Re: "Statin safe in kids with high cholesterol"

"Juhana Harju" <shantigiri@xxxxxxxxxxxxx> wrote in part:

>Jim Chinnis wrote:
>:: "Juhana Harju" <shantigiri@xxxxxxxxxxxxx> wrote in part:
>::
>::: Jim Chinnis wrote:
>::::: "Juhana Harju" <shantigiri@xxxxxxxxxxxxx> wrote in part:
>:::::
>:::::: I can see that you are not familiar with the studies about the
>:::::: Portfolio diet. That is natural, nonpharmacological and
>:::::: effective. There is also the sugar cane wax derived supplement
>:::::: Policosanol, which has been shown to be effective in the
>:::::: treatment of familial hypercholesterolemia. Please do some study
>:::::: in Medline if you are not familiar with these results.
>:::::
>::::: You are comparing apples and oranges. While policosanol and the
>::::: "Portfolio Diet" have been [shown] to have desirable effects on
>::::: blood lipids or on CRP or both, neither have ever been shown to
>::::: improve outcomes, while statins and aspirin and hypertensive
>::::: drugs have.
>:::
>::: I find your comment very strange as even doctors state commonly
>::: that it is healthier to reduce cholesterol by diet than by drugs.
>::: By using a very healthy diet you get antioxidant vitamins and
>::: phytochemicals, fiber and healthy fats in addition to the
>::: improvement of risk markers.
>::
>:: There's nothing strange about it. Doctors have said a lot of
>:: things were good for us that have turned out not to be. The level
>:: of evidence for statins is different from that for the "Portfolio
>:: Diet" or for policosanol.
>
>It should be obvious that there can not be any studies about the long term
>effects of the Portfolio diet as the diet has been developed only few years
>ago. I would like to see a study showing that it is healthier to reduce
>cholesterol by statins than by a healthy diet. Any references?

A "healthy" diet is, by definition healthy and would improve
health. People differ on what makes a diet healthy. The research
isn't all that clear, either.

I still think you're talking about apples and oranges, at least a
bit.

Do you mean over a lifetime, starting at birth? In an apparently
normal individual? In a middle-aged man who's had a heart attack?
I suspect the answers will differ.

The study you want to see has been done only in the sense that
various statin studies have used patients undergoing treatment for
secondary prevention. They have sometimes used patient groups that
have received diet education and assistance both for controls and
for statin groups. I doubt that the reverse has been done, where
both groups get a statin and the active treatment group gets a
"healthy" diet of one sort or another. Neither has a head-to-head
been done, as far as I know. The Portfolio diet itself emerged
from a comparison of the diet with lovastatin--a very weak
statin--and measured only lipids and CRP, as I recall.

I looked it up: Three groups were compared over a 90 day period: a
diet very low in saturated fat, based on milled whole-wheat
cereals and low-fat dairy foods (n = 16; control); the same diet
plus lovastatin, 20 mg/d (n = 14); or a diet high in plant sterols
(1.0 g/1000 kcal), soy protein (21.4 g/1000 kcal), viscous fibers
(9.8 g/1000 kcal), and almonds (14 g/1000 kcal) (n = 16; dietary
portfolio). The results showed that the statin group improved (LDL
and CRP) more than did the diet group, but the difference was not
statistically significant. Both diet and statin groups improved
compared to the placebo group.

No meaningful endpoints. 90 days duration. Small n.

I think we know more about the effects of statins than we do about
the effects of diets, where morbidity and mortality endpoints are
concerned.
--
Jim Chinnis Warrenton, Virginia, USA
.

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