The Experts

Dr Ross Walker
+ About Ross Walker

A vitamin a day keeps hearts pumping away!

Tuesday, July 23, 2019

Following on from my article published on this website yesterday (Monday 22 July 2019), let me give you some examples of the studies ignored by most proponents of orthodox medicine: one of the greatest learning and medical institutions in the world, Harvard University in the United States, has been running, for the last 30 years, the Nurses Health Study and the Male Physicians Trial in around 180,000 people. To use the example of a standard multivitamin, when you examine the randomised controlled trial in the doctors up to 10 years, there was no clinical benefit from taking a multivitamin every day. When the data was analysed at 10 years, however, there was a statistically significant 8% reduction in cataracts and common cancers. You may well say, 8% isn’t that much but we’re talking about something that many conservatives argue has no benefit whatsoever. When you look at the observational study in the women at 15 years, there was a 75% reduction in bowel cancer, a 25% reduction in breast cancer and a 23% reduction in cardiovascular disease.

Possibly even more striking, is the 20-year data in men, which showed a 44% reduction in cardiovascular disease, purely by taking a good quality multivitamin on a daily basis. This is better than average dose statin drugs to lower cholesterol!

A recent meta-analysis published in Mayo Clinic proceedings showed an 18% reduction in cardiovascular events in people who consumed high-dose fish oil supplementation or regularly consumed fish over a long period of time, but no benefit up to 5 years, which is typically the maximum time period for most of the trials in this meta-analysis.

The GISSI trial in Italy performed, in a uniform group of patients with acute myocardial infarction, given 1gm a day Omega3 fatty acids in supplement form for 12 months, had a 28% reduction in overall death and a 47% reduction in sudden cardiac death. Again, hardly no evidence for benefit…?

Over the last 10 years, I have been involved in research on the natural juice from bergamot fruit grown on the southern ionic coast of Italy. We have published a number of trials in well-respected medical journals showing clear reductions in cholesterol, blood sugar, improvements in liver function and profound benefits when combined with statin therapy. There are a number of ongoing trials that will be published over the next few years, showing even greater benefit for the regular supplementation with Bergamot polyphenolic fraction.

I should also mention the supplement Ubiquinol, the active component of CoenzymeQ10. Ubiquinol has been shown to reduce statin induced muscle pain along with improved cardiac function, not to mention general improvements in stress levels, sports performance and general energy levels.

One of the “new kids on the block” is vitamin K2, which has some very promising data around arterial decalcification, improved arterial flexibility and improvement in bone strength. Prof Matthew Budoff from UCLA Harbor Medical School has performed evidence-based studies clearly showing Kyolic aged garlic extract reverses atherosclerotic cardiovascular disease over a 12-month period in patients with proven disease, utilising CT coronary angiography.

Many conservative researchers, not working in the field of Complementary Medicine research, do not appear to know the difference between synthetic and natural vitamin E. Synthetic vitamin E has been shown in a number of trials to be of no benefit, and in some cases, possibly even harmful. Vitamin E does not work well without Vitamin C and the only two trials in the history of evidence-based medicine where natural vitamin E was combined with vitamin C both showed an average 25% reduction in the progression of coronary and carotid atherosclerosis. These two trials, IVUS & ASAP have been largely ignored by orthodox medicine.

I have shown above just a few studies from many that show the significant benefit of many aspects of complementary medicine, conveniently ignored by orthodox researchers who promote the benefits of pharmaceutical therapy and medical interventions at the same time weaken and downplay any contribution from complementary medicine.

But, I’m a proud member of the medical profession and feel many of our achievements do go unnoticed and are not recognised by the general public. That doesn’t mean, however, that doctors should be universally proud of the service they provide. Before there is a continued onslaught against our poorer cousins in complementary medicine, shouldn’t we start to try and clean up our own backyard first?

(This is the second in a series of three articles on this topic. The first article was published on 22 July and the third article will be published on Wednesday 24 July 2019.


Another dig at complementary medicine

Monday, July 22, 2019

A study published recently in the well-respected journal, the Annals of Internal Medicine was titled: “Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map”.

