17 October 2010

Accounting and History, not Red Wine

Yesterday's FT had an intriguing and fascinating letter about the so-called "French paradox" which asks why the French have such low levels of heart disease yet a diet rich in saturated fats.  Red wine has been the popular answer.  Professor Timo Strandberg suggests another.  Here is an excerpt:
According to a skilful dissection of this myth in the British Medical Journal by professors Malcolm Law and Nicholas Wald in 1999 (May 29), wine consumption may actually explain little of the paradox. Some of it has pertained to a habit of French doctors not to ascribe all deaths basically due to coronary artery disease (for example heart failure) to a coronary cause.

A major part of this paradox is, however, explained by a time lag, the slow development of atherosclerotic coronary artery disease during several decades. Fewer coronary deaths during the 1970s and 1990s in France than in Britain (or the US) were simply reflecting much lower saturated fat consumption and lower cholesterol levels in France during earlier decades. While saturated fat consumption started to increase in Britain from the late 19th century and reached a plateau during the 1930s, this increase did not happen in France, a Mediterranean country, until from the 1970s.

But we may not be seeing a reciprocal increase of heart disease in France any more, because of early adaptation of modern cardiovascular prevention. Already during the 1990s, French patients were receiving cholesterol-lowering drugs some nine-fold more frequently than their British counterparts. Eating lots of cream, cheese and butter-rich croissants may not be so dangerous, if you are on a statin.
Interpreting data requires knowing something about the data and its context.  Nothing can be taken for granted.

4 comments:

eric144 said...

Don't tell that to BBC journalists, they have been pushing the red wine story for a very long time. The relationship between journalists and alcohol is well established and not contested.

Pat Moffitt said...

Do mummies count when calculating a nation's average life expectancy?

From AP
"The story unfolded in late July when police discovered that Sogen Kato, who would have been 111 and was thought to be Tokyo's oldest man, had actually been dead for 32 years, his decayed and partially mummified body still in his home.

Police are investigating his family for possible abandonment and pension fraud."

Seems Kato wasn't the only one-- Japan may not be the longest lived nation.

markbahner said...

"But we may not be seeing a reciprocal increase of heart disease in France any more, because of early adaptation of modern cardiovascular prevention. Already during the 1990s, French patients were receiving cholesterol-lowering drugs some nine-fold more frequently than their British counterparts. Eating lots of cream, cheese and butter-rich croissants may not be so dangerous, if you are on a statin."

I measure my blood pressure more often than probably 99.99% of the population. (More than 1100 times so far this year.) It's led me to know much more about my body/health than most people.*

I think that, in the near future (less than 3 decades) commercially available and affordable devices will be implantable just under the skin capable of continuously measuring pulse rate, body temperature, blood pressure, blood oxygen levels, blood glucose levels, and much more. Such devices will be of unbelievable value in detecting and preventing disease and disability. For example, per Google Health, the following symptoms are present up to an hour before ventricular fibrillation:

Rapid heartbeat
Shortness of breath (which presumably would show up either in low blood oxygen level or rapid breathing rate)

If such medical information was available to be transmitted to 911, the technicians could actually arrive with a defibrillator BEFORE the fibrillation event occurred.

This type of thing shows how making predictions for the future based on the past is a very tricky business. (Hence the wisdom of: "Predictions are hard. Especially about the future.")

*P.S. In fact, it has led me to formulate a hypothesis that I think could eventually lead to a Nobel Prize in Physiology or Medicine. (No kidding.)

markbahner said...

Sorry to divert/destroy the discussion. ;-)

However, the subject of heart attacks/strokes is another reason why the discussion of global warming is so unfortunate.

In the U.S. alone, there are over 400,000 first strokes every year, with an annual cost of over $40 billion, or $100,000 per first stroke.

But one doesn't see politicians, pundits, or bloggers saying much about strokes.

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