One can tell a lot about how solid a scientific opinion is by the response to questioning. Genuine science is never settled. It is constantly questioning assumptions as new knowledge emerges. Dogma rejects questioning and seeks to harass those who dare pose questions.
The science program Catalyst has done an expose on the cholesterol theory. The information is not new or “invented” by the program. It has sourced scientific evidence, which is already in the public domain.
The response to the reports questioning the role of cholesterol in heart disease and the use of cholesterol lowering medications (statins) by those in “authority” could be best described as one of hysteria.
We are talking about drugs taken by tens of millions of people at considerable cost for many years. And which can have significant side effects. Anything this significant must constantly be questioned.
In the same week a significant piece in the British Medical Journal attacked current orthodoxy.
Regular readers will know my views on fats in the diet and the use of statins. This group of drugs have been over prescribed, their benefits oversold and their side effects down played. Given the hundreds of billions (yes billions) of dollars in sales this is hardly surprising.
Fats in the diet are NOT the problem we have been told they are. Excess sugars (often found in low fat foods) are the biggest problem.
The current beliefs (yes they are beliefs in a theory not scientific fact) are based on the work of Ancel Keys in the 1960’s. His theory was that cholesterol was a major cause of heart disease and that saturated fats in the diet contributed to an increase in cholesterol and so called “bad cholesterol” in particular.
There are numerous problems with his original work including the fact that he analyzed data from 22 countries but only used data from the six, which supported his ideas. Later work, which failed to verify his conclusions, was dismissed.
As years have gone by cholesterol theory has gained ascendency and is promoted as gospel. One irate professor wanted the program banned claiming that showing it would lead to deaths
The Heart Foundation puffed out its chest saying, “Australians need to be aware that information presented by the ABC is not supported by the Heart Foundation…”
In other words how dare they run something we disagree with and those who watch may be struck down? This sounds medieval.
There are studies, which show benefit from statins. Manufacturers did virtually all of these. Some such as the Jupiter trial are totally discredited.
Yet a review of 500 trials published in the Archives of Internal Medicine (The Journal of The American Medical Association) showed NO correlation between dietary fat intake and Coronary Heart Disease. A second analysis of nearly 350,000 people over 23 years showed no association between dietary fat intake and either heart disease or stroke!
Despite all the years of study and all the claims by authorities that going low fat is good for the heart-there is not actually any evidence to support this. It has been shown that a Mediterranean type diet does reduce rates of heart attack.
Two major studies in 2008 comparing cholesterol lowering medications, showed that the one which lowered cholesterol more did not lower heart disease or death by any more. In other words just lowering cholesterol made no difference in real outcomes as against blood test measurements.
And lets not also forget unpublished trials and ghostwritten trials. Plus that statistics can be manipulated. Indeed a 1970s study on saturated fats in the diet was hailed as showing that lowering dietary saturated fats lowered cholesterol. Fine except the low fat group had NO difference in mortality!
The most famous study on heart disease was the Framingham study but like many famous works it has been misquoted. We are told that cholesterol is a major risk factor in heart disease and must be lowered and that “bad cholesterol” is, of course, bad and must also be lowered.
In fact the study found that “total cholesterol per se is not a risk factor for coronary heart disease at all” and low-density lipoprotein (LDL or “bad” cholesterol) is a marginal risk factor.
Because saturated fats raised LDL it was assumed that saturated fats are bad. In turn LDL is bad because it is raised by saturated fats. This is a circular argument, much like saying it is wet because it is raining and it is raining because it is wet. Maybe it is wet because the hose was left on!
So at best the evidence we have is contradictory. If after 40 years of trials there is no clear-cut benefit seen then the assumption must be dubious. Certainly there is absolutely no case for major public policy to be based on contradictory findings.
Here are a few more questions
How much money has been donated to the Heart Foundation by statin manufacturers? And how many of the professors and other experts screaming hysterically about death and doom have conflicts of interest? None have declared their position. How many have been involved in trials sponsored by pharma? How many trials have the Heart Foundation been sponsored to run? And how many board members of the Heart Foundation have ties to pharma?
The Catalyst program raised serious questions from many, including a Harvard Professor. The dismissive response of local “experts” is appalling. Clearly they do not appreciate having to justify their positions.
Given the cost in human and economic terms, of the fat is bad and lets lower cholesterol mantra, we need far more, not less questioning. It is time experts and authorities were held to account and any conflicts of interest exposed.