season, published in the April 2016 issue of Otolaryngology-Head and Neck Surgery is one such example.

What are the notable findings?

• Wire-bristle grill brushes, used for cleaning grill grates, may lose bristles when used. These bristles can adhere to the grill, become stuck to food, and then accidentally be ingested. A literature and national database review yielded case reports and documented injuries from ingestion, sometimes requiring surgery.
• The public and physicians may not be cognizant of the dangers and the medical implications of wire bristle injuries. Lack of awareness can result in a delayed diagnosis and intervention.
• Data show that the majority of these injuries tend to be located in the head and neck region, with incidents more commonly occurring in the summer months.
• Use of alternative cleaning methods may reduce this problem.

Researchers reviewed the literature and used the Consumer Product Safety Commission's National Electronic Injury Surveillance System and the consumer reported injury database SaferProducts.gov to estimate emergency department visits for wire bristle injuries. They  counted  1698 cases presented to emergency departments between 2002 and 2014  but caution that the estimate doesn't include cases presenting at urgent care facilities or other outpatient settings.

"The issue is likely under-reported and thus underappreciated," said the study's lead author, C.W. David Chang, MD. "Because of the uncommon nature of wire bristle injuries, people may not be as mindful of the dangers and implications. Awareness among emergency department physicians, radiologists, and otolaryngologists is particularly important so that appropriate tests and examinations can be conducted."

The most common location of injury was the oral cavity and the oropharynx which includes the throat and tonsils. In all databases, injuries involving the esophagus and head and neck were more frequent than abdominal injuries.

Take home messages:  

Consumers must exercise caution when cleaning grills with wire-bristle brushes; they must examine brushes prior to each use; they must not hesitate to discard them  if bristles are loose. They must inspect cooking grates prior to cooking, and check into alternative cleaning methods.

Evacetrapib reduces LDL and increases HDL but doesn't reduce cardiovascular events

This news item is based on a presentation being made at the American College of Cardiology's 65th Annual Scientific Session

Cleveland Clinic researchers studying evacetrapib  showed that despite reducing levels of low-density lipoprotein (LDL, or "bad" cholesterol) by 37 percent and raising levels of high-density lipoprotein (HDL, or "good" cholesterol) by 130 percent, the drug failed to reduce rates of major cardiovascular events, including heart attack, stroke, angina or cardiovascular death.

The ACCELERATE trial involved more than 12,000 patients at more than 540 sites who were at high risk for serious cardiovascular problems. They were randomized to receive either 130 milligrams of evacetrapib or a placebo daily, along with standard medical therapy throughout the trial. Study participants either had an acute coronary syndrome 30 days to one year before enrolling, had cerebrovascular atherosclerotic disease, had peripheral vascular disease, or had both diabetes and coronary artery disease.

Those receiving evacetrapib saw their LDL cholesterol levels reduced by 37 percent and their HDL levels increased by 130 percent. Still, the improvements in cholesterol did not result in any reduction in the occurrence of cardiovascular death, heart attack, stroke, coronary artery bypass surgery or hospitalization for chest pain due to unstable angina. Researchers observed a borderline significant reduction in all-cause mortality in the evacetrapib group; however, that was not driven by a decrease in cardiovascular death.

Researchers discontinued the phase 3, multi-center clinical trial  in October 2015, on the recommendation of the independent Data Monitoring Committee after preliminary data suggested the study would not meet its primary endpoint of a reduction in major cardiovascular events.

"Here we have a paradox. The drug more than doubled HDL and lowered LDL levels by as much as many statins, but had no effect on cardiac events," said Steve Nissen, M.D., chairman of Cardiovascular Medicine at Cleveland Clinic. "These findings illustrate the importance of performing large, high-quality outcome trials. Just looking at the effects a therapy has on cholesterol levels doesn't always translate into clinical benefits."

"We were certainly hoping for different results, and are trying to understand why we didn't see a benefit from this drug" said Dr. A. Michael Lincoff, M.D., director of the Cleveland Clinic Coordinating Center for Clinical Research (C5Research) and a Principal Investigator on the study. "The trial raises questions about the benefits of raising HDL and the future of this class of drugs."
Despite widespread use of statins, many patients continue to experience cardiovascular events. Therefore, considerable efforts have been put into investigating whether the protective benefits of HDL cholesterol could be targeted as a form of therapy.

