Within these paragraphs there is a lot of hogwash, including the usual pseudo wisdom that people over age 90 like to present to us KIDS. But at least 40% of this strikes me as sound and half of that as very illuminating. Where have you gotten such a high percentage of solid advice before?

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Dr. Shigeaki Hinohara, Japan, turned 101 on 4th October 2012

As a 97 year old Doctor, he was interviewed, and gave his advice for a long and healthy life.

Shigeaki Hinohara is one of the world’s longest-serving physicians and educators. Hinohara’s magic touch is legendary: Since 1941 he has been healing patients at St. Luke’s International Hospital in Tokyo and teaching at St. Luke’s College of Nursing.

He has published around 15 books since his 75th birthday, including one “Living Long, Living Good” that has sold more than 1.2 million copies. As the founder of the New Elderly Movement, Hinohara encourages others to live a long and happy life, a quest in which no role model is better than the doctor himself.

Doctor Shigeaki Hinohara’s main points for a long and happy life:

* Energy comes from feeling good, not from eating well or sleeping a lot. We all remember how as children, when we were having fun, we often forgot to eat or sleep. I believe that we can keep that attitude as adults, too. It’s best not to tire the body with too many rules such as lunchtime and bedtime.

* All people who live long regardless of nationality, race or gender share one thing in common: None are overweight. For breakfast I drink coffee, a glass of milk and some orange juice with a tablespoon of olive oil in it. Olive oil is great for the arteries and keeps my skin healthy. Lunch is milk and a few cookies, or nothing when I am too busy to eat. I never get hungry because I focus on my work. Dinner is veggies, a bit of fish and rice, and, twice a week, 100 grams of lean meat.

* Always plan ahead. My schedule book is already full until 2014, with lectures and my usual hospital work. In 2016 I’ll have some fun, though: I plan to attend the Tokyo Olympics!

* There is no need to ever retire, but if one must, it should be a lot later than 65. The current retirement age was set at 65 half a century ago, when the average life-expectancy in Japan was 68 years and only 125 Japanese were over 100 years old. Today, Japanese women live to be around 86 and men 80, and we have 36,000 centenarians in our country. In 20 years we will have about 50,000 people over the age of 100…

* Share what you know. I give 150 lectures a year, some for 100 elementary-school children, others for 4,500 business people. I usually speak for 60 to 90 minutes, standing, to stay strong.

* When a doctor recommends you take a test or have some surgery, ask whether the doctor would suggest that his or her spouse or children go through such a procedure. Contrary to popular belief, doctors can’t cure everyone. So why cause unnecessary pain with surgery I think music and animal therapy can help more than most doctors imagine.

* To stay healthy, always take the stairs and carry your own stuff. I take two stairs at a time, to get my muscles moving.

* My inspiration is Robert Browning’s poem “Abt Vogler.” My father used to read it to me. It encourages us to make big art, not small scribbles. It says to try to draw a circle so huge that there is no way we can finish it while we are alive. All we see is an arch; the rest is beyond our vision but it is there in the distance.

* Pain is mysterious, and having fun is the best way to forget it. If a child has a toothache, and you start playing a game together, he or she immediately forgets the pain. Hospitals must cater to the basic need of patients: We all want to have fun. At St. Luke’s we have music and animal therapies, and art classes.

* Don’t be crazy about amassing material things. Remember: You don’t know when your number is up, and you can’t take it with you to the next place.

* Hospitals must be designed and prepared for major disasters, and they must accept every patient who appears at their doors. We designed St. Luke’s so we can operate anywhere: in the basement, in the corridors, in the chapel. Most people thought I was crazy to prepare for a catastrophe, but on March 20, 1995, I was unfortunately proven right when members of the Aum Shinrikyu religious cult launched a terrorist attack in the Tokyo subway. We accepted 740 victims and in two hours figured out that it was sarin gas that had hit them. Sadly we lost one person, but we saved 739 lives.

* Science alone can’t cure or help people. Science lumps us all together, but illness is individual. Each person is unique, and diseases are connected to their hearts. To know the illness and help people, we need liberal and visual arts, not just medical ones.

* Life is filled with incidents. On March 31, 1970, when I was 59 years old, I boarded the Yodogo, a flight from Tokyo to Fukuoka. It was a beautiful sunny morning, and as Mount Fuji came into sight, the plane was hijacked by the Japanese Communist League-Red Army Faction. I spent the next four days handcuffed to my seat in 40-degree heat. As a doctor, I looked at it all as an experiment and was amazed at how the body slowed down in a crisis.

