CancerConflicts of Interest

Aspirin & a new drug game being played

This is a short blog about a new game, as I see it…

The headlines on 6th August 2014 were that millions more people should be taking aspirin daily for a minimum of 5 years, ideally 10, heck – make that for ever…

The original article is here. The BBC reported the story as “Daily aspirin ‘cuts bowel and stomach cancer deaths.'” Of course nothing cuts deaths – we are all going to die – but let not the facts get in the way of the story.

The article is interesting in that it’s the first that I’ve seen to detail explicitly how many people might be saved and how many might be killed by taking aspirin. Yes, killed. Check out figure 1 and the researchers have estimated how many men and women they claim will be saved by taking aspirin and how many deaths they forecast “due to stroke, GI bleeding or peptic ulcer caused by aspirin.”

On balance, they say more will be saved than killed and so an aspirin a day for loads of people will kill a few here and save more there. And here’s the big point. Aspirin is as cheap as chips, cheaper than chips no doubt, so why would you not want to put every over 50 year old on aspirin (the age will no doubt get lowered) if you can save more than you kill?

Conflicts of interest

The first thing I check in any article is declarations of interest. If someone tells me walnuts are going to save lives and they and/or the study were funded by the walnut foundation, I am inclined not to take much of what I read very seriously.

In this article the disclosure states: “JC [that’s the lead author – the one who was on the TV that day]: Member of the Bayer advisory board. JB: Consultancy for Bayer Pharma. Research funding from Bayer Pharma. A stockholder and medical director in QuantuMDx, a new medical devices company which will develop point of care pharmacogenetic testing. Aspirin sensitivity is one of company’s targets. JAJ: Consultant to Astra-Zeneca, Dr Falk Pharmaceuticals, Chief investigator of AspECT trial and ChoPIN trial. PMR: Has received honoraria for talks, advisory boards and clinical trial committees from several pharmaceutical companies with an interest in antiplatelet agents including Astra-Zeneca, Bayer, Boehringer Ingelheim, Sanofi-BMS, Biotronic, Johnson & Johnson and Servier, and is on the executive committee of the ARRIVE trial. Research funding from Boehringer Ingelheim. All remaining authors have declared no conflicts of interest.”

The game

If all the companies with an interest in antiplatelet agents (things that aim to prevent blood clotting) – Astra-Zeneca, Bayer, Boehringer Ingelheim, Sanofi-BMS, Biotronic, Johnson & Johnson and Servier etc – were seen to be behind a paper saying “give millions of people antiplatelet agents”, we would probably see through this and wonder about the drug cost and not just the cost of those ‘killed’ by stroke and stomach bleeds weighed up against those ‘saved’ from cancer.

So here’s the plan:

1) Do a paper about the benefits of the cheap, generic, everyone-has-it-in-the-medicine-cabinet, friendly, aspirin.

2) Call for millions of people to be given cheap aspirin for years and years and a humongous medication opportunity has just been created.

3) As soon as possible after the aspirin prescribing occurs, show that the expensive, branded, drug company antiplatelet agents are so superior to aspirin that to keep people on the generic, cheap aspirin would be a crime. Particularly, I suspect, having highlighted the stomach bleed/ulcer problems – these branded drugs will no doubt be better at avoiding stomach problems. Then millions of people will be switched to the patented drugs and stay on them for decades.

4) Make riches beyond wild dreams.

Watch this space…

16 thoughts on “Aspirin & a new drug game being played

  • My doctor hates me. She has been pressuring me to take statins and asprin. I am a 50 year old with no symptoms of heart disease. I refused. I think asprin causes hearing loss. She also hates me because I wont’ do mammograms anymore. I looked at evidence and it doesn’t look like it works. I also won’t have colonoscopy because I am not sure that it helps and I won’t be the part of that experiment to see if it really saves lives.

  • Hi Zoe – great blog. I was thinking exactly the same when I heard the announcement, but couldn’t work out how they would make money out of it. I like your theory, and by including the side effects they open the door for their dastardly plan.
    Keep up the good work


  • Hi Zoe, your YouTube video / seminar from a few years ago where you explain how and why the body stores fat finally made sense to me and I’ve been reading through this blog and trying to get a grasp on the best way to eat, moving forward as a lifestyle and completely removed from what the food lobby are trying to push on me as an eating pattern. I have also purchased your e book and read that too. So I understand what you are saying.

