Free checking, auto shows, low-cost hotel rooms, and bypass surgery

20. March 2008 William Davis (3)
Of the three major highways that lace the city of Milwaukee, there are at least five, and sometimes as many as ten, billboards that prominently feature one hospital heart program or another.

The passing of former First Lady, Ladybird Johnson in July, 2007, reminds us that, just 30 years ago, billboards were a far more common feature (many called them eyesores), proliferating like a dense forest of trees competing for a sliver of sunlight. Ladybird Johnson played a pivotal role in helping to dramatically reduce the number of billboards permissible on the nation’s highways. Of the relative few that remain today, a premium must be paid to post an advertisement. It costs several thousands dollars every month to maintain these highway commercials. But it’s not just an expense; it’s an investment.

The tens of thousands of eyes that view these billboards every day are potential customers, insured Milwaukeeans who carry health insurance and represent a major heart procedure just waiting to happen. They “need” to be directed to the right place. The billboards don’t feature health and wellness, heart disease prevention, or nutritional advice. They feature surgeons proudly wearing scrubs and masks, nurses, and declarations of the advantages of each hospital program. In effect, they invite you to have your heart attack, heart catheterization, bypass surgery, or other major heart procedure at their hospital. High-tech, high-ticket hospital heart care has become the subject of mainstream marketing, the stuff of flyers, brochures, and billboards.

The excesses of “big heart disease” have created a system that makes procedural heart disease “repair” far more profitable than heart disease prevention. Unfortunately, “repair” has disastrous financial, physical, and emotional consequences for everyone save the “repairman.”

While great good has been achieved by the American health care system, this gargantuan and inefficient system has also cultivated a culture of excess that has made many of its participants—physicians, hospitals, drug and device manufacturers—rich. And at our expense.

This approach was, to a degree, justifiable at a time when nothing better was available. But that's no longer true.


Copyright 2008 William Davis, MD
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Comments (3) -

  • Anonymous

    3/21/2008 4:01:00 AM |

    Hmmm I have never seen a billboard advertising these things in Canada, I'd find that rather like Dr Snake Oil, advertising to get you to buy their product!!!

    We need to get you a billboard Dr DSmileSmileSmile

    chick

  • Anonymous

    3/21/2008 4:29:00 PM |

    There are 450,000 billboards in America today, with 579 in Milwaukee. New digital billboards can change ads in seconds--thus flashing more (distractions) to already overburdened drivers (ie:  cell phones).  These cost between $200,000 to $500,000 to install. The digitals are used by many communities for Amber Alerts, and other law enforcement iniatives--like wanted criminals, so have some useful purposes other then advertisements.  

    Of course the answer is obvious as to why alternative and preventative health is not advertised.  No money in it.  The billboard message is only a symptom of what is wrong with our healthcare system.  The root causes are in Washington DC with all the special interest groups. ie:  pharmaceutical companies, lawyers, insurance companies.  Many people do not know who their congressmen/senators are, let alone their voting history on the Hill.

  • Gold Coast Hotels

    12/8/2009 4:23:40 PM |

    Billboards are really a great mode of advertising. Big expense but big revenue.

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Fish oil makes you happy: Psychological distress and omega-3 index

Fish oil makes you happy: Psychological distress and omega-3 index

30. October 2009 William Davis (24)
For another perspective on omega-3 blood levels, here's an interesting study in northern Quebec Inuits.

Traditionally, Inuits consumed large quantities of omega-3-rich seal, fish, caribou, and whale, even eating the fat. However, like the rest of the world, modern Inuits have increased consumption of store-bought foods, largely processed carbohydrates. Along with this trend has emerged more heart disease, diabetes, and depression.

A group from Laval University and University of Guelph, both in Canada, examined the relationship of plasma EPA + DHA levels and measures of psychological distress. This group had previously shown that Inuits older than 50 years had twice the plasma omega-3 levels (11.5%) compared to those younger than 50 years (6.5%), reflecting the shift away from the traditional diet.

Psychological distress was measured with The Psychological Distress Index Santé-Québec Survey (PDISQS-14): the higher the score, the greater the psychological distress. (In the graphs, tertile 1 is least distressed; tertile 5 is most distressed. Sorry about the small chart graphic--click on the graphic to make it bigger.)