The conclusion of this trial stated reduced salt intake, omega-3 PUFA use and folate supplementation could reduce risk for some cardiovascular outcomes in adults. Combined calcium plus vitamin D might increase risk for stroke. The headlines were released stating:

“Vast majority of dietary supplements don't improve heart health or put off death, study finds.”

Basically, the theme of the study was that there was no real benefit for the vast majority of supplements and, in most cases, these supplements have no place in the management of cardiovascular disease. This is yet another large trial that will warm the hearts (so to speak) of the conservatives in medicine who want everyone to believe all that works is a prescription pad or scalpel.

But when you read the study very carefully, there’s no mention in the body of the study about the vital aspects that will tell you whether this information has validity. I reviewed the entire article, including the appendix and it was only there that I found the average follow-up for these trials. I have included the table below noting that the authors purely gave average follow-up times that could vary between six months up to the very longest of 10 years. They didn’t specify which of the particular trials they examined fitted into any of the follow-up categories (i.e. short or long-term trials). They did not specify whether the vitamins used were synthetic, naturally sourced, or the dose, or whether the vitamins were used alone or in combination. There was also no specification regarding the type of people in whom these supplements were used i.e. primary or secondary prevention.

Primary prevention is where a person does not have the disease and you’re trying to prevent it. Secondary prevention is where the person has already suffered an event and you are trying to prevent further events. People in the second category typically have a much greater disease burden and the chance for further events is much higher. If any reader of this study wanted this vital information, then you’d have to review each individual trial of the nine systematic reviews and 4 new RCTs selected that encompassed a total of 277 trials, 24 interventions, and 992,129 participants. A total of 105 meta-analyses were generated. 

We will hear all the usual claims from conservative clones, supported by the findings from this very large review suggesting there is no evidence for the benefits of supplementation: “if you follow a standard diet, you are obtaining all of the micronutrients necessary without supplementation, and that complementary medicine is useless or in some cases may even cause harm.”

There are always the demeaning comments that all vitamins do is give you expensive urine, and that they are recommended by charlatans.

A few years ago, an Australian TV show, Four Corners, presented a segment on US complementary medicine companies that showed very clearly that (most importantly, US) complementary medicines are made to food standard and not pharmaceutical grade. A study of 300 different products demonstrated the vast majority had contaminants and the ingredients written on the bottle were not actually in the tablets or capsules.

However, Australian supplements are made to pharmaceutical grade and are under strict regulation. There are no contaminants and the ingredients written on the bottle are actually what you get.

(This is the first article in a series of three. Check out the second tomorrow on this website.)


A major breakthrough for spinal cord injuries

Thursday, July 18, 2019

One of the worst traumas imaginable is to suffer a spinal-cord injury and to be left with either paraplegia or even worse quadriplegia. In Australia alone, there are over 12,000 people with spinal cord injuries, with 400 new cases a year. Of these, 15% are complete quadriplegics and 20% complete paraplegics. The typical causes are some form of motor vehicle or motorbike accidents or through the various types of body contact sports.

Surgeons at the Austin hospital in Melbourne have performed study on 16 young adults with quadriplegia, with the average age of 27. These young people had nerve transfer surgery, with or without tendon transfer surgery, in an attempt to restore some degree of their upper limb function. Some improvement in upper limb function would allow elbow extension, grasp, pinch and hand opening. The ability to perform these functions would then allow these young people to perform day-to-day activities, that the vast majority of people take for granted, such as brushing your teeth or being able to use the toilet without assistance.

This nerve transfer surgery in 13 out of the 16 adults demonstrated that these previously dependent, complete quadriplegics could feed themselves, brush their teeth and hair, write and use a variety of electronic devices. In the three people where the procedure was not successful, there were no complications. So in reality, they were not worse off, so the procedure was worth the risk. Interestingly, nerve transfer surgery was more effective when the operation was delayed for at least 12 months after the injury.

