On The Age Chew On This I submitted the following post:
Yes, you can worry all you like about cholesterol being too high, but being too low is far more of an issue. Low cholesterol is associated with increased risk of cancer, depression, infection and lower life expectancy in general. Why would you want lower cholesterol anyway? The only means of
lowering cholesterol that has been proven to reduce heart-disease is
statins. None of the above methods, as healthy as they may seem, have
been proven to be affective in reducing risk of heart disease by
lowering cholesterol. Furthermore, statins do not reduce heart-disease
risk by lowering cholesterol, they do it through another means, as they
can reduce heart-disease risk independently to level of cholesterol
reduction. Omega 3, Co-Enzyme Q10 and natural Vitamin E and K2 are suspected to
reduce heart-disease risk, and they may or may not affect blood
cholesterol levels. Cholesterol is the bodies most powerful anti-oxidant, used for
repairing damaged tissue and fighting off disease. High cholesterol may
indicate the body is under stress, but if you are otherwise healthy it
is best ignored. Blaming high- cholesterol for Heart disease is then
like blaming the Fire Brigade for the fire! If your doctor is worried because you have high-cholesterol, tell
him to do some research. Statins may lower your risk of heart disease
by a fraction, but have not been proven to reduce total mortality! Margarines and other cholesterol lowering functional foods are the
worst food-scam ever invented. While they can lower cholesterol, there
is absolutely no evidence at all that they can reduce heart-disease
risk. Note that they never claim this, but they let you infer it! Their
advertisements are continually removed from the air in New Zealand
because of their misleading claims. If a drug could lower cholesterol
but have no other proven benefit - would it get approval? (in the case
of statins, sadly yes)
Remember that this product is a drug, it contains warnings for children
and pregnant women. If it did have benefit, then surely it should still
require a doctors prescription! Cholesterol theory should have been buried years ago. Dr Ancel Key's
dubious seven nations study should have been questioned for
miraculously choosing seven data points that lined up, out of another
twenty or so that bore no correlation at all. Unfortunately, the theory
became commercial, leading it to becoming a dogma before ever being
proven. Unfortunately the damage has been done, people are avoiding
real foods, because they are scared of cholesterol. We are getting less
Vitamin A, Vitamin D and Vitamin K because they are found in foods said
to raise cholesterol, this leads to poor teeth, dental crowding (if
from a young age), infertility, depression and many other modern
illnesses. An article published recently in The Age mentioned a study in which
Researchers tabulated the most healthy habits which lead to longer
life. Glaringly absent from their list was avoiding saturated fat and
cholesterol! why? - because it has little bearing at all statistically
INTERHEART did a similar study specifically for Heart-disease risk, and
listed 7 habits that affect heart-disease risk - no mention of
cholesterol or saturated fat again. Researchers may still pay lip
service to the theory, but when it comes to hard facts, cholesterol is
slowly slipping off the radar. It is only the food industry and zealous
dietitians who keep bringing it back to the forefront. References: see http://www.thincs.org (The International Network of Cholesterol Skeptics) ---- This post brought out the big guns from The Australian Heart foundation ---- Here's a response from Dr David Sullivan. "In this case, the
association is explained by the fact that these conditions (cancer,
infection etc) CAUSE low cholesterol, not visa versa. This was well
established in epidemiological studies over a decade ago.
Unfortunately, new analyses of trials overlook the fact that if you
adjust for undetected disease, the association is eliminated. The
concept fits with the fact that infants and most other animals have LDL
cholesterol levels around 1, and there is evidence that reducing
cholesterol by medication does not cause any of these problems. Then
follow several factual errors. There is no proof that CoQ10 or vitamin
E prevent cardiovascular disease. Cholesterol is not an anti-oxidant.
INTERHEART strongly endorsed the importance of a diet that is
consistent with weight control and cholesterol reduction and suggested
that the blood fats were the strongest determinant of heart attack
risk. Statins have been proven to reduce mortality. I can't answer
every point in detail, but the National Lipid Association's Statin
Safety Task Force concluded: 'one can express both the risk of side
effects and the benefits for cardiovascular disease in term of events
per person-year of statin treatment. The mortality risk from fatal
rhabdomyolysis is approximately 0.3 per 100,000 person-years and the
risks of non-fatal rhabdomyolysis and putative stati-attributable
peripheral neuropathy are approximately 3 and 12 per 100,000
person-years....In contrast, the benefit of statin use is to avert
several hundred deaths and several hundred cases each of heart and
brain infarction per 100,000 person-years in appropriately treated
high-risk patients.' Many of us in the field are aghast that no-one
holds those responsible for discouraging patients from effective
treatment responsible for the consequences of that advice. " David
Sullivan
------
Notice that Dr David Sullivan is so authoritative he can dismiss any claim he wants without acknowledging even any scientific dissent.
