The whole topic of cholesterol is a mess. First of all, if you read the package material on the statins, you will find that they state, somewhere where you may be unlikely to notice it, that "XXX has not been shown to reduce the risk of death from heart disease."
I think some recent work *has* shown a reduction in death from heart disease, but, unfortunately, the same study showed an increase in cancer deaths. Overall, the death rate for those taking statins was not improved.
It is completely unclear that lowering cholesterol levels will improve heart disease risk. Yes, cholesterol levels are associated with heart disease, but an association is not a causal linkage; the theory that cholesterol causes heart disease is apparently unproven, and there is some substantial evidence against it, such as the existence of plenty of people with high cholesterol and no heart disease. Take my mother. I just asked her about her cholesterol and she said, "Yes, I have a problem with that." She is 95 and has no heart problems. She only thinks she has a problem because, I'm sure, her doctor told her she did.
If, however, you believe you must lower your cholesterol (total cholesterol numbers don't mean much, LDL/HDL ratio means more, triglycerides mean more, and fractionated LDL means more, but that last test is hardly ever done, there are always plant stanols (such as in "Cholest Off," by Nature Made, widely sold -- I bought it at Costco); in one study, dietary intervention using plant stanols and other cholesterol-lowering food substances was just as effective as statins in lowering serum cholesterol.
When I was found to have total cholesterol of 285, my wife freaked out. I discussed it with my doctor and we agreed to try to treat it with diet, specifically the South Beach diet. But I did the research (including finding low-carber.org) and found that the science was behind Atkins more than South Beach. So I went on the Atkins diet. And began to come up with a whole series of realizations.
Since I was a child, fat was my favorite food. Yes, I liked frosting on cake, but, really, it was the fat, not the sugar. "Have some bread with your butter," was a comment I heard many times. About twenty years ago, I had a high cholesterol test (240) and, on my doctor's advice, started trying to lower the fat content of my diet, low-fat this, low-fat that, and, of course, no butter. And -- I never put this together -- gradually my weight crept up. On Atkins, my weight went back down.
And my total cholesterol went up, to 385. My wife was pretty upset.... *But* we also did a C-reactive protein test, and the number was *very* low. My HDL was good and the ration was acceptable, and triglycerides were extremely low. Given that and a cardiac CAT scan with an Agatston score of 25, no reason from family history to expect heart disease, not a smoker, etc., my doctor acknowledged that I am, overall, low risk for heart disease, and I obviously don't have it yet.
Yet, he said, every cardiologist in the area would insist that I go on statins. And there is *no* evidence that they would impact anything but my bank balance. Plus, of course, the side effects.
Perhaps, someday, it will turn out that statins are good for you. But it hasn't been proven.
When I was leaving my doctor, he said, "Well, you are doing well, but be careful with the saturated fats." I asked him, "Why?" He paused, then said, "Religion."
That saturated fats are bad for you is a religious belief, it is not a scientific fact. It's truly unfortunate.
I've just been trying to find out if I should take the rest of this large bottle of Cholest Off. Every reference indicates that it will lower cholesterol, but they *assume* that lowering cholesterol will actually reduce risk. There are no studies actually showing a connection. (To be sure, such studies are difficult to do, which is why so much is made of "risk factors." A "risk factor" is something you can measure, whereas "risk" is ... very difficult to estimate. And doctors like to be able to say something with certainty. Statins certainly lower your "risk factor." But do they lower your risk?
My guess is not. I could be wrong. But I would also guess that plant stanols are safer, we've been eating them for a long time, and the claim is made that the human diet used to be *much* higher in plant stanols than it generally is now.
It can be confusing and frustrating, but I don't see any substitute for really doing the research. Just understand that there is a huge amount of material out there from "experts" that is nothing more than repetition of unproven assumptions, deeply held beliefs. Just like we still see with so many "experts" writing about the Atkins diet, none of whom would have expected the truth: the Atkins diet, in general, improves lipid profiles and probably lowers heart disease risk, even though it can be high in fat and even saturated fat, that bete noir.
So why *did* my doctor recommend I avoid saturated fats? Well, my guess is that if he didn't, he'd be open to a malpractice suit should I happen to end up having a heart attack. It's the standard of practice, just as a cardiologist could similarly be sued for not prescribing statins. The system enforces its drug-company-research dogmas, punishing heretics.
And when current research shows that the whole low-fat recommendation was, from the beginning, useless, well, there must be something wrong with the research. After all, we *know* that fat is bad for you. What about the studies that showed that the western diet, compared to low-fat diets in other countries, is producing much higher heart-disease rates?
Bad science. Data selection (the author of the original study selected the countries to include in order to create the pattern in the results, leaving out countries that would have inconveniently contradicted his conclusions).
We badly need media and science we can trust. We'll only get it when we realize that *we* need to make it happen. Government is not going to do it for us.
http://beyondpolitics.org/wiki
Too funny!
Perhaps
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