* Find a role model and aim to achieve even more than they could ever do. My father went to the United States in 1900 to study at Duke University in North Carolina. He was a pioneer and one of my heroes. Later I found a few more life guides, and when I am stuck, I ask myself how they would deal with the problem.

* It’s wonderful to live long. Until one is 60 years old, it is easy to work for one’s family and to achieve one’s goals. But in our later years, we should strive to contribute to society. Since the age of 65, I have worked as a volunteer. I still put in 18 hours seven days a week and love every minute of it.

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Contributed to this journal by Leonard Carrier.

Some people like to say “I gave at the office” or “I made my annual donation two months ago.” All this is good but leaves you far short of what you opught to be doing. The likelihood that you can’t help more than you are doing is slim to none. Just skip two meals per month in your favorite fancy restaurant and send the saved money to some place where it will be appreciated much more than your local restauranteur. Consider what just happened in South Sudan.

BRUSSELS/NEW YORK, May 16, 2013—The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today strongly condemned the deliberate damage and looting of its hospital in Pibor town, in South Sudan’s Jonglei State, which has left tens of thousands of people without access to essential medical care.

The hospital’s infrastructure was systematically damaged May 11–12 in order to render it unusable without major repairs. Therapeutic medical food and hospital beds were looted. The MSF structure is the only hospital facility for Pibor County, with the nearest alternative more than 90 miles away. The hospital’s closure leaves roughly 100,000 people cut off from health care. Many of them have fled to the bush amid conflict between the South Sudan Army (SPLA) and the David YauYau armed militia group.

“A special effort was made to destroy drug supplies by strewing them on the ground, to cut and slash the warehouse tents, to ransack the hospital wards, and even to cut electricity cables and rip them from the walls,” said Richard Veerman, MSF operations coordinator for South Sudan.

From January to March, the Pibor hospital treated 3,000 people and provided surgical care to more than 100 people suffering war-related injuries, including SPLA soldiers. Prior to the attack, MSF was forced to suspend activities in Pibor on April 19 because of threats and intimidation of staff and patients.

“The rainy season has just started and we know from previous years that malaria and respiratory diseases such as pneumonia will start to claim lives if there is no health care available,” Veerman said. In a report issued in November last year, South Sudan’s Hidden Crisis, MSF documented the devastating health consequences when people are forced to flee to the bush.

An MSF team was preparing to return and restart medical activities when the looting and destruction took place. It was the sixth time an MSF medical facility has been looted or damaged in Jonglei State in the past two years.

“It is unthinkable that there will be no health care whatsoever for the next six months for some 100,000 frightened and vulnerable people hiding in the swamps,” Veerman said. “Unless we can return to resume medical activities and have the freedom to move to wherever people need assistance, this unthinkable scenario may become the horrific reality.”

MSF urges the Government of South Sudan to meet its responsibilities to ensure full respect of medical humanitarian facilities and activities. MSF also calls urgently for assurances from all parties in the Jonglei State conflict that its medical teams have unhindered freedom to return to Pibor and the ability to reach out impartially to people in need of medical assistance, on either side of the conflict. Humanitarian and medical assistance is urgently needed in Pibor County and must be resumed in the coming days or weeks.

MSF works in Akobo, Nyirol, Pibor, and Uror counties in Jonglei State. The activities in all locations, including Gumuruk Clinic in Pibor County, continue to function, with the exception of the hospital in Pibor town and the MSF clinic in the village of Lekwongole in Pibor County, which was targeted and damaged in August 2012 and where insecurity and fighting have made access impossible for MSF.

Twenty bucks to help in this crisis would be very sweet. [And maybe again in two months]

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http://www.youtube.com/watch?v=PpBvKgL8Obo
www.samaritanspurse.org

and, of course, Doctors Without Borders/Médecins Sans Frontières (MSF)

The arteries in my heart having been duly explored last week, I was ordered not to lift anything as heavy as a gallon of milk prior to the next step in my care – bypass surgery. It was determined that angioplasty plus stenting would not do me much good. Naturally, I was very curious about the weightlifting restriction.

