The raison d'etre of this website is to provide you with hard scientific information which may help you make informed decisions in your quest for health (so far I have blogged concise summaries of over 1,500 scientific studies and have had three books published).

My research is mainly focused on the effects of cholesterol, saturated fat and statin drugs on health. If you know anyone who is worried about their cholesterol levels and heart disease, or has been told to take statin drugs you could send them a link to this website, and to my statin or cholesterol or heart disease books.

David Evans

Independent Health Researcher

Thursday, 28 February 2013

Statins may cause nightmares

This paper was published in the British Medical Journal 2006 Apr 22;332(7547):950
 
Study title and author:
Atorvastatin may cause nightmares.
Gregoor PJ.
Department of Internal Medicine, Albert Schweitzer Hospital, PO Box 444, 3300 AK Dordrecht, Netherlands. p.smakgregoor@asz.nl

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16627511

This case report relates atorvastatin to the occurrence of nightmares.

(i) A 72 year old woman was prescribed 10 mg atorvastatin once a day.
(ii) Five days after starting atorvastatin, she had extreme nightmares each night for two and a half weeks.
(iii) She stopped taking the statins for five days and no nightmares occurred.
(iv) She restarted the atorvastatin again, which promptly resulted in nightmares; these dreams again disappeared after discontinuation.

The author of this paper, Dr Peter Gregoor an internist-nephrologist at the Albert Schweitzer Hospital in Holland, speculates that the nightmares could be a direct effect of atorvastatin on the central nervous system.

Wednesday, 27 February 2013

Beef fat increases the absorption of beta-carotene compared to sunflower oil

This study was published in the American Journal of Clinical Nutrition 2000 May;71(5):1170-80

Study title and authors:
Intestinal absorption of beta-carotene ingested with a meal rich in sunflower oil or beef tallow: postprandial appearance in triacylglycerol-rich lipoproteins in women.
Hu X, Jandacek RJ, White WS.
Department of Food Science and Human Nutrition and the Center for Designing Foods to Improve Nutrition, Iowa State University, Ames 50011-1120, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/10799380

The objective of the study was to investigate the influence of sunflower oil and beef tallow (dripping) on (i) intestinal beta-carotene absorption and (ii) triglycerides content in lipoproteins (chylomicrons and very low density lipoprotein (VLDL) cholesterol. The study included 11 women who each ingested two different vitamin A-free, fat-rich meals that were supplemented with beta-carotene (47 micromol) and contained equivalent amounts (60 g) of sunflower oil or beef tallow.

The study found:
(a) The appearance of beta-carotene in chylomicrons and in VLDL cholesterol was lower after ingestion with the meal containing sunflower oil than after ingestion with the meal containing beef tallow.
(b) The appearance of triglycerides in chylomicrons and in VLDL cholesterol was higher after ingestion with the meal containing sunflower oil than after ingestion with the meal containing beef tallow. (High levels of triglycerides are associated with heart disease, see here).

The study reveals that beta-carotene absoption is higher in meals rich in beef tallow as compared with a meal rich in sunflower oil. 

Tuesday, 26 February 2013

Statins are associated with erectile dysfunction

This study was published in the International Journal of Clinical Practice 2006 Feb;60(2):141-5
 
Study title and authors:
Erectile dysfunction and statin treatment in high cardiovascular risk patients.
Solomon H, Samarasinghe YP, Feher MD, Man J, Rivas-Toro H, Lumb PJ, Wierzbicki AS, Jackson G.
Department of Cardiology, Cardiothoracic Centre, St. Thomas' Hospital, Lambeth Palace Road, London, UK.
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16451283

This study investigated the relationship between statins and erectile dysfunction.  In this study, International Index of Erectile Function (a measure of erectile functioning, where higher scores indicate better functioning) scores were measured in 93 men attending cardiovascular risk clinics.

The study found:
(a) Prior to statin therapy, the average International Index of Erectile Function score was 21.
(b) After statin therapy, International Index of Erectile Function scores were reduced to 6.5.
(c) After statin therapy 22% of the men experienced new onset erectile dysfunction.

This study reveals that statins are associated with erectile dysfunction.



Monday, 25 February 2013

An association exists between low cholesterol, suicide, and depression

This study was published in the Journal of Clinical Psychiatry 1994 Jun;55(6):252-4
 
Study title and authors:
Serum cholesterol levels and suicidal tendencies in psychiatric inpatients.
Modai I, Valevski A, Dror S, Weizman A.
Gehah Psychiatric Hospital, Petah-Tiqva, Israel.
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8071280

The aim of this study was to investigate the relationship between cholesterol levels and suicide in psychiatric inpatients. The study include 584 psychiatric inpatients who were divided into three groups:
(i) Patients who had attempted suicide at least once.
(ii) Patients who expressed a suicidal wish or plan during hospitalization or the month before hospitalization.
(iii) Patients who had neither made suicidal gestures nor expressed suicidal thoughts.

