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I used to tell my patients to sprinkle algae on their food and the would look at me like I was crazy??
Yes. I have read every board that exists. Every board seems excited.
My first Adcom. My husband and I listen to most of it. Around 1:30-3pm I though “holy crap we are going to lose all our money, what we’re we thinking”. Mainly because everyone on the panel seemed so clueless. I thought, how could it all come down to these strangers, who don’t seem that knowledgeable about Vascepa. Then all of a sudden, they voted and I went from scared to death to calm. But all along, I was betting on human nature. And human nature tells me people don’t want to change the way they eat. They want a pill to make up for their poor dietary choices. I have seen it every day in my career as a dietitian. It has been a long 18 months. This is my very first investment in a single stock. I’m guessing they don’t all turn out this way!
“Some of the panelists were horrific”.
I especially thought that of the lady who talked about all the mineral oil we eat in our food, such as apples. She sounded like an idiot. I wanted to tell her to look at the big picture lady! It’s all the processed oils were are eating that is causing heart disease and this drug puts the right kind of fat in out bodies. Morons!
What about Obesity?
Eat ALOT of fresh fruits and vegetables with their skin, and smaller amounts of whole grains, but not processed whole grains. Make things like barley and oats and brown rice. Eat grass fed meats and poultry, but not a lot of it. Eat fresh fish. Stay out of restaurants! Unless they cook from scratch. Don’t buy bakery foods. Limit frozen foods to frozen vegetables and fruits. Although you can find some whole grains frozen.
Tasty...
And defer to the Registered Dietitians on nutrition and dietary questions
No, I have taken them in zip lock bag at least 5 times. All domestic flights.
I have told them about this...most think the ADA is being "paid off"...
I live in the south, that could explain a lot.
Any none of the nephrologists I work with will even consider putting their patients on Vascepa. I have been giving everyone a copy of the NEJM Reduce It Study. Most of them have said "It's only one study", "I will believe it in 5 years, when the data is stronger" or "don't you know that most data is made up". Drives me crazy!!!
While sitting in a family medicine doctor's office this morning in the waiting room, a man walked in and asked the nurse for a RX called Vascepa. He said he heard it was for "triglycerides", but that his insurance won't cover it because his triglycerides are not "high enough", but he wants to take it anyway.
After he talked with the nurse, I told him I overheard his conversation and that I thought I could help. Via email, I sent him a copy of the NEJM article about Reduce-IT. I explained how he could have his doctor complete a prior authorization and include a copy of this study. This is what Dr. Bhatt has recommended via Twitter.
People all over the place must be asking for this drug. It's just a matter of time.
JL- "face it, most of you got lucky investing in Amarin"...
Damn Skippy, cause I sure am never going to get rich trying to educate people about eating healthy! I spent my whole career listening to every patient tell me why they couldn't eat what I was telling them to. Now, I am "all in" and was at the right place at the right time. I have been saving my whole life for this opportunity. I am absolutely sure people want a pill! And am banking on it. Thanks for all your support along the way.
"Diet seems to be the common denominator"...
Right on doctor! Somebody else get's it! Now all we have to do is get other people to listen. I have never been successful at this. People never think I know what I am talking about, which is my biggest disappointment in my chosen career path.
Sorry Jam,
Never saw your question. "Chicken in and of itself" isn't bad. It is how it is prepared. Those charts we were referencing back in March show chicken at the top of the list referencing the way most people are consuming it. Most people consume it in the form of chicken nuggets!
If you prepare it at home, by roasting, baking, grilling, etc.you will be fine! Also, choose more chicken breast, than other parts of the chicken.
Again, sorry about the late reply. And remember, always eat more plants than chicken :)
"Does it mean a low protein and red meat free diet is recommended for longevity?"
The answer is yes. If you want to live a long time... you have to have a diet where you limit meat, dairy, processed foods and sugar. You should consume fish, beans, fruits, vegetables, nuts, and whole grains like barley, millet, oats and rye. You should drink water, mostly, and some green or black tea. Check out the Blue Zones where people live to be over 100. They have a 95% plant based diet.
