What Cholesterol Myth? (part 2)

The only effective way to lower cholesterol is with drugs, but neither heart mortality or total mortality have been improved with drugs the effect of which is cholesterol-lowering only. On the contrary, these drugs are dangerous to your health and may shorten your life.

Whoa! What kind of nonsense is this? “The only effective way to lower cholesterol is with drugs.” That’s total hogwash. It’s about the diet, baby. What you put into your temple affects what happens inside that temple.

Many people I know just don’t care to eat right. They think they can eat whatever they want and then take a pill to fix it. I see it all the time, even in my own family. I watch my relatives eat fried pork chops, cheeseburgers, and french fries and then go fill their prescriptions for a statin. Poor strategy. ALL drugs have side effects.

But some people have a genetic variation which requires an additional boost from medicine on top of a strict diet. They have to weigh the risk of dying from a heart attack, the leading cause of death in the United States, to the risks of taking a drug which can have harmful side effects. This is an independent, personalized decision.

When it comes to improving mortality, there’s plenty of controversy about using a drug for primary prevention. That means that just because your blood level of cholesterol is high, if you don’t already have heart disease, then you’re probably not getting enough benefit for the risk. The data isn’t really there. But if you have already had a heart attack, then a cholesterol lowering drug may significantly reduce the chances you’ll have another one – or that a second one is fatal. Those drugs work partly by reducing cholesterol, but there is also an indication that they stabilize the cholesterol plaques, preventing that second factor which works in concert, like inflammation or infection, from exploding it.

See a related post of mine here about the potential for harm from cholesterol medications.

 

6  The modern cholesterol-lowering drugs, the statins, do prevent cardiovascular disease, but this is due to other mechanisms than cholesterol-lowering. Unfortunately, they also stimulate cancer in rodents, disturb the functions of the muscles, the heart and the brain and pregnant women taking statins may give birth to children with malformations more severe than those seen after thalidomide.

Um… why can’t it be both? They lower cholesterol and they work by other mechanisms such as stabilizing plaques.

While I’m far, far away from believing that statins should be added to the water supply, there are a few people whose risk-to-benefit ratio makes them useful tools in a total plan that should primarily include diet, exercise, good sleep, stress reduction and weight loss. The trick is to do every freakin’ thing you can to lower your cholesterol to safer levels, and take a drug as a very, very, very last resort. If possible, use it as a bridge for the absolute shortest time possible. They’re not candy. Theyre not a free pass that lets you eat whatever unhealthy food you want. They can be dangerous. It’s not something to take, or to prescribe, lightly.

 

7  Many of these facts have been presented in scientific journals and books for decades but are rarely told to the public by the proponents of the diet-heart idea.

I’m not sure what this means. Science is a long and difficult PROCESS. There are good studies and bad ones, or rather different studies with different kinds of bias and flaws. For almost everything, you can find a study that shows exactly the opposite of what another study shows. The trick is to gather as much information as you can, as much evidence as possible, and then interpret the whole big picture. And the conclusions drawn may very well change over time as data trickles in. That’s good. It means we’re learning. We can’t just snap our fingers and know everything about the human body in an instant. If we could, that would be really awesome.

8  The reason why laymen, doctors and most scientists have been misled is because opposing and disagreeing results are systematically ignored or misquoted in the scientific press.

Um, what I said above.

References:

Mozaffarian D, Micha R, Wallace S. Effects on coronary heart disease of increasing polyunsaturated fat in place of saturated fat: a systematic review and meta-analysis of randomized controlled trials. PLoS Med. 2010 Mar 23;7(3):e1000252.

Fung TT, et al “Low-carbohydrate diets and all-cause and cause-specific mortality” Ann Intern Med 2010; 153: 289-298.

American Heart Association Dietary Guidelines: Revision 2000

http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf

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