SG: How did you arrive at the limitation of one gallon of milk?
Cardio: It is about 8 pounds.
SG: Actually, I think it is closer to 8.8 pounds.
Cardio: No matter.
SG: Is it, then, one waxed container with 3.2% fat in the milk suits all?
Cardio: If you insist on being a wise guy, YES.
SG: I hope the desire to understand does not equal wanting to be a wise guy. Let me ask you this: Do you admit that people start from different levels of strength and fitness?
Cardio: What are you getting at? [Boredom and eagerness to leave creeping into his voice.]
SG: Ed Coan is a man who can hoist over 1000 lbs. off the ground. Others can do about the same. Are you sure an 8-pound restriction on him is the same as on a woman who can not lift more than 25 pounds? For her, 12 pounds is close to half her capacity. I don’t understand how one size can fit all.
Cardio: It does.
SG: No, I don’t get it.
Cardio: For some time now you have been very difficult and distrusting of my advice.
SG: I regard you as the best there is in the County.
Cardio: I think you should seek somebody else.
SG: That would worry me. Who?
Cardio: I can give you a list of other cardiologists.
SG: What good would that do me? I’d be a pest to them, too.
Cardio: That’s the best I can do for you.
SG: Thank you, but I am staying right here.
Cardio: But under protest.

That was a year ago. The Great Man remains my cardiologist.

In 8 and 1/2 hours (at Noon), “doctors” will penetrate my heart. I have confidence. Tomorrow I will be back at the old stand, dishing out my opinions and free coconut whips. Betty inspires me. http://www.youtube.com/watch?v=zZYYqQInrDg

IoM is my GO-TO source for matters of medicine. I back up IoM with the Cochrane Library. If you rely on these sources then you will know more about the evidence for medical claims than your current physician, assuming that he is not in the upper 3% of the best informed. If you have a herd instinct and like to say, “I trust my doctor and do as he says,” then the work of the Institute of Medicine is wasted on you. Of course, knowing the evidence does not make you a good physician or any kind of physician at all.

From the IoM website: The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public.

Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as the National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM.

The IOM asks and answers the nation’s most pressing questions about health and health care.

Our Work — Our aim is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely. Each year, more than 2,000 individuals, members, and nonmembers volunteer their time, knowledge, and expertise to advance the nation’s health through the work of the IOM.

Many of the studies that the IOM undertakes begin as specific mandates from Congress; still others are requested by federal agencies and independent organizations. While our expert, consensus committees are vital to our advisory role, the IOM also convenes a series of forums, roundtables, and standing committees, as well as other activities, to facilitate discussion, discovery, and critical, cross-disciplinary thinking.

Our Impact — For millions of people across the United States, and spanning the globe, improving health is not merely an academic exercise; it is of utmost importance. For that reason, we take our mission very seriously, and in all our work, we seek to make a real difference in the world. We do not shy away from making honest calls and from demanding the most from our leaders. We provide information to decision makers so that they can change regulation or policy and to other influential groups who can change behavior, all aimed eventually at improving health. Through the actions of government and other organizations, our work has a large impact on the health of the nation and of the world.

Advising Congress and Policy Makers — The Institute of Medicine advises Congress on important health questions, from the quality of medical care to conflicts of interest in medical research, from malaria treatment to environmental hazards, and from vaccine safety to childhood obesity. Since 1970, when the IOM was established as the health arm of the National Academy of Sciences, the IOM’s recommendations have shaped health policies to improve the lives of millions of people around the world.

We are available to brief Members of Congress and Congressional staff, as well as agency leaders, about key health issues addressed in IOM studies. To receive more information about a study or to request a briefing, please contact Jim Jensen, Director of the Office of Congressional and Government Affairs, at 202-334-1601 or jjensen@nas.edu.

To date, IoM has issued 808 reports: 316 in the area of public health, 272 on Biomedical and Health Research. Diseases (198), Quality and Patient Safety (175)
Health Services, Coverage, and Access (163), and more. [Some considerable overlap, as you see.]

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One report that is utterly absorbing is the 450 page report titled PREVENTING MEDICATION ERRORS: QUALITY CHASM SERIES (2007) You can buy it or do as I do: read it online, free of charge. http://books.nap.edu/openbook.php?record_id=11623&page=R15 The statistics will frighten you. You will pull a blanket over your head and never even wander out to the kitchen for food again. Still, you MUST read this report or admit you are the child of an ostrich.

I have often raved, (admittedly) quite out of control, against the medical industry [a.k.a. the self-described "medical profession"] and am aware that this hot-headed treatment of these maniacs gets me nowhere and certainly wins me no friends. Still, all I can say in my defense, and it is not much, I confess, is that I am ALWAYS RIGHT.

