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A selection of my newsletters |
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For
several years I have sent newsletters to people who have shown interest in the
many contradictions of the cholesterol hypothesis and/or the work of our group THINCS,
The International Network of Cholesterol Skeptics. Here comes a selection of these letters. If you want to become a
recipient of my newsletters, please click here. |
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| October
2004
About
those who write the guidelines
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October 2004 How to convert healthy people into patients
You
have probably heard about the new guidelines issued a few months ago by the
National Institutes of Health and according to which “normal” cholesterol
now is considered to be far below the mean value in most populations. Bingo thus
for the drug companies (and the authors of the guidelines). |
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About lowcarb diet and diabetes Recently Heine and coworkers published a review in British Medical Journal about the treatment of type 2 diabetes without mentioning a word about the many succesful low-carbohydrate trials. The strong resistence against these trials is of course due to the cholesterol campaign according to which we shall eat carbohydrates instead of fat, an advice that has been given to diabetic patients as well. Read the many comments to that study in BMJ, including my own (the last one). If you want to read more about the lowcarb diets I can recommend these papers, freeely available on the web: Arora SK, McFarlane SI. The case for low carbohydrate diets in diabetes management.
Ridicule instead of answer As readers of my newsletters or my books know there is no evidence whatsoever that saturated fat has anything to do with atherosclerosis or coronary heart disease. But do you know that there is no evidence either that saturated fat raises the cholesterol concentration in the blood? A recent paper by Krauss and coworkers is a further confir- mation, but their finding, clearly recorded in a table, wasn´t mentioned in the discussion or in the abstract. This is a common observation when researchers come up with results that go counter to the cholesterol paradigm. Therefore I sent a letter to the editor My letter was commented in a vicious editorial by Martijn Katan, one of the most eager proponents of the cholesterol campaign. You can read more about this discussion here. |
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Pfizer fraud Pfizers new cholesterol-lowering drug
Torcetrapib was a
failure; instead of lowering the risk of heart disease, it resulted in more
heart attacks, although in addition to lowering LDL cholesterol, it also raised
the "good" HDL. Now
it appears that Merck´s Vytorin is just as bad. Instead of halting the progress
of atherosclerosis the trial directors of ENHANCE noted an increased progress,
although cholesterol was lowered more than ever before. Here is
a
comment in New York Times But there are more curious facts about that trial. Read for instance a comment in The Guardian A
new
article about statin treatment has just been published on the web by our member Sandy
Szwarc. ...and
here are more critical articles published in Bloomberg Businessweeek: Critical
comments have also been aired by Gary
Taubes and Tara
Parker-Pope, both of them in New YorkTimes.
An unsuccesful statin trial In
this week´s issue of The New England Journal of Medicine the report from the
unsuccesful ENHANCE trial was published, almost two years after it had been
terminated. Not unexpectedly, at least for those who have been informed by
THINCS´ members, a further lowering of cholesterol by a non-statin drug did not
improve the angiographic changes of the coronary arteries; on the contrary. Read
Sandy
Szwarc´s report!
November
2008 ...and another one First, you have probably heard about the new statin trial JUPITER. According to its authors their new super statin drug Crestor may soon eradicate cardiovascular disease. Not so – we are again misled by industry-paid socalled researchers. Here are two excellent comments; the first one by Dr. Michael Eades, the second one by one of our members Sandy Szwarc
Scary
news. According
to the new guidelines for cholesterol lowering even children should be treated
with statins. Fortunately a host of critical comments have appeared in various
media. Here are two from Tara Parker-Pope, the wise medical reporter on New York
Times:
8-Year-Olds
on Statins? A New Plan Quickly Bites Back …and one from Sandy Szwarc: Is it for real? Cholesterol screening in toddlers and statins from elementary school age? Why the bad things aren´t told Here are some cuttings from an article by New York Times reporter Duff Wilson: |
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...In
a first-year pharmacology class at Harvard Medical School, Matt Zerden grew wary
as the professor promoted the benefits of cholesterol drugs and seemed to
belittle a student who asked about side effects. Mr. Zerden later discovered
something by searching online that he began sharing with his classmates. The
professor was not only a full-time member of the Harvard Medical faculty, but a
paid consultant to 10 drug companies, including five makers of cholesterol
treatments.
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The statins are better than snake oil It
is often said that statins are good for almost any human disease. The method
used to ‘prove’ that is to compare people on statin treatment with untreated
people. Most people in the latter group have of course low cholesterol, and not
only low, but very low cholesterol, because as you know the upper limit for
normal has been lowered again and again through the years. It is well-known that
low cholesterol is a risk factor for many diseases; to mention only infectious
ones and cancer. What these researchers have shown is therefore that high
cholesterol is beneficial because people in the statin group have had high
cholesterol most of their life.
Recomended reading If
you think that the statin trials have proved that cholesterol lowering is
beneficial I recommend you to read two important books written by people with
inside information about how we are conned by the drug industry. The first one
is “The Truth About the Drug Companies” by Marcia Angell, former
editor-in-chief of New England Journal of Medicine, one of the world’s most
respected medical journals. The other one is “The Trouble With Medical
Journals” by Richard Smith, former editor-in chief of British Medical Journal,
another great and respectable publication. You should also listen to Beatrice Golomb. She is an associate professor of medicine at the University of California, San Diego and has devoted many years studying the side effects of statin treatment. Here is a youtube talk she gave recently entitled Pharma corruption of medical science December
2009 A dietary U-turn Those of you who have followed our work already know that saturated fat isn´t a menace to human health. Recently WHO and FAO published a new report, Fats and Fatty Acids in Human Nutrition. Now, finally, their experts have come up with the same conclusion; go to pages 191 and 239. However, they havern´t changed their recommendations! You can read more about that paper here (from my new book Ignore the Awkward! How the Cholesterol Myths Are Kept Alive) top The press is awakening The
press is awakening. Here you will find interesting articles from major
newspapers and journals: Statins have been hailed as a miracle cure for cholesterol, but little is known about their side effects. Read also the 140 comments, but beware, they are scary. Melinda Wenner Moyer (Scientific American): It's Not Dementia, It's Your Heart Medication: Cholesterol Drugs and Memory. Why cholesterol drugs might affect memory. Tom
Naughton: Big Fat Fiasco: how the misguided fear of
saturated fat created a nation of obese diabetics. A humourous speech with a serious content. Five parts, on
Youtube No more fraudulent trials? After
the Vioxx scandal new clinical research regulations have come into force. Trials
that begin enrolment of patients after 1 July 2005 must register before their
start in a recognised trials registry to be considered for publication and they
must be published within 90 days after the ending regardless
of whether the results are positive, negative or inconclusive. The China Story - from Alice in Wonderland? Have
you been mislead by Colin Campbell? Here is
an
excellent analysis by
our member Stephanie Seneff of his book The China Study. It is sad that this
book has had such great impact on people's dietary habits. More revelations More
and more people realize that the cholesterol campaign is built on bad or
fraudulent research. Here are a number of recent eye-opening articles: Steven
Lewingston (Washington Post): Ike and the war on meat
October
2010 How to get the desired results A colleague of mine asked about my view on an article in Science Daily. Here you can read that ”A new study by researchers at Harvard School of Public Health (HSPH) provides the first conclusive evidence from randomized clinical trials that people who replace saturated fat in their diet with polyunsaturated fat reduce their risk of coronary heart disease” The paper, the main author of which is Dariush Mozaffarian from the Channing Laboratory at Harvard Medical School, is available here. The
article in Science Daily also tells about another recent review co-authored by
Frank B Hu and Ronald M Krauss, two other well-known US scientists. They
concluded that ”there is no significant evidence for concluding that dietary
saturated fat is associated with an increased risk of CHD or CVD.” The
abstract of that paper is available here.
Their
conclusion was explained away by these words: ”Some of these mixed findings
may relate to absence of prior focus on the specific replacement nutrient for
saturated fat.”
How did Mozaffarian and his coworkers reach to their contradictory
conclusion, you may ask. It is particularly curious because Mozaffarian himself
has published
a study that contradicts his new paper.
What he and his coworkers found was that progress of
atherosclerosis was less pronounced the more saturated fat the participants had
eaten. Let me tell you how Mozaffarian succeded with turning around: By including the Finnish Mental Hospital study, a dietary trial that did not satisfy the most elementary requirements for a correctly performed trial. For instance, it was neither controlled, randomised or blind. By excluding two trials where mortality increased in the treatment
groups and a third where no effect was achieved. (You can read more about
these trials in my books) Furthermore, they included the DART trial, where the only group that improved had increased their intake of fish as the only dietary measure. What proponents of polyunsaturated fat forget is also that today,
most of such fat comes from corn, soy and sunflower oil. Here the main type of
polyunsaturated fat is omega-6, and there are numerous papers having shown that
an excess intake of omega-6 polyunsaturated fats has many serious adverse
effects. A humorous talk about serious matters Recently Tom Naughton gave a speech at the local library entitled "Big Fat Fiasco: how the misguided fear of saturated fat created a nation of obese diabetics." Luckily a photographer was there, because it is both funny and serious, and it is now available on Youtube in five parts
Fraud revealed Do you believe in medical science? Do you think that what has been published in the major medical journals reflects the truth and nothing but he truth? Then read this article by John Ioannidis entitled ”Lies, damned lies and medical science” published recently in The Atlantic. Ioannidis has spent his career challenging his peers
by exposing their bad science. Here is a quotation from the article: ”We could
solve much of the wrongness problem, if the world simply stopped
expecting scientists to be right. That’s because being wrong in science is
fine, and even necessary—as long as scientists recognize that they blew it,
report their mistake openly instead of disguising it as a success, and then move
on to the next thing, until they come up with the very occasional genuine
breakthrough.” More
and more journalists have realized that the drug companies aren’t thrustworthy
either. Read for instance this
article by Stephen Adams from
the British newspaper The Telegraph. Good news For
many years Walter Willett, head of the world´s largest dietary study
situated at Harvard, has warned against saturated fat. This is most curious
because none of the many Harvard studies has ever found that those who gorge in
saturated fat are at a higher risk than those who follow the offical guidelines.
