Let us see what Dr Malcom Kendrick has got to say on cholesterol control and heart disease citing from the famous Framingham Heart Study , one of the most respected and longest run heart studies ever..I particularly urge those who quote ADA guidelines for fat restrictions to read the excerpt from Dr Malcom's article reproduced below:
Cholesterol is not bad ..It is not the cause for heart disease either. It is very essential for the functioning of brain and body cells.World mortality statistics released by WHO says that the mortality rate in world population due to cardiovascular disease is the lowest among the population having TC in the range 200-220 mg/dl. Pl note ADA / AHA reference value is 200 ( max) !
To give another example of facts that aren't true. Namely, that saturated fat intake raises cholesterol levels. The Framingham study, the longest lasting, most respected study into the causes of heart disease (started in 1948) reported that ‘In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people's serum cholesterol.' Dr William Castelli - director of the Framingham study at the time - 1992.
What was the effect of such a startling finding. Absolutely nothing at all. Complete silence. To quote Winston Churchill: 'Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened.' How true.
More recently, a major eight year long interventional study on fifty thousand women (the Woman's Health Intervention) found that a 25% reduction in saturated fat intake had no effect on LDL ‘bad cholesterol' levels, or heart disease rates. [One of many studies that have shown the same thing].
Commenting on this study, the director of the National Heart Lung and blood Institute stated that: ‘The results of this study do not change established recommendations. Women should work with their doctors to reduce their risks for heart disease including following a diet low in saturated fat, trans fat and cholesterol.' Never let the facts get in the way of a good recommendation, I say.
The cholesterol hypothesis is, perhaps, the greatest ever example of a medical hypothesis that has become too powerful to die. Too many vested interests are intertwined with it. World famous experts would look incredibly stupid if the hypothesis were to be accepted to be wrong. An entire industry of cholesterol lowering would fall apart. Hundreds of billions of dollars of statin sales are at stake. Worse, much worse, the medical profession would end up with a few million eggs on its face. Perish the thought. Much better that millions die, surely.
In fact, I have come to realize that there is, literally, no evidence that can dent the cholesterol hypothesis. Believe me, I have had a good go. For example, here is another quote from the Framingham study on the impact of cholesterol levels themselves. There is a direct association between falling cholesterol levels over the first 14 years of the study and mortality over the following 18 years. 11% overall and 14% CVD death rate increase per 1mg/dl per year drop in cholesterol levels
In short, once your cholesterol level starts to fall, you are much more likely to die from heart disease. A 150% increase in relative risk for every 10 % fall, approximately. Add this to another very big study of the elderly, published in the Lancet: Our data accord with previous findings of increased mortality in elderly people with low serum cholesterol levels, and show that long term persistence of low cholesterol concentration actually increases the risk of death. Thus, the earlier that patients start to have lower cholesterol concentrations the greater the risk of death.
The effect of this study on the cardiovascular research community was.....as you would expect...nothing at all. A deafening silence. Cholesterol continues to be demonised as the terror, killer substance. Statins are pushed more and more widely to lower cholesterol levels even further. When I tell people that the higher their cholesterol level they longer they will live, they look at me in a way that suggests they believe that my medication is clearly not working.
Now that I know that cholesterol has nothing to do with heart disease, and that lowering it with statins is a complete waste of time, I find myself in the position of the little boy who points out that the Emperor has no Clothes. With one rather important difference.
Even though the ‘experts' have been made aware of it many times, they care not that this particular emperor has no clothes. Or, to be more accurate, they cannot and will not allow themselves to accept that it might be true. For to accept this would be far too humiliating for the great and the good. Which, I suppose, is why people become so enraged when anyone dares to point out the truth.
It is a slight comfort to know that in fifty years (hopefully many fewer than this), people will look back at cholesterol lowering and say ‘You did WHAT?' Were you MAD? Don't you know that cholesterol is absolutely vital for human health? Didn't you realise that blocking cholesterol synthesis would directly lead to nerve cell damage, muscle destruction, liver obliteration and cancer?
‘My God, you presided over the greatest iatrogenic medical disaster ever.' I, of course, will probably be dead by then. But at least I will not have poisoned my metabolism with statins.
Malcolm Kendrick (MbChB MRCGP) M.D.
Dr. Kendrick has worked in family practice for almost twenty years.
He has specialized in heart disease and set up the on-line educational website for the European Society of Cardiology.