In episode 253, James and Mike continue biting off the evidence around nutrition. We discuss salt, breakfast, eggs, fiber, coffee, fruit and vegetable servings, and alcohol. At the end, we get terribly confused and go out and have a smorgasbord.

Show notes

1) Salt

N Engl J Med 2014;371:601-11

BMJ 2013;346:f1325 doi: 10.1136/bmj.f1325

Institute of Medicine – May 2013

N Engl J Med 2014;371:612-23

N Engl J Med 2014;371:677-9

2) Breakfast

Am J Clin Nutr 2013;98:1298-308

Am J Clin Nutr 2014;100:539–47

Am J Clin Nutr 2014;100:626–56

3) Eggs

Atherosclerosis 2012;224:469-73

BMJ 2013;346:e8539 doi: 10.1136/bmj.e8539

4) Fiber

Arch Intern Med 2004;164:370-6

BMJ 2013;347:f6879

BMJ 2011;343:d6617 doi: 10.1136/bmj.d6617

5) Coffee

Circulation 2014;129:643–59 

Eur J Epidemiol 2013;28:527–39

6) Servings

J Epidemiol Community Health – March 2014

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g4490

7) Alcohol

Addiction 2012;107:1246–60

In episode 252, James and Mike start off on a food/nutrition diatribe. We start off by speaking in general about nutrition issues and how we should figure out if a particular food is healthy or unhealthy. We chew up the advantages and disadvantages of RCTs and cohorts and set the plate on what evidence we need to make decisions about nutrition.

Show notes

1) Food Tribes: Making up the rules as we go

Randy Shore Vancouver Sun

2) Implausible results in human nutrition research

BMJ 2013;347:f6698

In episode 251, PREMIUM Mike and James look at the most recent update of the ACCORD trial and find not a lot. We then look at a relatively new class of medication (neprilysin inhibitor) and actually find something but realise it all needs to be put into context.

1) Effects of intensive glycaemic control on ischaemic heart disease: analysis of data from the randomised, controlled ACCORD trial.

Lancet 2014 Jul 31. pii: S0140-6736(14)60611-5

2) PARADIGM-HF – Angiotensin–Neprilysin Inhibition versus Enalapril in Heart Failure

DOI: 10.1056/NEJMoa1409077

In episode 250, Mike and James double up on the value by giving you close to 60 minutes of pure gold – fools gold actually. We discuss a number of new studies that help answer questions about dual antiplatelets, niacin, OST, the number of fruit and vegetable servings, and acetaminophen for acute low back pain. At the end we realize 250 podcasts is a lot and we so much thank all the people who have chosen to listen over the years.

Show notes

1) How long for dual antiplatelets?

Circulation 2014;129:304-12

2) The end of niacin

N Engl J Med 2014;371:203-12

3) OST versus FRAX

J Am Geriatr Soc 2014 62:442–6

OST and fracture risk tables

See under #12 rheumatology

4) Fruit and vegetable consumption meta-analysis 

BMJ 2014;349:g4490 doi: 10.1136/bmj.g4490

Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data

J Epidemiol Community Health 2014;0:1–7. doi:10.1136/jech-2013-203500

5) Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial

Lancet 2014 Jul 23

NSAIDs and low back pain

CD000396

Muscle relaxants and low back pain

CD004252

6) PEIP conference in Edmonton

In episode 249, Mike and James dive into all the latest data on glucosamine for osteoarthritis. Early on, the research showed it might have some benefit but the most recent meta-analyses indicate glucosamine does not reliably improve pain or function in osteoarthritis.

Show notes

1) Tools For Practice

Does glucosamine improve pain and function in osteoarthritis?

2) Glucosamine withdrawal makes no difference 

Arthritis Rheuma 2004;51:738–45 

In episode 248, Mike and James and Mike tackle another Tools For Practice and discuss the myth about NSAIDs and delayed fracture healing and review all the evidence. At the end we join everything all together and NSAIDs didn’t in anyway prevent that.

Show notes

 1) Tools For Practice

Do non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of fracture non-union or impede healing? 

In episode 247, Mike and James and Mike look at the evidence for the new anticoagulants compared to warfarin in the treatment of DVTs and PEs. At the end we realise the decision between these agents is a personal one guided by the best available evidence, which hopefully we have done an OK job in providing.

Show notes

 1) Tools For Practice

Are novel anti-coagulants as effective as warfarin in treating acute venous thromboembolism (VTE)?

2) Choosing Wisely Video

In episode 246, Mike and James go over all the evidence that has looked at the issue of statins and cognitive impairment. Overall the evidence is not confusing and it indicates that statins do not prevent, treat, or cause cognitive impairment or dementia. Still confused?

Show notes

1) Tools For Practice

Statins and cognitive impairment: Don’t forget the evidence? 

In episode 245, Mike and James PREMIUM the listeners with talk about three new studies. Aleglitazar a new drug that was supposed to help people with type 2 diabetes, how best to use delayed antibiotic prescribing and a trial that answers the question about population screening for high cardiovascular risk patients.

Show notes

1) AleCardio – aleglitazar

JAMA 2014;311:1515-25

2) Delayed prescribing of antibiotics

BMJ 2014;348:g1606

3) INTER99 – Population screening and lifestyle counsellng

BMJ 2014;348:g3617

In episode 244, Mike and James continue to delve into issues around industry and discuss the costs of research, patent protection, and policies on industry relations. At the end we come to the conclusion that the phrase industry and us includes 2 people so everybody plays a role in the process.

Show notes

1) Industry and us

Handout for the references discussed in this podcast

2) Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2014