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Tag: Heart Disease

  • 4 Healthy Cat Diet Tips to Prevent Obesity | Animal Wellness Magazine

    These four key healthy cat diet tips will help you understand how to use food to keep your feline friend lean and full of energy!

    Obesity is a common health issue in cats. In fact, it’s estimated that over 60% of cats are overweight or obese. Luckily, it’s easy to prevent, and there are plenty of reasons you should take steps to do so. Excess weight can shorten their lifespan, reduce their quality of life, and cause health conditions like diabetes, joint problems, and heart and liver disease. Regular play and exercise are essential components for a healthy lifestyle, but the real key to preventing obesity in cats lies in their food bowl. Here are four healthy cat diet tips that will help you keep your kitty lean, happy, and healthy!

    1. Practice Portion Control

    Overfeeding is one of the biggest contributors to cat obesity. The easiest way to combat it is by feeding your cat twice daily instead of allowing them to free feed, which can easily lead to constant snacking, overeating, and weight gain. And be sure to measure the proper amount of food for your cat based on the feeding guidelines provided by your vet or the food manufacturer.

    2. Adjust Calories Based on Life Stage and Activity Level

    Cats have different caloric needs depending on their age and how active they are. Kittens need more calories and nutrients to support growth, while adults and seniors typically require fewer calories. Spayed or neutered cats also have slower metabolisms and may gain weight more easily. Similarly, indoor cats who aren’t as active as outdoor cats may need a weight-maintenance formula. Regular checkups with your veterinarian will help you stay on track with a healthy cat diet.

    3. Prioritize Nutrient-Rich Cat Foods

    While it is important to pay attention to the number of calories your cat consumes, it’s just as important to make sure they’re getting the right nutrients. Cats are obligate carnivores, and they thrive on meat-rich diets. Look for foods with real animal protein as the first ingredient, minimal carbohydrates, and no artificial additives. High-quality foods ensure your cat gets the vitamins, minerals, and nutrients they need while also helping them feel satisfied with smaller portions.

    4. Keep Treats and Human Food to a Minimum

    Treats are okay, as long as they’re just that—treats. They shouldn’t make up more than 10% of your cat’s daily calories. And that includes human food. Even though some human foods are safe for cats (like lean meats, salmon, tuna, and even some vegetables), you must be careful not to overfeed. When you do feed treats, prioritize nutrient-dense ones. Here are some things to look for:

    • Single- or minimal-ingredient treats
    • Meat as the first ingredient
    • No added salt or sugar
    • Real-food ingredients

    A Healthy Cat Diet Starts with NutriSource Recipes!

    NutriSource has been nourishing cats for over 60 years with nutrient-dense foods, prioritizing high-quality ingredients and meat-rich recipes that supply cats with the calories and nutrients they need to maintain energy and a healthy body condition. They have a variety of options for cats of all ages in their NutriSource, Element, and PureVita lines, including grain-inclusive options, grain-free recipes, and weight management formulations, all of which feature animal protein as the first ingredient.

    Visit NutriSource to learn more and find the purrfect healthy cat diet for your feline friend!

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    Animal Wellness is North America’s top natural health and lifestyle magazine for dogs and cats, with a readership of over one million every year. AW features articles by some of the most renowned experts in the pet industry, with topics ranging from diet and health related issues, to articles on training, fitness and emotional well being.

    Animal Wellness

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  • Polly the dog to be crowned a “CPR Hero” for helping save her owner’s life during a cardiac arrest

    A golden retriever is being lauded as “the first responder” who helped saved her owner’s life when he suffered a cardiac arrest in the middle of the night.

    Hannah Cooke, from County Fermanagh in Northern Ireland, was woken up one night last year by a bark from Polly, she and her husband’s four-year-old dog, who the couple said normally sleeps quietly through the night.

    When she turned to her husband sleeping next to her, Hannah found him breathing irregularly, and then he stopped breathing entirely, according to the British Heart Foundation, which told the couple’s story ahead of a ceremony on Tuesday that will see both Hannah and Polly crowned “CPR Heroes” for their actions.

    Golden retriever Polly from Fermanagh helped save her owner Adam’s life when he had a cardiac arrest asleep in bed in 2024.

    British Heart Foundation


    “When I heard the noise Adam was making I sat bolt upright in bed, as I previously worked as a carer and it hit me that it was the same noise I’ve heard when people are taking their final breaths,” said Hannah, 33.

    She immediately sprang into action, calling an ambulance and performing CPR on her husband until paramedics arrived to whisk him to the hospital. On the way, they shocked Adam seven times with a defibrillator before his heart rate normalized.

    Adam woke up at the hospital six days later and learned that he had been diagnosed with a heart disease called dilated cardiomyopathy, which prevents the heart from pumping blood around the body effectively.

    After weeks of recovery and a procedure to have a Implantable Cardioverter Defibrillator put in his chest, Adam was finally allowed to go home — where he was reunited with Polly.

    polly-cooke.jpg

    Polly’s barking woke Adam’s wife Hannah who performed life-saving CPR and contacted the emergency services

    British Heart Foundation


    “When I got out of hospital, I’ll never forget seeing Polly again and knowing how she had intervened that night. I just cuddled her and cried for 20 minutes,” Adam said.

    The couple credit Polly with having saved Adam’s life by being “in tune” with him, and they believe she even knew what was happening.

    “Polly alerted me, possibly within seconds of Adam’s cardiac arrest, she was the first responder,” Hannah told the BHF, a charity that raises awareness of cardiovascular disease and money to fund research into treatments and cures. “Because of her, I was able to start CPR almost immediately.”

    Hannah and Polly were set to receive their honors as “CPR Heroes” at the BHF’s Heart Hero Awards ceremony in London on Tuesday evening.

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  • Plant-Based Hospital Menus | NutritionFacts.org

    The American Medical Association passed a resolution encouraging hospitals to offer healthy plant-based food options.

    “Globally, 11 million deaths annually are attributable to dietary factors, placing poor diet ahead of any other risk factor for death in the world.” Given that diet is our leading killer, you’d think that nutrition education would be emphasized during medical school and training, but there is a deficiency. A systematic review found that, “despite the centrality of nutrition to a healthy lifestyle, graduating medical students are not supported through their education to provide high-quality, effective nutrition care to patients…”

    It could start in undergrad. What’s more important? Learning about humanity’s leading killer or organic chemistry?

    In medical school, students may average only 19 hours of nutrition out of thousands of hours of instruction, and they aren’t even being taught what’s most useful. How many cases of scurvy and beriberi, diseases of dietary deficiency, will they encounter in clinical practice? In contrast, how many of their future patients will be suffering from dietary excesses—obesity, diabetes, hypertension, and heart disease? Those are probably a little more common than scurvy or beriberi. “Nevertheless, fully 95% of cardiologists [surveyed] believe that their role includes personally providing patients with at least basic nutrition information,” yet not even one in ten feels they have an “expert” grasp on the subject.

    If you look at the clinical guidelines for what we should do for our patients with regard to our number one killer, atherosclerotic cardiovascular disease, all treatment begins with a healthy lifestyle, as shown below and at 1:50 in my video Hospitals with 100-Percent Plant-Based Menus.

    “Yet, how can clinicians put these guidelines into practice without adequate training in nutrition?”

    Less than half of medical schools report teaching any nutrition in clinical practice. In fact, they may be effectively teaching anti-nutrition, as “students typically begin medical school with a greater appreciation for the role of nutrition in health than when they leave.” Below and at 2:36 in my video is a figure entitled “Percentage of Medical Students Indicating that Nutrition is Important to Their Careers.” Upon entry to different medical schools, about three-quarters on average felt that nutrition is important to their careers. Smart bunch. Then, after two years of instruction, they were asked the same question, and the numbers plummeted. In fact, at most schools, it fell to 0%. Instead of being educated, they got de-educated. They had the notion that nutrition is important washed right out of their brains. “Thus, preclinical teaching”— the first two years of medical school—“engenders a loss of a sense of the relevance of the applied discipline of nutrition.”

    Following medical school, during residency, nutrition education is “minimal or, more typically, absent.” “Major updates” were released in 2018 for residency and fellowship training requirements, and there were zero requirements for nutrition. “So you could have an internal medicine graduate who comes out of a terrific program and has learned nothing—literally nothing—about nutrition.”

    “Why is diet not routinely addressed in both medical education and practice already, and what should be done about that?” One of the “reasons for the medical silence in nutrition” is that, “sadly…nutrition takes a back seat…because there are few financial incentives to support it.” What can we do about that? The Food Law and Policy Clinic at Harvard Law School identified a dozen different policy levers at all stages of medical education and the kinds of policy recommendations there could be for the decision-makers, as you can see here and at 3:48 in my video.

    For instance, the government could require doctors working for Veterans Affairs (VA) to get at least some courses in nutrition, or we could put questions about nutrition on the board exams so schools would be pressured to teach it. As we are now, even patients who have just had a heart attack aren’t changing their diet. Doctors may not be telling them to do so, and hospitals may be actively undermining their future with the food they serve.

    The good news is that the American Medical Association (AMA) has passed a resolution encouraging hospitals to offer healthy food options. What a concept! “Our AMA hereby calls on [U.S.] Health Care Facilities to improve the health of patients, staff, and visitors by: (a) providing a variety of healthy food, including plant-based meals, and meals that are low in saturated and trans fat, sodium, and added sugars; (b) eliminating processed meats from menus; and (c) providing and promoting healthy beverages.” Nice!

    “Similarly, in 2018, the State of California mandated the availability of plant-based meals for hospital patients,” and there are hospitals in Gainesville (FL), the Bronx, Manhattan, Denver, and Tampa (FL) that “all provide 100% plant-based meals to their patients on a separate menu and provide educational materials to inpatients to improve education on the role of diet, especially plant-based diets, in chronic illness.”

