The Cholesterol debate

I’m not generally a watcher of the ABC’s Catalyst program because when it replaced Quantum, it opted for the Mickey Mouse style of reporting. Short articles and a gee whiz style that left me feeling short changed as a source of information. Basically a kids show.

But I may have to revisit the show after this one where they spent the whole program investigating the background on Cholesterol lowering.

Here is the link to the program but be warned. It’s 28 minutes and you have to draw your own conclusions. Both sides are presented and you have to weigh up the data yourself.

Now the reason I even got to know of this story is from an email complaining about the program but it wanders around like Barnaby Joyce and it was hard to work out exactly what the writer was complaining about. It’s purported to be from a doctor but I doubt it due to the lack of coherence in it’s presentation.

Incidentally, I did a search on Dr Graham Pinn and this is the only hit that cropped up. It may be a different chap but any time I see someone is an author of a Herbal Medicine book I get nervous about their credentials.

Check this out …..

Dear All,

We are away for a few days, so this note tonight is after watching the shocker on cholesterol. This program was confused, misguided and dangerous. It confused the effects of diet on heart disease with the effect of cholesterol lowering. There is no doubt that a raised cholesterol is associated with an increased risk of heart and artery disease, and that the risk increases with the level of cholesterol. 40 years of studies have confirmed this, also that lowering cholesterol reduces the risk. The other important risk factors are family history, high blood pressure, raised sugar, raised homocysteine levels, smoking, obesity and stress – so this is only part of the problem.

What is true is that for most people diet has little effect on cholesterol level, as most cholesterol is made by the body in the liver. So, if the level is high then medication may be needed and is effective. What is true is that far too many people are given treatment for minor increases, this boils down to a statistical quirk in clinical trials relating to relative versus absolute risk reduction. This means that the more people treated at lower levels the less benefit – but bigger profits for the manufacturers. There is  no evidence of benefit in the elderly (older than us), so patients who have been treated when younger, do not need to continue in later life – another source of extra revenue for the drug companies.

If someone has a high cholesterol level ( and the acceptable “normal”level has regularly been reduced to include those with only mild increases) then medication is indicated. Apart from the lipid hypothesis, it is logical to eat a healthy ( Mediterranean) diet, exercise, keep weight down, not smoke, drink alcohol in moderation ( less than your doctor) – and also pick the right parents !!! Those who have high levels of cholesterol will benefit from treatment, those with only minor increases should discuss the benefits with their doctor.

I fear this program will result in many people stopping therapy, with adverse consequences – keep taking the tablets.

Your friendly physician, Graham Pinn

Some of the claims in this letter directly contradict the data presented but there is no explanation as to if he is referring to new information or simply using the discredited data the program is complaining about. The thrust of the article is about promoting a solution that doesn’t appear to have any evidence. The advice given in Catalyst is to only take the tablets for a serious problem so complaining about folk stopping misses the whole point.

Do we really want to dumb down our understanding of medicine on the off chance it will solve one problem but lead to others?

I sure as hell hope not.

Like accurate labelling of food stuffs, we really should be able to rely on professional bodies to give us the data to make our choices from, rather than build snappy ad campaigns based on very dodgy studies.

The Heart Foundation’s claim that you can’t test accurately is simply a lazy response. Do they have professional Scientists there? If so do the job and do it properly. The whole point of having this body is to improve outcomes and if all they can manage is a PR campaign and no ability to test the data then why are we funding them?

The next episode is the second part of this story and I’ll be keen to see what turns up. I’m always on about Homeopathy not being able to prove it’s claims and the same should apply to real medicine. Test it properly then get other labs to test your results and make sure there are no links between the testing bodies.

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