STEPHEN PHINNEY m2 | REDUCING INFLAMMATION …CRP:indicator of inflammation cut by fish oil; DHA

Summary

This transcript discusses the role of CRP (C-reactive protein) as a biomarker for cardiovascular risk, highlighting studies that examine its predictive value and treatment strategies. It explores the effect of statins in reducing CRP levels and the limitations of existing drugs. The transcript also covers newer treatments like monoclonal antibodies, such as canakinumab, and their modest impact on heart disease risk. Additionally, it critiques the use of isolated anti-inflammatory nutrients like resveratrol and vitamin E, while emphasizing the potential of gamma tocopherol, an effective anti-inflammatory compound found in food.

Takeaways

• 😀 CRP (C-reactive protein) is a significant biomarker for cardiovascular risk, showing up to a four-fold difference in coronary disease risk between high and low CRP levels.
• 😀 Statins, while effective in lowering CRP by 20-30%, do not definitively prove that reducing CRP alone lowers heart attack risk, as other factors like LDL reduction also play a role.
• 😀 A large-scale study (177,000 participants) on statins showed a reduction in coronary events, but statin use was linked to a 28% increase in type 2 diabetes incidence.
• 😀 Monoclonal antibodies like Canakinumab, which reduce CRP by targeting inflammation mediators, demonstrated a modest 10% reduction in coronary risk but increased the incidence of fatal sepsis.
• 😀 Lowering CRP levels too much can compromise the body’s immune defense, exposing individuals to higher risks of infection and other health issues.
• 😀 Anti-inflammatory nutrients like fish oil (omega-3s) and resveratrol have varying levels of efficacy, with isolated nutrients sometimes being less effective than whole foods.
• 😀 Resveratrol, found in red wine, is only a small part of the beneficial polyphenols in wine, and taking isolated supplements may not provide the full health benefits of the whole compound.
• 😀 Gamma-tocopherol, a form of vitamin E found in food, is a potent anti-inflammatory agent and has been shown to lower CRP more effectively than the common alpha-tocopherol form found in supplements.
• 😀 Despite its effectiveness, gamma-tocopherol remains relatively unknown due to commercial interests and patent protection by pharmaceutical companies.
• 😀 The pharmaceutical industry’s suppression of effective treatments, like gamma-tocopherol, is a result of market defense, prioritizing existing products over more effective alternatives.

Q & A

What is the significance of CRP (C-reactive protein) in cardiovascular disease risk?

CRP is considered a robust biomarker for inflammation and is associated with increased cardiovascular disease risk. Studies show that individuals with high CRP levels have a significantly higher relative risk for subsequent cardiovascular events compared to those with lower levels.

How does statin therapy influence CRP levels?

Statins, especially modern ones like rosuvastatin, can reduce CRP levels by 20-30%. However, while statins lower CRP, it is not clear if CRP reduction is the direct cause of the decrease in cardiovascular risk, as statins also lower LDL cholesterol.

What did the major study on statins and CRP (the 177,000-person study) find?

The study found that statin use in people with high CRP values led to a modest reduction in cardiovascular events, even though these individuals had relatively low LDL cholesterol. However, the study could not definitively prove that CRP reduction was the primary cause of this benefit.

What controversy arose from the follow-up study of statins and CRP?

The follow-up study revealed that statin use was associated with a 28% increase in the incidence of type 2 diabetes, which potentially undermined the cardiovascular benefits. This finding raised questions about the balance of statin risks and benefits.

What role does inflammation play in the body's defense mechanisms?

Inflammation is crucial for defending against infections, healing wounds, and responding to internal damage. Therefore, lowering inflammatory markers like CRP can have unintended consequences, including an increased susceptibility to infections.

How does the monoclonal antibody canakinumab affect CRP and cardiovascular risk?

Canakinumab is a monoclonal antibody that reduces CRP by inhibiting the production of interleukin-1 beta. In a study, it modestly reduced cardiovascular risk by 10-15%, but also increased the risk of fatal sepsis, highlighting the potential dangers of broadly suppressing inflammation.

Why is it difficult to establish causality between CRP reduction and cardiovascular risk reduction?

Establishing causality is challenging because other factors, like LDL cholesterol reduction, might also contribute to the observed reduction in cardiovascular risk. The difficulty lies in isolating CRP as the sole factor responsible for the benefit.

What are the potential benefits and pitfalls of using isolated anti-inflammatory nutrients like fish oil or resveratrol?

Nutrients like fish oil (omega-3 fatty acids) and resveratrol have been touted for their anti-inflammatory properties. However, isolated compounds may not have the same potency or effectiveness as those found in whole foods. Moreover, the benefits of these nutrients are often overblown, and supplements may not provide the same protective effects seen in natural sources.

What is the issue with using purified resveratrol as a supplement?

Purified resveratrol is only a minor component of red wine’s polyphenols, and its isolated form may not provide the same benefits as consuming the full spectrum of compounds found in wine. Additionally, the overall effectiveness of resveratrol in reducing inflammation is debated.

What is the significance of gamma-tocopherol in reducing CRP, and why is it not widely known?

Gamma-tocopherol, a type of vitamin E found in whole foods, is a potent anti-inflammatory agent and can reduce CRP effectively. However, despite its benefits, it is not widely recognized because a startup company researching its use went bankrupt, and major pharmaceutical companies have not pursued it due to market interests in other products.