Lowering Cholesterol

[partington]

PS Just because you have high cholesterol levels, doesn't necessarily mean you are going to have a heart attack or stroke. Lots of people live happily with extremely high levels. It tends to run in families. I think it's just the latest fad to get people to take statins.

And sorry if I seem to be hounding you, but this statement is such a prize example of unscientific (i.e. lacking simple common sense) thinking.

It is the exact logical equivalent of saying: "Just because you join the Army and go off to fight in Afghanistan, it doesn't necessarily mean you are going to get killed or mutilated. Lots of people have, and it hasn't happened to them."

True of course, but only an idiot would deny that fighting in Afghanistan hugely increases your risk of getting killed or mutilated.

Nothing occurs with 100% certainty: even people who shoot themselves in the head don't always die. This doesn't mean it isn't dangerous to try!

Also have you ever considered that heart disease 'tends to run in families' because high LDL cholesterol also tends to run in families?

(In fact there is a completely inherited genetic disease, called FH, that causes massively high LDL cholesterol levels from birth. The worst sufferers get heart disease as children because of their cholesterol levels. Studying this disease led to the development of statins. The clinicians involved got a Nobel prize)

Edited April 17, 2012 by partington

[grumpyoldman]

Statins are rapidly falling from favour. All sorts of side effects, including myopathy. The longer you take any drug, the more likely something will go wrong, in any case.

Advice from dieticians in Australia is to aim for 5 vegetables & 2 fruits a day. Try making your own green juice. I also heard that the three most useful vegetables are carrot, tomato & onion. You need leafy green ones if you are getting older for your macula as well.

If you're using margarine (or butter) regularly, you have a problem. It's a TREAT.

I agree that Thai food is preferable. However, it still has high levels of carbohydrate and limited variety of oils.

Just to worry you - the latest drama is about vitamin D levels. Lots of people are finding out they have very low levels.

Simvastatin and Lipitor, both statins, are number two and number seven in the world's most prescribed drugs and represent more than 130 million prescriptions a year, making them as a class the most prescribed drugs in the world, by far.

Yep, ching-ching-ching ($$$$$$$$$$) listen to the cash roll in for big pharma.

Whose to say a low fat vegetarian diet, wouldn't have helped 75% of those 130 million prescriptions? Oh yeah, Dr.'s commissions..........

[jocko]

Statins are rapidly falling from favour. All sorts of side effects, including myopathy. The longer you take any drug, the more likely something will go wrong, in any case.

Advice from dieticians in Australia is to aim for 5 vegetables & 2 fruits a day. Try making your own green juice. I also heard that the three most useful vegetables are carrot, tomato & onion. You need leafy green ones if you are getting older for your macula as well.

If you're using margarine (or butter) regularly, you have a problem. It's a TREAT.

I agree that Thai food is preferable. However, it still has high levels of carbohydrate and limited variety of oils.

Just to worry you - the latest drama is about vitamin D levels. Lots of people are finding out they have very low levels.

Simvastatin and Lipitor, both statins, are number two and number seven in the world's most prescribed drugs and represent more than 130 million prescriptions a year, making them as a class the most prescribed drugs in the world, by far.

Yep, ching-ching-ching ($$$$$$$$$$) listen to the cash roll in for big pharma.

Whose to say a low fat vegetarian diet, wouldn't have helped 75% of those 130 million prescriptions? Oh yeah, Dr.'s commissions..........

It suit's most people to take the pill and carry on as normal even asprin can have side effect's for some people , i agree with partington drug's saves life's and can give you a quality of life you would'nt have if you did;nt have them i am speaking from experience i tried all the allternative cure's which i hoped would work.

[partington]

Statins are rapidly falling from favour. All sorts of side effects, including myopathy. The longer you take any drug, the more likely something will go wrong, in any case.

Advice from dieticians in Australia is to aim for 5 vegetables & 2 fruits a day. Try making your own green juice. I also heard that the three most useful vegetables are carrot, tomato & onion. You need leafy green ones if you are getting older for your macula as well.

If you're using margarine (or butter) regularly, you have a problem. It's a TREAT.

I agree that Thai food is preferable. However, it still has high levels of carbohydrate and limited variety of oils.