    Let’s check out some of their menu offerings: How about some lentil Bolognese? Or a cauliflower scramble with baked hash browns for breakfast, mushroom ragu for lunch, and, for supper, white bean stew, salad, and fruit for dessert. (This is the first time a hospital menu has ever made me hungry!)

    The key to these transformations was “having a physician advocate and increasing education of staff and patients on the benefits of eating more plant-based foods.” A single clinician can spark change in a whole system, because science is on their side. “Doctors have a unique position in society” to influence policy at all levels; it’s about time we used it.

    For more on the ingrained ignorance of basic clinical nutrition in medicine, see the related posts below.

    Michael Greger M.D. FACLM

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  • Fetterman says he’s back home after a fall put the Pennsylvania senator in the hospital

    WASHINGTON — WASHINGTON (AP) — Sen. John Fetterman says he has returned home to his family in Pennsylvania after being hospitalized due to what his office said was a ventricular fibrillation flare-up that caused him to feel light-headed and fall during an early morning walk Thursday.

    Fetterman, D-Pa., posted a picture Saturday on X that showed the aftereffects to his nose and forehead, saying “20 stitches later and a full recovery, I’m back home” with his wife, Gisele, and their children.

    The smiling Fetterman also said he was grateful for the medical team in Pittsburgh that “put me back together.”

    “See you back in DC,” he concluded.

    Ventricular fibrillation is the most serious form of abnormal heartbeat and can lead to cardiac arrest — when the heart suddenly stops beating — and sudden cardiac death, according to the American Heart Association.

    Ventricular fibrillation occurs in the heart’s lower chambers, and the heart association says its causes include cardiomyopathy, which Fetterman was diagnosed with in 2022. Cardiomyopathy can impede blood flow and potentially cause heartbeats so irregular they can be fatal.

    Fetterman, 56, disclosed that he was diagnosed with cardiomyopathy and another type of abnormal heartbeat, atrial fibrillation, after he had a stroke during his 2022 campaign.

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  • Pennsylvania Sen. John Fetterman Hospitalized After Fall, His Office Says

    HARRISBURG, Pa. (AP) — U.S. Sen. John Fetterman had what his office says was a “ventricular fibrillation flare-up” that caused him to feel light-headed and fall during an early morning walk Thursday.

    Fetterman was doing well and hospitalized in Pittsburgh, his office said. He sustained minor injuries to his face and was under “routine observation” at the hospital while doctors fine-tune his medication regimen, his office said.

    Cardiomyopathy can impede blood flow and potentially cause heartbeats so irregular they can be fatal. Atrial fibrillation can cause blood to pool inside a pocket of the heart, allowing clots to form. Clots then can break off, get stuck and cut off blood, causing a stroke.

    Fetterman has said the stroke was atrial fibrillation. Fetterman, 55, underwent surgery after the stroke to implant a pacemaker with a defibrillator to manage the condition.

    The lingering effects of his stroke include diminished auditory processing speed, called auditory processing disorder, which makes it harder to speak fluidly and quickly process spoken conversation into meaning.

    Weeks after joining the Senate in 2023, Fetterman checked himself into the hospital for clinical depression. He was released six weeks later and has since urged people who are depressed to get professional help.

    Post-stroke depression is common and treatable through medication and talk therapy, doctors say.

    Copyright 2025 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

    Photos You Should See – Oct. 2025

    Associated Press

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  • Rates of high blood pressure in children have nearly doubled in 20 years

    (CNN) — Global rates of hypertension, or high blood pressure, in childhood and adolescence have nearly doubled since 2000, putting more kids at risk for poor health later in life.

    “In 2000, about 3.4% of boys and 3% of girls had hypertension. By 2020, those numbers had risen to 6.5% and 5.8% respectively,” said Dr. Peige Song, a researcher from the School of Public Health at Zhejiang University School of Medicine in China. Song is one of the authors of a study describing the findings that published Wednesday in the journal The Lancet Child and Adolescent Health.

    Children who have hypertension could be at greater risk later on of developing heart disease –– the No. 1 cause of death in the United States, said Dr. Mingyu Zhang, assistant professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center. He was not involved in the research.

    “The good news is that this is a modifiable risk,” Song said in an email. “With better screening, earlier detection, and a stronger focus on prevention, especially around healthy weight and nutrition, we can intervene before complications arise.”

    High blood pressure in kids can be addressed

    The rise in hypertension in children is likely due to many factors.

    Childhood obesity is a significant risk factor, because it is associated with factors like insulin resistance, inflammation and vascular function, Song said.

    Dietary factors such as consuming high levels of sodium and ultraprocessed food can also contribute to hypertension risk, as well as poor sleep quality, stress and genetic predisposition, she said.

    Many children also get less movement than past generations and spend more time on sedentary activities, like screen use, which may be affecting risk, she said.

    “We are also starting to know that other factors, including environmental pollutants, can contribute,” Zhang added.

    Zhang served as senior author on a previous study that showed a connection between prebirth exposure to chemicals called PFAS — a class of about 15,000 human-made compounds linked to cancers, endocrine-related conditions and developmental issues in children — and childhood hypertension. Short for perfluoroalkyl and polyfluoroalkyl substances, PFAS are sometimes called “forever chemicals” because they don’t fully break down in the environment.

    The biggest takeaway of this research for families is not to assume high blood pressure is only a problem for adults, Song said.

    If you are worried about your child’s risk for obesity or hypertension, pressure, shame and restriction are not the best approaches.

    Instead, focus on increasing healthy behaviors in a happy way, said Jill Castle, a pediatric dietitian in Massachusetts, in a previous CNN article.

    “The goal of the food pillar is really to embrace flexibility with food and to emphasize foods that are highly nutritious and … to allow foods also that might be minimally nutritious within the diet in ways that can be fully enjoyed and flexible,” Castle said.

    Try to prioritize sitting down as a family for meals and avoid labeling foods as “good” or “bad,” said Castle, author of “Kids Thrive at Every Size.”

    “The clean plate club or rewarding with sweets — they might work in the moment, but they don’t do a good job of establishing the self-trust and an intuitive, good relationship with food as kids grow up,” Castle said.

    Masked hypertension in children

    The study didn’t just track rates in the United States. Instead, researchers analyzed data from 96 studies across 21 countries.

    Another important consideration the study team made is how blood pressure differs in and outside the doctor’s office. Some children might have normal blood pressure at home, but a higher reading in the office, while others might have a lower blood pressure in the office than they normally would.

    By including data from both office visits and at-home blood pressure readings, the researchers were able to include hypertension rates that are “masked,” or wouldn’t be caught in a doctor’s visit, Zhang said. Masked hypertension was found to be the most common kind, according to the data.

    “This is important because it means that many children with true hypertension could go undetected if we rely only on office blood pressure readings,” he said.

    The result show that one reading may not be enough, and there may be a need for more scalable solutions for better monitoring and care of hypertension around the world, Song added.

    Madeline Holcombe and CNN

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  • A study questions melatonin use and heart health but don’t lose sleep over it

    WASHINGTON (AP) — Don’t lose sleep over headlines linking melatonin to heart failure.

    That’s the message after some scary-sounding reports about a preliminary study involving the sleep-related supplement. It raised questions about the safety of long term use of melatonin for insomnia.

    Doctors have long known that too little or interrupted sleep raises the risk of heart disease. But heart experts say this kind of so-called observational study can’t prove that melatonin use plays any role — instead of the insomnia patients were trying to treat.

    “We should not raise the alarm and tell patients to stop taking all their melatonin,” said Dr. Pratik Sandesara, an interventional cardiologist at Emory Healthcare who wasn’t involved with the research.

    Our bodies naturally produce melatonin, a hormone that regulates our sleep cycles. Levels normally increase as it gets darker in the evening, triggering drowsiness.

    People may take lab-produced melatonin to help them fall asleep or to adjust for jet lag or time changes.

    The new study used international electronic health records, tracking adults diagnosed with insomnia who had a melatonin prescription that suggested they used the supplement for at least a year.

    Over five years, 4.6% of the chronic melatonin users developed heart failure compared to 2.7% of insomnia patients whose charts showed no melatonin use, the researchers found. The study is being presented at an American Heart Association meeting but hasn’t undergone peer review.

    This article is part of AP’s Be Well coverage, focusing on wellness, fitness, diet and mental health. Read more Be Well.

    But only certain countries require a melatonin prescription. It’s over-the-counter in the U.S., meaning Americans in the study might have used the supplements without it being recorded, said Northwestern University cardiology chief Dr. Clyde Yancy, who wasn’t involved in the study. The study also did not show dosages.

    Also, U.S. supplements don’t require government approval, meaning brands can vary in their ingredients. The researchers, from SUNY Downstate Health Sciences University, characterized the findings as a call for more research.

    Meanwhile, patients wondering about melatonin should talk it over with their doctors, said Emory’s Sandesara. Generally doctors recommend it for short-term use, like for jet lag.

    Yancy noted that while the study doesn’t prove there’s a danger from long term melatonin use, there’s also no evidence that people should use melatonin indefinitely.

    And one key to better shut-eye is to practice better sleep hygiene, like making sure your room is dark.

    “When we expose ourselves to blue light in particular at night, we are diminishing our melatonin levels. That’s science,” he said. Sleep problems aren’t about “just being sleepy and tired — they’re putting yourself at risk.”

    ___

    This story has been corrected to show that the Northwestern University cardiology chief is Dr. Clyde Yancy, not Yancey.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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  • A study questions melatonin use and heart health but don’t lose sleep over it

    WASHINGTON — Don’t lose sleep over headlines linking melatonin to heart failure.