    But I would love some clarity on the argument being put forward that studies are now showing that meats raise insulin levels up to 27 times higher than carbs do (American Journal of Clinical Nutrition, VOL 66, page 1264). What does this mean for protein and fat storing? This is a study many Vegans / high fructose vegans and raw til 4 are promoting on youtube at the moment. Should we be worried, freely eating protein and low carbs?

    I’d love to see some more info on this, hope you’ll find the time to address this as I can’t find out anymore on my own.

    • Hi Anna
      I remember seeing this a while back (it is a 1997 paper!) so I took the opportunity to look at this in more detail following your request.

      First thing – the study was sponsored by Kellogg’s – did you notice all the favourable (and surprising) results for breakfast cereals and mentions of All Bran?! Always worth checking the conflict first.

      Second – the study involved 41 people. Only 1 person consumed all the foods and hence could provide a genuine comparison between foods. 15 others consumed 2 or more foods. I assume the other 25 people tested 1 food alone.

      38 foods were studied – served in 240 calorie portions – from 6 categories: fruit; bakery goods; snacks; carb rich foods; protein rich foods and breakfast cereals:
      There were 4 fruit items tested by 11 people. An average of 2.8 people testing each item.
      There were 5 bakery items tested by 12 people. An average of 2.4 people testing each item.
      There were 7 snack items tested by 12 people. An average of 1.7 people testing each item.
      There were 6 protein rich items tested by 11 people. An average of 1.8 people testing each item.
      There were 9 carb rich items tested by 13 people. An average of 1.4 people testing each item.
      There were 7 breakfast cereal items tested by 11 people. An average of 1.6 people testing each item.

      That’s pretty tiny. Claims about protein rich items (and lentils/beans are richer in carb than protein) appear to have been made with an average of 1.8 people having tested fish and beef?!

      White bread was used as the reference, tested by each person and given a score of 100 for that person. How their 1 or 2 (or all) test foods scored was compared to the impact of white bread for that person.

      The only foods of relevance to the no carb/Paleo debate are fish and beef. Every other food has a carb content (albeit eggs only a trace). Ignore anything in the paper that aggregates protein rich foods, while high carb lentils and baked beans are in that group.

      Hence, the only figures of interest are in Table 4 – the lines for beef and fish. Beef records a glucose area under the curve for 120 mins of 18 +/-6 and fish 29 +/-14. White bread, as an average for this group, was 121 +/- 19. The glucose score (GS) is supposed to be the area under the 120 min curve for the test food divided by the area under the 120 min curve for white bread. The insulin score is supposed to be done in the same way. This suggests that the beef GS should be 18/121 = 14.8, but it is 21 in the second from last column. Fish should be 23.9 but it is 28. You can do the same for insulin to see that these are out too. This is likely just a consequence of all the averaging going on and the standard deviations being so high with such tiny sample sizes.

      These two foods are in the bottom three for glucose response – as you would expect. The bottom food is interestingly peanuts – the highest fat food out of the 38. This brings us to the key points in all this: fat is the only macronutrient that doesn’t elicit a glucose/insulin response. Two more important facts:

      1) Protein is in every food except oils and sucrose. There is thus no actual food that we eat that doesn’t contain protein (assuming you don’t see oils or table sugar as foods).

      2) Nuts and seeds have all three macronutrients in good measure. Such foods are rare. Foods tend to be fat/proteins (meat/fish/eggs/dairy) or carb/proteins (grains/veg/fruits etc) – the key nutrition debate is therefore about fat vs carb.

      The fish and beef chosen in this study were high protein and low fat. Protein breaks down into amino acids and these need insulin to be driven into the cells where they are needed. This explains the insulin response. The glucose response is more interesting. Protein rich foods encourage the production of glucagon (think of this as the ‘equal and opposite’ hormone to insulin – insulin removes glucose from the blood stream – glucagon puts it in). Hence the beef and fish will stimulate glucagon and this will be where the glucose over the next 120 mins comes from. In making this glucose available, glucagon breaks down triglyceride – aka body fat! Hence there is a response, but it’s a good one.