So often the media reports new therapies or studies as major breakthroughs, dashing the hope of sufferers of various conditions when they find out that the so-called breakthroughs have only been in a variety of cells in a laboratory or in experimental animals (typically mice) and the chance for the so-called breakthroughs to be available to humans can be anywhere between 5 to 20 years away, if it all.

This nerve transfer surgery, through superb Australian research, has been performed on humans with spinal cord injury and has had a clear, practical success in restoring upper limb function in this situation. Over the past few decades there have been some extraordinary approaches to treating spinal cord injury with some anecdotal marked improvements. To date, not many of these approaches have been demonstrated in clinical trials to have consistent success.

I am delighted to be able to call this a major clinical breakthrough which will hopefully, in the near future, become standard of care for people with significant spinal cord injuries.


The power of the gut

Wednesday, July 10, 2019

With the increasing evidence regarding the importance of the gut microbiome, two more studies were released recently showing the importance of having healthy gut bacteria. Both published in Nature Medicine, the first (from Harvard University) looked at the relationship between specific gut bacteria and allergies.

It’s estimated that around 10% of the population are now experiencing some degree of food allergies. It’s also estimated that human beings are only 10% human and 90% bacteria, most of which reside in the gut. There are trillions of microorganisms, including thousands of species of bacteria living within the gastrointestinal tract. It’s well known that there are strong interactions between gut bacteria and the immune system, which can trigger a range of diseases from cancer, cardiovascular disease, autoimmune disease and now even allergies.

It appears the risk for food allergies is higher in people who come from smaller families, those who were not breastfed, those who were born by caesarean section and young children who had significant antibiotic use throughout their early years.

The Harvard researchers collected for faecal samples from babies every few months and compared the gut bacteria of 56 infants with food allergies compared with 98 age-matched individuals who didn’t have food allergies. They found different bacteria living in the allergic children compared with those who were nonallergic.

They then transplanted the gut bacteria from the children into mice that were sensitive to eggs. The mice who received gut bacteria from children without food allergies were less likely to have an allergic reaction compared with those who received the gut bacteria from the children with food allergies. It was found that certain Clostridial species and also Bacteroides species protected the mice from food allergies.

The second study looked at a particular bacteria known as Akkermansia Muciniphila. This particular bacteria has been previously linked to people with healthy metabolism, reduced weight and low blood sugar levels. This study from Belgium also published in Nature Medicine, initially gave 20 healthy volunteers a probiotic of Akkermansia Muciniphila for a 3-month period and found a better insulin response, lower cholesterols and slight weight loss and this was despite no change in diet and exercise.

The second component of the study looked at 32 overweight/obese individuals and gave them either placebo or 10 billion Akkermansia Muciniphila per capsule. Those in the active treatment group had much lower inflammatory markers, lower cholesterol and just under 2 ½ kg weight loss over the 3-month period. Large studies will be performed in the near future.

It’s interesting that there is a strong possibility in the near future of all these healthy bacteria species being put into a probiotic capsule, which may help food allergies, diabetes, cholesterol levels and weight loss. There are a variety of different treatments for all these conditions already available on the market but to be able to use healthy bacteria as another form of effective therapy is a very exciting proposition.


More evidence for the Brain-Gut connection to Parkinson’s disease

Wednesday, July 03, 2019

Over the past decade, there has been increasing evidence regarding the vital importance of gut health, not only as an indication of well-being, but also as a guardian against a number of other diseases. Two months ago, I wrote an article about the vital importance of the appendix. I detailed a large study of 62 million people in the US. Of the just under 500,000 people who’d their appendix removed, just under 5,000 developed Parkinson’s disease i.e. an incidence of 1%. Of the 61.7 million people who hadn’t had their appendix removed, just under 180,000 developed Parkinson’s disease i.e. an incidence of 0.29%.

For those of us with enormous skills in mathematics, this is around a 3 times higher incidence of Parkinson’s disease in those who have had their appendix removed. It appears that the appendix harbours a protein known as alpha synuclein and when the appendix is removed, it appears the alpha synuclein is released with toxic clumps being found in parts of the gastrointestinal tract. Interestingly, the same toxic clumps appear in the brains of people with Parkinson’s disease and an associated condition known as Lewy body dementia.