    That’s the message after some scary-sounding reports about a preliminary study involving the sleep-related supplement. It raised questions about the safety of long term use of melatonin for insomnia.

    Doctors have long known that too little or interrupted sleep raises the risk of heart disease. But heart experts say this kind of so-called observational study can’t prove that melatonin use plays any role — instead of the insomnia patients were trying to treat.

    “We should not raise the alarm and tell patients to stop taking all their melatonin,” said Dr. Pratik Sandesara, an interventional cardiologist at Emory Healthcare who wasn’t involved with the research.

    Our bodies naturally produce melatonin, a hormone that regulates our sleep cycles. Levels normally increase as it gets darker in the evening, triggering drowsiness.

    People may take lab-produced melatonin to help them fall asleep or to adjust for jet lag or time changes.

    The new study used international electronic health records, tracking adults diagnosed with insomnia who had a melatonin prescription that suggested they used the supplement for at least a year.

    Over five years, 4.6% of the chronic melatonin users developed heart failure compared to 2.7% of insomnia patients whose charts showed no melatonin use, the researchers found. The study is being presented at an American Heart Association meeting but hasn’t undergone peer review.

    But only certain countries require a melatonin prescription. It’s over-the-counter in the U.S., meaning Americans in the study might have used the supplements without it being recorded, said Northwestern University cardiology chief Dr. Clyde Yancy, who wasn’t involved in the study. The study also did not show dosages.

    Also, U.S. supplements don’t require government approval, meaning brands can vary in their ingredients. The researchers, from SUNY Downstate Health Sciences University, characterized the findings as a call for more research.

    Meanwhile, patients wondering about melatonin should talk it over with their doctors, said Emory’s Sandesara. Generally doctors recommend it for short-term use, like for jet lag.

    Yancy noted that while the study doesn’t prove there’s a danger from long term melatonin use, there’s also no evidence that people should use melatonin indefinitely.

    And one key to better shut-eye is to practice better sleep hygiene, like making sure your room is dark.

    “When we expose ourselves to blue light in particular at night, we are diminishing our melatonin levels. That’s science,” he said. Sleep problems aren’t about “just being sleepy and tired — they’re putting yourself at risk.”

    ___

    This story has been corrected to show that the Northwestern University cardiology chief is Dr. Clyde Yancy, not Yancey.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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  • Treat the Cause | NutritionFacts.org

    Treat the underlying cause of chronic lifestyle diseases.

    It’s been said that more than 2,000 years ago, Hippocrates declared, “Let food be thy medicine and medicine be thy food.” In actuality, it appears that he never actually said those words, but there’s “no doubt about the relevance of food…and its role in health and disease states” in his writings. Regardless, 2,000 years ago, disease was thought to arise from a bad sense of “humors,” as you can see here and at 0:32 in my video Lifestyle and Disease Prevention: Your DNA Is Not Your Destiny.

    Now, we have science, and there is “an overwhelming body of clinical and epidemiological evidence illustrating the dramatic impact of a healthy lifestyle on reducing all-cause mortality”—meaning death from all causes put together—“and preventing chronic diseases such as coronary heart disease, stroke, diabetes, and cancer.” But don’t those diseases just run in our family? What if we just have bad genes?

    According to the esteemed former chair of nutrition at Harvard, for most of the diseases that have contributed “importantly” to mortality in Western peoples, we’ve long known that non-genetic factors often account for at least 80% to 90% of risk. We know this because rates of the leading killers, like major cancers and cardiovascular diseases, vary up to 100-fold around the world, and, “when groups migrate from low- to high-risk countries, their disease rates almost always change to those of the new environment.” Modifiable behavioral factors have been identified, “including specific aspects of diet, overweight, inactivity, and smoking that account for over 70% of stroke and colon cancer, over 80% of coronary heart disease, and over 90% of adult-onset [type 2] diabetes”—diseases that can largely be prevented by our own actions.

    If most of the power is in our own hands, why do we allocate massively more resources to treatment than prevention? And speaking of prevention, “even preventive strategies are heavily biased towards pharmacology rather than supporting improvements in diet and lifestyle that could be more cost-effective. For example, treatment of [high] serum cholesterol with statins alone could cost approximately 30 billion dollars per year in the United States and would have only a modest impact on coronary heart disease incidence. The inherent problem is that most pharmacologic strategies don’t address the underlying causes of ill health in Western countries, which are not drug deficiencies.”

    Ironically, the chronic diseases that are most amenable to lifestyle treatment are the same ones most profitably treated by drugs. Why? If you don’t change your diet, you have to pop the pills every day for the rest of your life. So, the cash-cow drugs are the very drugs we need the least. “Even though the most widely accepted, well-established chronic disease practice guidelines uniformly call for lifestyle change as the first line of therapy, physicians often do not follow these recommendations.” “By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm.”

    “Traditional medical care relies primarily on the application of pharmacologic and surgical interventions after the development of illness,” whereas lifestyle medicine relies primarily on “the use of optimal nutrition (a whole foods, plant-based diet) and exercise in the prevention, arrest, and reversal of chronic conditions leading to premature disability and death. It looks in a holistic way at the underlying causes of illness.”

    Dr. Adriane Fugh-Berman, director of PharmedOut, a wonderful organization I’m proud to support, wrote a great editorial entitled “Doctors Must Not Be Lapdogs to Drug Firms.” “The illusion that the relationship between medicine and the drug industry is collegial, professional, and personal is carefully maintained by the drug industry, which actually views all transactions with physicians in finely calculated financial terms…The drug industry is happy to play the generous and genial uncle until physicians want to discuss subjects that are off limits, such as the benefits of diet or exercise, or the relationship between medicine and pharmaceutical companies…Let us not be a lapdog to Big Pharma. Rather than sitting contentedly in our master’s lap, let us turn around and bite something tender.”

    Doctor’s Note

    The organization I mentioned, PharmedOut, is a project of Georgetown University Medical Center.

    For more on Lifestyle Medicine, see related videos below.

    Michael Greger M.D. FACLM

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  • Ideal vs. Normal Cholesterol Levels  | NutritionFacts.org

    Having a “normal” cholesterol level in a society where it’s normal to die from a heart attack isn’t necessarily a good thing.

    “Consistent evidence” from a variety of sources “unequivocally establishes” that so-called bad LDL cholesterol causes atherosclerotic cardiovascular disease—strokes and heart attacks, our leading cause of death. This evidence base includes hundreds of studies involving millions of people. “Cholesterol is the cause of atherosclerosis,” the hardening of the arteries, and “the message is loud and clear.” “It’s the Cholesterol, Stupid!” noted the editor of the American Journal of Cardiology, William Clifford Roberts, whose CV is more than 100 pages long as he has published about 1,700 articles in peer-reviewed medical literature. Yes, there are at least ten traditional risk factors for atherosclerosis, as seen below and at 1:11 in my video How Low Should You Go for Ideal LDL Cholesterol?, but, as Dr. Roberts noted, only one is required for the progression of the disease: elevated cholesterol.

    Your doctor may have just told you that your cholesterol is normal, so you’re relieved. Thank goodness! But, having a “normal” cholesterol level in a society where it’s normal to have a fatal heart attack isn’t necessarily good. With heart disease, the number one killer of men and women, we definitely don’t want to have normal cholesterol levels; we want to have optimal levels—and not optimal by current laboratory standards, but optimal for human health.

    Normal LDL cholesterol levels are associated with the hidden buildup of atherosclerotic plaques in our arteries, even in those who have so-called “optimal risk factors by current standards”: blood pressure under 120/80, normal blood sugars, and total cholesterol under 200 mg/dL. If you went to your doctor with those kinds of numbers, you’d likely get a gold star and a lollipop. But, if your doctor used ultrasound and CT scans to actually peek inside your body, atherosclerotic plaques would be detected in about 38% of individuals with those kinds of “optimal” numbers.

    Maybe we should define an LDL cholesterol level as optimal only when it no longer causes disease. What a concept! When more than a thousand men and women in their 40s were scanned, having an LDL level under 130 mg/dL left them with atherosclerosis throughout their body, and that’s a cholesterol level at which most lab tests would consider normal.

    In fact, atherosclerotic plaques were not found with LDL levels down around 50 or 60, which just so happens to be the levels most people had “before the introduction of western lifestyles.” Indeed, before we started eating a typical American diet, “the majority of the adult population of the world had LDLs of around 50 mg per deciliter (mg/dL)”—so that’s the true normal. “Present average values…should not be regarded as ‘normal.’” We don’t want to have a normal cholesterol based on a sick society; we want a cholesterol that is normal for the human species, which may be down around 30 to 70 mg/dL or 0.8 to 1.8 mmol/L.

    “Although an LDL level of 50 to 70 mg/dl seems excessively low by modern American standards, it is precisely the normal range for individuals living the lifestyle and eating the diet for which we are genetically adapted.” Over millions of years, “through the evolution of the ancestors of man,” we’ve consumed a diet centered around whole plant foods. No wonder we have a killer epidemic of atherosclerosis, given the LDL level “we were ‘genetically designed for’ is less than half of what is presently considered ‘normal.’”

    In medicine, “there is an inappropriate tendency to accept small changes in reversible risk factors,” but “the goal is not to decrease risk but to prevent atherosclerotic plaques!” So, how low should you go? “In light of the latest evidence from trials exploring the benefits and risks of profound LDLc lowering, the answer to the question ‘How low do you go?’ is, arguably, a straightforward ‘As low as you can!’” “‘Lower’ may indeed be better,” but if you’re going to do it with drugs, then you have to balance that with the risk of the drug’s side effects.