Now, a man with a more dispassionate approach has written a devastating critique of physicians in so far as they deal with dying patients. Jonathan Rauch is the man with good sense and Angelo Volandes, a 41-year old assistant professor at Harvard medical School is the hero of Rauch’s article. And what an article it is! If this article won’t help swing you over to my side, I really should give up. But, of course, you know perfectly well that, like Volandes, I won’t.

http://www.theatlantic.com/magazine/archive/2013/05/how-not-to-die/309277/

As people say, if you have time to read only one article this year, make it this one.

Atkins, South Beach, and all the others, it is time to move to the sidelines. There is a new kid on the block getting all the attention.

New England Journal of Medicine, 04/08/2013 Continuing Medical Education
Estruch R. et al.– Observational cohort studies and a secondary prevention trial have shown an inverse association between adherence to THE MEDITERRANEAN DIET. and cardiovascular risk. The study is a randomized trial of this diet pattern for the primary prevention of cardiovascular events. It was concluded that among persons at high cardiovascular risk, a Mediterranean diet supplemented with extra–virgin olive oil or nuts reduced the incidence of major cardiovascular events.

Methods

In a multicenter trial in Spain, the authors randomly assigned participants who were at high cardiovascular risk, but with no cardiovascular disease at enrollment, to one of three diets: a Mediterranean diet supplemented with extra–virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). Participants received quarterly individual and group educational sessions and, depending on group assignment, free provision of extra–virgin olive oil, mixed nuts, or small nonfood gifts. The primary end point was the rate of major cardiovascular events (myocardial infarction, stroke, or death from cardiovascular causes). On the basis of the results of an interim analysis, the trial was stopped after a median follow–up of 4.8 years

Results

A total of 7447 persons were enrolled (age range, 55 to 80 years); 57% were women. The two Mediterranean–diet groups had good adherence to the intervention, according to self–reported intake and biomarker analyses. A primary end–point event occurred in 288 participants.

No diet–related adverse effects were reported.

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Do it the right way – THE JEWISH WAY. https://www.youtube.com/watch?v=5nqydycykiE

People can argue until Doomsday, and they do, as to whether medicine is, on the whole, a good thing or an outrageous scam. Obviously, it is an outrageous scam but so is religion and where does rationality get us there? Everyone can point to tens of thousands of instances where hospitals and physicians have saved our lives. Make that millions. However, we are addicted to the Fallacy of Dramatic Instances and victims of a fabulously successful promotional scheme by the Health Care INDUSTRY. [Please forswear the term "profession."] Sometimes, we do see well beyond the end of our noses — all the way to our fingertips. What are the facts about medicalization? Try these:

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Medicalization is the process by which human conditions and problems come to be defined as medical conditions, and thus become the subject of medical study and treatment. Once a condition is classified as medical, a medical model of disability tends to be used in place of a social model.

The concept of medicalization was devised by sociologists to explain how medical knowledge is applied to behaviors which are not self-evidently medical or biological. The term “medicalization” entered the sociology literature in the 1970s in the works of Irving Zola, Peter Conrad and Thomas Szasz. These sociologists viewed medicalization as a form of social control by medical authority, and they rejected medicalization in the name of liberation. This critique was embodied in works such as Conrad’s “The discovery of hyperkinesis: notes on medicalization of deviance”, published in 1973 (hyperkinesis was the term then used to describe what we might now call “attention deficit disorder” – ADHD).

IN SHORT, WE HAVE ENTERED INTO THE AGE OF DISEASE MONGERING.

In his 1975 book Limits to medicine: Medical nemesis, Ivan Illich argued that the medical profession harms people through iatrogenesis, a process in which illness increases due to medical intervention. Illich saw iatrogenesis occurring on three levels: the clinical, involving serious side effects worse than the original condition; the social, whereby the general public is made docile and reliant on the medical profession to cope with life in their society; and the structural, whereby the idea of aging and dying as medical illnesses effectively “medicalized” human life and left individuals and societies less able to deal with these “natural” processes.

Marxists such as Vicente Navarro (1980) linked medicalization to an oppressive capitalist society. They argued that medicine disguised the underlying causes of disease, such as social inequality and poverty, and instead presented health as an individual issue. Others examined the power and prestige of the medical profession, including use of terminology to mystify and of professional rules to exclude or subordinate others. A series of publications by Mens Sana Monographs have focused on medicine as a corporate capitalist enterprise.