How to cover up the bad news You
have probably read about the new report from the
Cochrane Collaboration mentioned in many of the major media recently (for
instance The Telegraph, BBC, Boston Globe, CBC News, LA Times,
and Reuters. The aim of
the Cochrane authors was to assess the effects, both harms and benefits,
of statins in people with no history of CVD. For that purpose they had analysed
randomised controlled trials of statins with minimum duration of one year and
follow-up of six months, a total of 14 including 34272 participants. The authors concluded that ”although reductions in all-cause
mortality, composite endpoints and revascularisations were found with no excess
of adverse events, there was evidence of selective reporting of outcomes,
failure to report adverse events and inclusion of people with cardiovascular
disease. Only limited evidence shed that primary prevention with statins may be
cost effective and improve patient quality of life. Caution should be taken in
prescribing statins for primary prevention among people at low cardiovascular
risk.” As mentioned in the Cochrane report the low number of side effects
is unlikely. To mention only that independent researchers have found that
muscular problems are seen, not in less than 1 percent as reported in all statin
trials, but in about 25 % of those who exercise regularly. But
it is worse than that. As the authors had included only trials with a length of
one year or longer, they have missed the first statin trial, named EXCEL. It included
more than 8,000 healthy individuals (named ‘patients’ in the trial reports,
because of their moderately elevated cholesterol) who received one of four
different doses of lovastatin (Mevacor®) or a placebo. The trial was terminated
already after 48 weeks of treatment. The
reason? Because the authors only wanted to see if the ”patients” tolerated the drug, and they did, at least according to the trial report. In
the abstract you look in vain after the clinical outcome. In the text you can
read that total mortality was 0.2 percent in the control group and about 0.5
percent in the four treatment groups. The total number of deaths was 36, but as
nothing was said about the exact number of participants in each group (they were
”of similar size”), it is impossible to calculate if the higher number of
deaths in the treatment groups was statistically significant or not. However, it
would most likely have become significant had the trial continued. It
is also worth mentioning that whereas all statin trials with a positive outcome
are freely available on the web, this is not the case with EXCEL. April 2011 Cholesterol and the brain Although members of THINCS since long have warned against the harmful
cerebral effects from cholesterol lowering, few doctors know about it and
nothing is mentioned on the drug labels. Here is a
thorough review about
this issue by Emily Deans, MD, a clinical instructor in psychiatry at Harvard
Medical School. Obesity - a man-made problem More
and more scientists realize that the cholesterol campaign is the greatest
medical scandal of modern time. Here you can listen to a brilliant talk "How
Bad Science and Big Business Created the Obesity Epidemic" by our
member Professor David M Diamond from
the Departments of Psychology and Molecular Pharmacology and Physiology, Center
for Preclinical and Clinical Research on PTSD in Tampere.
How to explain away bad results Using
a new technique named strain imaging US researchers have found that statin
treatment decreases myocardial function.
This is not new knowledge, of course; just consult the writings of our
members Alena and Peter Langsjoen. Do we expect official warnings now? |
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You
make the mistake of believing that peer reviewers actually read the papers
they are sent.... Another solution is to create an ad-hoc hypothesis. If you don´t know
what that means, read Tom
Naughton´s explanation! The statins are bystanders only A new problem for the cholesterol campaign has appeared: There is no association between the decrease of heart disease and the use of statins.This has been shown by Swedish researchers who compared the two measures in all Swedish districts. No association! In some districts heart disease went down and statin use increased but in just as many it was the opposite. You can read the paper here to be published in Journal of Negative Results, meaning that very few will take notice, unless of course you tell about it whenever you have the possibility. Again,
this is no surprise for those who have followed the literature with a
critical eye. If you want a detailed explanation why cholesterol is not
the enemy, read this
review by one of our members Stephanie
Seneff. Its title is How Statins Really Work Explains Why They Don't
Really Work.
Alzheimer and low chlesterol Researchers
paid by the drug industry are eager to tell us that people with Alzheimer´s
disease should be prescribed a statin drug. How do they explain that all
the blood lipids are lower in such patients, lower the more advanced the
Alzheimer has progressed? You
can read more about that
here
A funny video Scary statin news, but editors, please keep quiet! Half a year ago I told you about the new Cochrane report the authors of which concluded that the benefit from statin treatment of people without heart disease is questionable. What I didn´t tell about was the results from a report by Hippisley-Cox and Coupland published last spring in British Medical Journal. The reason was that I hadn´t observed it myself at that time. In the QResearch database 368 general practices in England and Wales had supplied data from more than 2 million patients of whom 225,922 were new statin users. By analysing these data Hippisley-Cox and Coupland concluded that whereas the total number of prevented coronary events, almost all of which were non-fatal, was less than 3 per cent, the total number of adverse effects was more than 4 per cent. The adversities were not harmless either, but consisted of acute renal failure, cataract, and serious liver and muscle damage. You may probably ask yourself if statin treatment of healthy people has been stopped after the publication of this scary report. The answer is no. Neither the practicing doctors nor common people know about these figures, possibly because the British report is difficult to understand for people without thorough knowledge about epidemiology and statistics. But what about the experts? Why haven’t they reacted? Are they anxious to loose their research money and their other financial benefits from the drug industry? Together with two highly qualified members of THINCS (Professors Paul J Rosch and Morley C Sutter; see our list of members) I sent a paper to British Medical Journal about this issue. In the paper we showed in many details that the number of adverse effects must have been even higher because liver disease was recorded only if the substance that reflects liver damage was three times higher than the upper limit of normal, and muscle disease was recorded only if the substance that reflects muscle damage was four times higher. In accordance independent researchers have reported that 20-25% of statin-treated people experience muscle pain or weakness. We also pointed out that several types of adversities were not recorded at all. It is well known for instance that diabetes occur in about 0.5% of statin-treated people and that 20% of the male patients become more or less impotent after a few months treatment. Reviews taking all cholesterol-lowering trials together have also shown a significant increase in death from accidents, suicide, or violence, and there are numerous reports about memory loss and other cerebral disturbances. Worst of all is that the risk of cancer has been ignored by all experts although there is much scientific evidence that cholesterol lowering may result in cancer (you can read much more about that in my recent book Ignore the Awkward!). A few days later I received the following message from the editor: |
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Thank you for sending us your paper. We read it with interest but I regret to say that we have decided not to publish it in the BMJ. Although we are sympathetic to the general point that the downsides of statins are underappreciated, we think that we have covered the point enough. Indeed, we published the Hippesley Cox article that you draw heavily upon.
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Dear Dr. Ravnskov, Many thanks for submitting your manuscript to The Lancet. We have considered your manuscript, but our decision is that it would be better placed elsewhere We tried Archives of Internal Medicine, but with the same result: Dear Dr. Ravnskov, Your manuscript has been reviewed by the senior editors of Archives of Internal Medicine. I regret to inform you that its priority rating is not sufficiently high to warrant our considering it further for publication. Based on our initial review, we will not be sending the paper for additional outside editorial review Today millions of healthy people are on statin treatment without knowing about the imbalance between benefits and risks. How should we inform them when the experts and the medical journals don´t? We haven´t given up and we shall try other journals. The problem is however, that few medical journals are able to survive without their income from the drug industry, and editors are therefore reluctant to publish papers like ours. In
Sweden we have succeeded in informing the public by publishing an article
in Dagens Nyheter, the largest and most influential Swedish
newspaper. An
English version is available on the web. Click also on the text
in the upper. right hand corner: Svenska Dagbladet: Debate on reignited. Shuffle the cards and the reader will believe you! Misleading
papers about the benefits of statin treatment published
by research groups from prestigious universities are countless. Here is an
example. In 2003 the results from a large, multinational statin trial named ASCOTT-LLA (Anglo-Scandinavian Cardiac Outcomes Trial—Lipid-Lowering Arm) including 10305 patients, half of whom had received statin treatment. All of them had three risk factors, but none of them had had a heart attack. The trial was planned to continue for five years, but was stopped already after 3.3 years because of its “large reduction in major cardiovascular events”. Fatal and non-fatal myocardial infarction was reduced by 36 %, seemingly an impressive figure. However, the absolute figures were 1.93 % “heart events” in the statin group against 3 % in the untreated control group, thus a difference of only 1.07%. The figure 36% is correct, however, because 1.07 is the difference between 3 and 1.93, and 1.07 is 36 % of 3.The difference in mortality was even lower. 3.6 % died in the statin group against 4.1 % among the untreated. You could also say that the chance of being alive after 3.3 years without statin treatment is 95.9 %, but if you take a statin drug every day you can increase your chance to 96.4 %. You have to consider the risk of adverse effects, however. In the statin group 3.8 % either got diabetes, renal failure or life-threatening heart arrhythmia, against 3.2 % among the untreated. None of these adverse effects had increased with statistical significance, but perhaps they would, had the trial continued for the planned five years. Nothing was said about other adverse effects, although there are many reports about muscle damage, impotency, cancer, bad memory or temper, to mention just a few, and some of them have been reported in much larger number. More about that in my previous newsletter. Now to the amazing news. Eight years after the discontinuation of the trial the outcome of the British participants was analysed. To their surprise the researchers found that among those who had been on statin treatment eight years before, fewer had died from an infectious or respiratory disease compared with the untreated control individuals. Only 1.6% of those, who had been on statin treatment, had died from these diseases against 2.44% among the untreated. The authors were excited, and the news were spread to many newspapers and professional websites; for instance Science Daily, Daily Mail, Pulse, Netdoctor and The Heart to mention a few. The authors had a number of reservations. But what
they didn’t consider was the fact that the number of statin-treated
individuals after these eight years was almost the same in the two groups.
To cite the authors: |
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The crucial question is of course the following: Why did the original treatment group stop taking statins? Could the reason be unpleasant adverse effects? And isn´t it possible that some of those who started statin treatment during these eight years had not yet decided to stop because of unpleasant symptoms? If so, no conclusions can be drawn from these findings. That cholesterol-lowering should prevent infectious diseases is also highly unlikely, because the lipoproteins protect against all kinds of infectious diseases, an issue that I have described in detail in my books.
More brave journalists Now to the good news. Skepticism against the cholesterol campaign is growing. A few days ago medical journalist Lois Roger published a critical article about this issue entitled Big Fat Lies in the Sunday Times. Unfortunately it is not available without paying, but somebody has sent it to a website named Active Low-Carber Forums Another
eloquent journalist and researcher is Roy Moynihan. In the August 15 issue
of BMJ he published a new, critical paper entitled “Surrogates under
scrutiny: fallible correlations, fatal consequences”. Those who have
read my books are of course familiar with the issue. Here are a few
quotations for those who haven´t, as it is not available for
nonsubscribers: |
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…The
benefits of long term preventive therapies like cholesterol lowering drugs
are usually portrayed as relative reductions in risk, but when the risks
are considered in absolute terms, a different picture emerges. For
example, based on a Cochrane review of trials for primary prevention,
there has been recent enthusiasm that for people without a history of
heart disease statins can reduce premature deaths by 17%, coronary heart
disease by 28%, strokes by 22%, and revascularisation by 34%. Yet a close
reading of the tables from that systematic review suggests the estimated
absolute risk reductions with around four to five years of drug taking are
0.5% for death, 1.9% for coronary heart disease, 0.5% for stroke, and 0.7%
for revascularisation. …The magic of numbers may help corporate profits and professional pride, but at what cost to the health of ordinary people who mistake a numerical benefit for a genuine one? Surely it’s time to ask if there might be a healthier new model for medicine based on far less harmful and costly ways to try to reduce human suffering.”
A Swedish revolution
In Sweden there is an increasing understanding that
meat, eggs and dairy products have nothing to do with atherosclerosis or
heart disease. The story began the year 2005. Lars Erik Litsfeldt, a
Swedish lawyer contacted me to tell me about his success with a lowcarb,
high fat (LCHF) diet. A few years earlier he was an overweight diabetic
with heart problems, but after a few days on the LCHF diet his blood sugar
became normal and he could stop his medication, and soon after his body
weight was back to normal. Our discussions about fat and cholesterol
inspired him to wrote a book “Fettskrämd” (Scared by fat). The same year a book was published by Sten Sture
Skaldeman, a journalist, who had almost halved his body weight (141 kg;
311 lb) by eating a LCHF diet. He had followed the usual dietary
recommendations in vain; his body weight increased more and more. When he
got diabetes and heart failure he realised that his life could end very
soon and he therefore decided to eat the food he enjoyed the most, eg. fat
food. To his surprise he noted that week after week he lost weight and all
his ailments disappeared. However, what really created attention was what
happened to Annika Dahlquist, a general practitioner in Northern Sweden.