    Why don’t we just drug everyone with statins, by putting them in the water supply, for instance? Although it would be great if everyone’s cholesterol were lower, there are the countervailing risks of the drugs. So, doctors aim to use statin drugs at the highest dose possible, achieving the largest LDL cholesterol reduction possible without increasing risk of the muscle damage the drugs may cause. But when you’re using lifestyle changes to bring down your cholesterol, all you get are the benefits.

    Can we get our LDL low enough with diet alone? Ask some of the country’s top cholesterol experts what they shoot for, “and the odds are good that many will say 70 or so.” So, yes, we should try to avoid the saturated fats and trans fats found in junk foods and meat, and the dietary cholesterol found mostly in eggs, but “it is unlikely anyone can achieve an LDL cholesterol level of 70 mg/dL with a low-fat, low-cholesterol diet alone.” Really? Many doctors have this mistaken impression. An LDL of 70 isn’t only possible on a healthy enough diet, but it may be normal. Those eating strictly plant-based diets can average an LDL that low, as you can see here and at 5:28 in my video.

    No wonder plant-based diets are the only dietary patterns ever proven to reverse coronary heart disease in a majority of patients. And their side effects? You get to feel better, too! Several randomized clinical trials have demonstrated that more plant-based dietary patterns significantly improve psychological well-being and quality of life, with improvements in depression, anxiety, emotional well-being, physical well-being, and general health.

    For more on cholesterol, see the related posts below.

    Michael Greger M.D. FACLM

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  • A Longer Life on Statins?  | NutritionFacts.org

    What are the pros and cons of relative risk, absolute risk, number needed to treat, and average postponement of death when taking cholesterol-lowering statin drugs?

    In response to the charge that describing the benefits of statin drugs only in terms of relative risk reduction is a “statistical deception” created to give the appearance that statins are more effective than they really are, it was pointed out that describing things in terms of absolute risk reduction or number needed to treat can depend on the duration of the study.

    For example, let’s say a disease has a 2% chance of killing you every year, but some drug cuts that risk by 50%. That sounds amazing, until you realize that, at the end of a year, your risk will only have fallen from 2% to 1%, so the absolute reduction of risk is only 1%. If a hundred people were treated with the drug, instead of two people dying, one person would die, so a hundred people would have to be treated to save one life, as shown below and at 1:01 in my video How Much Longer Do You Live on Statins?.

    But there’s about a 99% chance that taking the drug all year would have no effect either way. So, to say the drug cuts the risk of dying by 50% seems like an overstatement. But think about it: Benefits accrue over time. If there’s a 2% chance of dying every year, year after year, after a few decades, the majority of those who refused the drug would be dead, whereas the majority who took the drug would be alive. So, yes, perhaps during the first year on the drug, there was only about a 1% chance it would be life-saving, but, eventually, you could end up with a decent chance the drug would save your life after all.

    “This is actually the very reason why the usage of relative risk makes sense…” Absolute risk changes depending on the time frame being discussed, but with relative risk, you know that whatever risk you have, you can cut it in half by taking the drug. On average, statins only cut the risk of a cardiovascular “event” by 25%, but since cardiovascular disease is the number one killer of men and women, if you’re unwilling to change your diet, that’s a powerful argument in favor of taking these kinds of drugs. You can see the same kind of dependency on trial duration, looking at the “postponement of death” by taking a statin. How much longer might you live if you take statins?

    The average postponement of death has some advantages over other statistics because it may offer “a better intuitive understanding among lay persons,” whereas a stat like a number needed to treat has more of a win-or-lose “lottery-like” quality. So, when a statin drug prevents, say, one heart attack out of a hundred people treated over five years, it’s not as though the other 99 completely lost out. Their cholesterol also dropped, and their heart disease progression presumably slowed down, too, just not enough to catch a heart attack within that narrow time frame.

    So, what’s the effect of statins on average survival? According to an early estimate, if you put all the randomized trials together, the average postponement of death was calculated at maybe three or four days. Three or four days? Who would take a drug every day for years just to live a few more days? Well, let’s try to put that into context. Three or four days is comparable to the gains in life expectancy from other medical interventions. For example, it’s nearly identical to what you’d get from “highly effective childhood vaccines.” Because vaccines have been so effective in wiping out infectious diseases, these days, they only add an average of three extra days to a child’s life. But, of course, “those whose deaths are averted gain virtually their whole lifetimes.” That’s why we vaccinate. It just seems like such a small average benefit because it gets distributed over the many millions of kids who get the vaccine. Is that the same with statins?

    An updated estimate was published in 2019, which explained that the prior estimate of three or four days was plagued by “important weaknesses,” and the actual average postponement of death was actually ten days. Headline writers went giddy from these data, but what they didn’t understand was that this was only for the duration of the trial. So, if your life expectancy is only five years, then, yes, statins may increase your lifespan by only ten days, but statins are meant to be taken a lot longer than five years. What you want to know is how much longer you might get to live if you stick with the drugs your whole life.

    In that case, it isn’t an extra ten days, but living up to ten extra years. Taking statins can enable you to live years longer. That’s because, for every millimole per liter you lower your bad LDL cholesterol, you may live three years longer and maybe even six more years, depending on which study you’re reading. A millimole in U.S. units is 39 points. Drop your LDL cholesterol by about 39 points, and you could live years longer. Exercise your whole life, and you may only increase your lifespan by six months, and stopping smoking may net you nine months. But if you drop your LDL cholesterol by about 39 points, you could live years longer. You can accomplish that by taking drugs, or you can achieve that within just two weeks of eating a diet packed with fruits, vegetables, and nuts, as seen here and at 5:30 in my video. 

    Want to know what’s better than drugs? “Something important and fundamental has been lost in the controversy around this broad expansion of statin therapy.…It is imperative that physicians (and drug labels) inform patients that not only their lipid [cholesterol] levels but also their cardiovascular risk can be reduced substantially by adoption of a plant-based dietary pattern, and without drugs. Dietary modifications for cardiovascular risk reduction, including plant-based diets, have been shown to improve not only lipid status, but also obesity, hypertension, systemic inflammation, insulin sensitivity, oxidative stress, endothelial function, thrombosis, and cardiovascular event risk…The importance of this [plant-based] approach is magnified when one considers that, in contrast to statins, the ‘side effects’ of plant-based diets—weight loss, more energy, and improved quality of life—are beneficial.” 

    Michael Greger M.D. FACLM

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  • The Real Benefits of Statins and Their Side Effects  | NutritionFacts.org

    A Mayo Clinic visualization tool can help you decide if cholesterol-lowering statin drugs are right for you.

    “Physicians have a duty to inform their patients about the risks and benefits of the interventions available to them. However, physicians rarely communicate with methods that convey absolute information, such as numbers needed to treat, numbers needed to harm, or prolongation of life, despite patients wanting this information.” That is, for example, how many people are actually helped by a particular drug, how many are actually hurt by it, or how much longer the drug will enable you to live, respectively.

    If doctors inform patients only about the relative risk reduction—for example, telling them a pill will cut their risk of heart attacks by 34 percent—nine out of ten agree to take it. However, give them the same information framed as absolute risk reduction—“1.4% fewer patients had heart attacks”—then those agreeing to take the drug drops to only four out of ten. And, if they use the number needed to treat, only three in ten patients would agree to take the pill. So, if you’re a doctor and you really want your patient to take the drug, which statistic are you going to use?

    The use of relative risk stats to inflate the benefits and absolute risk stats to downplay any side effects has been referred to as “statistical deception.” To see how one might spin a study to accomplish this, let’s look at an example. As you can see below and at 1:49 in my video, The True Benefits vs. Side Effects of Statins, there is a significantly lower risk of the incidence of heart attack over five years in study participants randomized to a placebo compared to those getting the drug. If you wanted statins to sound good, you’d use the relative risk reduction (24 percent lower risk). If you wanted statins to sound bad, you’d use the absolute risk reduction (3 percent fewer heart attacks).

    Then you could flip it for side effects. For example, the researchers found that 0.3 percent (1 out of 290 women in the placebo group) got breast cancer over five years, compared to 4.1 percent (12 out of 286) in the statin group. So, a pro-statin spin might be a 24 percent drop in heart attack risk and only 3.8 percent more breast cancers, whereas an anti-statin spin might be only 3 percent fewer heart attacks compared to a 1,267 percent higher risk of breast cancer. Both portrayals are technically true, but you can see how easily you could manipulate people if you picked and chose how you were presenting the risks and benefits. So, ideally, you’d use both the relative risk reduction stat and the absolute risk reduction stat.

    In terms of benefits, when you compile many statin trials, it looks like the relative risk reduction is 25 percent. So, if your ten-year risk of a heart attack or stroke is 5 percent, then taking a statin could lower that from 5 percent to 3.75 percent, for an absolute risk reduction of 1.25 percent, or a number needed to treat of 80, meaning there’s about a 1 in 80 chance that you’d avoid a heart attack or stroke by taking the drug for the next ten years. As you can see, as your baseline risk gets higher and higher, even though you have that same 25 percent risk reduction, your absolute risk reduction gets bigger and bigger. And, with a 20 percent baseline risk, that means you have a 1 in 20 chance of avoiding a heart attack or stroke over the subsequent decade if you take the drug, as seen below and at 3:31 in my video.

    So, those are the benefits. In terms of risk, that breast cancer finding appears to be a fluke. Put together all the studies, and “there was no association between use of statins and the risk of cancer.” In terms of muscle problems, estimates of risk range from approximately 1 in 1,000 to closer to 1 in 50.

    If all those numbers just blur together, the Mayo Clinic developed a great visualization tool, seen below and at 4:39 in my video.