Conversation between doctor and patient/consumer.
The physician’s role in this present-day notion of medicalization is similarly complex. On the one hand, the doctor is an authority figure who prescribes pharmaceuticals to patients. However, in some countries such as the US, ubiquitous direct-to-consumer advertising encourages patients to ask for particular drugs by name, thereby creating a conversation between consumer and drug company that threatens to cut the doctor out of the loop. There is also widespread concern regarding the extent of the pharmaceutical marketing direct to doctors and other healthcare “professionals,” for example through visits by sales people, funding of journals, training courses or conferences, incentives for prescribing, and the routine provision of “information” written by the pharmaceutical company.

According to Nicholas Kittrie, a number of phenomena considered “deviant”, such as alcoholism, drug addiction and mental illness, were originally considered as moral, then legal, and now medical problems. Due to these perceptions, peculiar deviants were subjected to moral, then legal, and now medical modes of social control. According to Franco Basaglia and his followers, whose approach pointed out the role of psychiatric institutions in the control and medicalization of deviant behaviors and social problems, psychiatry is used as the provider of scientific support for social control to the existing establishment, and the ensuing standards of deviance and normality brought about repressive views of discrete social groups.

Medical institutions code menaces to authority as mental diseases during political disturbances. According to Mike Fitzpatrick, resistance to medicalization was a common theme of the gay liberation, anti-psychiatry, and feminist movements of the 1970s, but now there is actually no resistance to the advance of government intrusion in lifestyle if it is thought to be justified in terms of public health. The crazed Michael Bloomberg, the man who crookedly got himself a third term as NY’s mayor, in defiance of the City’s laws, wants to stop people from drinking Coca Cola.

According to Thomas Szasz, “the therapeutic state swallows up everything human on the seemingly rational ground that nothing falls outside the province of health and medicine, just as the theological state had swallowed up everything human on the perfectly rational ground that nothing falls outside the province of God and religion.”

An editorial in the British Medical Journal warned of inappropriate medicalization where the boundaries of the definition of illnesses are expanded to include personal problems as medical problems or risks of diseases are emphasized to broaden the market for medications. The authors noted “Inappropriate medicalisation carries the dangers of unnecessary labelling, poor treatment decisions, iatrogenic illness, and economic waste, as well as the opportunity costs that result when resources are diverted away from treating or preventing more serious disease.”

Go to your favorite search engine and look up each of these AND WEEP.
(1) Iatrogenesis; (2) Interventionism (medicine)
(3) Sociology of health and illness; (4) Big Pharma

And, later, try some of these. First, do more groveling and boot licking. Let the man in the white gown pat you on the head when you ask him, “Doctor, will my son be all right?”
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^ White, Kevin (2002). An introduction to the sociology of health and illness. SAGE. p. 42.
^ Conrad P (October 1975). “The discovery of hyperkinesis: notes on the medicalization of deviant behavior”. Soc Probl 23 (1): 12–21.
^ Ajai R Singh, Shakuntala A Singh, 2005, “Medicine as a corporate enterprise, patient welfare centered profession, or patient welfare centered professional enterprise?” Mens Sana Monographs, 3(2), p19-51
^ Ajai R Singh, Shakuntala A Singh, 2005, “The connection between academia and industry”, Mens Sana Monographs, 3(1), p5-35
>^ Kittrie, Nicholas (1971). The right to be different: deviance and enforced therapy. Johns Hopkins Press.
^ Conrad, Peter; Schneider, Joseph (1992). Deviance and medicalization: from badness to sickness. Temple University Press. p. 36.
^ Szasz, Thomas (Spring 2001). “The Therapeutic State: The Tyranny of Pharmacracy”. The Independent Review V (4)
^ Offman A, Kleinplatz PJ (2004). Does PMDD Belong in the DSM? Challenging the Medicalization of Women’s Bodies. The Canadian Journal of Human Sexuality, Vol. 13
^ Moynihan, Ray; Heath, Iona; Henry, David (13 April 2002). “Selling sickness: the pharmaceutical industry and disease mongering”. BMJ. 324(7342): 886–891.
Peter Conrad, The Medicalization of Society: On the Transformation of Human Conditions into Medical Disorders (Johns Hopkins University Press, 2007)
Allan Horwitz and Jerome Wakefield, The Loss of Sadness: How Psychiatry has Transformed Normal Sadness into Depressive Disorder (Oxford University Press, 2007)
Christopher Lane, Shyness: How Normal Behavior Became a Sickness (Yale University Press, 2007)
Illich, Ivan (July 1975). “The medicalization of life”. Journal of Medical Ethics 1 (2): 73–77.