When she experienced the same benefit on herself from this diet,
she started recommending it to her patients as well. Two local dieticians
accused her for misconduct and reported her to The National Board of
Health and Welfare (Socialstyrelsen) and her chief prohibited her from
giving dietary advice. However, two years later The National Board
acquitted Annika; although her dietary advice went contrary to the
official guidelines, as they wrote, they were supported by science. Annika wrote a book herself, which became a
blockbuster. Today every Swede knows Annika Dahlquiost and her message.
She has appeared in several television shows and she has given numerous
lectures for lay people all over the country
She has been followed by another general practitioner, Andreas
Eenfeldt, who has written a blockbuster book as well and started an LCHF
blog that has become the largest health blog in Sweden. Together with eight colleagues I have backed up the
LCHF movement by criticizing The National Food Administration for giving
unhealthy dietary advices, both in the newspapers and in the Swedish
medical press. Here is an excerpt from my book “Ignore the Awkward!”
about one of our papers, published in Dagens Medicin, a popular medical
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“Recently, the Swedish Food
Administration published a list of seventy-two studies, which they claimed
were in support of their warnings. Together with eleven colleagues I
scrutinized the list and what we found was the following:
Eleven
studies did not concern saturated fat at all. Another contradiction is, that for many years the
consumption of saturated fat has decreased in many countries, while during
the same time period we have seen a steady increase in the incidence of
type 2 diabetes.”
According to a recent poll almost 25% of the Swedish population has changes their dietary habits in the LCHF direction and in today´s local newspaper you could read that there is lack of butter in all districts in Sweden. False and dangerous advertisements from Unilever Recently David Jenkins and 16 colleagues published the results from a dietary trial in JAMA (The Journal of the American Medical Association). They had compared the usual low−saturated fat diet with a diet that included plant sterols, soy protein, fibers, and nuts. They succeeded in lowering LDK-cholesterol by about 13% with the plant sterol diet, but only by 3% with the usual low-fat diet. What is a plant sterol, you may ask. Cholesterol is an important constituent of plants as well, although the molecule looks a little different. There are several types of plant cholesterol; together they are named plant sterols. A typical Western diet contains 400-500 mg plant sterols, but little is taken up in the gut. Human and plant cholesterol compete for uptake in the gut. If you eat much plant sterol, your intake of normal cholesterol goes down. This fact got Unilever the idea to add plant sterols to their food products; in the first hand to margarine. The product is named Promise Active in the US, and Flora Pro.active or Becel Pro.active in other countries. And this was also the product that was given to the participants in the plant sterol group. It is correct that cholesterol goes down if we eat much plant sterol, but that doesn’t mean that it is able to prevent heart disease, because no one has ever tested that in a scientific experiment. What happens is that our own cholesterol is exchanged with a foreign type of cholesterol, not only in the blood but also in our cells and cell membranes. Is it really a good idea? Isn’t it likely that the molecular differences between animal and plant sterols have a meaning? I think so, and science is in support of my view. Several studies have shown that even a mild elevation of plant sterols in the blood is a risk factor for heart disease, and the findings in people with a rare inborn disease named sitosterolemia are in accord. These people absorb much more plant sterols than normally and they also become atherosclerotic much earlier in life than normal people. Statin treatment lowers blood cholesterol, but at the same time it raises the level of plant sterols. In the 4S-trial about 25 % of the patients had a mildly elevated level of plant sterols before treatment. In this group statin treatment resulted in a further increase of plant sterols and the number of heart attacks was twice as high compared with the patients with the lowest plant sterol levels. This means that for about 25% of the many millions of people on statin treatment, their risk of heart disease may increase, not decrease. In spite of that, Unilever still advertise their margarine and other food products with high contents of plant sterols: Enjoy heart healthy buttery spread with Promise! I
became upset when I read that paper and I therefore sent a letter to the
editor of JAMA with the following text: Questionable conclusions
from a dietary trial It
is well known that an addition of plant sterols and soybean products to
the diet may lower cholesterol by 10-15%. The findings in the dietary
trial performed by Jenkins et al.(1) are therefore no surprise.
It is questionable, however, if a lowering of cholesterol by dietary means
is equivalent with a lowering of the risk of coronary heart disease (CHD)
because hitherto no unifactorial dietary trial has succeeded in lowering
cardiovascular or total mortality (2,3). What the authors also
ignore is that an increased intake of plant sterols is associated with an
increased cardiovascular risk. In at least four cohort studies a high
intake or a high plasma level of plant sterols were independently
associated with a higher risk of CHD,
and in experiments on mice a dietary supplementation with plant sterol
esters equivalent to a commercial spread induced endothelial dysfunction (4). 1.
Jenkins DJ, Jones PJ, Lamarche B et al. Effect of a Dietary
Portfolio of Cholesterol-Lowering Foods Given at 2 Levels of Intensity of
Dietary Advice on Serum Lipids in Hyperlipidemia: A Randomized Controlled
Trial. JAMA.
2011:306(8),831-839. 2.
Ravnskov U. The questionable role of saturated and polyunsaturated
fatty acids in cardiovascular disease. J
Clin Epidemiol. 1998;51(6):443-460. 3.
Hooper L, Summerbell CD, Higgins JP et al. Dietary fat intake and
prevention of cardiovascular disease: systematic review. BMJ.
2001;322(7289):757-763. 4.
Weingärtner O, Böhm M, Laufs U. Controversial role of plant
sterol esters in the management of hypercholesterolaemia. Eur
Heart J. 2009;30(4):404-409. A
month later I got the following answer from the Editor: Dear Dr. Ravnskov: Thank you for your recent letter to the editor. Unfortunately, because of the many submissions we receive and our space limitations in the Letters section, we are unable to publish your letter in JAMA. After considering the opinions of our editorial staff, we determined your letter did not receive a high enough priority rating for publication in JAMA. We are able to publish only a small fraction of the letters submitted to us each year, which means that published letters must have an extremely high rating. We encourage you to contact the corresponding author of the article, although we cannot guarantee a response. We do appreciate you taking time to write to us and thank you for the opportunity to look at your letter. Sincerely yours, Jody W. Zylke, MD Senior Editor, JAMA Letters
Section Editor I
haven´t contacted the corresponding author of the paper, as suggested by
Dr. Zylke, by the simple reason that nothing would happen. According to
the Conflict of Interest Disclosures ten of the authors were supported
financially by Unilever and several other producers of the food types used
in the trial. Here is for instance Dr. Jenkins´ list: “Dr
Jenkins reported serving on the Scientific Advisory Board of Unilever,
Sanitarium Company, California Strawberry Commission, Loblaw
Supermarket,Herbal Life International, Nutritional Fundamental for Health,
Pacific Health Laboratories, Metagenics, Bayer Consumer Care, Orafti, Dean
Foods, Kellogg’s, Quaker Oats, Procter & Gamble, Coca-Cola, NuVal
Griffin Hospital, Abbott, Pulse Canada, Saskatchewan Pulse Growers, and
Canola Council of Canada; receiving honoraria for scientific advice from
the Almond Board of California, International Tree Nut Council Nutrition
Research and Education Foundation, Barilla, Unilever Canada, Solae,
Oldways, Kellogg’s, Quaker Oats, Procter & Gamble, Coca-Cola, NuVal
Griffin Hospital, Abbott, Canola Council of Canada, Dean Foods, California
Strawberry Commission, Haine Celestial, and Alpro Foundation; being on the
speakers panel for the Almond Board of California; receiving research
grants from Loblaw Brands Ltd, Unilever, Barilla, Almond Board of
California, Solae, Haine Celestial, Sanitarium Company, Orafti,
International Tree Nut Council, and Peanut Institute; and receiving travel
support to meetings from the Almond Board of California, Unilever, Alpro
Foundation, and International Tree Nut Council.” In addition Unilever Research and Development provided the donation of margarines used in the study. Misleading scientists - once again Statins
cure almost everything. This is the message we are told again and again in
the scientific press; at least from researchers supported by the drug
companies. Here is a new example. In European
Heart Journal Peter
S Sever and his coauthors claimed that statin treatment also lower
mortality from infections and respiratory diseases. How did they
come up with this surprising result? It is surprising because as readers
of my books know, the lipoproteins, the carriers of cholesterol, is an
important part of our immune system. If we lower cholesterol, we lower the
lipoproteins as well. Their
argument comes from a large statin experiment called ASCOTT-LLA. This
trial included more than 10,000 patients with hypertension, half of whom
were treated with atorvastatin. The trial was stopped prematurely in 2002
after three years because of the allegedly obtained benefit at that time.
In the treatment group 3.58% had died; in the untreated group 4.13%. After
that the treated participants decided for themselves whether they wanted
to continue the treatment or not, and the untreated were offered
treatment. About a third in the first group stopped or had already stopped
treatment, and more
than half of the others started. Eight years later more had died from
infections and pulmonary diseases in the control group. But
how could they know whether the difference was due to statin treatment? As
I wrote in
a letter to the journal:
It is not too farfetched to assume that those who stopped the treatment,
did it because of unpleasant adverse effects, and that many of those, who
had started it, not yet had recognized that possible adverse effects were
caused by the treatment. The
analyses were supported by an unrestricted grant from Pfizer and two of
the authors, including Peter Sever, had served as consultants or received
travel expenses, or payment for speaking at meetings, or funding for
research from one or more pharmaceutical companies that market
blood-pressure-lowering or lipid-lowering drugs, including Pfizer for
ASCOT. If
you want more information about the many misleading ways we are informed
about the statins, read this
paper by
Stephanie Seneff. Stephanie is a senior scientist at Massachusetts
Institute of Technology (MIT) and a member of THINCS And if you think that the lipid guidelines are written by independent researchers, please read this article by Larry Husten. Recently, the Danish government committed an act of extreme folly: They taxed saturated fat, ostensibly ‘to prevent obesity’. And in so doing, they got it disastrously wrong. Why? Because saturated fat is not only not fattening; it is actually one of the best slimming agents. If you understand the Scandinavian languages, you can read why that is a bad idea in my chronicle in Berlingske Tidende, one of the major Danish newspapers. (You can get an approximate translation using Google´s language tool). To prevent similar mistakes by other governments Members of THINCS are just now preparing a similar paper in seven different languages to be sent to newspapers in other countries. We are not too optimistic because articles critical to the cholesterol campaign are rarely accepted for publication. How to cheat with complicated calculations The
New England Journal of Medicine recently published the
results of the SATURN trial.
It was designed to study the effect of atorvastatin (Lipitor) vs.
rosuvastatin (Crestor) on the volume of atheroma in a coronary artery. It
was hoped that the volume would be reduced, demonstrating that high dose
statins can decrease the burden of atherosclerosis. Initially
1578 patients were selected for the trial, but after a run-in period of 2
weeks where they were treated with half-maximal doses of either
atorvastatin or rosuvastatin, 193 patients were excluded. The rest were
treated either with 80 mg atorvastatin or 40 mg rosuvastatin. After 2
years of treatment a further 346 patients had disappeared. Before
and after the trial the patients underwent intravascular ultrasonography
to measure the lumen diameter and the total diameter of a coronary artery.