This misfolded protein, alpha synuclein, clumps together within certain parts of the brain and replaces normal nerve tissue with dead clumps of cells, which are called Lewy bodies. Interestingly, one of the early symptoms of Parkinson’s disease is constipation, which is now felt to be also due to the alpha synuclein in the gut altering normal gastrointestinal function.

One of the major connections between the gut and the brain is the vagus nerve system. Researchers at the Johns Hopkins university set out to see whether the alpha synuclein can travel up the vagus nerve from the gut to the base of the brain.

They took a group of mice and injected 25 µg of synthetic, misfolded alpha synuclein into the gastrointestinal tract of healthy mice. They then sampled brain tissue at a variety of intervals over the next 10 weeks after the injection. The researchers found the alpha synuclein building up from where the vagus nerve starts in the gut and then followed the spread to-related parts of the brain.

The next step was to cut the vagus nerve in one group of mice and again inject alpha synuclein into the gastrointestinal tract. At seven months, there were no signs of alpha synuclein in the vagus nerve or the brains of these mice, compared with those who had intact nerves.

The next step was to determine whether the specific injections affected the progression of Parkinson’s disease so the mice were split into three groups. The first injected with misfolded alpha synuclein, the second had the injections but severed vagus nerves and, finally, the control mice had no injections and normal vagus nerves.

They looked at the indications of Parkinson’s disease as seen in mice, which included the mice’s ability to construct nests and also measured mice anxiety levels by seeing how often they explored new cages and general mice behaviour.

The study found that only the mice injected with misfolded alpha synuclein with intact vagus nerves developed Parkinson’s disease.

This very elegant study clearly shows a link between the gut and the brain. This information takes us much closer to developing specific treatments for conditions such as Parkinson’s disease and Lewy body dementia with research directed at blocking the ability of the vagus nerve to take up alpha synuclein. I believe this is a significant breakthrough at many levels, which hopefully will see a cure at some stage in the relatively near future for two diseases, Parkinson’s disease and Lewy body dementia, both of which have a very deleterious effect on quality of life and lifespan.


You’re much more than my best friend

Wednesday, June 26, 2019

Over the past decade, there has been mounting evidence that owning pets is extraordinarily good for your health. The stress relieving benefits of dog and cat ownership have been proven beyond doubt with low rates of chronic illnesses having been demonstrated in a number of studies.

Mainly with dog ownership, it’s almost a form of enforced exercise but also the companionship of domestic animals is a proven stress reliever and often great therapy for those who are lonely. But, a recent study published in the Journal of the American Osteopathic Association has demonstrated another benefit from our four-legged friends.

There’s no doubt that the best treatment of cancer is early detection. Unfortunately, many of our screening studies are not overly accurate with a significant false positive and false negative rate. Also, many of the scans performed are expensive and not always 100% accurate.

This study involved training three beagle dogs to sniff out lung cancer from blood samples. As most of us are aware, the olfactory acuity (smelling ability) of a dog is 10,000 times more sensitive than that of a human being. A beagle, which is also known as one of the scent hounds has 225 million olfactory receptors compared with the human beings measly five million.

Following an eight-week training period, the dogs were exposed to a number of samples from patients with lung cancer and with those from healthy patients. The samples were placed in one room at a sniffable height and the dogs were trained to sit down if the sample contain the scent of lung cancer but to move on if the samples were considered normal. The extraordinary results showed that the dogs were accurate in predicting or excluding cancer with a 97% hit rate. Dogs are now being trained to detect early breast and colorectal cancer as well.

There has been research performed all over the world but particularly in Israel moving towards detecting early cancers with breath testing. These tests are detecting volatile organic compounds which are released into the breath in people with a variety of cancers. When the DNA mutates to become cancerous, protein fragments are released from the altered DNA which create a different footprint compared with people without cancer.