Evacetrapib is in a class of drugs known as cholesteryl ester transfer protein (CETP) inhibitors. They work by disrupting the process which normally transfers cholesterol from HDL cholesterol to LDL cholesterol in the body. Animal and genetic studies have suggested that CETP deficiency is cardioprotective; however, this is the third failure in this class of drugs. Results of a phase 3 clinical trial of the first drug, torcetrapib, showed an increase in adverse outcomes. Trials were stopped for dalcetrapib, a second CETP inhibitor, when it was also found to be ineffective. Evacetrapib was thought to be a promising approach because it is a potent CETP inhibitor and lacks the toxicity of torcetrapib.

Safety concerns were not raised by the trial, and the study didn't reveal any major side effects.

Are there 'simple' methods to prevent heart attacks and stroke worldwide ?

 Are there 'simple' methods to prevent heart attacks and stroke worldwide ? Researchers claim that there are three simple solutions to prevent heart attacks and stroke worldwide; they have been proven effective by an international team led by Hamilton medical researchers.

They are presenting the HOPE-3 trials at the 2016 American College of Cardiology (ACC) Scientific Session and Expo in Chicago this weekend.

Controversies on treatment of blood pressure with anti hypertensive drugs and statins to reduce cholesterol were attracting attention worldwide. The New England Journal of Medicine published three articles highlighting the results of recent trials in this important field.

The research team from the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences studied more than 12,000 patients from 21 countries to evaluate drugs that can prevent cardiovascular diseases (CVD). These diseases lead to 18 million deaths and about 50 million heart attacks and strokes globally every year.

"These are incredibly important findings with potential for significant global impact," said Dr. Salim Yusuf, principal investigator and executive director of PHRI. "If just 10 percent of the world's population at intermediate risk of CVD is impacted, we're talking about 20 to 30 million people who could be helped by these drugs."

The three methods examined included two forms of therapy: Statins, a group of cholesterol-lowering drugs, and antihypertensives, a class of drugs used to treat high blood pressure. In addition, a combination of statins and antihypertensives was reviewed.

 Under the name of HOPE-3, or Heart Outcomes Prevention Evaluation-3, the studies involved 228 centres looking at the effects of the three treatments in people at intermediate risk of, but without, clinical heart disease.

Statins proved to significantly and safely reduce CVD events by 25 per cent in patients at intermediate risk without CVD. Antihypertensives did not reduce major CVD events overall in the population studied, but did reduce such events in the group of people with hypertension, but not in those without hypertension. When combined, statins and antihypertensives reduced CVD events by 30 per cent--with a 40% benefit in those with hypertension, suggesting that patients with hypertension should not only lower their BP but also consider taking a statin.

The HOPE-3 research reports were led by Yusuf and Dr. Eva Lonn, both professors of medicine of McMaster's Michael G. DeGroote School of Medicine, and Jackie Bosch, an associate professor of the university's School of Rehabilitation Science.

"The HOPE-3 trial brings clarity in the management of blood pressure and cholesterol, two of the most common cardiovascular risk factors," said Lonn. "Primary prevention can be greatly simplified and made available to most intermediate-risk people worldwide."

Bosch added: "Treatment with a statin was remarkably safe and beneficial in our study, regardless of cholesterol or blood pressure levels, age, gender or ethnicity. We are incredibly encouraged by the study's results."

HOPE-3's findings will have a major influence on primary care in developed nations, where statins and antihypertensives are inexpensive, Yusuf added. While still relatively inexpensive in developing nations, the drugs are less affordable in relation to income. Still, Yusuf said the study's results hold promise everywhere as the price of these drugs start to come down.

"These simple methods can be used practically everywhere in the world, and the drugs will become even cheaper as more and more systems and people adopt these therapies," he said.

Yusuf, Lonn and Bosch are presenting the HOPE-3 trials at the 2016 American College of Cardiology (ACC) Scientific Session and Expo in Chicago this weekend.

 I have to add the following paragraph extracted from Japan Today dated April 4, 2016 to indicate the conflict of interests of the authors:

"The study used 10 milligrams daily of rosuvastatin, sold as a generic or under the brand name Crestor. The editorial authors said other statins would likely have similar results. Crestor’s maker, AstraZeneca, and the Canadian Institutes of Health Research paid for the study. Yusuf reported receiving grants from both; and several co-researchers reported grants and personal fees from the company and other drug-makers."