Every so often there's a post from someone worrying about their cholesterol, so I thought it might be apposite to crimp off a few thoughts on the subject.
Here's the thing: we're all going to die. We don't want it to happen too soon, but once we get ancient, creaky, and crinkly, we're pretty much ready to hand off the baton to the younger generation. Before that happens, I guess we all have two main concerns:
- We want a fulfilling life.
- We don't want our last years (or decades) to be filled with pain, worry, immobility, or niggling ill-health.
Now, here are the top few causes of death (in the West) for over 50s:
1) Heart disease
2) Lung cancer
3) Breast cancer
4) Prostate cancer
5) Colorectal cancer
6) Liver disease
And of all those choices, you know what? I'll pick heart disease any day of the week. Because the others are horrible, horrible ways to go, that drag on for years and cause your family great anguish and expense. So let us assume for a moment that the experts are right (despite the mounting evidence that they're disastrously wrong) and the meat, eggs, butter and suchlike that I eat regularly will eventually give me a heart attack. I can live with that.
In my opinion the modern obsession with alleviating heart disease is misguided. There are several long-term experiments which, with dietary interventions, or drugs, or both, have shown a statistically-significant decrease in heart disease ... but no improvement in all cause mortality, implying that while people might not be dying of heart disease, they're dying of something far more unpleasant. The headline might truthfully read: statins and low-fat diets cause cancer.
Of course I'm being a little flippant here. Cardiovascular disease - as it presents in modern society - doesn't mean a heart attack or a massive stroke. It's a slow, degenerative process not dissimilar to the other items on that list. It causes huge headaches for the NHS because the only treatments available are palliative, and expensive ones at that. It often occurs together with other intractable problems like obesity, diabetes, and idiopathic autoimmune disorders. So to that extent, one can understand the official obsession with it.
While the pharmaceutical industry fiddles about with drugs that give you cancer - and coincidentally reduce your risk of heart disease by 20% or 30% - and the government cheers them on, there's a much-neglected method of improving your chances in the disease lottery. It requires some very simple, low-cost equipment, viz., a pair of trainers and a 10-pound sledgehammer. What you do is this: you take your TV out into the garden and you smash it to pieces. Then you put your trainers on and go for a run. You have to repeat the run every day for best results, but the other aspects are one-offs. This method reliably slashes your disease risk in half, or better. Not just your risk of heart disease, but of many others too. It even keeps you young: it quite literally slows the ageing process at a cellular level. This paper demonstrates the point fairly clearly:
...but there are many others. This result is so commonly reproduced that it's now accepted as "fact", although you will not hear any public-policy experts pointing out that daily exercise delivers results five times better than statins at a much lower cost.
Here's the kicker:
"These associations were consistent in men and women, across categories of body mass index and volume of MVPA, and in those with and without existing cardiovascular disease or diabetes mellitus."
In other words, if you're doing a lot of hard exercise, what you eat is of minor importance. Even your existing conditions don't appear to matter greatly. The single biggest predictor of a full life well-lived, with a properly-functioning cardiovascular system, is your level of activity.
Which is, when you think about it, rather obvious.