    For those at average risk, 10 people out of 100 who do not take a statin may have a heart attack over the next ten years. If, however, all 100 people took a statin every day for those ten years, 8 would still have a heart attack, but 2 would be spared, so there’s about a 1 in 50 chance that taking the drug would help avert a heart attack over the next decade. What are the downsides? The cost and inconvenience of taking a pill every day, which can cause some gastrointestinal side effects, muscle aching, and stiffness in about 5 percent, reversible liver inflammation in 2 percent, and more serious damage in perhaps 1 in 20,000 patients.

    Note that the two happy faces in the bottom left row of the YES STATIN chart represent heart attacks averted, not lives saved. The chance that a few years of statins will actually save your life if you have no known heart disease is about 1 in 250.

    If you want a more personalized approach, the Mayo Clinic has an interactive tool that lets you calculate your ten-year risk. You can get there directly by going to bit.ly/statindecision.

    Michael Greger M.D. FACLM

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  • Are We Being Misled About the Benefits and Risks of Statins?  | NutritionFacts.org

    What is the dirty little secret of drugs for lifestyle diseases?

    Drug companies go out of their way—in direct-to-consumer ads, for example—to “present pharmaceutical drugs as a preferred solution to cholesterol management while downplaying lifestyle change.” You see this echoed in the medical literature, as in this editorial in the Journal of the American Medical Association: “Despite decades of exhortation for improvement, the high prevalence of poor lifestyle behaviors leading to elevated cardiovascular disease risk factors persists, with myocardial infarction [heart attack] and stroke remaining the leading causes of death in the United States. Clearly, many more adults could benefit from…statins for primary prevention.” Do we really need to put more people on drugs? A reply was published in the British Medical Journal: “Once again, doctors are implored to ‘get real’—stop hoping that efforts to help their patients and communities adopt healthy lifestyle habits will succeed, and start prescribing more statins. This is a self-fulfilling prophecy. Note that the author of these comments [the pro-statin editorial] disclosed receipt of funding from 11 drug companies, at least four of which produce or are developing new classes of cholesterol-lowering agents,” which make billions of dollars a year in annual sales.

    Every time the cholesterol guidelines expand the number of people eligible for statins, they’re decried as a “big kiss to big pharma.” This is understandable, since the majority of guideline panel members “had industry ties,” financial conflicts of interest. But these days, all the major statins are off-patent, so there are inexpensive generic versions. For example, the safest, most effective statin is generic Lipitor, sold as atorvastatin for as little as a few dollars a month. So, nowadays, the cholesterol guidelines are not necessarily “part of an industry plot.”

    “The US way of life is the problem, not the guidelines…” The reason so many people are candidates for cholesterol- and blood-pressure-lowering medications is that so many people are taking such terrible care of themselves. The bottom line is that “individuals must take more responsibility for their own health behaviors.” What if you are unwilling or unable to improve your diet and make lifestyle changes to bring down that risk? If your ten-year risk of having a heart attack is 7.5 percent or more and going to stay that way, then the benefits of taking a statin drug likely outweigh the risk. That’s really for you to decide, though. It’s your body, your choice.

    “Whether or not the overall benefit-harm balance justifies the use of a medication for an individual patient cannot be determined by a guidelines committee, a health care system, or even the attending physician. Instead, it is the individual patient who has a fundamental right to decide whether or not taking a drug is worthwhile.” This was recognized by some of medicine’s “historical luminaries such as Hippocrates,” but “only in recent decades has the medical profession begun to shift from a paternalistic ‘doctor knows best’ stance towards one explicitly endorsing patient-centered, evidence-based, shared decision-making.” One of the problems with communicating statin evidence to support this shared decision-making is that most doctors “have a poor understanding of concepts of risk and probability and…increasing exposure to statistics in undergraduate and postgraduate education hasn’t made much difference.” But that understanding is critical for preventive medicine. When doctors offer a cholesterol-lowering drug, “they’re doing something quite different from treating a patient who has sought help because she is sick. They’re not so much doctors as life insurance salespeople, peddling deferred benefits in exchange for a small (but certainly not negligible) ongoing inconvenience and cost. In this new kind of medicine, not understanding risk is the equivalent of not knowing about the circulation of the blood or basic anatomy. So, let’s dive in and see exactly what’s at stake.

    Below and at 3:55 in my video Are Doctors Misleading Patients About Statin Risks and Benefits? is an ad for Lipitor. When drug companies say a statin reduces the risk of a heart attack by 36 percent, that’s the relative risk.

    If you follow the asterisk I’ve circled after the “36%” in the ad, you can see how they came up with that. I’ve included it here and at 3:56 in my video. In a large clinical study, 3 percent of patients not taking the statin had a heart attack within a certain amount of time, compared to 2 percent of patients who did take the drug. So, the drug dropped heart attack risk from 3 percent to 2 percent; that’s about a one-third drop, hence the 36 percent reduced relative risk statistic. But another way to look at going from 3 percent to 2 percent is that the absolute risk only dropped by 1 percent. So, in effect, “your chance to avoid a nonfatal heart attack during the next 2 years is about 97% without treatment, but you can increase it to about 98% by taking a Crestor [a statin] every day.” Another way to say that is that you’d have to treat 100 people with the drug to prevent a single heart attack. That statistic may shock a lot of people.

    If you ask patients what they’ve been led to believe, they don’t think the chance of avoiding a heart attack within a few years on statins is 1 in 100, but 1 in 2. “On average, it was believed that most patients (53.1%) using statins would avoid a heart attack after statin treatment for 5 years.” Most patients, not just 1 percent of patients. And this “disparity between actual and expected effect could be viewed as a dilemma. On the one hand, it is not ethically acceptable for caregivers to deliberately support and maintain illusive treatment expectations by patients.” We cannot mislead people into thinking a drug works better than it really does, but on the other hand, how else are we going to get people to take their pills?

    When asked, people want an absolute risk reduction of at least about 30 percent to take a cholesterol-lowering drug every day, whereas the actual absolute risk reduction is only about 1 percent. So, the dirty little secret is that, if patients knew the truth about how little these drugs actually worked, almost no one would agree to take them. Doctors are either not educating their patients or actively misinforming them. Given that the majority of patients expect a much larger benefit from statins than they’d get, “there is a tension between the patient’s right to know about benefiting from a preventive drug and the likely reduction in uptake [willingness to take the drugs] if they are so informed,” and learn the truth. This sounds terribly paternalistic, but hundreds of thousands of lives may be at stake.

    If patients were fully informed, people would die. About 20 million Americans are on statins. Even if the drugs saved 1 in 100, that could mean hundreds of thousands of lives lost if everyone stopped taking their statins. “It is ironic that informing patients about statins would increase the very outcomes they were designed to prevent.”

    Michael Greger M.D. FACLM

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  • Should You Take Statins?  | NutritionFacts.org

    How can you calculate your own personal heart disease risk to help you determine if you should start on a cholesterol-lowering statin drug?

    The muscle-related side effects from cholesterol-lowering statins “are often severe enough for patients to stop taking the drug. Of course, these side effects could be coincidental or psychosomatic and have nothing to do with the drug,” given that many clinical trials show such side effects are rare. “It is also possible that previous clinical trials”—funded by the drug companies themselves—“under-recorded the side effects of statins.” The bottom line is that there’s an urgent need to establish the true incidence of statin side effects.

    “What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug?” That’s the title of a journal article that reports that, even in trials funded by Big Pharma, “only a small minority of symptoms reported on statins are genuinely due to the statins,” and those taking statins are significantly more likely to develop type 2 diabetes than those randomized to placebo sugar pills. Why? We’re still not exactly sure, but statins may have the double-whammy effect of impairing insulin secretion from the pancreas while also diminishing insulin’s effectiveness by increasing insulin resistance.

    Even short-term use of statins may “approximately double the odds of developing diabetes and diabetic complications.” As shown below and at 1:49 in my video Who Should Take Statins?, fewer people develop diabetes and diabetic complications off statins over a period of about five years than those who do develop diabetes while on statins. “Of more concern, this increased risk persisted for at least 5 years after statin use stopped.”

    “In view of the overwhelming benefit of statins in the reduction of cardiovascular events,” the number one killer of men and women, any increase in risk of diabetes, our seventh leading cause of death, would be outweighed by any cardiovascular benefits, right? That’s a false dichotomy. We don’t have to choose between heart disease and diabetes. We can treat the cause of both with the same diet and lifestyle changes. The diet that can not only stop heart disease, but also reverse it, is the same one that can reverse type 2 diabetes. But what if, for whatever reason, you refuse to change your diet and lifestyle? In that case, what are the risks and benefits of starting statins? Don’t expect to get the full scoop from your doctor, as most seemed clueless about statins’ causal link with diabetes, so only a small fraction even bring it up with their patients.

    “Overall, in patients for whom statin treatment is recommended by current guidelines, the benefits greatly outweigh the risks.” But that’s for you to decide. Before we quantify exactly what the risks and benefits are, what exactly are the recommendations of current guidelines?

    How should you decide if a statin is right for you? “If you have a history of heart disease or stroke, taking a statin medication is recommended, without considering your cholesterol levels.” Period. Full stop. No discussion needed. “If you do not yet have any known cardiovascular disease,” then the decision should be based on calculating your own personal risk. If you know your cholesterol and blood pressure numbers, it’s easy to do that online with the American College of Cardiology risk estimator or the Framingham risk profiler.

    My favorite is the American College of Cardiology’s estimator because it gives you your current ten-year risk and also your lifetime risk. So, for a person with a 5.8 percent risk of having a heart attack or stroke within the next decade, if they don’t clean up their act, that lifetime risk jumps to 46 percent, nearly a flip of the coin. If they improved their cholesterol and blood pressure, though, they could reduce that risk by more than tenfold, down to 3.9 percent, as shown below and at 4:11 in my video.