Subtracting the lumen area from the total area of the artery is thought to
reflect the total atheroma volume, (represented as the percentage atheroma
volume). The primary endpoint was to measure the reduction in percent
atheroma volume After
the treatment the lumen had increased on average by 0.99 % in the
atorvastatin group, and by 1.22 % in the rosuvastatin group, and the per
cent atheroma volume (eg. the area of the arterial wall) had decreased by
1.1 % and 1.3 % respectively.
TAVnormalized
= Σ (EEMarea − lumen area x median
no. of
no.
of images in pullback images in cohort
Anyway, the critical measure was the difference between the inner and
outer area of the artery. Unfortunately, there is no evidence that the
figure from this calculation reflects atheroma volume. For example,
vascular dilation will increase the inner diameter, without having any
effect on the thickness of the arterial wall. But this would result in an
apparent decrease in atheroma volume. To further understand what I mean,
read the following section from my book Fat
and Cholesterol are GOOD for You! The
anguish
of angiography
In short, the degree of arterial dilation is a massive and uncontrolled
variable in the SATURN study. This problem could have been solved if the
investigators had included a placebo group (a group of patients who
unknowingly received an ineffective pill). However, “It was not
considered ethically possible to measure disease progression in
placebo-treated patients”, as they wrote. There were other major problems with this study.
The issue of drug related adverse events is extremely important. This was
virtually dismissed within the paper. “Both agents had acceptable
side-effect profiles”. Can this be true. A more detailed review of
adverse events reveals that “new proteinuria”, defined as an excretion
of more than twice the amount of protein in the urine during the
follow-up, in 1.7 and 3.8 %, respectively in the two groups. An increase
in proteinuria is a measure of progressive damage to the kidneys. This
trial only lasted two years, so we don´t know what would have happened in
the longer term. Equally it was stated that less than two per cent
had laboratory signs of liver damage. However, liver damage was only
recorded if the laboratory signs were at least three times higher than the
upper limit of the normal range. And whilst less than two per cent had
muscular damage, this was only reported if the laboratory signs were at
least five times higher than the upper limit of the normal value. What do
you think will happen with the liver and muscles of patients whose
laboratory signs were “only” twice or four times higher, respectively? In the end a further 22 % of the patients had
disappeared. The reasons were said to be preference of patient (7.7% and
7.8 %), adverse effects (7% and 6.5 %), loss to follow-up (1.3% and 2.9 %)
and noncompliance (2.3% and 1.9 %). What they meant with “preference of
patient” I don´t know, but I am confident that “non-compliance” and
perhaps also “loss to follow-up” represent those who could not
tolerate the medication. Thus, whilst the authors claimed that ‘both
agents had acceptable side effect profiles,’ the reality is that 12%
could not tolerate these agents at the start of the study, and another 23
% dropped out – most likely to due to intolerable adverse events. My summary of the SATURN study would be that it
used a primary end point that has never been properly validated, and can
be affected by a host of confounding variables e.g. stress . This
variability could only have been controlled for by including a placebo
arm, which was not done. Therefore, the result is rendered meaningless. More importantly, it would appear that the burden
of adverse events from using high doses of statin drugs is unacceptably
high. It is likely that more than a third of patients will be unable to
tolerate 80 mg Atrovastatin, or 40 mg of Simvastatin. All of this
suffering in order to have an uncertain effect on a surrogate end-point,
which may or may not mean anything. |
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Dr.
Nicholls reports receiving consulting fees from Roche, Esperion,
Merck,
Omthera, Sanofi-Aventis, and Boehringer Ingelheim, serving as an unpaid
consultant for Abbott, Pfizer, LipoScience, Novo Nordisk, AtheroNova, and
CSL Behring, receiving grant support from Eli Lilly, AstraZeneca,
Novartis, Anthera, LipoScience, Roche, and Resverlogix and lecture fees
from AstraZeneca and Roche; |
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Should children lower their cholesterol??? There are more miserable news. Recently an expert
panel appointed by the National Heart, Lung and Blood Institute and
endorsed by the American Academy of Pediatrics has published new
guidelines according to which every child in the United States
should be tested for high cholesterol between ages nine and 11 so steps
can be taken to prevent heart disease later on. Such crazy thoughts have been aired several times
in the past. In a letter to
The Lancet (published on January 1, 2000; a good start of the new
millennium). I tried to explain why this is a most dangerous idea, but
obviously the letter made no impact.
December 2011 In many western countries
more and more get cancer although at the same time more and more people
stop smoking, one of the most cancer provoking factors. Members of
Skeptics think that the reason is the increasing use of cholesterol
lowering drugs. Those who promote such treatment argue that no analysis of
the statin trials have shown any association and some even claim that the
statins protect against cancer. There are many ways to
cover up the fact that lowering cholesterol may lead to cancer, but there
are also numerous observations that point to low cholesterol as the
villain. But how can low
cholesterol lead to cancer? This is a good question, and there is an
answer. Because the liporoteins partake in the immune defense system, and
because many cancers are caused by virus or bacteria. Together with two members of THINCS, Kilmer McCully, the discoverer of the association between homocysteine and atherosclerosis, and Paul Rosch, President of the American Institute of Stress, I have tried to present the facts around this issue. The paper has finally been published in Quarterly Journal of Medicine Before that, we sent the paper to six different medical journals (not at the same time of course), all of which rejected it. Here are their arguments |
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CA: A Cancer
Journal for Clinicians:
Cancer:
JAMA:
Journal of the National Cancer Institute: I am sorry that we shall not be able to use the above-titled manuscript. After careful evaluation, the Editorial Board did not accord it a priority sufficient for further consideration.
Scandinavian Cardiovascular
Journal: Read our
paper yourself and tell me if the paper is not "of broad
enough interest" or if it is "polemic in style" or
if "its priority rating is not sufficiently high" What I have told you here is no exception. Many of our members including myself can tell you about how difficult it is to publish papers that goes counter to conventional wisdom. On oe of our websites you can find many examples of rejected papers and comments.
Statin treatment and infections Several
researchers have claimed that statin treatment prevents infections.
Recently a Dutch group published an
analysis of the statin trials
where the authors had reported the number of infections. Not unexpectedly
they didn´t find any difference between the statin groups and the
controls (those who got an ineffective placebo pill). In
an editorial
in the same issue of British Medical Journal, where the Dutch report was
published, Beatrice Golomb commented the study. It was certainly not
expected either because, as she wrote, a number of relevant factors may
distort the results. One of them is the fact that among 632 statin trials,
only eleven reported the number of infections, and ”most authors
declined to provide the omitted information when approached”. “The
best evidence, she concluded, “is that statins should not be used to
forestall infection or its consequences.” There
is even evidence of the opposite. As mentioned, and as Golomb also pointed
out, low cholesterol is a risk factor for infection, and as we have a
plausible mechanism to propose, we send a letter to British Medical
Journal, now published as a Rapid
Response. Most Rapid Responses are available on the web ony. If you sympathize with our letter, you are most welcome to vote (on the right hand side of the letter). Many positive votes may possibly increase its chance to become published in the paper version as well. January 2012
In my
November
newsletter I
told you about the misleading SATURN trial. Together with two of our
members, Paul Rosch, Professor of Medicine and Psychiatry at New York
Medical College and President of The American Institute of Stress, and
Stephanie Seneff, Principal Research Scientist at MIT, I sent the
following letter to New England Journal of Medicine:
A few days later I got the following letter from the journal:
It is of course embarrassing that the editors accepted the SATURN report
for publishing in one of the world´s most respected medical journals, but
shouldn´t they have the guts to admit their mistake? Or has even this
journal become dependent on the money from the drug companies? They have
lots of them; take a look for instance at the short
movie with three of our members as actors. How to meet criticism
A few months ago Jan Pedersen and coworkers,
all of them strong supporters of the diet-heart idea, published an
editorial in British Journal of Nutrition entitled The
importance of reducing SFA to limit CHD. Pedersen
and his co-workers published a
response
to
our letter without answering any of our objections (To read their
response, click on the blue field in the upper right corner). Their answer
is almost identical with a response I got a few years ago from Martijn
Katan, one of Pedersen´s co-workers. You can read my letter and Katan´s
response on
Michael Eades blog
together with Michaels comments. An
interview with me
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Diabetics - don´t eat statins! It
is well established that patients with diabetes run a greater risk of
developing cardiovascular diseases. In Sweden and in most other countries
cholesterol-lowering treatment is therefore prescribed routinely to all
diabetics, whether their cholesterol is high or low and failure to do so
is seen as professional misconduct. But there are a number of observations
that should have stopped this habit long ago. First,
at least fourteen studies have shown that high cholesterol is not a risk
factor for patients with diabetes. If you are in doubt, go to chapter 4 in
my book “Ignore the Awkward!, there you will find the references to
these studies. The reason is probably the fact that high cholesterol may
protect against infections, a common problem for diabetic patients. As
readers of my books know, there is strong evidence that the lipoproteins
are able to bind and inactivate all kinds of bacteria and virus. You can
read more about that in a
paper
that I published together with Kilmer McCully. A
critical and well-informed reader may possibly say that the small effect from statin treatment is not due to cholesterol lowering, but
to their other effects, and this is true. If so, statin
treatment perhaps may benefit a diabetic in other ways. But here comes the
next warning: Statin treatment may cause diabetes! What happens with those who already have diabetes when they start statin
treatment? We don’t know because nobody has analysed this question.