It may be that at some stage in the relatively near future, as part of a routine screening assessment we either blow into a bag to detect these volatile organic compounds or possibly we may see the day when trained beagle dogs, such as those that we see at airports to sniff out illegal drugs, are used in medical practices to detect early cancers. In our extremely high tech world where medical investigations and treatments are becoming incredibly sophisticated, there is something quite compelling about man’s best friend providing us with an even simpler solution.


Top billing: Exercise & the great outdoors

Wednesday, June 19, 2019

We were designed to wander around a jungle for 30 to 40 years hunting and searching for food sources to keep ourselves nourished to basically stay alive. In our modern world, which is much less harsh, for most of us food is freely available and the hunter-gatherer existence is certainly a thing of the very distant past.

But our physiology was certainly designed for feast and famine in natural environments, where we had to use our legs all day to survive. Thus, regular exercise is a vital component of good health. The evidence is overwhelming that 3 to 5 hours of moderate exercise per week reduces the risk for a number of modern diseases by somewhere between 30% to 50%. This includes cardiovascular disease, cancer, diabetes, Alzheimer’s disease, depression and osteoporosis.

Two very interesting recent studies, the first around exercise and the second, nature, are worth reviewing. The first study from the University of Copenhagen in Denmark and University of Irvine in California looked at the different responses to exercise, depending on the time of day exercise is performed. The studies were done in mice and found that exercising in the morning increased metabolism in skeletal muscles, whereas exercise in the afternoon has more of a general effect on whole-body energy expenditure that was extended beyond the period of exercise seen in the morning.

My interpretation of this study is that it is probably better to do strength training and yoga in the morning and perform aerobic exercises such as walking, jogging, cycling and swimming after 2pm. You will probably build better muscles this way and have a more efficient cardiovascular system.

It is better to avoid heavy aerobic exercise in the morning because this is when the blood pressure is at its highest, your blood is thicker and your vascular beds are shutdown.

The second study, from the University of Exeter in England, looked at the benefits of spending time in nature. They examined the habits of 20,000 people living in England and determined the amount of time these people spend in nature on weekly basis. The best good health and higher psychological well-being was reported in those people who spent on average two hours per week visiting parks, woodlands, country or beaches. This was regardless of whether the person was male or female, older or younger, their occupation, ethnic group, rich or poor, healthy compared to those with chronic illnesses.

The message here from both the studies is very clear. Have a regular exercise habit and perform exercises at appropriate times during the day but also spend two hours per week in nature. Now here’s a novel idea! Get out of the gym and perform your exercise in nature and you’ll get two bangs for your buck.


I can tell by the way you smell

Friday, June 14, 2019

Although our sense of smell is vital for existence, it is often not mentioned as a part of good or bad health. With an acute sense of smell, we can appreciate the extraordinary aromas of the variety of foods and fluids we enjoy, the sweet smell of flowers and particular perfumes, not to mention the pheromones that can lead to attraction or repulsion depending on your own personal biology.

Then there are noxious smells that are very powerful and at times, may lead to death. Being able to detect these noxious smells allows us to immediately vacate the area in which they emanate, potentially saving our life.

But it also appears that the sense of smell may be an indication of good or bad health. A recent study released in the Annals of Internal Medicine examined 2,289 adults aged between 71 to 82 using a technique known as the Brief Smell Identification Test (BSIT) and rated people as to whether they can detect different odours. They were rated as good, moderate or poor sense of smell and then were followed up for 13 years. 1,211 participants in the study died during the 13-year follow-up period, which is not particularly surprising as this was an older age group.

The study showed that a poor sense of smell was higher in males, the black population, cigarette smokers or heavy consumers of alcohol. There was a strong association between poor sense of smell and Dementia, Parkinson’s disease, chronic kidney disease and depression. There was, however, no relation to cancer, hypertension or diabetes. It was suggested that a deteriorating sense of smell can be either age-related, with the general deterioration of olfactory neurons as we age, post viral, related to head trauma or the typically ubiquitous genetic abnormalities that determine many characteristics in our body. The study basically said that those participants with the poorest sense of smell, compared with those who had a good sense of smell, had a 46% increased death rate at 10 years into the study.