    Since the statin decision is based on your ten-year risk, what do you do with that number? As you can see here and at 4:48 in my video, under the current guidelines, if your ten-year risk is under 5 percent, then, unless there are extenuating circumstances, you should just stick to diet, exercise, and smoking cessation to bring down your numbers. In contrast, if your ten-year risk hits 20 percent, then the recommendation is to add a statin drug on top of making lifestyle modifications. Unless there are risk-enhancing factors, the tendency is to stick with lifestyle changes if risk is less than 7.5 percent and to move towards adding drugs if above 7.5 percent.

    Risk-enhancing factors that your doctor should take into account when helping you make the decision include a bad family history, really high LDL cholesterol, metabolic syndrome, chronic kidney or inflammatory conditions, or persistently high triglycerides, C-reactive protein, or LP(a). You can see the whole list here and at 4:54 in my video.

    If you’re still uncertain, guidelines suggest you consider getting a coronary artery calcium (CAC) score, but even though the radiation exposure from that test is relatively low these days, the U.S. Preventive Services Task Force has explicitly concluded that the current evidence is insufficient to conclude that the benefits outweigh the harms.

    Michael Greger M.D. FACLM

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  • Women who experienced stalking or obtained restraining orders have higher risk of heart disease, study finds

    Dr. Ramneek Dosanjh got married young. But before long, she says her marriage dissolved into a cycle of control and domestic violence. 

    “Within a week of meeting and dating, tells you they love you and they will marry you, you know, it all seems dreamy,” Dosanjh told CBS News. 

    It got worse, she says, when she tried to leave.

    “You just don’t know if you can sustain living that way,” said Dosanjh, who then chose to get an order of protection against her then-husband.

    The toll on her health started to show.
     
    “I had abnormal stress tests,” Dosanjh said. “I had to have a cardiac catheterization.”

    And she’s not alone according to a study released last month by the Harvard T.H. Chan School of Public Health.

    “We saw this association, which frankly also blew me away,” said Dr. Karestan Koenen, who led a team of Harvard researchers who analyzed data for about 66,270 American nurses, ages 36 to 56, who were surveyed about their own health for 20 years between 2001 and 2021.

    Of those in the survey, 11.7% reported experience with stalking, and 5.6% reported experience with obtaining a restraining order.

    The study, published in the scientific journal Circulation, found that the risk for cardiovascular disease was 41% higher in women who had experienced stalking — and 70% higher for women who had obtained a restraining order — compared to those who had not.

    “We have all the information on their diet and exercise,” Koenen said. “And we find that it’s really the stalking that increases the risk, not all these other factors, because we can adjust for them.”

    “Experiences of stalking and obtaining a restraining order are both associated with an increased risk of developing CVD (cardiovascular disease) in women,” the study concluded. “Common experiences of violence among women may affect cardiovascular health and warrant consideration alongside more traditional risk factors.”

    Many of the women that CBS News talked to were afraid to disclose their identities. One of them says she and her children were abused by their father.

    “I had three recurring episodes of deep vein thrombosis, which means another three blood clots in a short amount of time,” the woman told CBS News.

    According to a 2016-2017 survey from the U.S. Centers for Disease Control and Prevention, nearly one in three women have experienced stalking at some point in their lives.

    Researchers say the results of the study could spur doctors to add questions about stalking and restraining orders when screening for heart health risk factors in the future.

    Said Koenen, “The ultimate goal is to improve women’s health.”

    For anonymous, confidential help, people can call the National Domestic Violence Hotline at 1-800-799-7233 or 1-800-787-3224. People can text START to 88788 or chat on TheHotline.org.

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  • Nearly half of people with diabetes don’t know they have it, new study finds

    (CNN) — When was the last time you had your blood sugar checked? It might be worth looking into, a new study says.

    Forty-four percent of people age 15 and older living with diabetes are undiagnosed, so they don’t know they have it, according to data analysis published Monday in the journal The Lancet Diabetes & Endocrinology.

    The study looked at data from 204 countries and territories from 2000 to 2023 in a systematic review of published literature and surveys. The findings at the global level are for people age 15 and older.

    “The majority of people with diabetes that we report on in the study have type 2 diabetes,” said Lauryn Stafford , the lead author of the study.

    Around 1 in 9 adults live with diabetes worldwide, according to the International Diabetes Foundation. In the United States, 11.6% of Americans have diabetes, according to 2021 data from the American Diabetes Association.

    “We found that 56% of people with diabetes are aware that they have the condition,” said Stafford, a researcher for the Institute for Health Metrics and Evaluation. “Globally, there’s a lot of variation geographically, and also by age. So, generally, higher-income countries were doing better at diagnosing people than low- and middle-income countries.”

    Younger people don’t know they have diabetes

    People under 35 years were much less likely to be diagnosed if they had diabetes than people in middle age or older. Just “20% of young adults with diabetes were aware of their condition,” Stafford said.

    Routine screenings aren’t promoted as much for young adults as for older adults. Many larger organizations, like the American Diabetes Association, suggest annual routine screenings for adults 35 and older.

    “You can survive with elevated glucose levels for many, many years,” Stafford said. “People end up getting diagnosed with diabetes only at the point where they have complications,” which are more common in older adults.

    Depending on how long a person has had diabetes before it’s discovered, the health impacts may vary.

    “Diagnosing diabetes early is important because it allows for timely management to prevent or delay long-term complications such as heart disease, kidney failure, nerve damage, and vision loss,” said Rita Kalyani, chief scientific and medical officer at the American Diabetes Association. She was not involved in the study.

    Around one-third of adults are diagnosed with diabetes later than their earliest symptom, according to a 2018 study.

    What symptoms should you look for?

    “Symptoms of diabetes include increased thirst or hunger, frequent urination, blurry vision, unexpected weight loss, and fatigue. However, in the early stages, most people with diabetes are asymptomatic, which highlights the importance of screening and diagnosis,” said Kalyani, a professor of medicine in the division of endocrinology, diabetes and metabolism at Johns Hopkins University.

    If you experience any of these symptoms or have a history of diabetes in your family, experts recommend you get a glucose screening.

    Globally, in 2023, about 40% of people with treated diabetes were getting optimal results and lowering their blood sugar, said Stafford. That’s why it’s important that future efforts focus on ensuring that more people receive and follow proper treatment post-diagnosis.

    That only 4 in 10 patients were seeing optimal results was surprising, as several well-established treatments, including insulin, Metformin and other drugs like GLP-1s, are available.

    People with diabetes likely also have other health issues, such as hypertension or chronic kidney disease, which can make treatment complex, Stafford added.

    Can you prevent diabetes?

    It depends.

    While there is no known way to prevent type 1 diabetes, there are many ways to prevent the more common form of type 2 diabetes.

    Reducing the amount of red and processed meats you eat can help lower your risk of type 2 diabetes, as previously reported by CNN. You could do this with a Mediterranean diet or by introducing more plant-based foods to your meals.

    In addition, limit the amount of ultraprocessed foods you eat, adding more whole foods, like fruits and nuts, instead.

    Incorporating physical activity into your regular routine can also decrease your risk of developing not only diabetes but also other chronic diseases. Fast walking for at least 15 minutes a day is just one form of exercise you can do.

    “I think, ultimately, if we can also focus more on the risk factors for developing diabetes — preventing people from needing to be diagnosed in the first place — that is also critical,” Stafford said.

    Gina Park and CNN

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  • Mental Illness Linked to Higher Heart Disease Risk and Shorter Lives

    A sweeping review published in The Lancet Regional Health—Europe has drawn a direct line between mental health disorders and cardiovascular disease (CVD), showing that individuals living with psychiatric conditions face not only a higher risk of heart problems but also a shorter life expectancy. The paper, authored by researchers from Emory University, the University of Copenhagen, the University of Leeds, and others, concludes that people with depression, schizophrenia, bipolar disorder, post-traumatic stress disorder (PTSD), and anxiety live 10 to 20 years less on average, mainly due to heart disease.

    A Bidirectional Threat

    The analysis shows that the connection between mental health and cardiovascular disease is not one-directional. The stress of a heart attack or stroke can trigger psychiatric disorders, while psychiatric conditions themselves set the stage for heart disease. The risks are striking as depression raises cardiovascular risk by 72 percent, schizophrenia by 95 percent, bipolar disorder by 57 percent, PTSD by 61 percent, and anxiety disorders by 41 percent. “It is important to understand that stress, anxiety, and depression can affect your heart, just like other physical factors,” the paper noted, offering guidance for how doctors might begin crucial conversations with patients.

    A Widespread Burden

    One in four people will experience a mental health disorder in their lifetime, yet many go untreated and often receive poor cardiovascular care. “Despite having more interactions with the healthcare system, they undergo fewer physical checkups and screenings and receive fewer diagnoses and treatments for CVD and its risk factors,” the authors reported. According to 2023 U.S. survey data cited in the study, more than half of those who met the criteria for a mental health disorder had not received any treatment, with even lower rates among non-White populations.

    Shared Risk Factors

    Researchers identified a cluster of overlapping drivers—poverty, trauma, social disadvantage, substance use, and poor access to health care—that amplify the dual risks of mental illness and cardiovascular disease. Lifestyle behaviors such as smoking, poor diet, physical inactivity, and disrupted sleep patterns are also more common among people with psychiatric conditions. The biological picture is equally troubling. Dysregulation of the stress response system, inflammation, and autonomic nervous system dysfunction are all pathways through which psychiatric disorders may accelerate cardiovascular decline.