Just to worry you - the latest drama is about vitamin D levels. Lots of people are finding out they have very low levels.

Simvastatin and Lipitor, both statins, are number two and number seven in the world's most prescribed drugs and represent more than 130 million prescriptions a year, making them as a class the most prescribed drugs in the world, by far.

Yep, ching-ching-ching ($$$$$$$$$$) listen to the cash roll in for big pharma.

Whose to say a low fat vegetarian diet, wouldn't have helped 75% of those 130 million prescriptions? Oh yeah, Dr.'s commissions..........

No, scientific studies of the effects of changing diet on cholesterol levels say this. There have been hundreds of these, literally, and they show that it is rare to be able to change cholesterol more than 10-15% by diet changes alone.

Nevertheless diet change is always the first course of action every doctor recommends when they find you have high cholesterol.

"Give up smoking, eat more vegetables , less meat and do more exercise."

Are you really claiming doctors do not say this?? They do but people ignore them. Even the patients whose cholesterol is only 10-15% too high,(and so could be successfully normalised by diet) largely don't obey this advice - that's just a fact that any doctor will tell you.

People whose cholesterol is 50% or more too high will find it almost impossible to normalise by diet alone. This is not an assertion but based on countless clinical studies carried out by hospitals and clinicians completely independently of drug companies.

Oh yes, and the 'commissions' for prescribing drugs are another myth or lie. If a doctor does this and is found out, they are struck off.

Of course it will have happened occasionally, but some doctors have also raped their patients. It is not common and it is not legal.

Edited April 18, 2012 by partington

[MissChris]

Yes, they can't get commissions for prescribing drugs, but they sure do get lots of freebies & toys. For example, drug companies give away computers; provide expensive wines & cheeses for 'Journal Clubs' run by & for doctors; pens, stationery with logos on them...

Then there's the mad scramble to go to Conferences in The Maldives & other exotic places.

I once told my GP I thought it was tacky when the eye chart I was reading had a drug name on the last line. He had the grace to look embarrassed.

The only applications for prescribing habits of doctors, provided by the Pharmaceutical Benefits Scheme in Australia, are from drug companies, who then target the doctors who do not prescribe with their Trade name. The only way around it is to get the pharmacist who is filling your prescription to ask you if you want the cheaper brand. Doctors are completely a law unto themselves when it comes to prescribing.

I will repeat myself: statins are falling from favour. Watch & you will see...just like the old days when everyone was on Tagamet for their 'ulcers'. The person who worked out that they were mostly caused by a bug called Helicobacter pylori (an Australian) also won the Nobel Prize.

[partington]

Yes, they can't get commissions for prescribing drugs, but they sure do get lots of freebies & toys. For example, drug companies give away computers; provide expensive wines & cheeses for 'Journal Clubs' run by & for doctors; pens, stationery with logos on them...

Then there's the mad scramble to go to Conferences in The Maldives & other exotic places.

I once told my GP I thought it was tacky when the eye chart I was reading had a drug name on the last line. He had the grace to look embarrassed.

The only applications for prescribing habits of doctors, provided by the Pharmaceutical Benefits Scheme in Australia, are from drug companies, who then target the doctors who do not prescribe with their Trade name. The only way around it is to get the pharmacist who is filling your prescription to ask you if you want the cheaper brand. Doctors are completely a law unto themselves when it comes to prescribing.

I will repeat myself: statins are falling from favour. Watch & you will see...just like the old days when everyone was on Tagamet for their 'ulcers'. The person who worked out that they were mostly caused by a bug called Helicobacter pylori (an Australian) also won the Nobel Prize.

The wine and cheese and the conferences and the pens and charts are given whether the drugs are prescribed or not. While I am no supporter of big corporations or their tactics in general , this is just advertising, and not inducement, as any doctors are free to suck up the goodies and then prescribe a competitor's (or a generic) drug.

I didn't understand what you were trying to say about prescriptions in Australia so I can't comment.

I don't know what you were trying to say about statins in your comparison with Tagamet. Tagamet is still prescribed and provides symptomatic relief while the antibiotics eliminate the bacteria that cause the symptoms.