Interestingly, the participants rated their health at the start of the study and those who stated they had good health had even worse results, with a poor sense of smell increasing the death risk at 10 years to 62%.

There was no great explanation as to why a poor sense of smell was associated with poor health. One explanation given was that an impaired sense of smell led to reduced enjoyment of food and subsequent weight loss. A number of studies have demonstrated that as we age, people in the lower weight range i.e. a BMI from 20 to 25 have the same death rates as people with a BMI from 30 to 35 i.e. grade one obesity. Interestingly, the healthiest BMI for people over the age of 50 has been deemed to be 25 to 30, which is considered overweight.

There is, however, some hope on the horizon from a recent study performed, albeit on mice, showing that particular types of stem cells, known as globose basal cells replace olfactory sensory neurones when given via nasal drops to a genetic mouse model, where the mice were genetically primed to have a poor sense of smell.

Although this has not been trialled in humans as yet, it certainly shows promise that such a simple technique as a nasal spray may be able to restore the sense of smell. Unfortunately, these animal trials take years before they are translated to humans but, it is still hope for the future.

So the next time you’re taking in the wonderful aroma of a sweet smelling rose or the variety of your favourite wines, don’t take it for granted.


And do you want pills with that?

Thursday, June 06, 2019

I often state the statistics that the commonest cause of death and disability in the world is cardiovascular disease. It keeps me in a job. The second commonest cause of death and disability and closing in fast is cancer.

Disturbingly, the third commonest cause of death and disability is Western Healthcare. The most expensive health care system in the world, the United States of America, rates number 45 in terms of longevity. Clearly, over investigation, unnecessary medical procedures and the excessive use of pharmaceutical drugs contribute significantly to this statistic.

Although there have been enormous strides in medical investigations and therapies over the past few decades, significant complications of medical procedures and side effects from pharmaceuticals are unfortunately rather commonplace. It could be easily argued that, if the person was left alone, their underlying condition could either cause them significant issues or even bring on an early death. But there are increasing concerns, both within and outside of the practice of medicine, that we should look carefully at the medications we prescribe and the medical procedures we perform on many patients.

Two recent studies have clearly shown the concern over commonly prescribed medications. The first from the University of South Australia published in the journal “Australian Prescriber” looked at just under 8,900 veterans with hip fractures and compared them to 35,310 people without this condition. The average age in the study was 88 and 63% were female. The study showed that those patients who were chronically taking antidepressants, opioid painkillers, anticonvulsants and the common anxiety relieving pills the benzodiazepines such as Valium, had a significant increase risk for hip fractures. One or a combination of any of these medications may lead to an alteration in the level of consciousness, dizziness, blurred vision and unsteadiness. All these factors can then contribute to a fall leading to a traumatic hip fracture.

Is estimated that if an older person is on one of these medications, he or she has double the risk for hip fracture but, for example, if you combined antidepressants with anti-anxiety treatments, the risk is five times.

It is estimated that in Australia alone there are 28,000 hip fractures per year in people over the age of 50. 5% of these people die during the hospital stay and 10% are admitted to aged care. Clearly, the best treatment of hip fracture is prevention and most doctors and patients need to examine carefully the medications they are prescribing and swallowing to determine whether they are vitally necessary.

The second equally disturbing study was published recently in the British medical Journal by researchers at the Washington University School of medicine in St Louis. This study examined the use of the commonly prescribed heartburn drugs known as PPIs, such as Nexium, Pariet and Somac, to name a few. They examined the data from 2002 to 2004 from 157, 625 people prescribed PPIs and 56,842 people prescribed the gentler H2 blockers. These patients were mainly male, caucasian & over the age of 65 followed for 10 years. The study showed that there were 45 excess deaths per 1,000 people prescribed PPIs compared to H2 blockers and in particular deaths related to cardiovascular disease, stomach cancer & chronic kidney disease.