    Breaking the Cycle

    The study calls for a fundamental shift in medical practice. “For the best care, an integrated approach is needed to address the complex needs of this vulnerable population,” the authors wrote. “Such approach should offer enhanced support and interdisciplinary care encompassing mental, cardiovascular, and behavioral health, as well as consideration of the social needs and barriers to care.” Among the interventions reviewed, exercise emerged as one of the most effective treatments, improving both mood and heart health. Evidence shows that physical activity can deliver improvements on par with or greater than medication or psychotherapy for depression. Mind-body practices like yoga and mindfulness, while requiring more evaluation, also show promise for improving outcomes across both mental and cardiovascular health.

    A Call to Integrate Care

    The authors stressed that progress depends on healthcare systems breaking down the wall between physical and mental health. For decades, treatment has been siloed, with psychiatrists focusing on the mind and cardiologists on the body. That separation, the study finds, has left millions vulnerable. The authors argue for expanded insurance coverage, investment in housing and employment stability, and the inclusion of psychiatric patients in cardiovascular research. Above all, they call for integrated care models that recognize the tight link between mental and cardiovascular health.

    Global Health Priority

    The stakes are enormous. The World Health Organization has set a 2025 target to reduce the global burden of cardiovascular disease. The paper argues that this goal cannot be reached without directly addressing the disparities faced by those with psychiatric disorders.

    “Closing the disparity gap for individuals with mental health disorders would be consistent with the World Health Organization 2025 targets of reducing the global burden of CVD,” the researchers concluded. “Reducing these disparities would also uphold the rights of people with mental health disorders to achieve the highest possible level of health and to fully participate in society and the workforce.”

    Stacy M. Brown, NNPA Newswire Senior National Correspondent and NNPA

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  • There may soon be a new approach to treat hard-to-control high blood pressure

    Doctors may soon have a new way to treat high blood pressure, even among people for whom medicines haven’t worked well in the past.Baxdrostat, an experimental medicine made by AstraZeneca, showed promise in treating people with uncontrolled or resistant high blood pressure in a recent trial. If the medicine gets approved by regulatory authorities, it will be one of the first new approaches to treating high blood pressure in decades, researchers say.Scientists presented the trial results Saturday at the European Society of Cardiology Congress 2025 in Madrid and simultaneously published them in the New England Journal of Medicine.For the study, researchers enrolled 800 adults who still had high blood pressure after taking two or more medications for at least four weeks. To qualify for the study, patients’ systolic blood pressure had to be between 140 and 170.Blood pressure is measured in millimeters of mercury, which is abbreviated as mm Hg. The measurement has an upper number, or systolic reading, and a lower number, a diastolic reading. Systolic pressure measures the force of blood as it pumps out of the heart into the arteries; diastolic is the pressure created as the heart rests between beats.Normal blood pressure is less than 120/80 mm Hg, and elevated blood pressure is considered to be from 120 to 129/80 mm Hg. At 130/80 mmHg or higher, according to new U.S. guidelines, a person’s medical provider will want them to take a blood pressure medication if lifestyle changes — including eating healthier, reducing salt in the diet and exercising more — don’t work first.The researchers on the new trial placed the participants into three groups. One received 1 milligram of baxdrostat, another got 2 mg, and another got a placebo, which does nothing. Participants took their dose in addition to medicines they were already taking.At 12 weeks, about 4 in 10 patients taking baxdrostat reached healthy blood pressure levels, compared with less than 2 in 10 who got a placebo.Specifically, participants who got 1 or 2 mg of baxdrostat daily saw their systolic blood pressure – the upper number in the reading – fall around 9 to 10 mm Hg more than those taking a placebo. This reduction, studies show, is large enough to cut cardiovascular risk.When blood pressure is high, the force of the blood pushes against the walls of their blood vessels, making the heart less efficient: Both the vessels and the heart must work harder, and it’s more difficult to get blood to essential organs and cells. Without treatment, high blood pressure will eventually damage the arteries, raising the risk of conditions like a heart attack, stroke, coronary disease, vascular dementia and cognitive problems.Heart disease is the No. 1 killer in the world. Lowering blood pressure is the most modifiable way to avoid such a death.Nearly half of all adults in the U.S. have higher than normal blood pressure, and 1 in 10 people have what doctors call resistant hypertension: Despite being on three or more medications, they are not meeting the goal for blood pressure control.When a patient has high blood pressure, doctors may need to try a variety of medications to see what works best.Adding baxdrostat to the list of options could be a big help for patients, according to Dr. Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved with the new research.“What’s interesting about this medication is that they can really be a wonderful partner, so to speak, with some of the more classically recommended anti-hypertensive medications,” said Rosen, who is also a senior vice president of women’s health and executive director of the Katz Institute for Women’s Health of Northwell Health in New York City.Medication options now on the market control blood pressure in a variety of ways. Some, such as vasodilators, relax and widen arteries and veins to allow blood to get through easier and increase flow. Diuretics primarily work by removing excess fluid and salt from the body by increasing urine production. Centrally acting alpha agonists help prevent the nervous system from responding to stress. ACE inhibitors keep the body from producing angiotensin II, a hormone that makes blood vessels constrict. ARBs, or angiotensin II receptor blockers, help reduce the production of aldosterone, a hormone that promotes salt and water retention. Calcium channel blockers can keep calcium away from the cells of the heart and arteries so they don’t have to work as hard.Each can have different side effects, including dizziness, rapid or slower heart rate, exhaustion, upset stomach and swelling in the legs.Baxdrostat’s side effects, the study showed, were mild overall. The most common problem was abnormalities in potassium and sodium levels, but this was rare.Baxdrostat takes a new approach to managing high blood pressure. It focuses on blocking aldosterone, a hormone created by the adrenal glands that helps kidneys regulate salt and maintain the body’s water balance. Some people produce too much aldosterone, leading their body to retain too much water and salt, pushing up blood pressure.“We’ve also known for a while now that most of us eat too much salt and in doing that, it raises blood pressure. But we’re also increasingly recognizing that aldosterone may have a direct impact on causing damage to the blood vessels, to the heart, to the kidneys,” said Dr. Jenifer Brown, one of the lead investigators and co-author of the published study.Brown said she often sees cardiology patients at Brigham and Women’s who may have had a heart event, so she needs to be aggressive in getting their blood pressure under control to prevent another. Some patients may have trouble tolerating other blood pressure medications. For others, the standard medicines just don’t work well. Baxdrostat could be a good complement, she said.“We really have had the same tools as clinicians for many years,” Brown said. “I would be excited to have an option like this.”In an editorial accompanying the publication, Dr. Tomasz Guzik, a cardiovascular scientist at the University of Edinburgh, and Dr. Maciej Tomaszewski, a cardiovascular expert at the University of Manchester, write that next steps should be to figure out which patients would best respond to this new medicine and provide longer-term data. If the medication works long-term, they wrote, it could become a “central piller of therapy for difficult-to-control hypertension.”AstraZeneca said it plans to submit its data to regulatory agencies before the end of 2025.

    Doctors may soon have a new way to treat high blood pressure, even among people for whom medicines haven’t worked well in the past.

    Baxdrostat, an experimental medicine made by AstraZeneca, showed promise in treating people with uncontrolled or resistant high blood pressure in a recent trial. If the medicine gets approved by regulatory authorities, it will be one of the first new approaches to treating high blood pressure in decades, researchers say.

    Scientists presented the trial results Saturday at the European Society of Cardiology Congress 2025 in Madrid and simultaneously published them in the New England Journal of Medicine.

    For the study, researchers enrolled 800 adults who still had high blood pressure after taking two or more medications for at least four weeks. To qualify for the study, patients’ systolic blood pressure had to be between 140 and 170.

    Blood pressure is measured in millimeters of mercury, which is abbreviated as mm Hg. The measurement has an upper number, or systolic reading, and a lower number, a diastolic reading. Systolic pressure measures the force of blood as it pumps out of the heart into the arteries; diastolic is the pressure created as the heart rests between beats.

    Normal blood pressure is less than 120/80 mm Hg, and elevated blood pressure is considered to be from 120 to 129/80 mm Hg. At 130/80 mmHg or higher, according to new U.S. guidelines, a person’s medical provider will want them to take a blood pressure medication if lifestyle changes — including eating healthier, reducing salt in the diet and exercising more — don’t work first.

    The researchers on the new trial placed the participants into three groups. One received 1 milligram of baxdrostat, another got 2 mg, and another got a placebo, which does nothing. Participants took their dose in addition to medicines they were already taking.

    At 12 weeks, about 4 in 10 patients taking baxdrostat reached healthy blood pressure levels, compared with less than 2 in 10 who got a placebo.

    Specifically, participants who got 1 or 2 mg of baxdrostat daily saw their systolic blood pressure – the upper number in the reading – fall around 9 to 10 mm Hg more than those taking a placebo. This reduction, studies show, is large enough to cut cardiovascular risk.

    When blood pressure is high, the force of the blood pushes against the walls of their blood vessels, making the heart less efficient: Both the vessels and the heart must work harder, and it’s more difficult to get blood to essential organs and cells. Without treatment, high blood pressure will eventually damage the arteries, raising the risk of conditions like a heart attack, stroke, coronary disease, vascular dementia and cognitive problems.

    Heart disease is the No. 1 killer in the world. Lowering blood pressure is the most modifiable way to avoid such a death.

    Nearly half of all adults in the U.S. have higher than normal blood pressure, and 1 in 10 people have what doctors call resistant hypertension: Despite being on three or more medications, they are not meeting the goal for blood pressure control.

    When a patient has high blood pressure, doctors may need to try a variety of medications to see what works best.

    Adding baxdrostat to the list of options could be a big help for patients, according to Dr. Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved with the new research.