Are you saying that statins are falling out of favour because of side effects or because doctors are generally accepting that high LDL is not related to heart disease risk, and therefore they are being prescribed in error? Neither of these is true.

[Hostile17]

stop eating thai foods that cost less than 150baht per plate. Problem fixed.

[stevenl]

The wine and cheese and the conferences and the pens and charts are given whether the drugs are prescribed or not. While I am no supporter of big corporations or their tactics in general , this is just advertising, and not inducement, as any doctors are free to suck up the goodies and then prescribe a competitor's (or a generic) drug.

I think you could be right about certain things you mention here, but this of course is BS. Anybody who thinks these enticements have no positive effect on the sales of the company/product should start wondering why they keep offering them.

Like with all products, also here there are many, many reasons to buy/recommend a certain product that have nothing to do with the product itself but with the company selling it, the packaging, the service, etc.

[cdmtdm]

The wine and cheese and the conferences and the pens and charts are given whether the drugs are prescribed or not. While I am no supporter of big corporations or their tactics in general , this is just advertising, and not inducement, as any doctors are free to suck up the goodies and then prescribe a competitor's (or a generic) drug.

I think you could be right about certain things you mention here, but this of course is BS. Anybody who thinks these enticements have no positive effect on the sales of the company/product should start wondering why they keep offering them.

Like with all products, also here there are many, many reasons to buy/recommend a certain product that have nothing to do with the product itself but with the company selling it, the packaging, the service, etc.

prescrip drugs ..just another way to control the masses .... who controls the world ? Pharma Co, Oil Co and the banks ..... not govt ...

[MissChris]

Are you saying that statins are falling out of favour because of side effects or because doctors are generally accepting that high LDL is not related to heart disease risk, and therefore they are being prescribed in error? Neither of these is true.

Dunno. Usually in these cases research shows risk vs benefit are not acceptable. Also cost can be a factor. I'll check & get back to you...

One of the things I was on about is that Tagamet is the Trade name - owned by one drug company. Cimetidine is the generic name - used by all manufacturers of that drug. The public was subjected to a lot of 'infomercials' and asking their doctors for Tagamet. It was extremely expensive at first.

I don't think Tagamet (cimetidine) is used in therapy for Helicobacter pylori. Proton pump inhibitors such as omeprazole (Nexium) are used with antibiotics, usually tetracyclines, for a treatment regime.

Sorry to get all technical...

[xylophone]

Quote:

"No, scientific studies of the effects of changing diet on cholesterol levels say this. There have been hundreds of these, literally, and they show that it is rare to be able to change cholesterol more than 10-15% by diet changes alone.

Nevertheless diet change is always the first course of action every doctor recommends when they find you have high cholesterol.

"Give up smoking, eat more vegetables , less meat and do more exercise."

Are you really claiming doctors do not say this?? They do but people ignore them. Even the patients whose cholesterol is only 10-15% too high,(and so could be successfully normalised by diet) largely don't obey this advice - that's just a fact that any doctor will tell you.

People whose cholesterol is 50% or more too high will find it almost impossible to normalise by diet alone. This is not an assertion but based on countless clinical studies carried out by hospitals and clinicians completely independently of drug companies.

Oh yes, and the 'commissions' for prescribing drugs are another myth or lie. If a doctor does this and is found out, they are struck off.

Of course it will have happened occasionally, but some doctors have also raped their patients. It is not common and it is not legal",

Another interesting point you make Partington as regards high levels of cholesterol, inasmuch as I have read the same information that diet changes will only have a small effect on cholestrol levels. If that is the case, then my cholesterol levels have crept up over the years as a result of ???.

I felt sure that it was my diet that was giving the high readings or is it the fact that inherited high cholesterol only kicks in at a certain age, for example?

Regarding a couple of other posts, the reason that the pharmaceutical companies advertise through these promotional evenings etc.is to create " top of mind awareness" so that whenever a certain condition shows itself in a patient, the first name that the Dr. thinks of is XXXX, and that is common in much advertising and throughout many professions.

And Omeprazole was originally marketed as Losec, whereas Nexium is Esomeprazole.

[LivinginKata]

I have removed a couple of nonsense/trollish posts.