From Lucas M et al 2009 (http://www.nutrasource.ca/NDI/Assets/Articles/Plasma%20omega-3%20and%20psychological%20distress%20among%20Nunavik%20Inuit.pdf)

"Our main finding was that women in the second and third tertiles of EPA+DHA concentrations in plasma PLs [phospholipids] had a 3 times lower risk of having a high-level PD [psychological distress] score than women in the lowest tertile."

While the relationship is stronger for women, you can see that, the higher the EPA + DHA plasma level, the lower the likelihood of psychological distress. Interestingly, the tertile with the greatest distress and lowest EPA + DHA levels had a plasma level of 7.0-7.5%--far higher than average Americans.

(Plasma levels of EPA + DHA were used in this study, which tend to reflect more recent omega-3 intake than the more stable and slower-to-change RBC Omega-3 Index that we use. Plasma levels also tend to run about 10-20% lower than RBC levels.)

Of course, there's more to psychological distress than omega-3 blood levels. After all, eating fish or taking fish oil capsules won't make money worries go away or heal an unhappy marriage. But it is one variable that can be easily and safely remedied.
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Comments (24) -

  • Boris

    10/30/2009 1:31:07 PM |

    I think your are on to something, Dr. David. Every winter I get sad and depressed. After starting my omega-3 supplements, I noticed that I started feeling "better". I know that's very subjective. We set our clocks backwards 1 hour in a few days. I guess I will get a chance to test the "happy factor" of fish oil soon!

  • Rob McVey

    10/30/2009 2:14:08 PM |

    FYI, Laval is in Quebec, but Guelph is in Ontario (albeit both Canada). Perhaps you'd edit the post.
      --  Rob McVey, Markham, Ont.

  • Haggus

    10/30/2009 3:02:22 PM |

    Just to make it clear, the Univesity of Guelph is located in Ontario.

  • Jim Purdy

    10/30/2009 3:25:04 PM |

    I live in a high-rise apartment building where many of the residents are grouchy old ladies.

    Should I sneak fish oil into their food?

    Or should I move into a building with lots of happy old Inuits?

  • Deb

    10/30/2009 3:27:52 PM |

    I always enjoy and learn so much from you blog. Thank you.
    I have tried taking omega 3 fish oil capsules but they give me acid stomach and fish burps. Any solution to these problems? I have tried the enteric coated ones too.

  • William Trumbower

    10/30/2009 4:13:28 PM |

    I am not surprised at this data.  When I began taking adequate fish oil (7gm EPA+DHA) I noticed an improved mood, memory, and ability to organize my activities.

  • Dr. William Davis

    10/30/2009 5:00:07 PM |

    Rob and Haggus--

    Thanks for the correction.

  • Dr. William Davis

    10/30/2009 5:00:37 PM |

    Hi, Jim--

    Perhaps throw a fish oil party for the ladies!

  • Boris

    10/30/2009 6:13:55 PM |

    Deb,

    You are experiencing the effects of "cheap" fish oil that has a lot of other stuff in it besides Omega-3. I tried Walmart's Nature Made stuff and it made me feel sick. Now I am take Omapure 4x a day (one capsule each time) and I do not feel the same "fishy" burps.

  • Rich S

    10/30/2009 6:48:34 PM |

    Deb-

    Try lemon-flavored liquid form of EPA/DHA. Go with a high quality brand like Carlson, which a lot of us use.

    One tsp gives you 800EPA+500DHA (1300 total), and it actually tastes pretty good (it's not cod-liver oil).

    Buy it online, such as from i-Herb as an example:

    http://www.iherb.com/The-Very-Finest-Fish-Oil-Lemon-Flavor-16-8-fl-oz-500-ml/2796?at=0

    You won't have to swallow all those softgels, which used to bother me.  Also, a good quality distilled fish oil should not cause gastro distress, etc.

    Rich

  • Nameless

    10/30/2009 7:24:58 PM |

    They have done Omega 3 depression studies. I believe they found EPA more important than DHA for improving depression scores. A lot of the 'mood' fish oil supplements tend to be EPA heavy too.

    I think they theorize that EPA helps the brain function, while DHA is primarily for structure (hence why it's important for children/babies).

  • Anonymous

    10/30/2009 8:32:51 PM |

    I think this is an important study, but I have to wonder if low omega-3 might also indicate difficult in fiding adequate food, which would clearly be stressful.  It's a chicken and egg argument so to speak.  Without verying that total nutrition other than omega-3 was adequate, I'm no sure a real conclusion can be made.