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March 2012 Recently a new report has been published from the famous Channing Laboratory at Harvard. Here, a number of researchers headed by Walter Willett have studied the dietary habits for many years in more than 100,000 men and women. Again and again they have warned us against saturated fat, although none of their many studies have found that heart patients have eaten more of such fat than have other people. However, as I told you in my December Newsletter Willett has changed his mind This time the message, published in Archives of Internal Medicine, is that you will shorten your life if you eat too much unprocessed read meat. Two population groups, the Health Professionals Study that included 37698 men, and the Nurses’ Health Study that included 83644 women, were followed for 22 and 28 years, respectively. At the start and every 4 year they filled in a dietary questionnaire. At follow-up almost 24,000 had died. The authors divided the participants into five parts (quintiles) after their intake of read meat. The first quintile included those who had eaten the least, and the fifth those who had eaten the most. Fromthemfiguresmgiven in the tables it is possible to calculate the mortality in each group. The pattern was similar in both groups, but for simplicity I give you the figures for the Health Professionals´ Study only. Here 1.23 per cent had died each year in the first quintile; and 1.29 per cent in the fifth quintile. Thus, during the 22 years the total mortality in these two groups was 27.1 and 28.4 per cent, respectively. But it was only 21.8 per cent in the third quintile! So, what shall we do? If we eat too much, the risk increases, but so it does if we eat too little. How can we know whether we eat too much or too little? However, there were many factors that could have skewed the result. For instance, those with the lowest intake were more physically active, fewer smoked, they ate more fruits, vegetables and fish, and fewer had diabetes and high blood pressure compared with the other groups. These life style factors were particularly bad in the fifth quintile. But as mentioned, the risk of dying was about the same in all groups. You could also say that even if you smoke, eat too little fruits, vegetables and fish, and even if you have diabetes or high blood pressure, then you may live almost as long as people with a healthier lifestyle if you gorge in unprocessed read meat. The authors concluded otherwise, however, because their statistician has made some serious errors. After having corrected for the uneven distribution of the various factors, they found that the risk of dying was lowest in the first quintile and it increased step by step from the first to the fifth quintile. Their conclusion was that if you consume less than 42 gram unprocessed meat per day, you could lower your risk to die the next 22-28 years by about 8 per cent. It is not possible to know the exact mortality after their corrections, because it is expressed in a statistical term called hazard risk. But let us assume that the risk after the corrections was 30 per cent for those with the highest intake and 27.6 per cent for those with the lowest. These figures are of a similar magnitude as those that we can calculate ourselves from the original figures. The difference between 30 and 27.6 is 2.4, meaning that you can only lower your risk of dying by 2.4 per cent. Then how can they conclude that we can lower it by 8 per cent? Because 2.4 is 8 per cent of 30. There are more curious data. The body weight of the participants was pretty normal in all groups. To be precise, BMI varied between 24.7 and 26.0. But whereas the high-consumers on average ate about 2200 calories per day, the low-consumers ate only 1659. In the Nurses’ Health Study, where BMI varied between 23.9 and 24.7 the high-consumers ate 2030 calories and the low-consumers only only 1202! These figures are of course highly unlikely. People who have eaten only 1202 calories per day for 28 years cannot have the same body weight as people who have eaten 2030 calories per day. Thus, the statistician must have made some serious miscalculations. But let us assume that the figures are correct. Should we really bother? Let me calculate it in another way. If you eat as much unprocessed read meat as you like, your chance to be alive after 22 years is about 70 per cent, but if you avoid it as much as possible you can increase your chance to 73 per cent at most. But again, this is true only if the data published by Hu and his coworkers are correct, and this is very unlikely. You can learn more about this paper by reading a detailed comment by one of our members Zoë Harcombe. She also asked Frank Hu, if he could explain the curious result. Here is his answer: Thanks for your interest in our paper. Unfortunately, the crude mortality rate is misleading because the mean age in the first quintile (Q1) was older than other quintiles. Therefore, the crude mortality rate in the first quintile would be artificially higher than other quintiles. In this analysis, age was a stronger confounding factor than other lifestyle factors. Hope this helps. Frank Hu This answer is nonsense of course, because there were only minor differences in age between the five quintiles. In HPFS it varied between 52.2 and 53.8, and in NHS between 45.3 and 47.3 years. For instance, compare these small differences with the fact that in the fifth quintile there were almost three times more smokers than in the first; and only 17 percent were physically active against 27 percent in the first. Professor David Diamond, another member of THINCS, sent him a letter as well, but hitherto Frank Hu hasn´t answered him. Do you become fat by eating fat? A last question: Do you suffer from obesity? Then listen to this brilliant lecture by Zoë Harcombe.
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"New" statin side effects Those of you, who have read our member Duane Graveline´s book ”Thief of Memory” know that bad memory is one of the many serious side effects from statin treatment. According to Dr Graveline thousands of reports about cognitive problems that have occurred during statin treatment and have disappeared after its discontinuation, have been sent to FDA since the introduction of these drugs. A few months ago FDA finally have officially admitted in a New safety alert that such problems may occur. You can read more about that in several newspapers, for instance NY Times, Edmonton Journal and Boston Globe You may probably ask, how come that it took more than ten years? Let me cite a few words from Marcia Angell´s book ”The Truth About the Drug Companies. How They Deceive Us and What to Do About It”. Marcia Angell is the former editor in chief of The New England Journal of Medicine. ”Congress also put the FDA on the pharmaceutical industry´s payroll . . . Fees . . . soon accounted for about half the budget of the agency´s drug evaluation center. That makes the FDA dependent on an industry it regulates.” (page 208)
”The FDA is subject to industry pressures through its eighteen standing advisory committees on drug approvals. These committees, which consist of outside experts in various subspecialities, are charged with reviewing new drug applications and making recommendations to the agency about approval. The FDA almost always takes their advice. Many members of these committees have financial connections to interested companies . . . Members of FDA advisory committees are said to command unusually high consulting fees from drug companies.” (pages 210-211). More and more are realizing the dangers of statin treatment. Here is a warning from Sylvia Booth Hubbard, NewsMax Media (Peter Langsjoen, who is mentioned in the article, is a member of THINCS). And here is a scary video from an insider , who has worked for 15 years in the drug industry. In a previous newsletter I told you about statins and the risk of cancer. Our article about this issue has now been published in the paper version of Quarterly Journal of Medicine. Kim Greenhouse from a Los Angeles Radio named ”It´s Rainmaking Time” interiewed me recently. You can listen to it here.
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May 2012 There is light in the tunnel ahead A few months ago two well-known US scientists Rodney Hayward and Harlan Krumholz published an open letter entitled Three reasons to abandon low-density lipoprotein targets in the medical journal Circulation: Cardiovascular Quality and Outcome. In this paper they criticized the updated clinical guidelines to be published this year by the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. They showed that there is no scientific support for the idea to treat to a certain LDL value: “The dogma that treating to target is based on clinical trial evidence belies the fact that no clinical trial has yet tested this strategy”. …not all drugs that improve lipid profiles reduce patient risk”. Another argument was that “clinical trials demonstrate that the relative effects of statin therapy are not substantially related to a patient’s pretreatment LDL” Or said in another way: High LDL-cholesterol is not a risk factor for cardiovascular disease. But this conclusion would of course have been too provocative to be published in a journal owned by the American Heart Association. You can also listen to his message on Youtube Since then Professor Krumholz has gone further. In a recent issue of the same journal he has published a new paper entitled A Note to My Younger Colleagues...Be Brave. By that he means that if they have discovered something, grounded in science that goes counter to common belief, they should not avoid to speak truth to power. This is not too easy. Let me cite Professor Krumholz: ”Unfortunately, our profession does not often reward those who question dogma. In fact, there are many episodes throughout the history of medicine and science in which truth was resisted and dogmatic beliefs, however poorly supported by evidence, were imposed by those in a position to do so. If we are to accelerate innovation in medicine, eliminate wasteful practices, and improve the depth and effectiveness of how we care for patients, then there must be room to question traditional approaches and to introduce new and better ways of prevention, diagnosis, and treatment. We are now at that critical juncture.” There are a few who dare. Listen for example to this radio show where the host Alex Jones talks with Dr. Russel Blaylock, a retired neurosurgeon and author, about the dangers of statin drugs and how they are causing serious brain disorders and increasing the incidence of dementia. And here is a short video, where Beatrice Golomb is interviewed on ABC News about memory loss and cognitive side effects from taking Lipitor and other statins. After a few minutes ABC News´ medical editor Tim Johnson try to calm the viewers by telling them that ”only” two per cent of the users experience memory loss. As in the US alone at least 30 million people are on statin treatment, it means that more than half a million suffer from memory loss. Hopefully there aren´t too many pilots or bus or train drivers among them. Listen also to this audio where our member Zoe Harcombe, author of The Obesity Epidemic is interviewed on BBC by Steve Wright. On Youtube Malcolm Kendrick MD, author of The Great Cholesterol Con and another member of THINCS, reveals the disturbing results from a large study performed by WHO, one among numerous studies that contradict the cholesterol hypothesis and which have been ignored by the proponents of the cholesterol campaign. Mary Vernon , former president of the American Society of Bariatric Physicians (doctors specializing in treating obese patients), is another curageous researcher. She has published several papers about the miraculous results from treating diabetic patents with a low-carb, high-fat diet. In this interview by Swedish doctor Andreas Eenfeldt she tells about her experiences. Andreas himself has been one of the leading proponents of the lowcarb diet in Sweden. His blog is the most visited health blog in Sweden and is available also in English. Here is a new book about an old issue: How Statin Drugs Really Lower Cholesterol and Kill You One Cell at a Time by James and Hannah Yoseph. I have now read it and although I have studied this issue for more than 20 years, I found much new and shaky information about the criminal way the statins have been introduced. Even the Nobel Prize winners Goldstein and Brown, those who discovered why cholesterol was very high in familial hypercholesterolemia, seem to have participated in this scandalous process. A British film producer Justin Smith and his co-workers are just now preparing a critical movie about the cholesterol campaign entitled $29 Billion Reasons to Lie About Cholesterol. The film will be finished by August this year and is planned to have the first screening in August in London. A short trailer, recently renewed, is available. It is also possible to preorder a copy of the DVD. Several cholesterol critics have been interviewed, among them are John Abramson MD, author of Overdosed America, Professor Paul Rosch, President of The American Institute of Stress and a member of THINCS, Malcolm Kendrick, MD, Peter Langsjoen, MD, world expert on Q10 and also a member of THINCS, and myself. I
wonder if the increasing number of critical researchers (there are many
more) have made the drug industry desperate. Recently The
Cholesterol Treatment Trialists’ (CTT) Collaborators,
most of whom are paid by several drug companies, published
an analysis in The
Lancet, According to the authors their analysis provides strong
evidence that the reduction in vascular risk with statins is at least as
great in low-risk patients as in high-risk patients. They
have analysed the data from almost 175,000 participants in 27 statin
trials. According to their analysis, statin therapy caused a consistent
reduction in the relative risk for major vascular events even for healthy
low-risk people. Therefore, they wrote, the study suggests that current
guidelines might need to be reconsidered, meaning, according to a
commentary in the same issue, that all people above fifty should take
statins. I am sure that the crucial question for most people is not whether they can avoid a non-fatal heart attack by lowering their cholesterol, but whether they can prolong their life, and whether they can do it without risk of getting serious adverse effects from the treatment. From table 3 in the Lancet paper it is possible to calculate that the chance to be alive after five years for people without vascular disease and whose 5-year risk of a major vascular event is lower than 10% is the same, whether they are on statin treatment or not and whether they have a vascular disease or not. There is a benefit for people whose risk lies between 10% and 20%, but it is trivial at most. According to the table their chance of being alive after five years without treatment is 89.9%. If they take a statin every day they can increase their chance to 90.7%. Do this small benefit really exceed any known hazards of statin therapy, as the authors wrote? I doubt. As I mentioned in a previous newsletter more than four per cent run a risk of moderate or serious adverse effects from the muscles, liver, kidneys or eyes. As I explained in my letter, these numbers were even underestimated, and the authors had not examined the frequency of diabetes, impotency or cerebral symptoms either. |
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Statin treatment and bad muscles In my books I have given many examples of adverse effects after statin treatment that have been downplayed or ignored by the drug industry. One example is muscle pain and weakness which according to the industry is seen in less than one per cent of the treated patients, but which according to independent researchers occur in 20-25 per cent. Beatrice
Golomb, associate professor in medicine and her co-workers at the
University of California, San Diego has published a report about this
issue. They performed a regularly controlled double-blind trial in women
who were treated with identical capsules containing either a placebo or a
statin drug and found that 40 percent in the statin group got muscle
problems, which were serious in 10 percent. You can read more about the
trial in
Daily Mail. A Fraudulent dietary study Recently
Swedish-American scientists published a report in
British Medical Journal, where they claimed that women should eat as
much carbohydrates and as little proteins as possible to lower their risk
of getting a cardiovascular disease. The paper seemed convincing,
published in a respectable medical journal and four of the authors were
professors. Many newspapers around the world also took in the message. I
wonder if the editors of British Medical Journal have gone on an early
holiday. Not only was the methods used highly questionable, but the
benefit of this advice was exaggerated, to put it mildly and the most
important result was ignored. The
authors sent a questionnaire to 96,000 Swedish women aged 30-49 year. They
should answer how much of eighty different foods and drinks they had
consumed per day during the preceding six months, but only 49,000 of the
women responded. Fifteen
years later the authors looked into the national quality register for
health and health care to see, how many who had suffered from a
cardiovascular disease. The results were then compared with the
participants intake of protein and carbohydrates. How
many of you are able to recall what you have eaten yesterday in every
detail, not to mention what you ate half a year ago? And do you eat the
same food the next fifteen years? As
an example I shall mention that the intake of calories varied between 442
and 2992. Most people need about 2500 calories per day to stay in
metabolic balance; manual workers much more. How many people do you think
are able to survive with an intake of 442 calories per day without ending
up as a skeleton?