The study found:
(a) Patients who had attempted suicide had significantly lower cholesterol levels than nonsuicidal patients.
(b) Patients who were depressed had significantly lower cholesterol levels than patients who were not depressed.

The findings of the study may imply that an association exists between low cholesterol, suicide, and depression.

Sunday, 24 February 2013

Statins induce a decline in cognition

This paper was published in the Annals of Pharmacotherapy 2006 Oct;40(10):1880-3

Study title and authors:
Simvastatin-induced decline in cognition.
Padala KP, Padala PR, Potter JF.
Geriatrics Section, Department of Internal Medicine, 981320 Nebraska Medical Center, Omaha, NE 68198-1320, USA. kpadala@unmc.edu

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16940411

This paper describes a case of new-onset cognitive difficulties in an older patient after initiation of simvastatin therapy.

(i) A 64-year-old man developed cognitive difficulties (short-term memory loss, long-term memory loss, and item misplacement) within one week after starting simvastatin 40 mg/day.
(ii) Simvastatin was discontinued, and the patient's cognition improved to normal within six weeks.
(iii) He again tried simvastatin, this time at half the original dose and his cognition deteriorated over a two week period.
(iv) Simvastatin was stopped, and his normal cognition returned within four weeks.

This case shows that statins can induce a decline in cognition.

Saturday, 23 February 2013

Suicide attempters have low cholesterol levels

This study was published in European Child and Adolescent Psychiatry 2010 Jul;19(7):615-9
 
Study title and authors:
Total serum cholesterol levels and suicide attempts in child and adolescent psychiatric inpatients.
Plana T, Gracia R, Méndez I, Pintor L, Lazaro L, Castro-Fornieles J.
Child and Adolescent Psychiatry and Psychology Department, Neurosciences Institute, Hospital Clinic Barcelona, Centro Investigación Biomédica en Red de Salud Mental (CIBER-SAM), C/Villarroel 170, 08036, Barcelona, Spain. mtplana@clinic.ub.es
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/20047063

This study investigated the association between cholesterol levels and suicidal behavior in adolescent patients. The study included 66 patients (aged 8 to 18 years) admitted to a psychiatric inpatient unit following attempted suicide, who were compared with 54 patients with no history of suicide attempts.

The study found that cholesterol levels were significantly lower in attempted suicide patients than in those with no history of suicide attempts.

Friday, 22 February 2013

Statin users have an 82% higher risk of microalbuminuria

This study was published in PLoS One 2012;7(2):e31639
 
Study title and authors:
Statin use and the presence of microalbuminuria. Results from the ERICABEL trial: a non-interventional epidemiological cohort study.
van der Tol A, Van Biesen W, Van Laecke S, Bogaerts K, De Lombaert K, Warrinnier H, Vanholder R.
Renal Division, Department of Internal Medicine, University Hospital Ghent, Ghent, Belgium. Arjan.vandertol@ugent.be
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22359611

Microalbuminuria is when very small amounts of a protein called albumin pass through your kidneys and into your urine. This can be a sign of underlying conditions such as kidney disease or cardiovascular disease.

This study evaluated the association between statins and microalbuminuria. The study included 1,076 patients, aged 40 to 70 years, with high blood pressure who were followed for five years.

The study found that statin users had an 82% higher risk of microalbuminuria compared to nonusers.

Thursday, 21 February 2013

Soy products may cause developmental and growth delay in infants and young children

This study was published in Pediatrics 2012 Sep;130(3):e699-702
 
Study title and authors:
Unawareness of the effects of soy intake on the management of congenital hypothyroidism.
Fruzza AG, Demeterco-Berggren C, Jones KL.
Division of Endocrinology, Department of Pediatrics, University of California San Diego, La Jolla, California, USA. afruzza@rchsd.org
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22908106

This paper describes two patients born with hypothyroidism (hypothyroidism is a state in which the thyroid gland does not make enough thyroid hormone) who were fed soy products and continued to manifest clinical hypothyroidism despite receiving recommended doses of levothyroxine (a synthetic form of the thyroid hormone thyroxine).

Patient1
(i) The first patient was diagnosed with hypothyroidism and treated with 50 µg of levothyroxine since six days of age while simultaneously starting soy formula.
(ii) At three weeks of age, she was clinically and biochemically hypothyroid.
(iii) Her soy formula was stopped and her levothyroxine dose decreased.
(iv) Three weeks later signs of hypothyroidism were resolving, and, by 10 weeks of age, her thyroid was clinically and biochemically normal.

Patient 2
(i) The second patient was diagnosed hypothyroid, received levothyroxine, and did well.
(ii) Over the next two years she began consuming soy milk and became profoundly hypothyroid even though her primary care physician had increased her levothyroxine dose to 112 µg/day.
(iii) She was switched to cows milk, and her thyroid function slowly normalized with decreasing doses of levothyroxine.

