For the last few days, my Kindle has been my closest companion. “What are you reading”? my wife asked. “I’m reading Lore of Nutrition.” “Ooh, I was sure it was a thriller or one of your crime stories.” In fact, she was right. Although Lore of Nutrition is a book about nutrition, it reads like […]
19 Important Causes of Fatigue – Tiredness and Chronic Fatigue Explained
“Fatigue is here, in my body, in my legs and eyes. That is what gets you in the end. Faith is only a word, embroidered.” ― Margaret Atwood, The Handmaid’s Tale. Fatigue or tiredness is a common medical complaint that may seriously affect people’s quality of life. However, despite many possible underlying causes, a specific medical disorder is […]
The Fate of the PURE Study – Fat and Carbohydrate Intake Revisited
Most experts agree that diet is an important modifiable risk factor for cardiovascular disease and many other chronic noncommunicable disorders. Hence, defining and implementing a healthy diet is a matter of great public health interest. However, although there is substantial agreement on many issues, such as the importance of fruits and vegetables, several matters are still […]
The CANTOS Trial – Is Targeting Inflammation the Solution to Heart Disease?
The recently published results of the long awaited CANTOS trial may forever change our approach to the prevention and treatment of coronary artery disease (1). Inescapably, there is now proof that targeting inflammation, in this case by a drug, significantly improves outcome for certain very high-risk patients. But, as so often in clinical research, things […]
Can Low-Fat Be Salvaged? – Updated WHI Dietary Modification Trial Results
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 a […]
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 […]
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 Symptoms to Diagnosis 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 […]
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, […]
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 […]
Using Coronary Calcium Score to Target Statin Treatment in Primary Prevention – The Biolmage Study
Cholesterol-lowering medications are being prescribed to almost 30% of US adults aged 40 and over, most of these are statins drugs (1). The number increases with age, and approximately 48% of adults older than 75 are receiving such treatment. It has been suggested that treating more older individuals with statins may prevent a substantial number of cardiovascular events, and that, […]
GLAGOV – The Lipid Hypothesis Gains Ground
The results from the recent GLAGOV trial suggest that aggressive lowering of LDL-cholesterol with a PCSK9-inhibitor on top of statin therapy in patients with coronary artery disease may reduce atherosclerotic plaque burden. Although these results provide support for the lipid hypothesis and may have significant implications for the future of cardiovascular medicine, our eyes are still on safety and […]