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By
Uffe Ravnskov
author
of The
Cholesterol Myths
The National Cholesterol Education Program is based on the assumption
that it is possible to prevent cardiovascular death in a large number
of people. The expert panel´s main argument for the new guidelines
is that twenty percent of patients with coronary heart disease have
a new heart attack after ten years.1
To reach that number any minor symptom without clinical significance
has been included. Most people survive even a major heart attack,
many with few or no symptoms after recovery. What matters is how
many die and this is much less than twenty
percent. No doubt, the statins lower the risk of dying
from a heart attack, at least in patients who already have had one,
but the size of the effect is unimpressive.
In the CARE trial for instance, the odds of escaping death from
a heart attack in five years for a patient with manifest heart disease
was 94.3%, which improved to
95.4% with statin treatment.2
For healthy people with high cholesterol the effect is even smaller.
In the WOSCOPS trial, the figures were 98.4%
and 98.8%, respectively.2
These figures do not take into account
possible side effects of the treatment.
In most animal experiments the statins, as well as most other cholesterol-lowering
drugs, produced cancer, and
they may do it in human beings also.2
In The CARE Trial Breast Cancer Was Seen Significantly More Often
In The Treatment Group.
In the EXCEL trial the increase of total mortality in the treatment
group after just one year was borderline significant.3 Unfortunately
the trial was stopped before further observations could be made.
The original 1961 advice from the American Heart Association to
eat as much polyunsaturated fat as possible has been reduced successively
to the present "up to ten per cent".
But why this limit?
Ten years ago the main author of the new guidelines stated that
"intakes above 7% of total calories seemingly cannot be advocated
with prudence" because, as he argued, an excess of polyunsaturated
fat may be carcinogenic in human beings, just as they are in experimental
animals.2 4
Besides, the benefits of manipulating dietary fats have never been
proved.2 Instead of preventing cardiovascular disease the new guidelines
may transform healthy individuals into unhappy hypochondriacs obsessed
with the chemical composition of their food and their blood, undermine
the art of cuisine, destroy the joy of eating, and divert health
care money from the sick and the poor to the rich and the healthy.
References:
1.
Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults. Executive Summary of the Third Report of
the National Cholesterol Education Program (NCEP) Expert Panel
on Detection, Evaluation, and Treatment of High Blood Cholesterol
in Adults (Adult Treatment Panel III) JAMA 2001; 285: 2486-2496.
2.
Ravnskov U. The Cholesterol Myths. New Trends publishing, Washington
DC 2000.
3.
Bradford R H, Shear C L, Chremos A N, Dujovne C A, Franklin F
A, Grillo R B, Higgins J, Langendorfer A, Nash D T, Pool J L,
Schnaper H. Expanded clinical evaluation of lovastatin (EXCEL)
study results. Arch Intern Med 1991; 151: 43-49.
4.
Grundy SM. George Lyman Duff Memorial Lecture. Multifactorial
etiology of hypercholesterolemia. Implications for prevention
of coronary heart disease.
Arteriosclerosis 1991; 11: 1619-1635.
British
Medical Journal May
28, 2001
For more information, see Dr.
Ravnskov's website at http://www.ravnskov.nu/
cholesterol.htm.
If you would like to purchase his book The Cholesterol Myths
on Amazon.com, then CLICK
HERE.
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