In a 1999 study that followed 990 heart patients in a Kansas City hospital, the patients that were prayed for got better faster and had 11% fewer complications. In fact out of the 990 patients, 500 were prayed for and each one showed better results than the patients that did not have intercessory prayers on their behalf. The power of positive thinking? Possibly, but in this study, those patients did not know anyone was praying for them!

Here is a batch of articles on the subject.

Editor’s Correspondence
Data Without a Prayer
Arch Intern Med. 2000;160(12):1870. doi:.

Editor’s Correspondence
A Randomized, Controlled Trial of Prayer?
Arch Intern Med. 2000;160(12):1871-1872. doi:.

A Randomized, Controlled Trial of Prayer?
Arch Intern Med. 2000;160(12):1871-1872. doi:.
Editor’s Correspondence
P Value Out of Control
Arch Intern Med. 2000;160(12):1872. doi:.

Editor’s Correspondence
Does Prayer Need Testing?
Arch Intern Med. 2000;160(12):1873-1874. doi:.

Editor’s Correspondence
The Effect of Remote Intercessory Prayer on Clinical Outcomes
Arch Intern Med. 2000;160(12):1876. doi:.
Editor’s Correspondence
Ethical and Practical Problems in Studying Prayer
Arch Intern Med. 2000;160(12):1874. doi:.

Editor’s Correspondence
God, Prayer, and Coronary Care Unit Outcomes: Faith vs Works?—Reply
Arch Intern Med. 2000;160(12):1877-1878. doi:.

All these can be readily accessed via http://archinte.jamanetwork.com/article.aspx?articleid=485356

Read them and get back to me to tell me what you think.

There has been much hullabaloo about selenium as a wonder nutrient that we should be pumping up with. What are the facts?

Cardiovascular disease (CVD) is still the number one cause of death and disability worldwide; in 2008 it accounted for 30% of total global deaths. The burden of disease will increase with an aging population and increasing levels of obesity and sedentary lifestyles.

Selenium is a trace element that is essential to humans, and is currently the focus of major scientific debate and investigation. A number of observational studies have examined the association between selenium status and risk of chronic heart disease and other CVD end-points across different populations; however, to date, results of RCTs [i.e. randomized control trials] investigating the use of selenium supplementation for prevention of cardiovascular disease have been inconclusive.

Trials were only considered where the comparison group was placebo or no intervention. Only studies with at least three months follow-up were included in the meta-analyses, shorter term studies were dealt with descriptively.

Data collection and analysis: Two review authors independently assessed trial quality and extracted data. Study authors were contacted for additional information.

Main results: Twelve trials (seven with duration of at least three months) met the inclusion criteria, with 19,715 participants randomised. The two largest trials that were conducted in the USA reported clinical events. There were no statistically significant effects of selenium supplementation on all cause mortality. There was a small increased risk of type 2 diabetes with selenium supplementation but this did not reach statistical significance. Overall, the included studies were regarded as at low risk of bias.

Authors’ conclusions: The limited trial evidence that is available to date does not support the use of selenium supplements in the primary prevention of CVD.

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The above is excerpted from the latest edition of the Cochrane Journal Club. [You can join free of charge.]

Author’s credentials: Saverio Stranges, is an Associate Clinical Professor of Cardiovascular Epidemiology in the Division of Health Sciences at University of Warwick, where he has been since August 2006. He is originally from Italy, where he completed his medical school, and specialty training in Preventive Medicine, before moving to the USA (2002-06) to complete his doctoral training and carry out post-doctoral work in cardiovascular epidemiology. He started his academic career as an Assistant Professor in the Department of Social and Preventive Medicine in the School of Public Health at the State University of New York in Buffalo. His research focuses mainly on the epidemiology and prevention of cardiovascular disease and type 2 diabetes, and he has been involved in a number of research outputs on the role of nutrition and micronutrients, primarily selenium, in cardiovascular and metabolic disease in several populations across Europe and USA. He led a series of secondary analyses from the Nutritional Prevention of Cancer (NPC) Trial that examined the effect of long-term supplementation with selenium on cardiovascular disease and type 2 diabetes.