The risk of death increased with the duration of treatment, even at low doses. The suggestion from the study was that taking PPIs for months and especially years is not safe and, in fact, should not exceed 14 days.

It is important to realise, however, that heartburn and other forms of peptic ulcer disease can be disabling in many people and the PPIs are wonder drugs for the relief of symptoms. Over the past decade there have been a number of studies linking chronic PPI therapy to not only cardiovascular death but also heart attack and actual fibrillation. One study suggested a 40% increase risk for dementia especially with Nexium. There is also a link with osteoporosis and as mentioned gastric cancer and chronic kidney disease.

Strong medicine has strong effects, no doubt, but clearly may also have significant strong side-effects. Anyone reading this article who has been prescribed any of these therapies on a chronic basis should not stop treatment without discussing the pros and cons with your doctor.

The first line of the Hippocratic oath is “first do no harm”. For something written 2 ½ thousand years ago, it still is highly relevant for today’s practice of medicine.


Do you want your family to suffer?

Friday, May 31, 2019

A recent ad to raise awareness about heart health and have their hearts checked has caused outrage and consternation amongst the general public.

The heart health ad in question basically had this theme: “Do you want your family to suffer?”.

There has been a groundswell of opposition against the underlying sentiment of this commercial. Don’t get me wrong, as a cardiologist I’m all for raising awareness about the planet’s most common killer. I have spent the last 25 years of my career focusing on preventative cardiology so it warms my heart, so to speak, when heart health gets significant airplay.

But, it is my view that this advertisement reaches an all new low and I’m surprised that National Heart Foundation approved its release. I believe it is acceptable to make people feel guilty about drink-driving, speeding or using illegal drugs but should we now be parading obese people in the street, shaming them as well and telling them they don’t love their children. Certainly not, we should be showing some compassion to people who have different metabolic issues and no doubt less self-control when it comes to tempering their eating habits.

But, we must look at the reality of heart disease and, in almost all cases, it is purely genetic. Again, your genes load the gun but your environment pulls the trigger. The most common form of heart disease is atherosclerotic heart disease which is basically the progressive build-up of fats, inflammatory tissue and calcium in the walls of arteries over many decades. If you imagine a doughnut, as an analogy here to arteries, the blood goes through the hole in the middle but the fat & other components builds up in the wall. When the fat and other tissue reaches a critical mass it suddenly ruptures within the channel inducing a clot to form and blockages occur, which may lead to a heart attack or stroke depending on the site of the rupture. 

All people with cholesterols above 3 mmol per litre and systolic blood pressure (top reading) above 100 mmHg have a degree of atherosclerosis in the walls of their arteries. But, genetic factors contribute to either more significant build-up of atherosclerosis or a person possesses protective factors to prevent severe disease.

Although my main job is as a cardiologist, I’m also a professional speaker travelling the world talking about how to be healthy and manage stress. One of my slides shows a picture of Winston Churchill & Jim Fixx. Jim wrote “The Complete Book of Running” and had run multiple marathons. He didn’t have an ounce of body fat and dropped dead in a race at age 53. Winston Churchill smoked, drank, was obese and suffered intermittent depression throughout his life, dying at age 91. Clearly genetic factors operated in both cases, with Mr Fixx in the negative sense and in Winston’s case, keeping him alive despite his very poor life habits.

The commonest genetic abnormality in the world is insulin resistance affecting 30% of Caucasians, 50% of Asians and close to 100% of people with darker or olive skin. This genetic abnormality accounts for around 70% of cardiovascular disease. This leads to tendencies for diabetes, hypertension, specific cholesterol abnormalities with a high triglyceride and low HDL, along with a significant tendency to abdominal obesity. 20% of cardiovascular disease is related to Lipoprotein (a) and the remainder due to less common genetic abnormalities such as familial hypercholesterolaemia.

It is my strong suggestion that all males at age 50 and females at age 60, have a coronary calcium score which does not involve injections or dye, is low radiation and inexpensive. It is important to realise that this test is not covered by Medicare. The coronary calcium score is the most predictive test for heart attack risk.