[trashy]

Eat Thai food instead of western food its very healthy food

The fat Thais you see are the ones who eat KFC etc

Bacon, eggs, fried tomatoes and hash browns i eat once a fortnight

cooked at home, otherwise i mainly eat Thai food except for the occasional

roast which i enjoy

I beg to disagree that Thai food is healthy. MSG & sugar are too commonly used in Thai cooking. There is too much stir frying, in the cheapest oil possible. The roadside/market stalls have food! bubbling away all day, so no nutrition left at all. Coconut milk (as opposed to water) is a real no no. Government hospitals and community health centres all over Thailand have special clinic days for diabetes. No, sorry, there is not much health in Thai food.

[grumpyoldman]

Eat Thai food instead of western food its very healthy food

The fat Thais you see are the ones who eat KFC etc

Bacon, eggs, fried tomatoes and hash browns i eat once a fortnight

cooked at home, otherwise i mainly eat Thai food except for the occasional

roast which i enjoy

I beg to disagree that Thai food is healthy. MSG & sugar are too commonly used in Thai cooking. There is too much stir frying, in the cheapest oil possible. The roadside/market stalls have food! bubbling away all day, so no nutrition left at all. Coconut milk (as opposed to water) is a real no no. Government hospitals and community health centres all over Thailand have special clinic days for diabetes. No, sorry, there is not much health in Thai food.

I'm going to agree here.

Also, although not cholesterol related, it was proven years ago that a certain amount of plastic can breakdown and become carcinogenic when subjected to heat. How about all the hot Thai foods (soups) in plastic bags? Healthy?

[trashy]

Statins are rapidly falling from favour. All sorts of side effects, including myopathy. The longer you take any drug, the more likely something will go wrong, in any case.

Advice from dieticians in Australia is to aim for 5 vegetables & 2 fruits a day. Try making your own green juice. I also heard that the three most useful vegetables are carrot, tomato & onion. You need leafy green ones if you are getting older for your macula as well.

If you're using margarine (or butter) regularly, you have a problem. It's a TREAT.

I agree that Thai food is preferable. However, it still has high levels of carbohydrate and limited variety of oils.

Just to worry you - the latest drama is about vitamin D levels. Lots of people are finding out they have very low levels.

no margarine is not a treat, its poison ..... as for vitamin D i think here in Thailand we get adequate amounts of sunshine dont you ?

Butter v margarine.......... see link............butter has far more trans fats!!!!

http://www.ausfoodnews.com.au/2010/09/28/heart-foundation-butter-has-20-times-the-trans-fats-of-marg.html

[MissChris]

Latest on statins...

I checked with a newly graduated doctor. I find they tend to be the most up-to-date. Her comment was that statins don't work because people think they can eat as many fats as before, if not more. Needs the lifestyle change too. No getting away from the salads, the exercise...whether you're on the statins or not

[lowprofile]

I saw a Youtube video about this recently and the doctor (?) said there was no bad cholesterol, it was all used to repair damage done to the artery walls caused by scouring from table salt. He said that normal table salt has too many impurities in it (including sand) which causes the problems. He said use Himalayan salt to avoid this.

No idea as to the authenticity of this, though.

Might be quackery, but who knows?

[partington]

Latest on statins...

I checked with a newly graduated doctor. I find they tend to be the most up-to-date. Her comment was that statins don't work because people think they can eat as many fats as before, if not more. Needs the lifestyle change too. No getting away from the salads, the exercise...whether you're on the statins or not

This also is not true, for reasons that most will be able to work out.

A clinician will prescribe a lipid lowering drug, monitor the patient for effectiveness, and change treatments if the drug is not working. This is just how it is done. I worked with lipid clinic doctors for more than 10 years on cholesterol related research and I know what I am talking about.

If the patients are not eating salads and exercising, do their doctors not notice that their cholesterol levels have not fallen on follow up visits, and stop prescribing statins because they are not working?

In fact the actual truth is that there are clear reductions in most patients' LDL when taking statins whether they are doing the always recommended lifestyle changes or not.

All trials of statins involving 1000's of patients show massive reductions in LDL cholesterol (commonly 30-40%). You are claiming that the doctors running these trials have been successful in making these 1000's of patients follow a strict diet and exercise regime over the months and years of the studies so that they can achieve these reductions??