    “What’s interesting about this medication is that they can really be a wonderful partner, so to speak, with some of the more classically recommended anti-hypertensive medications,” said Rosen, who is also a senior vice president of women’s health and executive director of the Katz Institute for Women’s Health of Northwell Health in New York City.

    Medication options now on the market control blood pressure in a variety of ways. Some, such as vasodilators, relax and widen arteries and veins to allow blood to get through easier and increase flow. Diuretics primarily work by removing excess fluid and salt from the body by increasing urine production. Centrally acting alpha agonists help prevent the nervous system from responding to stress. ACE inhibitors keep the body from producing angiotensin II, a hormone that makes blood vessels constrict. ARBs, or angiotensin II receptor blockers, help reduce the production of aldosterone, a hormone that promotes salt and water retention. Calcium channel blockers can keep calcium away from the cells of the heart and arteries so they don’t have to work as hard.

    Each can have different side effects, including dizziness, rapid or slower heart rate, exhaustion, upset stomach and swelling in the legs.

    Baxdrostat’s side effects, the study showed, were mild overall. The most common problem was abnormalities in potassium and sodium levels, but this was rare.

    Baxdrostat takes a new approach to managing high blood pressure. It focuses on blocking aldosterone, a hormone created by the adrenal glands that helps kidneys regulate salt and maintain the body’s water balance. Some people produce too much aldosterone, leading their body to retain too much water and salt, pushing up blood pressure.

    “We’ve also known for a while now that most of us eat too much salt and in doing that, it raises blood pressure. But we’re also increasingly recognizing that aldosterone may have a direct impact on causing damage to the blood vessels, to the heart, to the kidneys,” said Dr. Jenifer Brown, one of the lead investigators and co-author of the published study.

    Brown said she often sees cardiology patients at Brigham and Women’s who may have had a heart event, so she needs to be aggressive in getting their blood pressure under control to prevent another. Some patients may have trouble tolerating other blood pressure medications. For others, the standard medicines just don’t work well. Baxdrostat could be a good complement, she said.

    “We really have had the same tools as clinicians for many years,” Brown said. “I would be excited to have an option like this.”

    In an editorial accompanying the publication, Dr. Tomasz Guzik, a cardiovascular scientist at the University of Edinburgh, and Dr. Maciej Tomaszewski, a cardiovascular expert at the University of Manchester, write that next steps should be to figure out which patients would best respond to this new medicine and provide longer-term data. If the medication works long-term, they wrote, it could become a “central piller of therapy for difficult-to-control hypertension.”

    AstraZeneca said it plans to submit its data to regulatory agencies before the end of 2025.

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  • Supreme Court says Trump may cancel DEI-related health research grants

    WASHINGTON — A divided Supreme Court said Thursday the Trump administration may cancel hundreds of health research grants that involve diversity, equity and inclusion or gender identity.

    The justices granted an emergency appeal from President Trump’s lawyers and set aside a Boston’s judge order that blocked the canceling of $783 million in research grants.

    The justices split 5-4. Chief Justice John G. Roberts Jr. joined the court’s three liberals in dissent and said the district judge had not overstepped his authority.

    The court’s conservative majority has repeatedly sided with the administration and against federal judges in disputes over spending and staffing at federal agencies.

    In the latest case, the majority agreed that Trump and his appointees may decide on how to spend health research funds allocated by Congress.

    Upon taking office in January, Trump issued an executive order “ending radical and wasteful government DEI programs and preferencing.”

    A few weeks later, the acting director of the National Institutes of Health said the agency would no longer fund “low-value and off-mission research programs, including but not limited to studies based on diversity, equity, and inclusion (DEI) and gender identity.”

    More than 1,700 grants were canceled.

    Trump’s lawyers told the court the NIH had terminated grants to study “Buddhism and HIV stigma in Thailand”; “intersectional, multilevel and multidimensional structural racism for English- and Spanish-speaking populations”; and “anti-racist healing in nature to protect telomeres of transitional age BIPOC [Black, Indigenous, and People of Color] for health equity.”

    California Atty. Gen. Rob Bonta and his counterparts from 15 Democrat-led states had sued to halt what they called an “unprecedented disruption to ongoing research.” They were joined by groups of researchers and public health advocates.

    The state attorneys said their public universities were using grant money for “projects investigating heart disease, HIV/AIDS, Alzheimer’s disease, alcohol and substance abuse, mental-health issues, and countless other health conditions.”

    They said the NIH had terminated a grant for a University of California study examining how inflammation, insulin resistance and physical activity affect Alzheimer’s disease in Black women, a group with higher rates and a more aggressive profile of the disease.

    Also terminated, they said, was a University of Hawaii study that aimed to identify genetic and biological risk factors for colorectal cancer among Native Hawaiians, a population with increased incidence and mortality rates of that disease.

    In June, the Democratic state attorneys won a ruling from U.S. District Judge William G. Young, a Reagan appointee. He said the sudden halt to research grants violated a federal procedural law because it was “arbitrary” and poorly explained.

    He said Trump had required agencies “to focus on eradicating anything that it labels as Diversity, Equity and Inclusion (“DEI”), an undefined enemy.” He said he had tried and failed to get a clear definition of DEI and what it entailed.

    When the 1st Circuit Court refused to lift the judge’s order, Trump’s Solicitor Gen. D. John Sauer appealed to the Supreme Court in late July.

    He noted the justices in April had set aside a similar decision from a Boston-based judge who blocked the new administration’s canceling of education grants.

    The solicitor general argued that Trump’s order rescinded an executive order from President Biden in 2021 that mandated “an ambitious whole-of-government equity agenda” and instructed federal agencies to “allocate resources to address the historic failure to invest sufficiently, justly, and equally in underserved communities.”

    He said the new administration decided these DEI-related grants “do nothing to expand our knowledge of living systems, provide low returns on investment, and ultimately do not enhance health, lengthen life, or reduce illness.”

    David G. Savage

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  • True Health Intiative: Scientific Consensus on a Healthy Diet  | NutritionFacts.org

    The leading risk factor for death in the United States is the American diet.

    About a decade ago, the American Heart Association (AHA) expressed concern that its “2020 target of improving cardiovascular health by 20% by 2020 will not be reached if current trends continue.” By 2006, most people were already not smoking and had nearly achieved their goal for exercise. But when it came to healthy diet score, only about 1 percent got a 4 or 5 out of its diet quality score of 0 to 5, as you can see below and at 0:35 in my video, Friday Favorites: The Scientific Consensus on a Healthy Diet. And that’s with such “ideal” criteria as drinking less than four and a half cups of soda a week.

    In the last decade, the AHA saw a bump in the prevalence of the ideal healthy diet score to about 1 percent of Americans reaching those kinds of basic criteria, but, given its “aggressive” goal of reaching a “20% target” by 2020, it hoped to turn that 1 percent into about 1.2 percent. (Really, as you can see here and at 1:01 in my video.)

    So, how’d we do? According to the 2019 update, it seems we’ve slipped down to as low as one in a thousand, and American teens scored a big fat zero. No wonder, perhaps, that “for all mortality-based metrics, the US rank declined…to 27th or 28th among 34 OECD [industrialized] countries. Citizens living in countries with a substantially lower gross domestic product and health expenditure per capita…have lower mortality rates than those in the United States.” Slovenia, for example, beat the United States, ranking 24th in life expectancy. More recently, the United States’s life expectancy slipped further, down to 43rd in the world, although the United States spent the most ($3.0 trillion) on health care…”

    What is the leading risk factor for death in the United States? As seen below and at 2:04 in my video, it is the standard American diet. Those trillions in health care spending aren’t addressing the root cause of disease, disability, and death. 

    Here are some of the lung cancer death curves, below and at 2:08 in my video:

    It took decades to finally turn the corner, but it’s so nice to finally see those drops. When will we see the same with diet?

    “Approximately 80% of chronic disease and premature death could be prevented by not smoking, being physically active, and adhering to a healthful dietary pattern.” What exactly is meant by “healthy diet”? “Unfortunately, media messages surrounding nutrition are often inconsistent, confusing, and do not enable the public to make positive changes in health behaviors….Certainly, there is pressure within today’s competitive journalism market for sensationalism. There may even be a disincentive to present the facts in the context of the total body of information consumers need to act on dietary recommendations.” And there’s an incentive to sell more magazines and newspapers. The paper I’m quoting was written in 1997, before the lure of clickbait headlines. In fact, about three-quarters of a century ago, it was noted: “It is unfortunate that the subject of nutrition seems to have a special appeal to the credulous, the social zealot and, in the commercial field, the unscrupulous….The combination is one calculated to strike despair in the hearts of the sober, objective scientist.”

    Indeed, the most important health care problem we face may be “our poor lifestyle choices based on misinformation.” It is like the climate change deniers: “Analogous to outspoken cynics denying climate change and influencing public opinion, healthy lifestyle and dietary advice are overshadowed by critics, diet books, the food industry, and misguided information in the media.” Maybe we need an entity like the Intergovernmental Panel on Climate Change (IPCC)—but for nutrition.

    These days, “no single expert, regardless of academic stature or reputation, has the prominence to overcome the obstacles created by confusing media messages and deliver the fundamental principles of healthy living effectively to the public.”

    What if there were “a global coalition consisting of a variety of nutrition experts, who collectively represent the views held by the majority of scientists, physicians, and health practitioners” that could “serve as the guiding resource of sound nutrition information for improved health and prevention of disease”?

    Enter the True Health Initiative, which “was conceived for that very purpose.” A nonprofit coalition of hundreds of experts from dozens of countries has agreed to a consensus statement on the fundamentals of healthy living. See www.truehealthinitiative.org.

    Spoiler alert: The healthiest diet is one generally comprised mostly of minimally processed plants.

    Michael Greger M.D. FACLM

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