If
the information about the daily intake of calories was so inaccurate, why
should we believe in the reported intake of carbs and protein? And don´t
other foods play a role? The
authors claimed that at least four similar studies had been performed
using the same methods and with a similar result, but this is not true.
One of them, the largest of all such studies which has been performed at
Harvard for may years, hasn´t come up with any evidence that a high
intake of proteins is dangerous to health. What they have noted is that
people who gorge in carbs have a higher risk of dying from a stroke or a
heart attack, but contrary to the new study, they had asked the
participants about their dietary habits regularly during the follow-up
period. In addition, several reports, ignored by the authors of the new
study, have been published with a similar result. To
draw conclusions about the effects of a low-carb diet is not possible from
the data presented in the Swedish-American study because very few ate such
a diet. Among the ten per cent who had the lowest intake, the carbs
accounted for about 40 per cent of the total intake of calories. The
benefits from a low-carb diet cannot be achieved, unless the intake is
lower than 40 per cent; the lower, the better. This has been demonstrated
in more than twenty experiments on people with type 2 diabetes or its
precursor the metabolic syndrome. Their body weight goes down
dramatically, their blood pressure and blood glucose becomes normal, their
blood lipids improve and many of the patients are able to quit their
antidiabetic medicine. Critics
of the low-carb diet claim that the high intake of saturated fat may be
dangerous in the long run. It is true that we have not yet any long-term
studies of the low-carb diet with cardiovascular disease or mortality as
outcome, but it seems highly unlikely that a diet able to reduce most of
the factors associated with a higher risk of cardiovascular disease should
increase the risk. Besides, as I have documented in my books and in my
scientific papers, no study has ever shown that a high intake of saturated
fat leads to cardiovascular disease. On the contrary, at least six studies
have shown that people with stroke have eaten less than healthy people. But
the study I tell about here included only women below the age of 50, and
it is very rare that anybody die from the complications of type 2 diabetes
in this age group. Why didn´t they include older women? Had they done
that, the result would with all certainty have become much worse. But
let us assume the very unlikely possibility that their results are correct
and that they are relevant. What was the benefit from eating as little
protein and as much carbs as possible? Using
the figures in one of the tables it is possible to calculate that only 2.5
per cent got a heart attack or a stroke during these fifteen years,
whereas this happened for 3.5 per cent among those who gorged in protein
and ate little
carbs. However,
I think, that the most important question is, if whether we can prolong
our life by dietary measures. There are good reasons to assume that
mortality was not affected in the study, because any researcher, who
discover a method to lower mortality with statistical significance would
report that eagerly. However,
in a report published from the same study, when the authors had followed
the participants for twelve years only, they told that mortality was 37
per cent higher among those who ate the “dangerous” diet compared with
those who ate as much carbs and as little protein as possible. Most
readers probably clap their hands, but to report an effect in per cent
rather than in percentage points is highly misleading. However, this
method is used by many researchers, when they try to exaggerate a trivial
effect of a new treatment. Results from statin treatment for instance are
always given as percentage. Let me exemplify how this method may mislead. If
only one patient die in a treatment group, which includes one hundred
patients, but two die in an untreated control group of the same size, you
can claim that mortality has been lowered by fifty per cent, because the
difference between one and two is one, and one is fifty per cent of two.
However, the true difference is of course only one percentage point. Using
the figures in one of the tables in the 12-year report we can calculate
that for those who ate the dangerous diet, the chance not to die from a
cardiovascular disease was 99.58 per cent, whereas the chance for those
who ate the beneficial diet was 99.87 per cent. Thus, the benefit of 37
per cent corresponded to only 0.29 percentage points. |
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Is egg yolk dangerous to health? On
August 1 the medical journal Atherosclerosis published a paper by three
Canadian researchers saying that eating egg yolks was just as dangerous to
health as cigarette smoking. Unfortunately, many newspapers have reported
the message from this study uncritically. (Read what the investigative
reporter Jon
Rappoport,
once nominated for a Pulitzer Price, has to say about uncritical
journalism). But
there are exceptions. In The Atlantic Kristin Wartman has given a
more balanced view.
For instance she has discussed the paper with MIT researcher and
senior scientist Stephanie Seneff, a
member of THINCS. The
authors' warnings against egg yolk is of course pure nonsense. Egg yolk
contains everything needed to create a living warmblooded creature, and no
previous study has ever been able to show any health problems associated
with the intake of eggs. Their "scientific" argument for
avoiding egg yolk is also flawed. You can read more about that study
on Zoê
Harcombe`s homepage.
Zoê is a member of THINCS and the author of several
books about
diet and obesity. On
September 10 Justin Smith releases his new film Statin Nation, where he
has interviewed a number of experts about the fraudulent way the
cholesterol campaign has been concerted. Among the interviewees are five
members of THINCS including myself. It has already been shown for a
selected public and has been commented
in three British newspapers.
You can read about the film, its producer Justin Smith and the
participants in this
press kit and
you can also look at a trailer and order the film. A calorie
is a calorie ...or is it? Here is a humorous youtube about the low-carb/high-fat diet, the diet that is able to cure type 2 diabetes and the metabolic syndrome in a few months.top |
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Fraudulent advertising for food containing plant sterols. For
many years Unilever has marketed its margarine Becel pro-activ (Flora
pro-activ) and certain yoghurt products with the argument that they lower
cholesterol. The cholesterol-lowering effect is due to the addition of
plant sterols extracted from soya beans and Finnish timber using
extraction petrol. The effect is that less normal cholesterol and more
plant sterols are taken up by the gut resulting in higher levels of plant
sterols and lower levels of human cholesterol in the blood Now
to the problem. Several studies have shown that an increased level of
plant sterols is associated with an increased formation of
atherosclerosis, heart disease and premature death. In the following I
shall mention the most important of these studies. I have also included
the web address for these studies. High
levels of plant sterols in the blood characterize a rare inborn disease
named sitosterolemia, and patients with this disease develop xanthomas
already in childhood. Xanthomas are benign tumours situated in the skin
consisting of cholesterol and are seen in many patients with extremely
high cholesterol, so-called familial hypercholesterolemia. In
sitosterolemia these tumours also contain many plant sterols (reference
1). Several
researchers have documented that patients with sitosterolemia become
atherosclerotic in early childhood and may die from a coronary already as
teenagers (references 2-5). There
are of course good reasons why animals and human beings are using the
cholesterol molecule instead of plant sterols to build cell walls and to
produce bile, various hormones, vitamin D and other useful substances. It
is therefore no surprise that exchanging our own cholesterol with plant
sterols are harmful as has been demonstrated in experiments on rats fed
large amounts of plant sterols. Not only was this diet harmful to their
cells; it shortened their life as well (reference 6). In
an analysis of one of the first statin experiments researchers led by
Finnish scientist Tatu Miettinen found that 25 percent of the patients had
an elevated level of plant sterol in their blood. These patients did not
benefit from statin treatment; on the contrary their risk of heart disease
increased (reference 7). In a review from 2003 all trials using food rich in plant sterol were analysed. The review was sponsored by Unilever, the main author´s research was also paid by Unilever; two of the other authors have patents on margarine containing plant sterols, and one of them had shares in the Finnish company Raisio, which produces margarine containing plant sterol. The authors concluded that plant sterols are harmless referring to animal experiment as evidence ignoring the rat study mentioned above (reference 6). They dismissed the studies reporting early atherosclerosis and cardiovascular death in sitosterolemia with the following argument: “This risk is believed to be largely hypothetical, and any increase due to the small increase in plasma plant sterols may be more than offset by the decrease in plasma LDL”. In
their review the authors claimed that a study has shown that patients with
sitosterolemia can eat plant sterols without risk. That study was included
in a list
of 33 similar experiments with the aim to measure the effect of plant
sterol intake on the plasma lipids in human beings. With one exception all
of them had a duration of less than nine weeks, almost all of them were
performed for 3-4 weeks only. One wonder why it has been necessary to do
33 experiments (most of them paid by Unilever) with the only purpose to
show that plant sterols lower cholesterol. Why has nobody performed a
five-year controlled experiment to study
the effect on cardiovascular events? The
authors of reference 8 also ignored Miettinens previous study (reference
7) showing that statin treatment increases the risk of heart disease in
people with raised plasma levels of plant sterols, although Miettinen was
a co-author of the review. In
some of their advertisements Unilever uses a report from European Food
Safety Authority published in 2008 (reference 8) as support, but the
authors of that report have not considered possible adverse effects
either. They conclude that the plant sterols lower cholesterol, but also
that “there are no human intervention studies
demonstrating that plant stanols reduce the risk of coronary heart
disease.” In
this connection it is relevant to mention that many studies have shown
that the effect of the statins do not depend on the very lowering of
cholesterol because the benefit is the same whether cholesterol is lowered
a little or very much. This fact explains why the patients in the 4S
trial, whose plant sterol levels were high, did not benefit from statin
treatment, although their cholesterol was lowered just as much or more
than the other participants´. Therefore the argument that plant sterols
lower cholesterol is misleading, because most people think that cholesterol
lowering is synonymous with a lowering of cardiovascular risk. A
few weeks ago I sent this report to the Swedish Consumer Ombudsman with
the purpose to stop the promoting of food enriched with plant sterols. You
are most welcome to send it to a similar governmental authority in your
own country Here
follow the references to the scientific studies mentioned above (click on
the authors name to read the full paper) together with a selection of
quotations from these papers: 1. Bhattacharyya
and Connor 1974. Sitosterolemia
and Xanthomatosis. A newly described lipid storage disease in two
sister. 2. Beaty
et al 1986. Genetic Analysis of Plasma Sitosterol,
Apoprotein B, and Lipoproteins in a Large Amish Pedigree with
Sitosterolemia. 3. Salen
et al. 1985: Lethal atherosclerosis associated with
abnormal plasma and tissue sterol composition in sitosterolemia with
xanthomatosis. 4. Assman
G. et al. 2006: Plasma sitosterol elevations are
associated with an increased incidence of coronary events in men: Results
of a nested case-control analysis of the Prospective Cardiovascular Münster
(PROCAM) study. 5. Weingärtner
et al. 2009. Controversial role of plant sterol esters in
the management of hypercholesterolaemia. 6. Walisundera
et al. 2000. Vegetable Oils High in Phytosterols Make
Erythrocytes Less Deformable and Shorten the Life Span of Stroke-Prone
Spontaneously Hypertensive Rats. 8. European
Food Safety Authority 2008. SCIENTIFIC OPINION. Plant
stanol esters and blood cholesterol |
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October 2012 Right and wrong about statin treatment Statin treatment
accelerates atherosclerosis Does
statin treatment protect against cancer? Here
comes a section from my book Ignore
the Awkward! to give you more details about this question Just
exchange the word Alzheimer with the word cancer. The
statins cure everything Statins
are said to be useful against more than heart disease, e.g. cancer, lung
disease, heart failure, hip fractures and much more. The way in which
researchers have studied these alleged benefits is confounded with a
serious error. As an example I shall analyse the allegation that statin
treatment prevents Alzheimer’s disease. The idea goes against
common sense. Today we know that not only is the brain the
cholesterol-richest organ in the body; cholesterol is also vital for its
function, because the creation of
nerve impulses demands
a steady production of cholesterol.