These two patients highlight the adverse affects soy products have on thyroid function and may cause developmental and growth delay in infants and young children. 

Wednesday, 20 February 2013

Review finds that statins and fibrates may cause erectile dysfunction

This paper was published in Family Practice 2002 Feb;19(1):95-8
 
Study title and authors:
Do lipid-lowering drugs cause erectile dysfunction? A systematic review.
Rizvi K, Hampson JP, Harvey JN.
University of Wales College of Medicine, Wrexham Academic Unit, Wrexham, UK.
 
This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/11818357

The aim of this study was to clarify the relationship between cholesterol lowering drugs and erectile dysfunction. To achieve this aim a systematic review of the scientific literature was carried.

The review found:
(a) Information from review articles, clinical trials and from regulatory agencies identified fibrates as a source of erectile dysfunction.
(b) A substantial number of cases of erectile dysfunction associated with statin usage have been reported to regulatory agencies.
(c) Case reports and clinical trial evidence supported the suggestion that statins can also cause erectile dysfunction.

The review suggests that both statins and fibrates may cause erectile dysfunction.

Tuesday, 19 February 2013

Low vitamin D and low HDL cholesterol levels associated with Benign Prostatic Enlargement

This study was published in the Journal of Urology 2013 Feb 8. pii: S0022-5347(13)00252-8

Study title and authors:
Low 25-OH Vitamin D Level is Associated with Benign Prostatic Enlargement (BPE).
Mellström D, Haghsheno MA, Behre CJ, Damber JE, Johansson H, Karlsson M, Lorentzon M, Peeker R, Barrett-Connor E, Waern E, Sundh V, Ohlsson C, Hammarsten J.
Sahlgrenska University Hospital, Centre for Bone and Arthritis Research at the Sahlgrenska Academy (CBAR), S-413 45 Goteborg, Sweden.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23399651

This study investigated factors associated with Benign Prostatic Enlargement. (Benign Prostatic Enlargement may lead to painful urination and increased risk of urinary tract infections). The study included 155 men aged 72-76 years.

Regarding vitamin D and high density lipoprotein (HDL) cholesterol, the study found that low levels of these factors was significantly associated with with large prostate glands.

Dietary vitamin D is virtually only available in foods of animal origin, see here, and the most effective dietary strategy to raise HDL cholesterol levels is to consume a diet high in saturated fat, see here and here.  

Monday, 18 February 2013

Statins associated with inflammation of the muscles

This study was published in the Journal of Clinical Rheumatology 2001 Oct;7(5):340-5
 
Study title and author:
A case of atorvastatin combined toxic myopathy and inflammatory myositis.
Folzenlogen D.
Department of Internal Medicine, Division of Immunology and Rheumatology, University of Missouri, MA 425, One Hospital Drive, Columbia, MO 65212, USA.
 
This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17039167

This paper reports the case of a 76-year-old male patient undergoing statin therapy.

(i) The patient had elevations of muscle enzymes and was diagnosed with inflammatory polymyositis (chronic inflammation of the muscles) combined with statin toxic myopathy (muscle disease).
(ii) His symptoms and enzyme abnormalities resolved with the removal of the statin medication.

This case highlights the association between statins and inflammation of the muscles.

Sunday, 17 February 2013

The bioavailability of minerals is poor in legumes

This paper was published in the British Journal of Nutrition 2002 Dec;88 Suppl 3:S281-5

Study title and author:
Bioavailability of minerals in legumes.
Sandberg AS.
Department of Food Science, Chalmers University of Technology, PO Box 5401, SE 402 29 Göteborg, Sweden. ann-sofie.sandberg@fsc.chalmers.se

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12498628

Professor Ann-Sofie Sandberg is head of the Life Science Division at Chalmers University of Technology, Göteborg, Sweden. She has an extensive record in the field of phytate/bioavailability of minerals, food processing/bioavailability of nutrients and in the development of analytical methods for measuring nutrients and bioactive compounds.

Professor Sandberg reviewed the scientific evidence regarding the bioavailability of minerals in legumes.

Professor Sandberg found:
(a) The content of iron and other minerals is generally high in legumes. However, the legumes also contain antinutritional factors, such as proteinase inhibitors, lectin, raffinose oligosaccharides, saponins, polyphenols and phytate. Antinutritional factors lower the nutritional value of a food by lowering the digestibility or bioavailability of nutrients.
(b) Phytate is a well-known inhibitor of absorption of essential dietary minerals such as non-haem iron, zinc and calcium. 
(c) Some polyphenols are potent inhibitors of non-haem iron absorption.
(d) In the modern food industry, the high phytate content of soya-based infant formulas is of concern as low zinc absorption from a soya-protein-based infant formula has been found.
(e) Soya protein per se has an inhibiting effect on iron absorption.
(f) In many developing countries where diet is based on cereal and legume products, deficiency of iron and zinc, is highly prevalent.
(g) In developing countries iron deficiency, due to poor bioavailability, retards normal brain development in infants and affects the success of a pregnancy by increasing premature deliveries, as well as increased disease of mother and child at or around childbirth.
(h) Zinc deficiency prevents normal child growth and greatly weakens the immune system, leading to more infections.
(i) In industrialised countries where diet is based on cereal and legume products, deficiency of iron and zinc, is highly prevalent in certain groups such as women of fertile age, infants, adolescents and vegetarians.

