Category Archives: Health

A New Class Of Cholesterol Drugs

I wish I had more confidence that they’re not just treating a symptom:

As for the efficacy of the drugs, it is not yet proved that very low LDL levels produced by drugs lead to sharp reductions in heart attacks, strokes and deaths from cardiovascular disease, as researchers have seen in people with the naturally inactive PCSK9 gene.

Many cardiologists, though, are persuaded by a large body of evidence supporting the idea that the lower the LDL, the lower the risk.

“I believe lower is better and do not believe that a very low LDL is harmful,” said Dr. Daniel Rader, a cardiologist at the University of Pennsylvania.

Others, like Dr. Harlan Krumholz, a cardiologist at Yale, urge caution. “We are in a period of exuberant enthusiasm about these drugs,” he said. “We could just be performing cosmetic surgery on a lab value.”

If it were certain that the PCSK9 inhibitors were safe and effective in preventing heart attacks and deaths there would be no need for clinical trials, he noted.

$14,000/year is a lot of money for a treatment for which we have no idea whether or not it’s effective. I think improving diets would be much more cost effective.

[Update Tuesday morning]

Here’s a longer piece about the new drugs and the issues. Note: 1) It is assumed that the goal is to lower cholesterol, and that this will in turn result in lower mortality and 2) No mention of diet as a potential solution. Of course, it’s hard to get people to change their diets. But I suspect that to the degree that doctors are telling people to do so, they’re still telling them to cut out sat fat and cholesterol, despite all the actual science, and probably still telling them to follow FDA food-pyramic advice, which is junk science.

[Bumped]

First Restaurants Raise Wages

Then what?

Americans spend a phenomenal amount of money consuming food outside their homes, and a major reason is that with restaurant labor so cheap, the convenience and price are attractive to people who don’t feel like cooking. If the wages go up, that calculus shifts. And unfortunately those “rich bosses” can’t just take it out of their profits, because margins in the industry are under 5 percent, and the difference between making that profit and closing up shop can be surprisingly thin. Empty seats don’t just cost you rent; they make it hard to get good servers, because empty seats mean lost tip income. You can end up in a vicious spiral where your service gets worse, so your restaurant loses more customers, so the service gets even worse . . . and it’s time to call the bank and tell them you won’t be paying off that loan.

The economic ignorami don’t seem to understand that restaurants have competition in addition to other restaurants — cooking your own meals at home. In fact, the high cost of dining out is one of the reasons (though not the only one, also I can feed myself more healthily, and I really don’t enjoy sitting around being served by people) that I rarely eat out unless I’m traveling. With 25% unemployment of black youth, raising the minimum wage (or in fact having one at all) is a moral atrocity.

The Science Of Skipping Breakfast

As with most of these studies, it’s junk science:

At 8:30 in the morning for four weeks, one group of subjects got oatmeal, another got frosted corn flakes and a third got nothing. And the only group to lose weight was … the group that skipped breakfast. Other trials, too, have similarly contradicted the federal advice, showing that skipping breakfast led to lower weight or no change at all.

Emphasis mine. I guess it didn’t occur to them to have a group that got a healthy breakfast, like bacon and eggs.

But at least they do admit that observational studies are worse than worthless.

Cholesterol

Finally. The feds are on the verge of withdrawing decades of unscientific warnings about eating it. But they’ve still got it wrong:

The finding follows an evolution of thinking among many nutritionists who now believe that, for healthy adults, eating foods high in cholesterol may not significantly affect the level of cholesterol in the blood or increase the risk of heart disease.

The greater danger in this regard, these experts believe, lies not in products such as eggs, shrimp or lobster, which are high in cholesterol, but in too many servings of foods heavy with saturated fats, such as fatty meats, whole milk, and butter.

There is zero scientific evidence that eating saturated fat is a problem. Zero. And yet they persist.

High Blood Pressure

This looks interesting, but I’d like to see some numbers. Like, how much does it cost, and what kind of reductions are they seeing? I often see studies that amuse me, as though a barely-statisrically-significant 10% risk reduction for some expensive drug with unpleasant side effects is actually worth it.

And is it a permanent solution, or does it require periodic retreatment? Also, are there side effects (like insufficient blood flow to the brain on suddenly standing up)?