Well to be blunt that is balls. They work without. There are hundreds of research papers showing this ( eg http://www.ncbi.nlm..../pubmed/8521762 ) and it is incontrovertible.

[xylophone]

Eat Thai food instead of western food its very healthy food

The fat Thais you see are the ones who eat KFC etc

Bacon, eggs, fried tomatoes and hash browns i eat once a fortnight

cooked at home, otherwise i mainly eat Thai food except for the occasional

roast which i enjoy

I beg to disagree that Thai food is healthy. MSG & sugar are too commonly used in Thai cooking. There is too much stir frying, in the cheapest oil possible. The roadside/market stalls have food! bubbling away all day, so no nutrition left at all. Coconut milk (as opposed to water) is a real no no. Government hospitals and community health centres all over Thailand have special clinic days for diabetes. No, sorry, there is not much health in Thai food.

I think the same about Thai food, esp the stuff cooked on the roadside carts with the oil bubbling away looking more like sump oil than anything else. Surely can't be good for you??

Look again at coconut oil as recent research has disproved the 40 yr old findings that it is bad for you. The research was flawed although this was promoted over the years by the corn and soy bean oil producers to further use of their own products.

[partington]

Just thought I would add this to reassure /encourage people who are on statins or thinking of taking them.

A study just published in the Lancet, one of the most respected medical journals, and funded by the British Heart Foundation , a completely independent charity, analysed data from 175,000 patients who participated in previous clinical trial of statins .

The study found that not only does taking statins reduce mortality significantly (~20% for each unit drop in LDL), but it also does so in the lowest risk groups, that is in people who do not have high cholesterol by currently agreed criteria.

This means that if you have normal cholesterol and you take statins it can protect you from heart disease. This is pretty significant news. It may change treatment guidelines in the UK once fully considered by the Department of Health in the UK.

Whatever the outcome, these new findings are unlikely to result in 'statins falling out of favour'.

Here's a link: http://www.guardian.co.uk/society/2012/may/17/statins-benefit-millions-heart-health

[dmitryspb]

I was reading this topic with great interest as unfortunately I suffer "family type' dyslipidemia" myself, I was born with it. And I'll take risk to give you some advices. If your bad cholesterol is about 20..25% higher than upper adoptable level then you can really try to correct it by your diet and life style. If it is 1.5...2 and higher, then it is really problem - same as my way . Diet' princips are quite simple: no any saturated fats and less fats at all, your aim is Omega-3 fats and fibre. If strict diet during 1 month would help you, then your health is generally OK. Also, you have check level of your triglecyrides - they are usually get higher as well and very dangeruos. Triglycerides' level is correlated with consuming of "simple-chain" carbohydrates and alcohol. Point is that only 10-20% of cholesterol arrives into body with food, all others are produced by your own LIVER! As to me: I have double level of bad cholesterol and high triglycerodes basically. I do not consume meat, dairy products (whole milk, cheese, butter etc) at all. I swim every other day 3 km in free-style, my weight is 85 kg and I'm 187 cm tall: it is normal. I also consume some nutritional supllements: Omega-3, lecithin, coQ-10 etc. Thus, I have to use statin to keep level more or less adoptabable. All I can let myself are fish, vegetables, fruits and chicken sometimes, all kind of porridges (best is WHOLE-GRAIN oats, not flakes!). And all this stuff lets me to lower cholesterol abt 10-15%, no more! Please, note: olive oil is NOT panacea, it is just neutral. Even flax oil is more healthier. Your aim is Omega-3: salmon, tuna, sardines, anchovy. Your weight/body fat also is extremely important. If your have also hypertension (most probably - yes), then you may 100% await for insult or stroke after 50th..

[cheeryble]

High LDL cholesterol shows such a huge association with increased risk of heart disease that almost no serious scientist or clinician would argue that lowering high cholesterol is not a significant benefit to the health of patients.

Hello Partington

I looked into this recently and had difficulty finding these studies (though I went to Framingham it was a predictive website).

Could you point to hard info you are basing your association on?

The other thing is of course that such study as far as I know would only show an association, ie a marker, rather than a cause.