The review finds that the bioavailability of minerals is poor in legumes and may lead to adverse health consequences.

Saturday, 16 February 2013

Report highlights the connection between statin treatment and considerable muscular weakness

This paper was published in the Annales de Dermatologie et de Venereologie 2005 Dec;132(12 Pt 1):996-9
 
Study title and authors:
Fluvastatin-induced dermatomyositis
Thual N, Penven K, Chevallier JM, Dompmartin A, Leroy D.
Service de Dermatologie, Centre Hospitalier Universitaire de Caen.
 
This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16446645

This paper reports a case of dermatomyositis occurring after fluvastatin intake. (Dermatomyositis is a muscle disease characterized by inflammation and a skin rash).

(i) A 76-year-old male patient sought medical attention for a skin rash and considerable muscular weakness present for one month.
(ii) Two months earlier, fluvastatin had been prescribed.
(iii) Creatine phosphokinase levels were elevated.
(iv) Dermatomyositis was diagnosed.
(v) All clinical and laboratory abnormalities diminished spontaneously within one month of the final intake of fluvastatin.

This case highlights the connection between statin treatment and considerable muscular weakness.

Friday, 15 February 2013

Consumption of fibre-rich wheat bread results in iron deficiency

This study was published in the European Journal of Nutrition 2005 Sep;44(6):334-40
 
Study title and authors:
A decrease in iron status in young healthy women after long-term daily consumption of the recommended intake of fibre-rich wheat bread.
Bach Kristensen M, Tetens I, Alstrup Jørgensen AB, Dal Thomsen A, Milman N, Hels O, Sandström B, Hansen M.
The Dept. of Human Nutrition, The Royal Veterinary & Agricultural University, Rolighedsvej 30, 1958, Frederiksberg C, Denmark. mbk@kvl.dk
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15349738

The objective of the study was to measure the effects of long-term consumption of the recommended intake of fibre-rich wheat bread on the iron status of young healthy women with adequate iron stores. The study lasted for four months and included 41 healthy women, average age 24.8 years, who were provided daily with 300 grams of fibre-rich wheat bread, prepared (i) with or (ii) without phytase (an enzyme that reduces the phytic acid content in food) as a supplement to their habitual diet.

After four months, the study found:
(a) Levels of ferritin were significantly reduced in all women by an average of 27%. (Low ferritin levels lead to anaemia).
(b) Levels of haemoglobin were significantly reduced in all women by an average of 1.5%. (When a person has a low haemoglobin level, they may feel weak,tired, dizzy or cold).

The study indicates that consumption of the recommended daily intake of fibre-rich wheat bread (with high or low phytic acid concentrations) results in an impairment of iron status in women with initially sufficient iron stores.

Thursday, 14 February 2013

Statins can cause the peripheral nerves to malfunction

This paper was published in Revista de Neurologia 2006 Dec 1-15;43(11):659-61

Study title and authors:
Multiple mononeuropathy associated to treatment with pravastatin.
Abellán-Miralles I, Sánchez-Pérez RM, Pérez-Carmona N, Díaz-Marín C, Mallada-Frechín J.
Unidad de Neurología, Hospital de la Marina Baixa, Partina Galandú s/n, E-03570 Villajoyosa, Alicante, Spain. iabellanm@jmalladaf.jazztel.es

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17133326

This paper reports of a woman who was diagnosed with multiple mononeuropathy after beginning pravastatin therapy. Multiple mononeuropathy (mononeuritis multiplex) is the simultaneous malfunction of two or more peripheral nerves in separate areas of the body. It causes abnormal sensations and weakness. Multiple mononeuropathy typically affects only a few nerves, often in different areas of the body. In contrast, polyneuropathy affects many nerves, usually in about the same areas on both sides of the body.

(i) A 51-year-old female patient who, after beginning therapy with pravastatin, suffered with abnormal sensations in the limbs and developed an unstable gait.
(ii) Multiple mononeuropathy was diagnosed.
(iii) Her condition improved on withdrawing from the statin treatment and it became worse again when statins were restarted.
(iv) When pravastatin therapy was stopped for good, the patient's condition progressively improved until she was practically free of symptoms.

This case shows that statins can cause the peripheral nerves to malfunction.