  • JD

    10/30/2009 10:37:58 PM |

    The question would be is it the Omega 3's or the fact that those who eat carbs get more depressed?

  • AuntWie

    10/31/2009 4:36:55 AM |

    I've battled depression on and off for most of my life.  Meds help.  Fish oil and lots of vitamin D help even more.  I increase my intake of both whenever my exposure to sunlight is limited (including when the summer heat keeps me indoors a lot.)

  • Anonymous

    10/31/2009 11:41:10 AM |

    So what would be the typical EPA+DHA daily dose (not the oil) to reach these heights of happiness...or plasma levels?

  • Dr Matti Tolonen

    10/31/2009 12:20:06 PM |

    Another recent report from Laval University suggests that highly purified ethyl-eicosapentaenoic acid (E-EPA) may relieve psychological distress in middle-aged women.
    The daily dosage was about 1gram.
    http://www.ajcn.org/cgi/content/abstract/89/2/641
    E-EPA is a very popular omega-3 supplement in Europe and Japan.

  • Dr. William Davis

    10/31/2009 1:32:40 PM |

    In response to several comments--

    Taken in the context of other studies, this study simply adds to the notion that omega-3 intake is associated with mood status.

    While omega-3 plasma levels may also serve as a surrogate for other phenomena, such as vitamin D intake (also rich in fish, though not fish oil), the experience as a whole do indeed show a strong relationship between omega-3 levels and depression/mood/"psychological distress."

  • Red Sphynx

    11/1/2009 2:24:01 PM |

    I'm skeptical of this study.  Look, I expect that, eventually, research will show a strong relationship between mood and LC ω-3.  But this study ain't it.

    First off, this is an observational study.  When observational studies turn up order-of-magnitude differences, they point to cause-and-effect relationships.  But when they turn up relationships that barely pass the statistical significance test (p ~ .05) they are more likely measuring the shared influence of some other cause.

    And what might this cause be?  Well, the authors point out (a) seafood consumption varies upwards with wealth and income.  (b) Happiness varies upwards with wealth and income. (c) They really would have liked to have controlled for wealth and income but they couldn't because the Inuits wouldn't fill out the wealth and income portion of the questionnaire.  

    So their study was underpowered to measure one of the most obvious non-physiological explanations of the (weak) correlation they found.

    This study would have us believe (a) Inuits have much higher ω-3 levels that other Quebec citizens.  (b) The suicide rate among Inuit in 1987–1994 was 6.5 times higher than in the rest of Québec, and the rate in the younger age group (15–
    24 years) was 20 times higher. (!!) (c) ω-3 is associated with better mood.

    Something is pretty discordant there.

    I'll wait for an intervention study.

  • Dr. William Davis

    11/1/2009 9:38:06 PM |

    Hi, Red-

    That's right.

    This study, taken in isolation, proves nothing. It only adds to the other observations that suggest that omega-3 may exert an effect on ADHD, bipolar illness, depression, etc.

    The fact that there appears to be concordance across different populations, though with differing frequencies of depession, is the argument of importance.

  • Dr. William Davis

    11/1/2009 9:38:13 PM |

    Hi, Red-

    That's right.

    This study, taken in isolation, proves nothing. It only adds to the other observations that suggest that omega-3 may exert an effect on ADHD, bipolar illness, depression, etc.

    The fact that there appears to be concordance across different populations, though with differing frequencies of depession, is the argument of importance.

  • Razwell

    1/26/2010 6:40:33 PM |

    Fish oil makes me depressed and nauseous and tired . I do not  know what all the fuss is about.

    I use a supposedly good type too, Carlson's.

  • buy jeans

    11/3/2010 10:03:25 PM |

    A group from Laval University and University of Guelph, both in Canada, examined the relationship of plasma EPA + DHA levels and measures of psychological distress. This group had previously shown that Inuits older than 50 years had twice the plasma omega-3 levels (11.5%) compared to those younger than 50 years (6.5%), reflecting the shift away from the traditional diet.

  • Lisa

    5/16/2011 9:13:39 AM |

    Omega-3 is geally great. Improves memory , I'm loosing pounds and I don't feel hungry or depressed (and when I'm depressed I eat soooo much!).  I prefer flax oil of flax seed as a sourse of omega-3.  My body seems to reject fish oil and I think it's not for nothing. The mercury pollution won't do any good.

