Have We Been Conned About Cholesterol? My oh my.. read on..

Conventional medical wisdom about cholesterol - and the role of statins - is now being challenged by a small, but growing number of health professionals. Among them is Dr Malcolm Kendrick. A GP for 25 years, he has also worked with the European Society of Cardiology, and writes for leading medical magazines.

When it comes to heart disease, we have been sold a pup. A rather large pup. Actually, it's more of a full-grown blue whale. We've all been conned.

If you've got a raised risk of heart disease, the standard medical advice is to take a cholesterol-lowering statin drug to cut your chances of having a heart attack - because, as we all know, cholesterol is a killer.

Indeed, many of you already believe that you should take statins for the rest of your natural lifespan.

But is it all worth it? According to an article being published in the medical journal The Lancet this week, the answer is probably NO!. 
A leading researcher at Harvard Medical School has found that women don't benefit from taking statins at all, nor do men over 69 who haven't already had a heart attack. There is a very faint benefit if you are a younger man who also hasn't had a heart attack - out of 50 men who take the drug for five years, one will benefit.

Nor is this the first study to suggest that fighting cholesterol with statins is bunk. Indeed, there are hundreds of doctors and researchers who agree that the cholesterol hypothesis itself is nonsense.

 

What their work shows, and what your doctor should be saying, is the following:

o A high diet, saturated or otherwise, does not affect blood cholesterol levels.

o High cholesterol levels don't cause heart disease.

o Statins do not protect against heart disease by lowering cholesterol - when they do work, they do so in another way.

o The protection provided by statins is so small as to be not worth bothering about for most people (and all women). The reality is that the benefits have been hyped beyond belief.

o Statins have many more unpleasant side effects than has been admitted, while experts in this area should be treated with healthy skepticism because they are almost universally paid large sums by statin manufacturers to sing loudly from their hymn sheet. 

It's true that foods containing cholesterol also tend to contain saturated fats because both usually come from animals. It's also true that neither dissolve in water, so in order to travel along the bloodstream they have to be transported in a type of molecule known as a lipoprotein - such as LDLs (low-density lipoproteins) and HDLs (high-density lipoproteins).

But being travelling companions is as close as fats and cholesterol get. Once in the body, most fat from our diet is transported to the fat cells in a lipoprotein called a chylomicron. Meanwhile, cholesterol is produced in the liver by way of an incredibly complicated 13-step process; the one that statins interfere with.

 

No biochemist has been able to explain to me why eating saturated fat should have any impact on this cholesterol production line in the liver. On the other hand, the liver does make fat - lots of it. All the excess carbohydrate that we eat is turned first into glucose and then into fat in the liver. And what sort of fat does the liver make? Saturated fat; obviously the body doesn't regard it as harmful at all.

Recently, attention has been shifting from the dangers of saturated fat and LDL "bad" cholesterol to the benefits of HDL "good" cholesterol, and new drugs that are going to boost it.

But the idea that more HDLs are going to fight off heart disease is built on equally shaky foundations.

These lipoproteins seem to be cholesterol "scavengers", sucking up the cholesterol that is released when a cell dies and then passing it on to other lipoproteins, which return it to the liver.

Interestingly, the "bad" LDL lipoproteins are involved in the relay.

The idea seems to be that HDLs can also get the cholesterol out of the plaques that are blocking arteries. 

However, there is a huge difference between absorbing free-floating cholesterol and sucking it out of an atherosclerotic plaque which is covered by an impermeable cap.....

Oh MY..

Extracted from The Great Cholesterol Con by Malcolm Kendrick, published by John Blake - £9.99.
The Daily Mail, 23rd January 2007