Wednesday, 13 February 2013

Increasing dietary polyunsaturated fats and decreasing saturated fats is associated with an increase in both overall death rates and heart disease death rates

This study was published in the British Medical Journal 2013 Feb 4;346:e8707

Study title and authors:
Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis.
Ramsden CE, Zamora D, Leelarthaepin B, Majchrzak-Hong SF, Faurot KR, Suchindran CM, Ringel A, Davis JM, Hibbeln JR.
Laboratory of Membrane Biophysics and Biochemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23386268

The objective of the study was to evaluate the effectiveness of replacing dietary saturated fat with polyunsaturated fat, for the prevention of coronary heart disease and death in men with heart disease. The study lasted for 39 months and included 458 men, aged 30-59 years, who had had a heart attack or angina.

The men were allocated into two groups and instructed to either:
(i) Increase their polyunsaturated fat intake to about 15%, reduce their intake of saturated fat and to less than 10% and reduce their dietary cholesterol to 300 mg per day. To achieve these targets these men were provided with liquid safflower oil and safflower oil polyunsaturated margarine (high polyunsaturated fat group).
(ii) Carry on with their normal diet (saturated fat group).

The study found:
(a) After 12 months the cholesterol levels of the men on the high polyunsaturated fat diet were 8.5% lower than the men on the high saturated fat diet.
(b) Men who consumed the high polyunsaturated fat diet had a 62% increased risk of death compared to the men who consumed the high saturated fat diet.
(c) Men who consumed the high polyunsaturated fat diet had a 70% increased risk of death from cardiovascular disease compared to the men who consumed the high saturated fat diet.
(d) Men who consumed the high polyunsaturated fat diet had a 62% increased risk of death from heart disease compared to the men who consumed the high saturated fat diet.

The study shows that increasing dietary polyunsaturated fats and decreasing saturated fats is associated with an increase in both overall death rates and heart disease death rates.



Tuesday, 12 February 2013

Statins significantly associated with worsening in knee pain and physical function in patients with osteoarthritis

This study was published in the Annals of the Rheumatic Diseases 2013 Feb;72(2):196-203
 
Study title and authors:
Associations between Statin use and changes in pain, function and structural progression: a longitudinal study of persons with knee osteoarthritis.
Riddle DL, Moxley G, Dumenci L.
Correspondence to Dr Daniel L Riddle, Departments of Physical Therapy and Orthopaedic Surgery, Basement, West Hospital, Room B-100, Virginia Commonwealth University, Richmond, VA 23298-0224, USA; dlriddle@vcu.edu.
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/23172752

This study set out to determine if statin usage was associated with changes in knee pain and function in persons with knee osteoarthritis. The study included 2,207 patients with knee osteoarthritis who were followed for four years.

The study found that statin usage was significantly associated with worsening in knee pain and physical function over the four-year study period.

Monday, 11 February 2013

Iron absorption is markedly inhibited in soy infant formula

This study was published in the British Journal of Nutrition 1987 May;57(3):345-53
 
Study title and authors:
Factors influencing the absorption of iron from soya-bean protein products.
Derman DP, Ballot D, Bothwell TH, MacFarlane BJ, Baynes RD, MacPhail AP, Gillooly M, Bothwell JE, Bezwoda WR, Mayet F.
 

This study compared iron absorption rates from soya-bean-based and milk-based infant formulas. The study included 138 women aged 21 to 63. None of the women were pregnant or lactating and all were unpaid volunteers. Ethical and practical considerations precluded the study being done on infants themselves.

The study found:
(a) Iron absorption was significantly less from the soya-bean formula compared to the milk-formula.
(b) The addition of ascorbic acid (vitamin C) markedly increased iron absorption from the milk-formula (a ten-fold increase), whereas ascorbic acid had a less-marked effect on the absorption of iron from the soya-bean formula, with only a two- to threefold increase.

The study reveals that iron absorption is markedly inhibited in soy infant formula.

Sunday, 10 February 2013

Statin and NSAID drugs lead to the death of a patient from kidney damage and severe skin lesions

This paper was published in the Annals of Saudi Medicine 2012 May-Jun;32(3):309-11
 
Study title and authors:
A fatal case of cutaneous adverse drug-induced toxic epidermal necrolysis associated with severe rhabdomyolysis.
Noordally SO, Sohawon S, Vanderhulst J, Duttmann R, Corazza F, Devriendt J.
Department of Critical Care Medicine, Centre Hospitalier Universitaire de Tubize-Nivelles, 1400 Nivelles, Belgium. Sheikoaleed.Noordally@chu-brugmann.be
 
This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22588445
 
Toxic epidermal necrolysis is a life-threatening skin condition that is usually induced by a reaction to medications. Atorvastatin is a recognized cause of rhabdomyolysis (the breakdown of muscle fibers that leads to kidney damage). Naproxen is a widely used nonsteroidal anti-inflammatory (NSAID) drug that is a known cause of skin lesions.
 