      Figure 4 by the way is absurd. Having no carbohydrate, the glucose/glucagon response from beef and fish will be very small and therefore of course any insulin response divided by a very small glucose response will be large.

      You may find this useful

      The key thing to take away is don’t fear fat! The food that would have been most interesting would have been fatty lamb or pork crackling. This is why low carb must be high fat and not high protein. High protein is unnatural and unhealthy. Fat is our best friend.

      Hope this helps
      Best wishes – Zoe

      • Hi Zoe, thanks so much for clarifying this for me, I really appreciate the time you’ve taken to explain it, it’s very generous of you.

        I have been using your book as a guide for my own approach to eating real food and I’m so grateful that you replied to me as I’ve been observing some very popular Youtube channels on ‘raw eating’ and have been surprised at some of the studies quoted and this one really struck me interesting and potentially worrying because whilst I have left vegetarianism (and a carb based weight gaining diet) I really enjoy ‘fasting’ and eating raw foods during the day and freely eating meat, eggs, fish and vegetables with yoghurt after 4pm. Even when everyone is telling me to ditch the fat and protein combinations.

        Thanks so much for this clarity, Anna

  • I think that the comparisons between aspirin and statins cannot be ignored. Are we to assume that that everyone will be put on statins, and anyone who gets side effects will be told, “You need to wait for three years before the benefits will be felt”? I feel that there is a retreat from pushing statins to pushing something more innocuous and trusted, with the long term view that if people take one pill for its supposed benefits, the medical professions will be able to sneak another one in until we’re all doped up to the eyeballs, and can’t be bothered to question the stupidity of medicating the perfectly healthy. Just fancy, one day we might never need doctors any more, just the ability to swallow 7000 pills every morning from the age of 6 months. And we’ll never die.

    Just for the record, I spoke to four different people over the weekend, all of whom stated that they would never take any pill until they had researched it first, weighed up the pros and cons and then would refuse it if they thought it would do them harm. There seems to be a continuous loss of faith in the current medical profession as a whole.

    And I have a new diabetes consultant to see on Friday. I will be very interested to know if we are going to have the following discussion :-

    “Do you eat your five a day?” “No”
    “Do you eat low fat?” “No”
    Do you take statins?” “No”

  • Amazing FDA link. That agency seems susceptible to commercial influence but they told Bayer to stuff it! Also shocked by the statement saying evidence does NOT show an aspirin benefit for type 2 diabetics! Every doctor visit I am told I MUST take aspirin and I MUST take statins because I’m diabetic. But my sugar level is normal thanks to my low carb diet which is never, ever recommended or even mentioned by my physician. Bloggers like Zoe are literally extending my life expectancy NOT the doctor. How can they be getting this so wrong? I’ve lost faith in medicine.

  • As soon as I heard the announcement on the radio, I thought, ‘Yeah. Sure.’ There was no mention of how otherwise illnesses might be avoided, such as by cutting out sugars, etc.

    Your points about ‘follow the money’ are spot on!

    In a slightly related point (on, I think, ‘You and Yours’ this week), a woman was saying how she had been struck off her doctors’ practice register because she hadn’t used said practice for over two years! ‘Tis the money again…

  • At the risk of sounding familiar, “you wise old cynic”. Sounds like the Questran story all over again.

  • Hi Zoe, can you make your post available for sharing on social media?

    • Hi Olga
      All the buttons are at the bottom of each blog :-)
      Best wishes – Zoe

  • Zoe, I do believe you are learning to think like them! Thanks, and I hope the feeling wears off quickly when you return to normal healthy activities.

  • Hi Zoe

    When I saw this news break I thought great, I was put on 80mg aspirin per day at diabetes diagnosis. Then I checked the numbers. Oh dear, pitiful, as always follow the money.

    They will have to get up very early in the morning if they are ever going to fool you.

    Great post as always.

    Regards Eddie

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