I recently reduced my TC from 298 to 221 reducing not primarily fat (though fat consumption no doubt went down a bit.....when u eat no cake to avoid sugar u avoid some fat), but sugars and carbs. As u say the link between fat consumption and TC seems small.

Fortuitously 221 is almost dead centre at the bottom of the all-cause-mortality curve (base at 200-240, study based on big WHO stats) despite the fact it's off the top of the cardiologist recommended TC levels.

Cheers

Edited June 11, 2012 by cheeryble

[Valentine]

I am interested to see if anyone tried Benecol as it worked for me & my diet is far from perfect.

[BEENTHEREDONETHAT]

My experience has been a fish oil pill every day caused my cholesterol to drop from 220 to 180 in less than 2 months. Recently I went onto a low carb diet to try and reduce my weight. While I have lost weight it has been nothing dramatic but I have notice that I have much less stomach trouble with the low carb diet. I use to take 6 or 8 anti acids (tums) a day now I rarely take one.

I have been on high blood pressure medication for 35 years and while it has controlled my blood pressure it has also caused annoying side effects. But I favor the side effects to death. Typically I stay away from medication but for some things there are no other choices.

[partington]

High LDL cholesterol shows such a huge association with increased risk of heart disease that almost no serious scientist or clinician would argue that lowering high cholesterol is not a significant benefit to the health of patients.

Hello Partington

I looked into this recently and had difficulty finding these studies (though I went to Framingham it was a predictive website).

Could you point to hard info you are basing your association on?

The other thing is of course that such study as far as I know would only show an association, ie a marker, rather than a cause.

I recently reduced my TC from 298 to 221 reducing not primarily fat (though fat consumption no doubt went down a bit.....when u eat no cake to avoid sugar u avoid some fat), but sugars and carbs. As u say the link between fat consumption and TC seems small.

Fortuitously 221 is almost dead centre at the bottom of the all-cause-mortality curve (base at 200-240, study based on big WHO stats) despite the fact it's off the top of the cardiologist recommended TC levels.

Cheers

Hi cheeryble

the evidence is based on many many publications and studies. The best way to find these is to read a general review which describes these studies in summary and gives the original references.

If you don't have links to a university it is hard to do this, and it is a little difficult to find online reviews that are free to general readers - here are links to two though, a little old but still completely relevant. If you don't have any science background parts will be heavy going, but you'll get the general idea.

http://www.ncbi.nlm....pubmed/16585781

http://www.ncbi.nlm....pubmed/11228031

When you click the links, to read the articles go to the button at the top right of screen that says FreeArticle or something like that.

You are of course right that association doesn't prove causation - however the other link in the chain is the proven fact that lowering cholesterol reduces heart disease risk. So if high cholesterol is associated with heart disease and lowering it reduces heart disease, causation is likely.

Even then someone could argue that cholesterol is associated with some undiscovered factor that goes down when cholesterol is lowered by statins and that factor is the real risk factor....this is hard to disprove, but is just not very likely.

cheers

[cheeryble]

Thankyou Partington

Sorry to have overlooked your post but of great interest I shall try to get further than the abstracts.

I started looking at the 2004 abstract though, and hearing things like "Some clinicians say the lower the better" raised doubt.

This grew when it continued "it was a long uphill battle" to get to that point.

It's suggestive that the author is part of that battle. But what scientist is in a battle rather than being an unattached arbiter?

It's suggestive to me of supporting a set opinion, it kind of presupposes that his "result" is the result one for some reason wants.

I might add that I immediately came across this comment on the paper, which I may as well copy straight in a separate post following (iPad app hopeless keeps crashing trying to paste that). Full refs are at:

http://qjmed.oxfordj...med.hcp028.full

So will look further and try to stay unbiased myself ha-ha, thanks again for the links

Cheeryble

Edited June 17, 2012 by cheeryble

[cheeryble]

Why the overstated beneficial effects of statins do not resolve the cholesterol controversy

