Comment: This is an important, large-scale population study, even with the weaknesses of the study design. An adjusted odds ratio of 1.50 for any cancer is a significant signal that cannot be easily dismissed, particularly given the strong associations noted for brain (AOR 1.90) and breast (AOR 1.24) cancers. While the authors rightly point out […]
Comment: I am in general not a fan of intermittent fasting as my experience is it puts the body in a state of stress, which may give short term gains, but longer term negative outcomes. This is a study showing that skipping breakfast increases metabolic syndrome, including blood sugar, blood pressure, blood lipids and central […]
Meta-analyses showed reductions in the absolute risk of 0.8% (95% CI, 0.4%-1.2%) for all-cause mortality, 1.3% (95% CI, 0.9%-1.7%) for myocardial infarction, and 0.4% (95% CI, 0.2%-0.6%) for stroke in those randomized to treatment with statins,
Comment: The traditional cardiological focus on lowering LDL-C in the elderly rests on a foundation of biochemical plausibility that is increasingly dismantled by actual survival data. This systematic review identified a critical physiological disconnect: for those over age 60, high LDL-C is not a mortality stressor but is actually associated with a longer lifespan. In […]
Comment: Another in a line of studies showing that our concept of cholesterol is wrong when it comes to the outcomes that matter. This one is particularly interesting as it breaks it down by age, showing that as we get older, higher cholesterol becomes more protective. The Wonk Debate – Audio Critique & Clinical Commentary: […]
Comment: Another in a series of studies that contradicts the dogma that lower cholesterol is better. Although the authors calculated cut off points, using the spline graphs you can see that cholesterol up to about the 230 range is lowest risk of overall deaths and even 300 is better than 160. For cancer you’re safer […]
Comment: This analysis of 17 prospective cohorts demonstrates that higher circulating levels of DHA and DPA are associated with a significant reduction in incident atrial fibrillation, effectively rebutting the idea that Omega-3s are universally pro-arrhythmic. The tangible significance of this data is that it provides a clear signal that dietary fish consumption and physiological levels […]
Comment: This review presents a biologically plausible mechanism for why we see such divergent outcomes between dietary omega-3 intake and high-dose pharmacological interventions. While low-to-moderate physiological levels can be antiarrhythmic, the massive dosing used in synthetic pharmaceutical trials may cross a threshold into proarrhythmic territory. The actual clinical utility of this data is the recognition […]
Comment: Although this doesn’t negate the potential of increased risk of atrial fibrillation seen in other studies, a lower rate of death seems more important. Summary: Clinical Bottom Line This large cohort study shows a modest association between habitual fish oil use and a lower risk of all-cause mortality. However, it is not possible to […]
Comment: This article made a big splash in the media and led to a lot of questions from patients about the safety of taking fish oil supplements. Understanding that this is an observational study, it does show an increase in atrial fibrillation in people who consume fish oil supplements. What’s intriguing, and makes me more […]