This paper reports of a fatal case of drug-induced toxic epidermal necrolysis associated with severe muscle necrosis (death of muscle cells) due to the use of Naproxen and a statin.
 
(i) A 61-year-old female patient was admitted to hospital with complaints of breathing difficulties, vomiting, and diarrhea that started two days prior to admission.
(ii) Her medications included atorvastatin 10 mg once daily and naxproxen 500 mg three times a day. 
(iii) Acute kidney injury and rhabdomyolysis were present on admission to the hospital.
(iv) She had very high levels of creatine phosphokinase (indicating muscle damage by statins).
(v) Naproxen treatment had started ten days before admission and had led to the rapid onset of skin lesions.
(vi) The patient rapidly developed multiple organ failure with respiratory failure, and complete skin necrosis (death of skin tissue). Despite treatment she died the following day.

The paper concludes that the patient died of drug induced toxic epidermal necrolysis associated with severe muscle necrosis due to the use of naproxen and statin drugs leading to acute kidney damage and complete skin necrosis.

Saturday, 9 February 2013

Diets high in bran decrease iron absorption by over 90%

This study was published in the American Journal of Clinical Nutrition 1989 Mar;49(3):542-5

Study title and authors:
Iron absorption: no intestinal adaptation to a high-phytate diet.
Brune M, Rossander L, Hallberg L.
Department of Medicine II, University of Göteborg, Sweden.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/2538051

Brune notes that several studies have shown that bran (and its high phytate content) inhibits the absorption of iron in man.

The present study examined the possibility that a high bran and phytate intake over a long period would induce adaption in the intestines or its microflora leading to a reduction of the inhibitory effect of dietary phytates on iron absorption. Such changes might occur in vegetarians and populations in developing countries with a usually very high dietary intake of phytates. The study included 13 dedicated vegetarians or vegans who had had a high phytate intake for around 25 years who were compared with six subjects who had a normal unrestricted diet.

The effect of bran on iron absorption was studied by comparing iron absorption from wheat rolls (i) with bran and (ii) without bran in both the vegetarian and non-vegetarian groups.

The study found:
(a) The bran rolls had a large inhibitory effect on iron absorption in both vegetarians and non-vegetarians.
(b) The effect was almost identical in both groups (93% inhibition in the vegetarian group and 92% in the non-vegetarian group) even though the vegetarians had had a very high phytate intake for a long time and the non-vegetarians had a much lower phytate intake.
(c) It can be concluded that no adaption could be observed among the vegetarians despite their high phytate intake.

The study concludes that the fact their is no intestinal adaptation to a high phytate intake has wide nutritional implications, and that a diet with a high phytate content must always be considered to impair iron absorption even if phytate intake has been high for several years.

Friday, 8 February 2013

Statins inflame and destroy blood vessels

This paper was published in Clinical Rheumatology 2008 Dec;27 Suppl 2:S75-7

Study title and authors:
A case of ANCA-associated systemic vasculitis induced by atorvastatin.
Haroon M, Devlin J.
Department of Rheumatology, Waterford Regional Hospital, Waterford, Republic of Ireland. mharoon301@hotmail.com

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/18839266

Vasculitis is a group of disorders that destroy blood vessels by inflammation. ANCA-associated vasculitides are diseases caused by vasculitis in which antineutrophil cytoplasmic antibodies (ANCAs) can be detected in the blood.

This paper reports a case of statin induced ANCA-associated vasculitides.

(i)  A 45-year-old male patient reported to an Accident and Emergency department with a six week history of pain and stiffness involving his legs. Both calves were markedly tender, and he was not able to bear weight.
(ii) He also complained of numbness involving his left big toe for a few days, which later spread to involve his arms, and tinnitus and hearing loss in his left ear.
(iii) He had been taking atorvastatin 10 mg for six months.
(iv) Investigations showed markedly increased inflammatory markers, markedly increased antineutrophil cytoplasmic antibody (ANCA) levels and muscle damage.
(v) A diagnosis of statin-induced ANCA-associated vasculitis and statin-induced distal myopathy (muscle disease) was made.
(vi) The patients symptoms and laboratory abnormalities resolved rapidly after cessation of the statin drug and implementation of treatment.

This case shows the association between statins and ANCA-associated vasculitis. 

Thursday, 7 February 2013

Low cholesterol levels linked with depression

This study was published in the African Journal of Psychiatry 2012 Jan;15(1):25-9

Study title and authors:
Elevated plasma homocysteine in association with decreased vitamin B(12), folate, serotonin, lipids and lipoproteins in depressed patients.
Ebesunun MO, Eruvulobi HU, Olagunju T, Owoeye OA.
Chemical Pathology, Olabisi Onabanjo University, Sagamu, Nigeria. onoebe@yahoo.com

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22344759

The study investigated the relationship between various blood measurements and depression. The study included 30 depressed patients and 30 healthy volunteers.