• L. Mascitelli
  

• F. Pezzetta
  

• M.R. Goldstein
  

+Author Affiliations

• ¹ Controversy continues to surround its etiology and pathogenesis, particularly with respect to cholesterol and lipids.²However, in his review,³ Thompson asserted that the cholesterol controversy should be considered overtaken by the discovery and development of statin drugs. We suggest that hypercholesterolemia does not represent a ‘causa sine qua non’ for the development of atherosclerosis and that the beneficial effects of statins are overstated and do not resolve the cholesterol controversy.
  It is well known that patients may present with coronary heart disease (CHD) events despite low low-density lipoprotein (LDL) levels, which fall well within guideline-recommended targets. Indeed, it has been shown⁴that half the patients hospitalized with CHD had admission LDL <100 mg/dl, and LDL <70 mg/dl was observed in 17.6% of patients; less than one-quarter of patients had an admission LDL >130 mg/dl.⁴
  Not surprisingly, accelerated severe atherosclerosis and its complications can be produced experimentally in herbivores with serum cholesterol levels below 100 mg/dl under conditions analogous to those prevailing in humans.² Furthermore, lipid and cholesterol crystals are found as a nonspecific pathological change in many chronic degenerative and inflammatory diseases and cannot be assumed to be causal. In particular, the histological features of tuberculosis resemble what has been described in atherosclerosis;⁵ hypercholesterolemia is not a prerequisite for such pathogenetic events. On the contrary, hypocholesterolemia, beyond being a common finding in different forms of pleuropolmonary tuberculosis, may represent a deleterious factor for the host in its fight against mycobacteria.⁶
  On the other hand, in primary prevention, statin therapy reduces the risks of CHD events for men but not for women, without reducing total mortality for either men or women.⁷ Furthermore, there is reason to believe that the beneficial action of statin drugs is mediated in spite of their cholesterol-lowering effects.⁸ Indeed, statins have an effect only when patients have a heightened inflammatory state.⁹ Finally, it has been shown that low total cholesterol is an independent and robust predictor of future external-cause mortality, and this association could not be explained by other obvious interrelated risk factors.¹⁰
  As Thompson stated, the cholesterol controversy in Britain dates back to 1950.³ Changing our current practice pattern could take other 50 or more years, but we may one day prescribe cholesterol-raising medications to certain patients.¹¹
  
  • 
    

Edited June 17, 2012 by cheeryble

[Galong]

Latest on statins...

I checked with a newly graduated doctor. I find they tend to be the most up-to-date. Her comment was that statins don't work because people think they can eat as many fats as before, if not more. Needs the lifestyle change too. No getting away from the salads, the exercise...whether you're on the statins or not

General practitioner doctors get next to NO nutrition information in their studies. It's all about giving people medicine. That's where they make their money. When money is involved, I lose trust.

If the medicine is so wonderful, why don't people get better results? At best, they cover the symptoms. At worse, they make you less healthy with all of the side effects.

Your body makes cholesterol. Search "dietary cholesterol vs blood serum cholesterol" and you'll find plenty of info.

You have have zero dietary cholesterol and still have high serum cholesterol levels depending on other factors.

How much do you exercise? Increase that and watch what happens.

The Thai food vs Western food comments on here are laughable. Both offer a lot of garbage. Both cultures are dreadfully unhealthy overall. Eat plenty of fruits and vegetable and less meat. Eat as little processed food as possible. That's always the way to get more healthy.

[partington]

Why the overstated beneficial effects of statins do not resolve the cholesterol controversy

