A recent paper published in the American Journal of Clinical Nutrition provides updated results from the Women’s Health Initiative (WHI) Dietary Modification Trial (1). One of the questions raised is whether there is still hope for a low-fat dietary approach for the prevention of heart disease. The primary aim of the WHI Dietary Modification Trial was to […]
From Low-Fat, High-Carb to Insulin Resistance, Fatty Liver, and Heart Disease
I recently gave a talk at a meeting with colleagues, most of them cardiologists and endocrinologists, where I, among other things, discussed the current status of diet-heart hypothesis and the possible relationship between our fear of dietary fats and the obesity epidemic. After the meeting, a senior colleague of mine, an old friend, and mentor […]
Who Wants To Live Forever
The famous song, Who Wants to Live Forever, performed by the British rock band, Queen was used for the scenes in the film Highlander, where Connor MacLeod must endure his beloved wife Heather growing old and dying while he, as an immortal, remains forever young. The scenes are both tragic and beautiful at the same […]
18 Important Causes of Shortness of Breath – Dyspnea Explained
Shortness of breath, also known as dyspnea is a symptom that describes a sense of breathing discomfort or difficulty in breathing. It is often expressed as feeling out of breath or suffering from breathlessness. It is estimated that up to 7-8 percent of patients presenting to emergency rooms complain of dyspnea (1). In half of […]
Artificially Sweetened Beverages and the Risk of Stroke and Dementia
I’m often asked which is worse for health, sugar- or artificially sweetened beverages. My most common response is to recommend skipping both and choose water. However, in the era of fructose phobia and the apparent association between high fructose consumption and the risk of metabolic syndrome and diabetes, many tend to prefer artificially sweetened beverages […]
19 Important Causes of Chest Pain
Chest pain is a common symptom associated with a variety of underlying causes. It is estimated that more than six million people visit hospital energy departments in the United States annually because of chest pain. It is the second most frequently reported principal reason for visiting the emergency unit, only abdominal pain is more common (1). […]
Polycystic Ovary Syndrome (PCOS) – From Diagnosis to Symptoms and Treatment
Polycystic ovary syndrome (PCOS) is a common disorder among women. It is characterized by menstrual irregularities, infertility, signs of androgen excess, and polycystic ovaries. It is often associated with obesity, insulin resistance, and lipid abnormalities. PCOS is the most common cause of infertility in women (1). PCOS was first described in 1934 by Irving F. Stein […]
Evolocumab (Repatha) for Heart Disease – The FOURIER Trial – Success or Failure?
The eagerly awaited results of the FOURIER trial were recently presented at the Annual Meeting of the American College of Cardiology (ACC) in Washington DC and simultaneously published in the New England Journal of Medicine (1). The goal of FOURIER was to evaluate the efficacy and safety of evolocumab (Repatha), a PCSK9 inhibitor, among subjects with elevated risk […]
Carbs, Fats and Heart Disease – Time For a Reappraisal Following the PURE Study
Recently many of us were provided an opportunity to watch a highly interesting video on the internet covering a talk given by Dr. Salim Yusuf at a recent Cardiology Update meeting. Dr. Yusuf is the Marion W. Burke Chair in Cardiovascular Disease at McMaster University Medical School in Hamilton, Ontario, Canada and current President of […]
The FOURIER Trial – Are We Entering a New Era in Cardiovascular Medicine?
The results of the recently completed FOURIER trial suggest that we have taken a huge step forward in the pharmacological therapy atherosclerotic cardiovascular disease (ASCVD). On February 2, 2017 the biotechnological company Amgen announced that the FOURIER trial evaluating whether the drug evolocumab (Repatha) reduces the risk of cardiovascular events in patients with clinically evident ASCVD […]
VLDL – The Role of Triglyceride-Rich Lipoproteins and Remnant Cholesterol
Knowing the role of VLDL (very low-density lipoprotein) and chylomicrons is a key factor in understanding how lipids (fats) and lipoproteins are involved in atherosclerotic cardiovascular disease (ASCVD). In the current era of adiposity and metabolic disease, VLDL has gained a bigger role than before and may help explain many of the disorders associated with the obesity epidemic such […]
Niacin (Nicotinic Acid, Vitamin B3) – Who Should Take Niacin?
Niacin (nicotinic acid), also known as vitamin B3, is one of eight known B vitamins. It has been used for decades to lower cholesterol and reduce cardiovascular risk. However, today its use is somewhat debated. Meat and fish are the richest sources of nicotinic acid followed by fortified enriched grain, vegetables, and yeast. Tuna, salmon, chicken, turkey, […]
Why LDL-Cholesterol May Be Overestimated on a Low-Carb, High-Fat (LCHF) Diet
Elevated LDL-cholesterol (LDL-C) is common among people who adopt a low-carb, high-fat (LCHF) lifestyle. That’s why many physicians and nutritionists remain doubtful when it comes to LCHF, despite overwhelming evidence that such a dietary approach improves several other lipid parameters, usually leads to weight loss and positively affects glucose metabolism. Several studies have shown that LDL-C constitutes a major risk factor for the […]
Adiposity, Adipokines, and Adiposopathy – Sick Fat Explained
By now, all of us should know that we are in the throes of an obesity epidemic. Worldwide, over 500 million people are believed to be affected (1). Obesity in children and adolescents is on the rise and so is type 2 diabetes. And, according to the media and the experts, this will have horrible consequences that ultimately will […]
Angina Pectoris – What Is Angina and How Do We Deal With It?
The term angina pectoris or angina is used to describe chest pain or discomfort, often felt like pressure or a squeezing sensation in the chest. The pain may radiate to the shoulders, arms, neck, jaw or the back region between the shoulder blades. Angina is not a disease. It is a symptom, usually caused by inadequate […]
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