Guidelines? Good Grief!

Guidelines? Good Grief!

Infuriating, annoying, preposterous, laughable

That pretty much sums up the new guidelines for heart disease prevention in women, released last week by the American Heart Association (AHA). And all of those qualities especially apply to the explanation of the guidelines offered by Good Morning America.

Gold standard

If you call Central Casting and ask them to send up an actor who can play the part of a favorite uncle – someone with a kindly smile, who speaks in soothing, authoritative tones – they might send someone exactly like Dr. Tim Johnson, the medical editor for Good Morning America.

Last week when the news about the AHA guidelines broke, Dr. Johnson was there to gently assure us that the guidelines have “many interesting messages.”

Then Dr. Johnson led off with this completely infuriating comment: “The guidelines remind us that many of the common antioxidant vitamins, including vitamin E (which used to be known as the heart vitamin) and folic acid that these aren’t helpful.”

Bing! Just like that. Vitamin E and folic acid are null and void when it comes to heart disease prevention. “These aren’t helpful.” I don’t know what’s more infuriating: the blatant inaccuracy or the breezy, dismissive tone.

And I seem to have missed the memo about vitamin E not being known as the “heart vitamin” anymore. But then I’m not in the same mainstream loop as Dr. Johnson. According to the medical mainstream, inept research (which tests inferior forms of vitamin E on subjects who are gravely ill) is considered the gold standard. Never mind the scores of studies that have shown vitamin E to be absolutely essential for heart health.

Forget the vitamins but take your drugs!

Next up: Annoying.

Dr. Johnson tells us that low dose aspirin is “probably important now for all women over 65.” Sure, if you don’t mind trading one risk for another. In the e-Alert “Wonder Goes Under” (3/16/05), I told you about a 10-year study in which nearly 20,000 women over the age of 45 took 100 mg of aspirin every other day. About the same number of women took a placebo. Results showed that subjects over the age of 65 reduced stroke and heart attack risk by about one-third, but they also had a 40 percent increased risk of gastrointestinal bleeding – so severe in some cases that transfusions were required.

And of course, you could see this preposterous comment coming a mile away: “Women who are at very high risk should get their LDL down below 70.”

As Dr. Johnson is well aware, it’s virtually impossible to reach the absurdly low LDL of 70 without using high doses of cholesterol-lowering statin drugs. And as you may recall, that 70 LDL guideline is based on a recommendation from an “expert panel” of the National Cholesterol Education Program (NCEP). In the summer of 2004, shortly after the recommendation was announced, an embarrassing report revealed that seven of the nine NCEP panelists had financial ties to Pfizer (the maker of Lipitor, a statin), five panelists had served as consultants to Pfizer, and seven panelists had financial ties to Merck (the maker of Zocor, a statin).

So until an impartial panel of experts with no drug company ties comes to the same conclusion, we’ll regard a recommended LDL of 70 as little more than a preposterous sales pitch for Lipitor.

Just for fun

I saved the laughs for last.

The new AHA guidelines lower recommended saturated fat intake for women from 10 to 7 percent of total vitamins. But here’s the laughable part: In the entire 22-page report, there’s not a single mention of carbohydrates. I guess the AHA will never get past its stubborn fixation on saturated fats, just as I’m never going to get past my stubborn fixation on carbohydrates, inasmuch as a steady intake of simple, refined carbs (a huge component of the typical U.S. diet) is directly linked to obesity and type 2 diabetes – two key enemies of heart health.

In his GMA report, Dr. Johnson helpfully pointed out that an ordinary portion of French fries or a single doughnut supplies most women with their recommended saturated fats for the day – as if you can equate a nutritionally valueless doughnut with a cut of steak from grass-fed beef that’s high in omega-3 fatty acids.

It’s laughable (and sad), but that’s the mainstream take on women’s heart health in 2007.

and another thing

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