First, the evidence for this alleged effect does not come from
trials. Instead, researchers
have counted the number of patients with Alzheimer’s disease among
people with low cholesterol and among people treated with statins. Because
the upper limit for normal
cholesterol has been lowered more and more, we can be confident that the
untreated people’s cholesterol was not only low, it was very low. The
fact that most Alzheimer patients were identified in this low-cholesterol
group is seen as a proof that statin treatment prevented those in the
other group.
What has been forgotten is that low cholesterol is a frequent
finding in people with various types of mental disturbances. For
example,
people whose cholesterol is lower than 200 are much more likely to decline
in functional performance tests such as walking, turning around and
dressing themselves.23 In addition, people with high cholesterol develop
Parkinson’s disease and dementia less often than people with low
cholesterol.24,25 Detailed records of the ability of people to
learn, to reason, to concentrate and to organize their thoughts have also
shown that, on average, the smartest people have the highest
cholesterol.26 That statins should prevent Alzheimer’s disease is
also contradicted by the finding that people with high cholesterol do not
develop Alzheimer’s disease more often than people with low
cholesterol.23
Not unexpectedly, researchers who are not employed by the
pharmaceutical industry have even found negative effects from cholesterol
reducing treatment. One of them is Matthew Muldoon, an American professor
of internal medicine. Already after six months he noted that the memory of
patients had declined.27 Later on
in my book I shall tell the reader about more serious, cerebral
disturbances caused by statin treatment.
Now to the crucial question. If Alzheimer´s disease is seen more
often in untreated people than in people on statin treatment, is it because
they have had low cholesterol
for many years or is it because they have not received statin treatment?
And if Alzheimer’s disease is seen less often in statin-treated people,
is it because they have lived most of their life with high cholesterol, or
is it because they have received statin treatment? Nobody knows. |
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December 2012 Does statin treatment prevent cancer? In my October newsletter I told you how it is possible to manipulate our minds to think that statins protect against almost everything. Here is another example. Last
month Danish researchers published a paper in New England Journal of
Medicine entitled Statin
use and reduced cancer-related mortality. They had studied how
many people who had got the diagnosis cancer in Denmark between 1995 and
2007, how many who had died from cancer and how many of them who had been
treated with statins before the cancer was discovered. What they found was
that fewer had died among those
who had got a statin prescription during this period. Therefore they
concluded that statin treatment protects against cancer. What they ignore is, that at least four studies have shown that people with low cholesterol had a greater risk of getting cancer 20-30 years later, and that people with familial hypercholesterolemia has a lower risk of cancer. What
they also ignore is that three statin
experiment resulted in more cancer in the treatment group an with
statistical significance. What they also ignore is that several studies of
cancer patients and patients without cancer have shown that the cancer
patients had been treated much more often with statins than the control
individuals. What
they also ignore is the Japanese study the authors of which treated more
than 40,000 patients with a low dose simvastatin. Seven years later three
tomes more among those whose cholesterol had been lowered the most had
died from cancer compared with those whose cholesterol was unchanged. Those
who advocate statin treatment deny the cancer risk by referring to reviews
of the statin trials, which have found no increase of cancer. There is a
serious error in these reviews because they have excluded skin cancer from
the calculations, although skin cancer is the first cancer type we should
expect to see, if statin treatment is carcinogenic, because it is easy to
diagnose at an early stage. Indeed, in the two first simvastatin trials 4S
and HPS skin cancer was seen more often in the treatment groups, and if
the figures from the two trials are calculated together the increase was
statistically significant. Since then the number of skin cancer has not
been recorded in any statin trial. The
reason
why cancer was seen less often among statin-treated people is probably
because they have lived most of their life with high cholesterol, which,
as I mentioned, protects against cancer, whereas the untreated have lived
most of their life with normal or low cholesterol, and low cholesterol is,
as mentioned, a risk factor for cancer. Furthermore, nobody knows how many
of the statin-treated patients who really took the drug. A Canadian study
found for example that most old people who have been prescribed statin
treatment have stopped the treatment after two years |
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January 2013 Scary
news, bad news and good news In my april 2012 newsletter I
referred to Duane Graveline´s report about memory loss due to statin
treatment. Duane has researched further in FDA´s archive and I can tell
you, it is much, much worse. Anyone who is on statin treatment and any
doctor who prescribe these drugs must read Duane Graveline´s report. The number of
people with Alzheimer´s disease has been inceasing for several years. One
explanation may be the increasing use of statin treatment, but there is
another way that leads to this deplorable condition: eating a
carbohydrate-rich food. Three THINCS members, Stephanie Seneff, Glyn
Wainwright and Luca Mascitelli have recently published a scientific paper, where they have explained the mechanism. Here comes the
crazy news. Recently a Danish research group published a report in which
they claimd that young men, who eat too much saturated fat, lower the
quality of their sperms. Their message was spread uncritically in many
newspapers. I feel it necessary to quote what Drummond Rennie had to say
about such reports, when he was the deputy editor of JAMA: “There seems
to be no study too fragmented, no hypothesis
too trivial, no
literature citation too biased or too egotistical, no design too warped,
no methodology too bungled, no presentation of results too inaccurate, too
obscure,
and too contradictory, no analysis too self-serving, no argument too
circular, no conclusions too
trifling or too unjustified, and
no grammar and syntax too offensive for a paper to end up in print.” If you think
this description of medical science is an overstatement, read our member Zoë Harcombe´s comment to the sperm paper. But there are
good news also. At first a sensational report from our member Jørgen
Vesti-Nielsen. He was one of the first scientists to show that the best
way to treat type 2 diabetes is to eat a low-carb, high-fat diet. The
benefit of this diet has now been verified by at least twenty
well-performed trials on patients with impaired insulin sensitivity or
manifest type 2 diabetes. Their blood glucose level became normal, they
lost weight, their blood pressure went down and many of the participants
were able to quit their insulin and pills. And please note, nothing
“bad” happened with their blood lipids. On the contrary, the
“good” HDL went up a little and their triglycerides plummeted. You can
find the references to these studies in a report of mine.
It is in Swedish, but click on the word Litteratur, and you will find the
references (numbers 6-26). But the same
diet can be used in type 1 diabetics as well. This is what Vesti-Nielsen
and his co-workers have documented in a new report.
About half of forty-eight type 1 diabetics were able to follow this diet,
which resulted in a major improvement of their laboratory values, and they
were also able to reduce their insulin doses. We can only guess how much
this may reduce their risk of future complications, but remember, that
blindness, gangrene, heart disease and other side effects of diabetes are
strongly associated with bad laboratory values. In a previous newsletter I told you about “STATION NATION – the Great Cholesterol Cover-Up”, a new film produced by the British medical journalist Justin Smith, in which among others a number of our members, including myself, have been interviewed. Hopefully this film may be able to inform many people about what I use to characterize as the greatest medical scandal in modern time. The producers have had some technical problems with the film, but everything has been solved, and you can now buy the film together with several additional interviews here. Justin himself has been interviewed in a British radio program. The interview starts at 8.05 |
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February 2013 The scandalous dietary guidelines According
to the current dietary guidelines we shall exchange saturated fatty acids
with polyunsaturated fatty acids to avoid cardiovascular disease. But what
is the difference between saturated and polyunsaturated fatty acids you
may ask. The
main part of a fatty acid is composed of a core of carbon atoms to which
hydrogen atoms are attached. When the number of hydrogen atoms is optimal,
as in saturated fatty acids, their electrons form stable pairs with those
of the carbon atoms. Saturated fatty acids are saturated with hydrogen
atoms. Unsaturated
fatty acids are missing hydrogen atoms. Monounsaturated fatty acids are
missing two atoms; polyunsaturated fatty acids (named PUFAs in the
following) are missing four or more. Therefore, instead of sharing one
pair of electrons with each other, some of the carbon atoms are sharing
two pairs of electrons with their neighbour carbon forming a so-called
double bound. Lack of hydrogen atoms makes the fatty acids unstable; they
go easily rancid. The more double bonds they have, the more unstable they
are. Two
of the PUFAs, linoleic acid and alfa-linolenic acid are essential, meaning
that we cannot produce them ourselves, but require small amounts in our
food. The first one is an omega-6 PUFA, the second one is an omega-3. (The
name omega refers to the placement of the double bound). Seafood
is rich in omega-3 PUFA and oils from corn, sunflower and soybeans are
rich in omega-6 PUFA:. To be very short (the PUFA biochemistry is
complicated) omega-6 PUFA stimulates inflammation and omega-3 lowers it.
Inflammation is a useful process, for instance if we become infected, but
not if it goes too far. This explains why eating much omega-6 is
associated with various human diseases, for instance asthma, arthritis,
vascular disease, thrombosis, immune-inflammatory processes, and tumour
proliferation. Now to the scary issue of this letter. Thirty-five
years ago a dietary experiment was performed in Sydney, Australia. About
half of 458 male patients with heart disease were given a diet low in
saturated fat and cholesterol and with a high content of linoleic acid.