The study found:
(a) Cholesterol levels were 42% lower in depressed patients compared to healthy volunteers.
(b) High density lipoprotein (HDL) cholesterol levels were 42% lower in depressed patients compared to healthy volunteers.
(c) Low density lipoprotein (LDL) cholesterol levels were 46% lower in depressed patients compared to healthy volunteers.
(d) Vitamin B12 levels were 21% lower in depressed patients compared to healthy volunteers. (Vitamin B12 can only be found in foods of animal origin, the richest sources are: Oyster's, mussel's, clam's, beef liver, trout, salmon, beef, pork, egg and chicken).
(e) Homocysteine levels were 116% higher in depressed patients compared to healthy volunteers. (High homocysteine levels are associated with deficiencies of vitamins B6, B9 (folate) and B12. The best sources of vitamin B6 are: Tuna, beef liver, chicken liver, pork chops, salmon, halibut, beef and turkey. Good sources of vitamin B9 include: Calf's liver, beef liver, other organ meats and chicken giblet's.

This study showed a significant decrease in vitamin B12, cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol coexisting with an increase in homocysteine levels in depressed patients. Increased homocysteine levels could be an indicator of B vitamins deficiency.

Wednesday, 6 February 2013

Statins are associated with a 71% increased risk of rheumatoid arthritis

This study was published in the Annals of the Rheumatic Diseases 2012 May;71(5):648-54

Study title and authors:
Use of statins is associated with an increased risk of rheumatoid arthritis.
de Jong HJ, Klungel OH, van Dijk L, Vandebriel RJ, Leufkens HG, van der Laan JW, Cohen Tervaert JW, van Loveren H.
Laboratory for Health Protection Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/21979000

The study investigated whether statin use was associated with an increased risk of developing rheumatoid arthritis. The study included 508 patients aged 40 years or older with a first-time diagnosis of rheumatoid arthritis who were compared with 2,540 subjects without rheumatoid arthritis.

The study found that statin use was associated with a 71% increased risk of rheumatoid arthritis.

Tuesday, 5 February 2013

Fibre rich diet results in zinc, copper and magnesium deficiencies

This study was published in the Journal of the Trace Elements in Medicine and Biology 1996 Jun;10(2):68-76

Study title and authors:
Zinc, copper and magnesium absorption from a fibre-rich diet.
Knudsen E, Sandström B, Solgaard P.
Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8829129?dopt=Abstract

This study investigated the effect of a high-fibre and high-phytate diet on levels of zinc, copper and magnesium. The study lasted for 21 days and included eight healthy subjects who were given a diet of conventional foods that included 1 mmol phytic acid, 29 g dietary fiber, 140 mumol zinc, 13 mumol copper, and 9 mmol magnesium per 2,415 calories.

The study found:
(a) The subjects levels of zinc decreased by 7 mumol.
(b) The subjects levels of copper decreased by 5 mumol.
(c) The subjects levels of magnesium decreased by 3 mmol.

The study reveals that a fibre-rich diet is associated with a net loss of the nutrients zinc, copper and magnesium.

Monday, 4 February 2013

Statin treatment associated with significant muscle mitochondrial DNA depletion

This study was published in Clinical Pharmacology and Therapeutics 2007 May;81(5):650-3

Study title and authors:
Decreased skeletal muscle mitochondrial DNA in patients treated with high-dose simvastatin.
Schick BA, Laaksonen R, Frohlich JJ, Päivä H, Lehtimäki T, Humphries KH, Côté HC.
Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and Research Unit, Tampere University Hospital, Finland.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/17329991

Mitochondrial DNA contains 37 genes, all of which are essential for normal mitochondrial function. Thirteen of these genes provide instructions for making enzymes involved in oxidative phosphorylation. Oxidative phosphorylation is a process that uses oxygen and simple sugars to create adenosine triphosphate (ATP), the cell's main energy source.

Any depletion of muscle mitochondrial DNA may lead to muscle weakness and/or liver failure, and more rarely, brain abnormalities. “Floppiness,” feeding difficulties and developmental delays are common symptoms.

The aim of this study was to determine whether muscle mitochondrial DNA levels are altered during statin therapy. This clinical trial included 43 patients, aged 31 to 69 years, who had their levels of muscle mitochondrial DNA measured at the start of the study and again after eight weeks. The subjects were placed into three groups:
(i) Simvastatin 80 mg per day.
(ii) Atorvastatin 40 mg per day.
(iii) Placebo.

The study found:
(a) A significant decrease in muscle mitochondrial DNA levels was observed in the simvastatin group and a smaller decrease in levels in the atorvastatin group.
(b) Half the patients in the simvastatin group had a greater than 50% decrease in muscle mitochondrial DNA levels.
(c) 13% of the patients in the atorvastatin group had a greater than 50% decrease in muscle mitochondrial DNA levels.

The study shows that statin treatment may be associated with significant muscle mitochondrial DNA depletion.