I also suggest that everyone, regardless of age or cardiovascular risk follows the five keys to being healthy

Depending on risk, you may also need to take long-term medications to control your blood pressure, cholesterol, manage diabetic risk and possibly blood thinning agents.

Clearly, the National Heart Foundation advertisement is trying to shame people into having a cardiac assessment, along with take better care of their health. Hopefully some good will come out of this, despite the rather abhorrent message.



Too old to be a Mum or Dad?

Is your appendix your friend or foe?

Colorectal cancer - a genuine breakthrough

Will stem cell therapy eradicate knee replacements?

Does stress cause heart disease?

Nutrition: how much is enough?

Is there a link between smoking & dementia?

What came first, the cholesterol or the egg?

Is there a link between some vaccinations and autism?

Let’s sleep on it

Should you be vaccinated against influenza?

Are we eating real food or lethal muck?

60 Minutes “trick or treatment?”

Is this a cure for cancer?

Pill testing: My response to an article in The Australian

Prolonging life or extending suffering and death?

The 5 keys to good health

Tests for cocaine, crystal meth, heroin

Is there a cure for Alzheimer’s in sight?

Are vitamins just expensive pee?

What's wrong with our modern diet?

Myth - High blood pressure is 100 plus your age

Does a drink a day keep the doctor away?

Flying cattle class

My 5 point plan to keep fit over Christmas.

Do you eat muck masquerading as food?

Fish oil & Vitamin D: do they help prevent disease?

Paraplegics walking again?

Can cancer be detected by a blood test?

Blood pressure down, lung cancer risk up?

The hippy hippy shake up

Is watching sports a health hazard?

An aspirin a day…

The rise of the super bug

Is booze a poison or a tonic?

Is coffee going to kill you?

Is salt good or bad for you?

Sleep - who needs it?

Metabolism - it’s what keeps us alive!

Supplements - Are we really wasting our money?

Medical cannabis for chronic pain

Can you be obese and healthy?

Type 1 Allergies - one of society’s most common conditions!

Antibiotics - the end of an era?

Cancer - not the death sentence it used to be

Women and heart disease

Do vitamin supplements help prevent cardiovascular disease?

Are there downsides to being too clean?

The common cold - could there soon be a cure?

Male Menopause - does it exist?

Are Omega-3 supplements a waste of money?

Is a personalised cancer vaccine the answer?

Vitamins - are they a load of hype?

Alcohol - how much should we drink?

Viagra - some more hard evidence for its benefits

A chocolate a day...

Are low calorie sweeteners safe for you?

Exercise - Is more really better?

Opinion: Media Watch needs to get its medical facts straight

5 major factors that make your ticker stop ticking

Frailty - all you need to know

Myth - Calcium is essential to prevent osteoporosis

It’s extraordinary what humans will put into their bodies

Hospital complications a leading cause of death

Opinion: Solving earth's overpopulation dilemma

What causes autoimmune disease?

Should medical cannabis be legalised?

Myth: Warfarin is a poison

Is it possible to slow, stop or reverse ageing?

Is there real science behind complementary medicine?

Myth - All milk is the same

Tips for keeping healthy over the Christmas break

Myth - all alcohol is equal

The case for compassionate medicine

Heart disease – is it reversible?

Exercise - is more better?

Depression: Is it just a brain disorder?

Is healthy eating always good for you?

Myth - An elevated PSA always means cancer

Choosing wisely

How long can we really live?

Low fat is dead

Sudden death - can it be prevented?

New study another nail in the coffin for E-cigarettes

Alcohol - is it all bad?

Breast cancer: What hurts and what helps

Overdiagnosis and overtreatment

Thinking - your brain needs it!

Can air pollution increase the risk of dementia?

Prevention is better than cure

Contraceptive Microchip

Weight loss - is it all about calories?

Is low dose alcohol safe?

Aspirin for all?

Can you die of a broken heart?

3 common myths about Fibromyalgia

Statin use in older people

Doctors warned about using the word pain

Euthanasia and compassionate medicine

Are hospitals always the safest place to be?