But let us look at his response point by point:
Cancer causes low cholesterol not vice versa Needless to say, that is an interpretation, however the reverse can also be true, ie Heart disease causes high cholesterol not vice versa. The point is essentially that if we are scared of high cholesterol because of association, then so should we be scared of low cholesterol by association! Unfortunately for Dr Sullivan however, the evidence that low cholesterol proceeds cancer does exist:
From: http://www.second-opinions.co.uk/cholesterol_myth_4.html
In a study from the USA published in 1990, changes in blood cholesterol over
time were studied in patients with colon
cancer. The doctors found that there had been an average thirteen percent
decline in blood cholesterol levels in the ten
years prior to diagnosis of the cancer compared with an average increase of two
percent in the control group.
(references available on the above link)
One can assume that Dr Sullivan is not aware of these studies?
there is evidence that reducing cholesterol by medication does not cause any of these problems.
In this case, Dr Sullivan must be referring to an absence of proof that cholesterol lowering causes cancer, as you cannot prove a negative. If a cholesterol lowering trial did continue for long enough and found no increased risk of cancer beyond ten years, then maybe this would be good enough. We have no such data as yet. What we do have is some experiments and trials that do suggest that statin therapy may cause cancer. Maybe not a direct result from cholesterol lowering but maybe still a cause for concern.
Statins have been shown to promote cancer in Rodents:
89. Newman TB, Hulley
SB. Carcinogenicity of lipid-lowering
drugs. JAMA 1996;275:55-60.
Statin trial on women also found increased levels of Breast cancer:
http://www.bmj.com/cgi/content/full/332/7553/1330?ijkey=XhTeJopzPkacsS2&keytype=ref#REF22
There is no proof that CoQ10 or vitamin E prevent cardiovascular disease It seems Dr Sullivan is so in favour of statins and cholesterol lowering, that any other competition is not considered. Here I am dismayed at his arrogance to not only dismiss other peer reviewed studies, but to deny their very existence. The use of Wheat-germ oil for preventing Heart disease was demonstrated back in 1969.
(Shute WE and Taub HJ. Vitamin E for Ailing and Healthy Hearts.
Pyramid House, New York, 1969)
Of course this result is refuted by many later attempts to reproduce this result using synthetic Vitamin E. Needles to say, it was natural Vitamin E that was found to be protective, and still counts as evidence! CoEnzyme Q10 is mentioned in this study (
Kendler BS. Recent nutritional approaches to prevention and therpy of cardiovascular disease.
Prog Cardiovasc Nurs
. 1997;12(3):3-23.)
The University of Maryland Medical Center has information on their website suggesting CoEnzyme Q10 helps prevent Heart Disease.
http://www.umm.edu/altmed/articles/coenzyme-q10-000295.htm Cholesterol is not an anti-oxidant According to Wikipedia http://en.wikipedia.org/wiki/Cholesterol
Some research indicates that cholesterol may act as an antioxidant.[3] - ^ Smith LL (1991). "Another cholesterol hypothesis: cholesterol as antioxidant". Free Radic. Biol. Med. 11 (1): 47–61. PMID 1937129.
If my assertion was a factual error, then so is Dr Sullivans! the point is disputed.
INTERHEART strongly endorsed the importance of a diet that is
consistent with weight control and cholesterol reduction and suggested
that the blood fats were the strongest determinant of heart attack
risk.
I am sure they do, but my point was, when it came to giving out advice that they could back up, cholesterol and saturated fat consumption was not mentioned. Check out what Dr Malcolm Kendrick had to say about the absence of cholesterol from their report: http://www.thincs.org/Malcolm2.htm#sep2-2004
Statins have been proven to reduce mortality
Depending on on which trial you quote, but the trials that have produced a statistical significant reduction in mortality were on those at high risk, ie those people with previous coronary event. Plenty of other statin trials have failed to produce a decrease in total mortality. The numbers get boggled easily. But nevertheless, I would suppose Dr Sullivan would be recommending statins to people who would fall into the category of moderate risk only.
I would suggest reading this article
http://www.cybernaut.com.au/optimal_nutrition/information/articles/statins_pr.pdf
Benefits of treatment
I do not dispute that statins may have benefits for 'high risk' patients, when treating numbers like 100,000. A high risk - person who has had a previous stroke or coronary event may get a 2-3% better chance of survival over five years by taking statins - granted, but against that there are other side effects, like memory loss, loss of balance etc that may occur. Unfortunately, statins are being prescribed to anyone who has a blood-cholesterol level above average, whether other high -risk signs are apparent! Does Dr Sullivan condone this reckless prescribing by doctors? Shirking Responsibilities
Toe the line or else, Dr Sullivan suggests, dissenters are risking lives. How many lives?
If a patient were to know the true statistical benefits of taking statins, would he still waste his money on them? At best, a high risk patient can improve his chances of surviving the next five years by 3%. At worst, he is risking many other side effects that could be affecting the quality of those last years of life. If giving patients real information is costing lives, then I am prepared to answer that charge.
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