The others ate as usual. Five
years later 17.2 per cent in the diet group had died from a cardiovascular
disease, but only 11 per cent in the control group. As only total
mortality was reported in the original report (17.6 versus 11.6 per cent),
the results were published recently once again in British
Medical Journal, because the authors wanted to warn against
eating too much omega-6 polyunsaturated fat. For
that purpose they included an analysis of the combined result from four
similar trials, where saturated fat was exchanged with omega-6 PUFA, and
in all of them mortality was highest in the treatment group. They also
analysed four trials, where the diet was composed of both omega-3 and
omega-6 PUFA, and in these trials mortality was a little lower in the
treatment groups. At
a closed consensus meeting in 2010 in Copenhagen invited scientists (no, I
was not invited; researchers with a controversial view are never invited
to consensus conferences in this field) concluded that “the evidence
from epidemiologic, clinical, and mechanistic studies is consistent in
finding that the risk of CHD is reduced when SFAs are replaced with
polyunsaturated fatty acids.” You can read more about that in a
paper authored by seventeen international experts. As
I have shown in my books, in my papers and in my newsletters, there is no
such evidence whatsoever. Read also what was written by authors of one
of the sections in the recent WHO/FAO report (p 191):
“The available evidence from cohort and randomised controlled trials is
unsatisfactory and unreliable to make judgement about and substantiate the
effects of dietary fat on risk of CHD”. However, in spite of the result
of their review, they found no reason to change the current advice. Most
PUFAs in our food to-day are of the omega-6 types. Nothing is mentioned in
the guidelines or in the mentioned paper about which type of PUFAs we
shall eat, meaning that if you ask people to eat more PUFA, they
automatically end up with eating much more omega-6 than omega-3 PUFAs, and
those who produce sunflower, corn and soybean oils clap their hands, of
course, as do researchers that are sponsored by the industry. Already
in 1991 Scott Grundy, one of the main actors in the cholesterol campaign,
warned against eating too much omega-6 PUFA. According to Grundy there was
no epidemiological support for this advice; it suppressed the immune
system; it lowered the “good” HDL, it promoted LDL oxidation, and it
increased the risk of gallstones. Of special concern was that linoleic
acid might promote carcinogenesis in humans, as it does in laboratory
animals. Since then many studies have confirmed his warnings. Associations
have been found between omega 6 PUFA and prostate, pancreas, colon and in
particular breast cancer. One of he first and longest dietary trials, where saturated fat was
exchanged with PUFA also resulted in cancer. Fewer died from a heart
attack but more died from cancer. (That fewer died from a heart attack
could at least partly be explained by the fact that there were many more
smokers in the control group). After
the introduction of the dietary guidelines for Americans in 1977 our
intake of saturated fat has decreased and our intake of carbohydrates has
increased. A few years later an obesity and diabetes epidemic started, and
it has continued up to today in many countries. Are we going to see a
cancer epidemic as well? The question is relevant because cancer may also
be an
effect of statin treatment A few weeks ago I was invited to a conference in Oslo by The Norwegian Heart and Lung Patient Organization. I took up this problem at the end of my talk, which is available on Youtube |
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February 2013 Light ahead in the cholesterol tunnel? Many
interesting things are happening just now, so therefore I send you yet
another February newsletter. Let me start with the French professor
Philippe Even, whose book "La Vérité sur le cholestérol"
(Editions du Cherche-Midi) is going to be published today. In this week´s
issue of Le Nouvel Observateur their journalist Anne Crignon has written
two articles based on interviews with Even and myself. Eight pages of the
magazine are devoted to cholesterol, and her articles have made a
tremendous impact in France. Use this
link, and you will find several hundred links to various
newspapers, magazines and blogs that have cited or commented this issue.
If you are not familiar with the French Language, you can translate the
text using Google
Translate. Another
interesting book is The
Great Cholesterol Myth: Why Lowering Your Cholesterol
Won't Prevent Heart Disease-and the Statin-Free Plan That Will by
Jonny Bowden and Stephen Sinatra. Their book inspired Dr Oz to interview
the authors in a program, which he called “the most important show I
have ever done on cholesterol”. (However, his demonstration of how
atherosclerosis is created using balloons filled with a yellow fluid is
nonsense). Here is part
1 and here is part
2. In
my August 2012 newsletter I told you about Justin Smith´s
film Statin Nation, a film that should be able to stop the cholesterol
campaign immediately if it could be shown on the major television
channels. If you haven´t seen it already, take a look at a few excerpts
available on Youtube: Here
is an excerpt about the so-called good
and bad cholesterol. Here is an excerpt about the
lowcarb-highfat diet, Here
is an excerpt about statins
and cancerAnd here is a short presentation of Justin
Smith himself But please see the whole film -
You can rent it here. There
are other critics out there. Here is a short review about the
many serious side effects of statin treatment. Probably
you may react, when Raymond
Francis tells you that statins do not prevent heart
attacks, but just continue, and you will know what he means. A
ketogenic diet is an extreme variant of the lowcarb-highfat diet. It has
been used for many decades to treat children with epilepsy and with great
success, but have you heard that it even may cure cancer? We are still
waiting for a correctly performed scientific trial, but there are already many
case stories about the success of that diet published in
medical journals. Here is a
television program from CBN about this issue Dominique
D´Agostino, one of our members, has recently started
such a trial |
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March 2013 Fraud is allowed but not questioning One of the most cited papers in
support of the official dietary guidelines is “Seven Countries” by
Ancel Keys. Those of you who have read my books know, that Keys was a
cheat. For instance, in his paper from 1953, the one that started the war
against fat, he excluded data from sixteen out of twenty-two countries,
data that did not fit with his idea. The results in “Seven
Countries” study did not
support his conclusions. For instance, heart mortality was 16-17 times
higher on Corfu than on Crete, although they ate the same amount of
saturated fat on the two islands. To say that he cheated in that study is
perhaps to go too far, because the figures were given in the tables. But in a
recent review (the second article down for March) our member Zoë
Harcombe has made a deeper analysis of Seven Countries and of other
arguments used by the creators of the dietary advices. Did you know for
instance that in the Seven Countries study as well as in the NICE
guidelines biscuits, ice-cream, cakes, pastries and savoury snacks are
classified as saturated fats? And there is much more.
A few days ago I got an email
from Robert Bramel, who has familial hypercholesterolemia. Here is what he
wrote: “I have FH so I joined a discussion group at theFHFoundation.org. I asked the group why no one seems to understand why it is some FHers have significant disease and some have none. That was met only with "danger, danger, danger. Start taking statins". I then offered Sijbrands study that FH isn't all that hazardous and reported my personal negative experience with statins and how much better life is without it.Today I was told I had been dropped from the discussion group with this message: "The
FH Foundation is made up of committed individuals who have FH and National
thought leaders in the field of lipidology. It is our mission to raise
awareness of Familial Hypercholeaterolemia and encourage proactive
treatment of this life-threatening genetic disorder. Your understanding of
the scientific data does not match that of our 11 renown physicians or
respected public health organizations such as the CDC. We respectfully ask
that you find another venue for your thoughts" For some people, keeping a monolithic story
is much more important than getting it right. I looked up the funding for
these doctors. According to propublica.org, five of ten received
$250,000 pharma funding (total) over two years.” I participate myself in
CardioExchange, a discussion group of cardiologists in the hands of New
England Journal of Medicine. A few months ago I received the following
letter: “Dear
Dr. Ravnskov, I
am writing on behalf of the editors of CardioExchange. As you know, we
encourage a free discussion of ideas about cardiology on the website, but
we also reserve the right to shape or curtail that discussion when
necessary to maintain an atmosphere that welcomes contributions from all
of our members. Although
we appreciate your contributions to the site, we are writing to request
that you refrain from the constant repetition of the same points (ie,
rejection of the lipid hypothesis). Please feel free to contribute
comments to the site, but, to be clear, every mention of lipids,
cholesterol, or statins on the site should not be used as an occasion to
educate other members about the shortcomings of this field. Constant
repetition around such points only serves to drive members away, which
doesn't serve anyone\'s interest. Best, Matt
O\'Rourke Director,
Product Development, NEJM Group” More news. Our member Malcolm Kendrick has
started a
blog Hundreds of videos about statin
treatment are available on
Youtube; most of them are warning against such treatment. There are
also some who recommend it because of “the great benefit”. Do not
believe them! If you do, please listen to the
interview with the
whistleblower Gwen Olsen, who has worked in several drug industries
for many years Here is a
sad story about the effect of statin treatment, and this is not a rare
case; I have received many letters with similar stories Justin Smith, the creator of the revealing film Statin Nation, has now uploaded the first thirteen minutes of the film Is
the Cochrane Collaboration still reliable? Doctors and researchers have great confidence in the Cochrane Collaboration. It is a non-profit organization consisting of a group of over 28,000 volunteers in more than 100 countries and said to be independent. The group conducts systematic reviews of randomized controlled trials of health-care interventions, which it publishes in the Cochrane Library. Hitherto no statin trial has succeeded in
prolonging the life of healthy people whose only “disease” is high
cholesterol, or who have risk factors for heart disease, but who have
never had any heart problem. As mentioned in one
of my previous newsletters Cochrane Collaboration published an analysis of
these trials in 2011. When all results were taken together they found a
minimal risk reduction. However, their conclusion was, that “only
limited evidence showed that primary prevention with statins may be cost
effective and improve patient quality of life. Caution should be taken in
prescribing statins for primary prevention among people at low
cardiovascular risk. But in a
recent Cochrane report about
the same issue, the authors conclude that Reductions in all-cause
mortality, major vascular events and revascularisations were found with no
excess of adverse events among people without evidence of CVD treated with
statins. How come they have changed their mind,
you may ask. Because the minimal benefit in the second review was a little
better. Let us take a look at the figures. The first Cochrane analysis included
about 28,000 “patients”. In the control group 3.06 % had died; in the
treatment group only 2.58%; a difference of 0.48 % You can also say, that
without statins your chance to be alive after a few years without
treatment is 96.9 %, but if you take a statin drug every day, you can
increase your chance to 97.4 %. In the new analysis, that included about
48,000 “patients”, the result was a little better. In the control
group 5.17 % had died; in the treatment group only 4,41 %; a difference of
0.76 %. You can also say, that without statins your chance to be alive
after a few years without treatment is 94.8 %, but if you take a statin
every day you can increase your chance to 95.6. These small effects were even
exaggerated, because in both analyses, the authors had excluded EXCEL, the
first trial performed on healthy people. It included more than 8000
people, but it was stopped after 48 weeks, because, as Merck explained to
me in a letter, they were only interested to know, if the “patients”
tolerated their drug, which they did. The trial included three treatment
groups, and the mortality in these groups were 0.5 %; in the control group
only 0.2 %. This is not mentioned in the abstract; you have to calculate
it yourself from figures given in the text. The reason for excluding EXCEL was that
they only accepted trials with a length of at least one year, and as
mentioned EXCEL was stopped after 48 weeks. Without
the data from EXCEL the new analysis seems to have shown a benefit
because, as the authors wrote, there was no excess of adverse
events. Obviously they had forgotten what they wrote in their previous
report: There was evidence of selective reporting of outcomes,
failure to report adverse events and inclusion of people with
cardiovascular disease. And
they were right. In my newsletters and in my books I have given many
examples of the fraudulent way the industry-sponsored trial directors have
downplayed the adverse effects from statin treatment. Let me just mention
that at least 20 % get muscular problems, just as many become impotent, at
least 4 % get diabetes, about 1 % cataract, and an unknown number
polyneuropathy or mental disturbances such as memory loss, depression,
sleep disturbances and aggressive behaviour. Duane Graveline has also written
about this issue,
and you can read about the influence of low cholesterol on brain function here. Most
serious is the risk of cancer. Together with Kilmer McCully and Paul
Rosch, two of our most respected members of THINCS, I have given detailed
arguments in
a paper for the view, that statin treatment, or rather
low cholesterol, is carcinogenic. More about red meat For several years we have been told that
red meat causes both cancer and cardiovascular disease. However, most
studies of this issue have calculated the outcome for intake of red meat
and processed meat taken together in their calculations, and as I
told in
a previous newsletter there were serious errors in the few studies
that found unprocessed read meat to be unhealthy. Recently Sabine Rohrman and 46 co-authors
published the
results from EPIC (European Prospective Investigation into Cancer
and Nutrition), a large dietary study conducted in 23 centers in 10
European countries. The authors organized interviews of
448,568 men and women about their habitual diet habits during the
previous year; and in most countries an extensive self-administered
dietary questionnaire was used as well. After that the participants were
followed for 12-13 years. After correcting for confounders they found that
intake of red meat is harmless; not unexpected it is the intake of
processed food that may be harmful.
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Note:
If
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If
you are not familiar with the scientific language used here and there in the
above, You can read about most of the issues taken up in the above in a more
popular way in my books.
In the most recent one I have also described how it has been possible to seduce
a whole world for many decades by ignoring all conflicting observations; by
twisting and exaggerating trivial findings; by citing studies with opposing
results in a way to make them look supportive; and by ignoring or scorning the
work of critical scientists. |