Yes, this is BIG news. I am a Registered Dietitian. My career spans back to the early 90's. I have worked in hospitals, nursing homes, cardiac rehab, diabetes centers and dialysis. Almost all my patients over my entire career would benefit from Vascepa. So yes, the new SOC diabetes guidelines will be a BIG, BIG deal. Unfortunately, it seems every other person in the US today is either diabetic or pre-diabetic. Even kids are getting diabetes. In 2015, 84 million people had pre-diabetes. Nobody is rushing to dietitians/nutritionists to learn how to eat right. Trust me, they want to take a pill. And if they find out there is a pill to help, they will be rushing to their doctor to get it. They do not want to die, they just are not willing to change what they eat. This will be HUGE.
"how does one decrease the AA"?
Avoid highly processed foods which have added oils such as soybean and cottenseed.
1 Chicken and chicken mixed dishes 26.9 26.9
2 Eggs and egg mixed dishes 17.8 44.7
3 Beef and beef mixed dishes 7.3 52.0
4 Sausage, franks, bacon, and ribs 6.7 58.7
5 Other fish and fish mixed dishes 5.8 64.5
6 Burgers 4.6 69.1
7 Cold cuts 3.3 72.4
8 Pork and pork mixed dishes 3.1 75.5
9 Mexican mixed dishes 3.1 78.7
10 Pizza 2.8 81.5
11 Turkey and turkey mixed dishes 2.7 84.2
12 Pasta and pasta dishes 2.3 86.5
13 Grain-based desserts 2.0 88.5
This data is from NHNES survey 2005-06
Most people are not eating just chicken, eggs, beef, pork. They are eating processed chicken, eggs, beef and pork from KFC, Hardee's, Arby's, Pizza Hut, McDonalds, or Taco Bell, or from the grocery store under the names of Hormel, and Tyson. It could be from the frozen food department, or the deli. All these products are processed foods. Nobody is going to the store and buying a chicken and roasting it. Or eating just a hard boiled egg. They eat already prepared foods, and it is killing them because they are getting too much of the wrong kind of fat. I have been a Registered Dietitian for a long, long time and find that most people actually think they eat healthy, but very few people do. I watched all my co-workers eat donuts, store bought muffins and bagels this morning at a meeting. That would be number 13 on the list (grain based desserts). All of it full of processed oils. Most days for lunch my co-workers eat pizza from Dominoes (#10 on the list), or Jersey Mikes (#7 on the list). I am the only one who actually brings my lunch with a salad, or a homemade dish such as chili today. My patients are even worse. They eat potato chips, poptarts, little debbie cakes, honey buns, Doritos, and bags of popcorn for breakfast and a hamburger and fries for lunch.
So you ask "how does one decrease the AA"? You have to start making everything from scratch, get out of a typical grocery store (80% of any grocery store is processed food), start shopping locally at farmer's markets. Eat lot and lots of fresh fruits and vegetables, lean meats, whole grains like farro, barley, millet, quinoa, buckwheat, whole rye, oats, etc. Eat beans, lentils, peas. And you have to stop eating out. Restaurants just shop at big grocery stores. They are not cooking from scratch. Also, you have to supplement with the right kind of fats found in Vascepa. I used to tell my patients to eat more fish, eat algae and sea vegetables such as Kombu and Dulse and Kelp. I used to tell them to put Kombu in soup and sprinkle Dulse on their food at the table. They all looked at me like I was crazy. Now I know I am not!
Hope this gives you an idea of what it takes to get the ratio right. It's not that easy to follow these suggestions, which is why I am so excited there is finally a pill to help everyone out.
I am laughing at the doctors idea at the end of the article about addressing everyone's lifestyle, instead of using Vascepa. Does this doctor REALLY think that's the answer? What a joke. I am a Registered Dietitian and have been in the business of trying to change people's diets for my entire career. People don't want to eat differently, they want a PILL!!!!!!
I am happy the guidelines mention diet, omega 3's and RD's. Finally, after all these years of being in the field of nutrition, the word is getting out about dietary approaches to health. Maybe Amarin needs an RD on their staff! I also have a marketing degree!!!
Yes, because Reduce It is mentioned near the bottom, but this also states at the top "dietary intake of fish and omega -3 fish oil" so we have a way to go, IMO...