The researchers conclude: "Given that statin therapy is often life-long, the large decrease (47%) observed raises concern about the potential longterm effect of statins on mitochondrial DNA and skeletal muscle mitochondria".

Sunday, 3 February 2013

Low-fat diets lead to increased abnormal growths in the colon

This study was published in the Journal of Clinical Epidemiology 1994 May;47(5):525-36
 
Study title and authors:
A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. Toronto Polyp Prevention Group.
McKeown-Eyssen GE, Bright-See E, Bruce WR, Jazmaji V, Cohen LB, Pappas SC, Saibil FG.
Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario, Canada.
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/7730878

This study investigated the effect of a low-fat, high fibre diet on the recurrence of neoplastic colorectal polyps (abnormal growths in the colon) in patients who had had previous colorectal polyps removed. The study lasted for two years and included 201 patients who had diets of the following:
(i) Given counselling to follow a low-fat, high-fibre diet: 25% fat and 35 grams a day of fibre (lower-fat , higher-fibre group).
(ii) Told to follow a normal higher-fat, lower-fibre diet: 33% fat and 16 grams a day of fibre (higher-fat, lower-fibre group).

The study found that the lower-fat, higher-fibre group had a 20% increased risk of recurrence of abnormal growths in the colon compared to the higher-fat, lower-fibre group.

Saturday, 2 February 2013

Statins may trigger the onset and worsening of diabetes

This paper was published in Endocrine Journal 2005 Jun;52(3):369-72
 
Study title and authors:
Acute onset and worsening of diabetes concurrent with administration of statins.
Ohmura C, Watada H, Hirose T, Tanaka Y, Kawamori R.
Department of Medicine, Metabolism and Endocrinology, Juntendo University School of Medicine, Tokyo, Japan.
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16006732

This paper reports a patient in whom the administration of statins might have triggered the onset and worsening of diabetes. The patient was a 48-year-old man who underwent annual medical examination but had never been told of high blood sugar.

The paper found:
(a) Four months after the commencement of atorvastatin (10 mg/day) treatment, a diagnosis of diabetes was made from his symptoms of high blood sugar.
(i) His after meal glucose level had risen to 29.8 mmol/l (536 mg/dL). Normal levels are below 8.1 mmol/L (8.1 mmol/L).
(ii) His HbA1c levels (a measurement of average blood sugar levels over the previous three months) had risen to 11.5%. Normal levels are below 5.6%.
(b) Three months after the cessation of atorvastatin, almost complete resolution of diabetes was observed.
(c) During the subsequent three months, diet therapy alone was sufficient to control blood sugar levels.
(d) Pravastatin (20 mg/day) was then prescribed and during the next three months his HbA1c levels gradually increased.
(e) After discontinuation of pravastatin, his HbA1c levels gradually decreased.

This case shows that statins may trigger the onset and worsening of diabetes.

Friday, 1 February 2013

High-fibre wheat-bran is associated with a significant increase in colorectal cancer

This study was published in the New England Journal of Medicine 2000 Apr 20;342(16):1156-62
 
Study title and authors:
Lack of effect of a high-fiber cereal supplement on the recurrence of colorectal adenomas. Phoenix Colon Cancer Prevention Physicians' Network.
Alberts DS, Martínez ME, Roe DJ, Guillén-Rodríguez JM, Marshall JR, van Leeuwen JB, Reid ME, Ritenbaugh C, Vargas PA, Bhattacharyya AB, Earnest DL, Sampliner RE.
Arizona Cancer Center, Department of Medicine, University of Arizona, Tucson 85724-5024, USA. dalberts@azcc.arizona.edu
 
This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/10770980

This study evaluated the effect of wheat-bran fibre in patients who had had one or more histologically confirmed colorectal adenomas removed. The study, which lasted three years, included 1,303 patients, aged 40 to 80 years, who were given wheat-bran fibre supplementation of either:
(i) 13.5 grams a day (high-fibre group).
(ii) 2 grams a day (low-fibre group).

The study found:
(a) The high-fibre group had a 5.8% increased risk of death compared to the low-fibre group.
(b) The high-fibre group had a 9.2% increased risk of any cancer compared to the low-fibre group.
(c) The high-fibre group had a 215% increased risk of colorectal cancer compared to the low-fibre group.
(d) The number of patients who reported gastrointestinal effects was significantly higher in the high-fibre group than in the low-fibre group for all effects except constipation.
Reported gastrointestinal effects:
(i) Nausea: 69% higher in the high-fibre group.
(ii) Abdominal Pain: 60% higher in the high-fibre group.
(iii) Diarrhea: 82% higher in the high-fibre group.
(iv) Constipation: 5% lower in the high-fibre group.
(v) Intestinal gas: 46% higher in the high-fibre group.
(vi) Abdominal bloating: 66% higher in the high-fibre group.

The study reveals that high-fibre wheat-bran is associated with a significant increase in colorectal cancer.