By Genevra Pittman
NEW YORK (Reuters Health) - Removing metals from the body through a controversial treatment has little effect on the long-term health of people who've previously suffered a heart attack, according to the results of a government-funded trial released Tuesday.
Researchers found no difference in how many of 1,708 participants died in the four and a half years after they received either so-called chelation therapy or drug-free placebo infusions, and only a small decline in the proportion that needed stents or other heart procedures following chelation.
The fact that many patients dropped out of the study - more than one in six - makes even that small benefit undependable, researchers said.
"I would consider it to be essentially an unreliable finding," said cardiologist Dr. Steven Nissen from the Cleveland Clinic Foundation, who wrote an editorial published with the study.
He called chelation "a form of quackery" that some vulnerable patients look to when they're facing bypass surgery, for example.
"The biggest danger here is that people get diverted from established therapies that we know work, to this sort of therapy that doesn't work," Nissen told Reuters Health.
During chelation therapy, a drug that binds to metals including calcium, lead and iron is infused into the bloodstream - allowing those metals to be more easily excreted in the urine.
The technique has been approved by the U.S. Food and Drug Administration (FDA) to treat lead poisoning, but has also been used for a range of other conditions, including on kids with autism (see Reuters Health story of Dec 21, 2012 here:).
In 2010, the FDA warned companies to stop marketing chelation for autism and cardiovascular disease as well as other untested and unapproved uses.
In response to the new study, an FDA spokesperson told Reuters Health in an email, "There are no chelation therapy products approved to treat heart disease. Additionally, all FDA-approved chelation therapy products require a prescription because they can only be used safely under the supervision of a healthcare practitioner."
Researchers lead by Dr. Gervasio Lamas from Mount Sinai Medical Center in Miami Beach randomly assigned older adults with a prior heart attack to receive 40 rounds of chelation therapy or drug-free placebo infusions at 134 clinics in the U.S. and Canada. Each infusion lasted about three hours.
Lamas and his colleagues then tracked study volunteers for the next four and half years, on average, to see who developed heart disease. They found no difference based on treatment in the proportion of people who suffered a second heart attack - between six and eight percent - and the proportion who had a stroke - about one percent.
However, when data on strokes, heart attacks, deaths, heart surgeries and hospitalizations were combined, people who'd had chelation did slightly better. Twenty-six percent of them had one of those outcomes - most often surgery - compared to 30 percent of the placebo group, according to findings published in the Journal of the American Medical Association (JAMA).
COSTS AND SAFETY CONCERNS
About twice as many people developed low calcium levels after chelation than after placebo infusions.
Lamas said that in his trial, chelation was safe. The concern is that if some clinics perform the infusions too quickly, a patient's calcium levels could drop dangerously low and cause heart rhythm problems.
A typical package of chelation treatments costs about $2,000 to $5,000 and is often not covered by health insurance.
Lamas said he would not recommend chelation to everyone recovering from a heart attack, but that he is more optimistic than he was before starting the study.
"There are some real anchors in the treatment of patients who've had a prior heart attack," such as aspirin. "Those anchors need to be tried first," he told Reuters Health.
Referring to the evidence doctors have for traditional treatments of atherosclerosis, he said, "You can't compare that sheer weight of data to 1,700 patients."
Still, that doesn't mean all heart patients should be discouraged from trying chelation in a safe setting, according to Lamas.
"If a patient asked me about it, it would depend on the patient's circumstances," he said. "If they were very ill (and) standard medical therapy had not worked, then I think one has to individualize and discuss it with the patient."
In their paper, he and his colleagues wrote that while their new evidence could be used to help design additional studies, that evidence is too weak to support using chelation in the average heart attack patient.
In a second editorial published with the report, JAMA editors pointed out the controversies that came up during the study - including allegations about researchers at some of the study sites - and said that the possible benefit of chelation, if any, appears to be small.
"This evidence and information should serve to dissuade responsible practitioners from providing or recommending chelation therapy for patients with coronary disease and should discourage patients with previous (heart attack) from seeking this therapy with the hope of preventing subsequent cardiovascular events," Editor in Chief Dr. Howard Bauchner and his colleagues concluded.
SOURCE: http://bit.ly/MvXYT6 Journal of American Medical Association, online March 26, 2013.
Source: http://news.yahoo.com/chelation-little-help-heart-disease-study-200324980.html
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Anyone can toss some oil into a pan and cook, but if you want to up your cooking game, consider using different oils based on the dish you're making and how you plan to cook it. Using the right one can mean the difference between a tasty, well-cooked meal and a smoke alarm going off over your burned food. 
First, a little science. Each different type of oil or fat has its own smoke point, or the temperature at which it begins to break down, smoke, and start to taste awful. Around that same temperature, the flavor and nutritional value falls off as well. What you're left with isn't very tasty and isn't very good for you.
As a rule, unrefined oils, dairy products, and animal fats have the lowest smoke points, and are best suited for lower-temperature cooking like baking, simmering, and low-heat pan frying. While unrefined oils are as close to the natural flavor of the oil you can get, that they have all of the free fatty acids and other ingredients that lower the oil's smoke point. This rule extends to full-fat diary products, which have milk solids and other fats in them that break down and burn easily. Here are a few oils in this range best reserved for lower-heat preparation methods, where you actually want to taste the oil or fat you're using:
Most of your middle of the road oils have applications in low-heat and cold preparations but can also be used on the stove or in the oven. Refined oils?the kind you'll find in most grocery stores?make their way up here, along with some all-purpose oils that you may already have. For example:
The highest-smoke point oils are generally reserved for high-heat frying, brushing on the grill, and deep frying. Some of these are best used because of their high smoke point and their flavor, others are so heavily refined that a high smoke point is pretty much all they have going for them. A few examples:
Like we said earlier, there's no reason to keep a half-dozen oils in your pantry (besides, you don't want your oil to go rancid on you.) Pick a few that you really enjoy using, both for flavor and for temperature. This cooking oil comparison chart, made with the help of Lifehacker friend, nutritionist, and Registered Dietitian Andy Belatti, does a great job of showing you which oils are best left for salads and low-heat preparations versus the ones that can stand a little heat.
There?s something reassuring about a high-altitude ski resort. Seasoned skiers want to know there?ll be snow to greet them once they reach the slopes, but for the beginner too, greater heights often mean the presence of powder on the lower slopes, and can ensure hassle-free skiing to and from your lodgings. At this stage in the season, it?s smart to head for the ski villages, which still promise a few months of cold weather. But where in the world can these record-breaking resorts be found?
system enabling skiers to reach climes of 4,843 meters. Thankfully, oxygen masks are provided. Elsewhere on the continent, Iran presents a surprising alternative to many lower European resorts with the high altitudes and reliable snows at places like Dizin, near Tehran.