Dietary intake of fish and omega-3 fish oil is associated with reductions in the risks of total mortality,
sudden death, and coronary artery disease through
various mechanisms of action other than lowering
of LDL-C. In a large clinical trial, highly purified,
prescription-grade, moderate-dose (1.8 g) eicosapentaenoic acid (EPA) added to a statin regimen was associated with a significant 19% reduction in risk of any
major coronary event among Japanese patients with
elevated total cholesterol (165) and a 22% reduction
in CHD in patients with impaired fasting glucose or
T2D (166). Among those with triglycerides >150 mg/
dL and HDL-C <40 mg/dL, EPA treatment reduced the
risk of coronary events by 53% (167). Other studies of
lower doses (1 g) of omega-3 fatty acids (combined
EPA and docosahexaenoic acid) in patients with baseline triglycerides <200 mg/dL have not demonstrated cardiovascular benefits (168,169). Recently, the
REDUCE-IT (Reduction of Cardiovascular Events
with EPA-Intervention Trial) study of icosapent ethyl,
an EPA-only prescription-grade omega-3 fatty acid
given at a dose of 4 g/day, demonstrated a 25% reduction in risk of major adverse cardiovascular events
among patients with LDL-C levels below 100 mg/
dL and triglyceride levels between 150 and 499 mg/
dL (170). Studies evaluating other high dose (4 g)
prescription-grade omega-3 fatty acids in the setting
of triglyceride levels >200 mg/dL are ongoing.
Relative to statin efficacy (30 to >50% LDL-C
Yes, you are correct.
This is a guide to provide clinicians with approaches to treatment. I am a Registered Dietitian, and Certified Diabetes Educator, and the first principle in the guide says "lifestyle therapy begins with nutritional counseling and education" and a "Registered Dietitian should discuss recommendations". 9 out of 10 patients with diabetes are never referred for counseling. I know first hand because I have been in the business for 27 years.
Have you tried sprouted breads? Sourdough is not high in fat or sugar, but it is made from refined wheat flour. Sprouted breads such as Ezekiel, have a long list of whole grains such as barley, whole wheat, spelt and millet, with added flax, which is full of omega 3's. Ezekiel is also devoid of unhealthy processed fats such as soybean, canola, cottonseed, corn and vegetable oils. Sprouted breads also have sprouted beans such as lentils and soybeans.
Besides bread, it is important to leave off any other foods that have these unhealthy oils. This means avoiding 80% of all grocery store foods, which is quite hard to do, and avoiding restaurants, who shop at bigger grocery stores, called Sysco.
Fabulous explanation. I have read many of your posts going back many years. Thank you for all the education. One reason I love reading this board...it's about my two favorite topics, which are nutrition and money :)
Cardio...I follow this board and have for about 8 months, turned onto Vascepa by my PCP...initially for an investment, and later as a patient. I have chronic pain and a long list of inflammatory symptoms from non-healing injuries. My PCP has tried every other drug, so thought why not give this one a try. The verdict is still out. I have been taking it for about 3 months.
I am a Registered Dietitian, for 26 years now, and have worked in cardiac most of my career. Now in renal. Both patient populations apply.
There are about 800 cardiac rehab programs across the US and 90,000 RD's. 10,000 RD's go to the annual meeting of the Academy of Nutrition and Dietetics every year.
Even though RD's can't write prescriptions, they do talk to patients and attend drug rep luncheons regularly. They also teach classes and make recommendations to patients. They monitor medications lists. They round with doctors and make recommendations to doctors, PA's and NP's.
In the renal world, RD's are actually responsible for making sure med list's are up to date. They work with pharmacies on a regular basis to make sure that med's are affordable. They fill out medication assistance paperwork and complete prior authorizations. Many RD's are even charged with passing out sample med's under the doctor's permission. Some states allow RD's to enter doctor's orders.
During my career, when I worked in cardiac rehab (for about 15 years) I saw 6-8 diabetic patients a day. Most all of these patients wanted to take a pill, rather than change their diet.
Along with reaching out to Cardio's, I believe this is an untapped group of professionals who could be utilized to get the word out about this drug.
RD's are already promoting EPA. I tried to explain the EPA ratio to people for years and years, encouraging them to replace other oils with fish oils in their diet. Most people just can't do this in the modern food system that exists, it's too complicated. My patients would say to me "isn't there just a pill I can take"?
Now we just have to get the word out about Vascepa. I think RD's will listen. I do hope AMRN is monitoring this board and they hear from this RD who has been paying attention. I am long AMRN and have high hopes for this company.