Evidence Mounts in favor of Weight Loss Surgery

Readers who have been following my posts for a few years know that weight-loss surgery is amassing an impressive body of scientific evidence supporting its effectiveness and safety. (Links to my previous posts about weight loss surgery are below.) This week, two studies in the Archives of Surgery attempted to compare the different kinds of weight loss surgery. An LA Times article (link below) has a clear explanation of the different kinds of surgery and summarizes the findings of the studies. T...

This Isn’t Your Father’s Heart Disease

What’s the most common cause of death among American women? Breast cancer? Accidents? Suicide after watching too many Lifetime Channel specials? Nope. Heart attacks kill more women than any other cause—same as men. A generation ago heart disease was mistakenly thought of as an exclusively male disease, but patients and physicians have learned that preventing and treating heart disease is critical in women too. This week the American Heart Association published their updated recommendations for ...

Progress in Type 1 Diabetes: Insulin Pumps with Continuous Glucose Monitoring

Before I review this week’s study, bear with me while I clear up some terms. Type 1 diabetes mellitus and type 2 diabetes mellitus are completely different diseases.  That they have such similar names and are differentiated only by a “type” promotes the common misunderstanding that they are subtypes of the same disease.  They should just have different names to keep things clear.  (I suggest “George” and “Bob”.)  They have entirely different causes and treatments.  Type 1 diabetes is caused by ...

Vitamin E is Effective for Fatty Liver

My regular readers know my skepticism about vitamin supplements.  I leap at the chance to bring you news that some vitamin has been tested for some disease and found useless.  So for balance, I have to also report when a well-designed study finds that a vitamin actually helps something. This week’s New England Journal of medicine published a study about the treatment of nonalcoholic steatohepatitis (NASH).  NASH, also known informally as fatty liver, is a condition in which fat is deposited in ...

Scientifically Proven Weight Loss Method: Eat Less

Few things captivate the public more than a new diet.  From Atkins to Ornish to the Mediterranean diet, each new theory attracts attention and true-believer adherents and generates lots of book sales and interviews on daytime TV.  People passionately argue about whether a diet low in carbohydrates or low in fat is best for weight loss.  But until now no large trial has ever been done to answer the question. This week’s New England Journal of Medicine published the largest study that di...

Can We Have Your Kidney?

For the hundreds of thousands of Americans whose kidneys have stopped functioning, there are two options: lifelong dialysis or kidney transplantation.  Dialysis is time consuming, carries serious risks, and only partially replaces the functions of a healthy kidney.  Patients live longer and have a much better quality of life after receiving a kidney transplant.  The difficulty with transplantation is that donated organs are scarce and transplants are more likely to be successful with living dono...

Resolutions for a Healthy 2009

Many people use the occasion of the New Year to reflect on the last year and make specific goals for the next.  Resolutions can be very helpful motivators if they are specific, realistic and written down.  Just as people make goals for their careers and their relationships, resolutions for your health are a smart way to work for achievable targets in the health-related struggles you face. So I encourage you this week to write down your health resolutions for 2009.  Obviously, what progress is a...

Crestor Prevents Heart Attacks and Strokes in Patients with Normal Cholesterol and High CRP

“If you think health care is expensive now, wait until you see what it costs when it’s free.” -- P.J. O’Rourke I’ve written several times about the proven benefits of a family of cholesterol-lowering medicines called statins.  Statins include the medications Crestor, Zocor, Lipitor, Mevacor, Pravachol and others.  The group has a solid base of evidence showing that they prevent strokes and heart attacks in patients with high cholesterol and in patients who have had...


The Aspirin Controversy, Part II

My post last week created much confusion and worry.  I received many emails asking “What about me?  Should I keep taking aspirin or not?” Let me clarify the issue by explaining what we already knew before last week’s study in the British Medical Journal.  We knew that aspirin is valuable in:
  • patients who have had a stroke
  • patients who have had a heart attack
  • patients who have had bypass surgery or angioplasty
  • patients with angina (chest pain or d...

Aspirin Doesn’t Prevent Heart Attacks in Patients with Diabetes

Aspirin has been a mainstay in the treatment and prevention of cardiovascular disease for decades. We know that in patients who have had a heart attack in the past aspirin prevents a second heart attack, and during a heart attack aspirin is life-saving.  We also know that in patients with a prior stroke aspirin prevents further strokes.  And in patients with symptomatic narrowing of the arteries, that is chest pressure with exertion (angina) or calf pain with walking (claudication), aspirin pre...