• L. Mascitelli
  

• F. Pezzetta
  

• M.R. Goldstein
  

+Author Affiliations

• ¹ Controversy continues to surround its etiology and pathogenesis, particularly with respect to cholesterol and lipids.²However, in his review,³ Thompson asserted that the cholesterol controversy should be considered overtaken by the discovery and development of statin drugs. We suggest that hypercholesterolemia does not represent a ‘causa sine qua non’ for the development of atherosclerosis and that the beneficial effects of statins are overstated and do not resolve the cholesterol controversy.
  It is well known that patients may present with coronary heart disease (CHD) events despite low low-density lipoprotein (LDL) levels, which fall well within guideline-recommended targets. Indeed, it has been shown⁴that half the patients hospitalized with CHD had admission LDL <100 mg/dl, and LDL <70 mg/dl was observed in 17.6% of patients; less than one-quarter of patients had an admission LDL >130 mg/dl.⁴
  Not surprisingly, accelerated severe atherosclerosis and its complications can be produced experimentally in herbivores with serum cholesterol levels below 100 mg/dl under conditions analogous to those prevailing in humans.² Furthermore, lipid and cholesterol crystals are found as a nonspecific pathological change in many chronic degenerative and inflammatory diseases and cannot be assumed to be causal. In particular, the histological features of tuberculosis resemble what has been described in atherosclerosis;⁵ hypercholesterolemia is not a prerequisite for such pathogenetic events. On the contrary, hypocholesterolemia, beyond being a common finding in different forms of pleuropolmonary tuberculosis, may represent a deleterious factor for the host in its fight against mycobacteria.⁶
  On the other hand, in primary prevention, statin therapy reduces the risks of CHD events for men but not for women, without reducing total mortality for either men or women.⁷ Furthermore, there is reason to believe that the beneficial action of statin drugs is mediated in spite of their cholesterol-lowering effects.⁸ Indeed, statins have an effect only when patients have a heightened inflammatory state.⁹ Finally, it has been shown that low total cholesterol is an independent and robust predictor of future external-cause mortality, and this association could not be explained by other obvious interrelated risk factors.¹⁰
  As Thompson stated, the cholesterol controversy in Britain dates back to 1950.³ Changing our current practice pattern could take other 50 or more years, but we may one day prescribe cholesterol-raising medications to certain patients.¹¹
  
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Hi Cheeryble

Just a quick reply to both your posts. On any issue there are going to be disagreements, and you will always be able to find papers that oppose the general consensus of what is true. Its a matter of common sense more than anything else. When the germ theory of disease was proposed it was a controversy, and people persisted in arguing that was nonsense and it was "bad air" that caused diseases, for decades afterwards.

Eventually no-one with any sense believed that germs weren't the cause of infectious diseases. I would say that 90-95% of scientists and clinicians accept that elevated cholesterol causes heart disease, based on a viewing of the evidence available. This is all anyone can do: look at the results and decide what they mean. When you have done this you will of course argue for the point of view that you have come to believe--this is normal!

Furthermore scientists are not unbiased arbiters but human beings attempting, if they are good scientists, to be completely objective about their results. There comes a point in science just as in any work, where the evidence makes you believe one point of view is right and one is wrong, and at that point you have to go with your belief.

As a final point--some scientists are better than others, smarter, more original, more creative. While it doesnt prove anything- the authors of the paper you quote are not leaders in the field, or even moderate in the field. They are kind of nobodies. While as I say this proves nothing, the major proponents of the cholesterol theory Joseph Goldstein and Michael Brown are Nobel prize winners in Medicine for this work, and the author of the review you mentioned is one of the leading physician scientists in the US. The conclusions he comes to are not "his results" (although his work is central and important in the field it is a tiny part of an immense whole). His reviews, and there are I think 5 in the series, that I gave you the link to, trace the entire history of the cholesterol theory from 1913 to 2004, and probably quote more than 2000 separate studies.

The paper you give quotes 10 or 12.

Moreover there is such a failure of logic in their basic arguments that it is almost ridiculous,

Think of heart disease like a car accident. Alcohol causes a lot of car accidents right? But so do many other things, there is not a single cause. Exactly the same with heart disease. So when someone makes a statement about heart disease and cholesterol translate it to alcohol and car accidents to examine how convincing the argument is.

Examples: " My cholesterol has been high for 30 years and I haven't had a heart attack, so cardiologists are wrong!!!" = " I've driven drunk many times and not had an accident so it can't really be dangerous!"

"50% of people who have heart attacks don't have high cholesterol so doctors are wrong!" = "50% of people who have car crashes aren't drunk, so alcohol doesn't really cause accidents!" (This is one of the false logic arguments your quoted paper makes)

And so on..

best

Edited June 18, 2012 by partington

[partington]

General practitioner doctors get next to NO nutrition information in their studies. It's all about giving people medicine. That's where they make their money. When money is involved, I lose trust.

While I actually agree with your argument, the above is quite untrue.

General Practitioners do not "make their money" by giving people medicine. I have no idea what you mean by this!