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Historical Event

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September 24, 2007

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Anti-Saturated Fat doctors still pushing LDL angle while mocking the skeptics.





The Cholesterol Wars: The Skeptics vs the Preponderance of Evidence


Important Text:


Today, in the era of the statins (cholesterol lowering drugs), there is no longer any doubt about the value of lowering blood cholesterol levels. The Cholesterol Wars chronicles the controversy that swirled around the 'lipid hypothesis' of atherosclerosis for so many years. In fact, 'the lower the better' is the position of many clinicians. However, getting to this point has been a long uphill battle marked by heated debate and sometimes violent disagreement. The history of this controversy is told here for its own sake and because remembering it may help us avoid similar mistakes in the future.

  • Dr. Steinberg and his colleagues have published over 400 papers relating to lipid and lipoprotein metabolism and atherosclerosis reflecting the prominence these authors have in the community

  • Chronicles the miraculous power of the statins to prevent heart attacks and save lives, of great interest to the many manufacturers of these drugs

  • Discusses new targets for intervention based on a better understanding of the molecular basis of atherosclerosis

Dr. Richard D. Feinman has a Review on Amazon of this book:

The most remarkable thing about this book is that it may be the only one of its kind. The number of books attacking the lipid or diet-heart hypothesis (some listed on people who bought the book) is large and growing -- there are two called The Cholesterol Con yet this appears to be the only answer to what are very serious criticisms. Chapter 1 is a shock right off: "...the hypothesis relates to blood lipids, not dietary lipids, as the putative directly causative factor. Although diet, especially dietary lipid, is an important determinant...." What? We haven't been hearing for thirty years that a low fat diet is the key player? Of course, throughout the book, saturated fat is made to appear a major if not overriding factor and the same lack of hard proof that saturated fat causes CVD is missing. The description of the big studies is remarkably different thatn as described by the skeptics. The big save of the diet-heart hypothesis are the statins but the demonstration that there is improvement in risk because of lowered LDL is still not reliable. The book is nonetheless well researched (within the bias) and worth reading but the title tells you that this is, by analogy with a court of law, a civil suit. The cholesterol hypothesis is not established beyond a reasonable doubt.

The author claims that he presents the totality of evidence including large amounts of evidence that you will not read about in the many sceptical books.

What I found was a very one-sided presentation and nothing that was new.

All the studies that support his point of view are ground breaking, solid, convincing etc. The studies that do not are ignored or subjected to selective demands for rigor.

There is very little by way of real and deep insight into the processes underlying heart disease. This was the most disappointing aspect - after reading the book I felt I had learned very little and that I had wasted my time.

You could summarise the book very succinctly as "shut up and take statins". Yes statins reduce LDL and according to industry sponsored studies they reduce the risk of dying of a heart attack somewhat. Is this purported effect because they reduce LDL? Who knows. No-one reading the book will be significantly enlighted on this or any other point.

You would read this book thinking that statins only have rare and/or minor side-effects. Tell that to people taking it.

This is not the book we are looking for. We really need a stronger rebuttal of the sceptic case, assuming that is possible.

Topics: (click image to open)

Diet-Heart Hypothesis
The diet-heart hypothesis, also known as the lipid hypothesis, proposes that there is a direct relationship between dietary fat intake, particularly saturated fat and cholesterol, and the development of heart disease. It suggests that consuming high amounts of these fats leads to an increase in blood cholesterol levels, specifically low-density lipoprotein (LDL) cholesterol, which in turn contributes to the formation of atherosclerotic plaques in the arteries. Some consider this hypothesis nothing more than wishful thinking.
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