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.
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
If you would like to purchase his book The Cholesterol Myths on Amazon.com, then CLICK HERE.
This is an excellent follow-up to an article that was posted in May and it provides some new data to the table on the relative benefits of statin drugs and the side effects of an increase in cancer.
I will also repost my comment from that article for those that missed it:
OK, here we go again. Now the "experts" have raised the ante. They changed the "normal" range so even more people will be put on cholesterol lowering drugs.
Prior to the new recommendations 13 million Americans "qualified" to be placed on these drugs. With these new recommendations 36 million Americans now qualify -- nearly triple the amount.
After all, that is the answer, isn't it? If people can't lower their cholesterol by following the low-fat nonsense then they need to take these drugs to prevent them from falling prey to the number one killer in the US, heart disease.
Hogwash. Nothing could be further from the truth.
If you have been receiving the newsletter for some time you will be familiar with my position on this issue. If not, I would encourage you to study the links below.
About one year ago, the experts predicted that HALF the population will be taking these types of drugs.
The big issue here is that these potent medications may be available over the counter in the near future with a massive PR campaign to encourage people to swallow these potentially dangerous drugs.
The amazing thing about these new recommendations is that they completely ignore the previously published evidence that are quite clear in documenting that the actual cholesterol level itself is not the most important risk factor. It is actually the ratio between the level of total cholesterol and HDL cholesterol.
The ideal HDL/cholesterol ratio should be higher than 25% and generally speaking the higher the better.
The ideal triglyceride/HDL ratio should be below 2.0.
If you did not know any better and just listened to the "experts" you would think cholesterol is an evil substance and that most of us would benefit from lowering our cholesterol as low as possible.
Not so. Cholesterol is a vitally important substance that is responsible for building our cell membranes and many of our hormones. If the level drops to low we are actually at increased risk for depression.
There are likely to be some people who benefit from them, but it is probably far less than 5% of the people who currently take them. These are individuals with total cholesterol above 350 who have inherited liver processing problems.
If these individuals take the statin drugs however, they should also take Coenzyme Q10, which is important for heart health and, like cholesterol, is reduced when one takes these drugs. The proper way for nearly everyone else to control their cholesterol levels is by reducing their grain intake by following the food choice program I recommend.
Another problem is the fact that low cholesterol is associated with numerous problems, as you can see from some of the studies below.