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If health won't motivate them, maybe money will

If health won't motivate them, maybe money will

23. July 2007 William Davis (0)
As part of our ongoing effort to educate everyone about the value of heart scans and how they can serve to start a program of heart disease prevention (or elimination), we occasionally distribute press releases on one facet of this discussion or another.

Here's the one we released on our Cost Calculator, the one we developed that showed that $20 billion would be saved annually just by applying the program to men, ages 40-59.




Accurate Detection and Prevention of Heart Disease Can Reduce Healthcare Costs, According to New Cost Analysis

A new cost analysis developed by cardiologist Dr. William Davis and his colleagues suggests that healthcare costs can be reduced by billions of dollars with the application of a simple program for heart disease detection and prevention.

Milwaukee, WI (PRWEB) July 23, 2007 -- Billions of dollars in healthcare could be saved every year by applying a simple program of heart disease detection and prevention on a wide scale in the U.S., suggests a new cost analysis developed by cardiologist Dr. William Davis and colleagues. Davis and his colleagues are the developers of the Track Your Plaque program for heart disease detection and prevention.

In the next 24 hours, 10,000 major heart procedures will be performed in hospitals across the U.S. The tab for this bill will top $400 billion in 2007 alone, nearly twice the sum spent on the war on cancer.

As costs escalate at an alarming rate, tools for prevention of disease are also advancing. While drugs like Lipitor® make headlines and dominate direct-to-consumer TV ads, a quiet revolution is taking place among physicians and the public eager to find better answers, some of which also pose opportunities for stretching the healthcare dollar.

“We’re essentially throwing away billions of dollars each and every year by ignoring the savings power of preventive strategies for heart disease,” proclaims Davis, a Milwaukee cardiologist. Davis is author of several books on heart disease detection and prevention, has been a vocal advocate for preventive strategies and is founder of www.cureality.com.

Davis and his colleagues developed a cost model to predict how much money could be saved by the adoption of new preventive strategies on a broad scale in the U.S. “The cost savings are startling. If males in the 40–59-year-old age group, for instance, were to undergo a simple CT heart scan for early detection of coronary heart disease, followed by a purposeful yet focused program of prevention using widely available tools, our cost model shows that we would save the American public over $20 billion annually. Extending this calculation to the broader population would multiply savings several-fold.”

Heart care is already the single largest healthcare category in the U.S. As costs go up by double-digit percentages, fewer people can afford healthcare. Those who can afford it spend an increasingly greater portion of their disposable income to maintain it. The Agency for Healthcare Research and Quality predicts that, at the current rate of growth, healthcare costs will balloon to absorb 20 percent of American Gross Domestic Product (GDP), about $4 trillion, in the next 10 years.

Davis points out that reducing the annual U.S. expenditure for heart disease by 20 to 30 percent could save between $80 and $120 billion each year. That marginal savings exceeds the sum the U.S. spends on the domestic war on terror.

Davis and his group have dubbed the conventional procedure-based approach to heart disease management the “crash and repair model” because of its focus on urgent procedural intervention that takes place in hospitals.

The crash and repair model is costly. According to the American Heart Association, a heart catheterization (performed 3,553 times per day, seven days a week) costs an average of $24,893; a coronary bypass operation (performed 1,170 times every day, seven days a week) costs an average of $67,823 (hospital costs, 2004, the latest year for which data are available). These figures don’t incorporate long-term costs incurred in the years following the procedure or time lost from work.

The relatively high payment to physicians and hospitals for performing high-tech heart procedures provides a disincentive to redirect patients to a less costly prevention model. The exceptional costs of high-tech, high-ticket heart procedures would become increasingly unnecessary if better heart disease preventive practices were delivered on a broad scale. “Like seatbelts, preventive measures for heart disease are more cost effective and extract a far lower toll in human suffering than the ‘crash and repair’ approach. Our cost calculations bear out the enormous savings possible. In fact, all of the tools necessary to deliver a method of early heart disease detection and prevention are already available throughout the U.S. We’ve just got to encourage physicians and the public to take advantage of them.”

The cost calculator program can be found at http://cureality.com/library/fl_hh005bankrupt.asp on the cureality.com Web site.

Track Your Plaque is an informational and educational Web site devoted to showing people how CT heart scans can be used as a starting point for a program of heart disease prevention and reversal.
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