Archive for March, 2011

I thought I’d review the book I just read. As a matter of fact, I’d like everyone to read this book. The book “Overdo$ed America: The Broken Promise of American Medicine” has the subtitle “How the pharmaceutical companies are corrupting science, misleading doctors and threatening your health.”  Pretty grim, isn’t it?

The author, John Abramson is a family practice physician who used his training as a Robert Woods Johnson Fellow to analyze the medical literature and recognize before it was widely published that well-respected journals like the New England Journal of Medicine and the Journal of the American Medical Association were publishing articles about “block-buster” drugs that didn’t tell the whole picture. And because his book came out just as Vioxx was being taken off the market he was interviewed widely by the media and got much more “play” than he would have otherwise.

In addition to Vioxx and Celebrex, he looks at the close ties between medical experts who wrote the cholesterol guidelines, the osteoporosis guidelines, and, of course, documented our not so pretty history of using hormones in women.

I recommend the book highly. If you or your loved one is taking a statin drug or Fosamax, wade through the statistics (he makes them quite readable!) and ask questions. This book should be required reading for all medical students and physicians.

I was especially pleased by the positive end note of the book (because really it could have stayed negative and bleak!). Dr. Abramson is continuing to work with medical students teaching primary care and is exploring the field of predictive modeling used in the context of health information (free of commercial bias) and wellness intervention. What is the bottom line message he delivers? You guessed it: pay attention to the quality of your food, don’t smoke, and exercise regularly!

Some things just don’t come in a pill….

I cringe every time I see a practitioner recommending krill oil.The latest was Dr. Mercola who was quoted on the LiveStrong website saying that krill oil is the best source of Omega-3 fatty acids. Krill oil is made from krill, small shrimp-like crustaceans. They are found in cold-water oceans, mainly in the northern seas. I speak with nutritional supplement salespeople regularly and am aware that several are now offering krill oil as an option and claim there is additional benefit (the antioxidant that makes the pink color in the little shrimp’s shell) and no fishy taste or “burp-back” with krill compared to other fish oils.

Don’t get me wrong. When krill are harvested and ground they do contain eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – the essential omega three fats that have been proven to reduce triglycerides and help with inflammation. A 2002 article in the New England Journal of Medicine showed that measuring the omega 3 index (the amount of EPA and DHA in the blood divided by the total measured red cell fatty acid content) showed that If the omega 3 index was less than or equal to 4% than people were ten times more likely to have a cardiac event than if it were 8%. There is also data that fish oils can slow cognitive decline and cellular aging. The question is not whether or not EPA and DHA from krill are good for you. The question is whether or not we should be killing krill to consume our needed EPA and DHA.

There are close to 500 million tons of krill in the northern sea, but the krill numbers may have dropped by as much as 80% since the 1970’s. Meaning that today’s stocks are a mere 1/5th of what they were only 30 years ago. The decline in krill may in turn account for the decline in the numbers of some penguin species. The Antarctic Peninsula, a key breeding ground for the krill, is one of the places in the world where there has been the greatest rise in temperatures due to man-made climate change. This region has warmed by 2.5°C in the last 50 years (much more than the mean global rate), with a striking consequential decrease in winter sea-ice cover.

“We don’t fully understand how the loss of sea-ice here is connected to the warming, but we believe that it could be behind the decline in krill,” according to Dr Angus Atkinson from British Antarctic Survey. There are commercial implications as well as scientific ones. The Southern Ocean is a valuable fisheries resource, many of the species caught feed on krill. Thousands of tourists are also attracted to Antarctica to enjoy the spectacular wildlife, most of which feed on krill.

So my problem isn’t that krill aren’t potentially good sources of fish oil. My problem is that krill are near the bottom of the food chain and other fish and penguins (and humans!) rely on their ability to keep the food chain going. “Krill harvesting” for nutraceutical supplements should be avoided and I encourage everyone who is taking krill oil to switch. As a matter of fact, as our fish population is being fished out globally, I was intrigued to learn of a microalgae that produces a mercury-free and PCB-free form of DHA that may be the ideal environmentally green solution to consuming our daily 2000 to 3000mg of fish oil. It is likely to be inexpensive because it is produced so rapidly. I haven’t seen it commercially available yet, but I’m watching and hoping that my colleagues become environmentally conscious and help me push for this!