A Catalyst for fat myths. The Heart of the Matter. Catalyst ABC TV

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Last Thursday (October 24) the ABC Catalyst program aired part one of the Fat Myths and how saturated fat and cholesterol are not actually the ogres the some would have us believe. http://www.abc.net.au/pm/content/2013/s3876403.htm 
 I was amazed to see it actually as Catalyst is normally very conservative but this was good and there'll be a follow up this week looking at statins (my pet topic after my book “The Great Cholesterol Deception”.  I was also amazed that it was the number one watched program that night and next Thursday it will be even bigger.

The Catalyst program highlighted that despite decades of organizations like The Heart Foundation and Nutrition Australia telling the public there really is no credible scientific evidence that saturated fat causes heart disease or, more generally, cardiovascular disease. It was embarrassing to say the least to see the Heart Foundation squirm on TV. Although we are constantly told that saturated fats are “bad” and that margarine is better than butter (which it is not), there is no evidence to support this “bad fat” myth.

Unfortunately there are many myths perpetuated by certain members of the health industry as well as so-called reputable groups who have strong vested interests in margarine and other foods. For example the position paper by the Heart Foundation 3 states that:

 Saturated fatty acids (SFA) intake is associated with coronary heart disease (CHD); and

 Replacing SFA with omega-6 PUFA (vegetable oils) to achieve a ratio of PUFA to SFA of greater than 1 will reduce the risk of CHD.

While a quote from Nutrition Australia states  “Butter is high in saturated fats and when consumed in excess amounts it can increase LDL (BAD) cholesterol levels, thus increasing the risk of cardiovascular disease.”

During the past 40 years the dietary instructions from governments and other authoritative bodies have told us to avoid all animal fats. Average fat consumption decreased, average blood cholesterol levels decreased and vegetable oils increased but the rate of heart disease and the cost of its treatment continued to rise.

The Catalyst program highlighted that poor studies and vested interests have led us astray and date back over 100 years to studies feeding rabbits animal fat, although rabbits normally do not eat meat or animal fat. The evidence against saturated fat has at best always been circumstantial. That is, saturated fat was said to elevate blood cholesterol and elevated blood cholesterol was said to cause heart disease therefore saturated fat would cause heart disease. There never has been any direct evidence that cholesterol or saturated fat cause heart disease or even of a mechanism whereby heart disease would occur.

Even the famous Framingham study, which originally hinted at a problem with saturated fats, now shows there is no association between dietary fat and heart disease and indeed the association of elevated cholesterol and heart disease is limited to a small segment of the study population. In the Framingham Heart Study, researchers working with a population-based cohort study, a total of 832 men, aged 45 through 65 years, found the risk of ischemic stroke declined with total fat, saturated fat and monounsaturated fat (e.g., olive oil) but not polyunsaturated fat such as margarine and vegetable oils. In effect, increased intakes of fat, saturated fat, and monounsaturated fat (olive oil) were associated with reduced risk of ischemic stroke in men. The exact opposite of what we have been told.

The evidence continues to mount that there’s no benefit and, in fact, probable harm from a low-fat diet. I cringe when I hear people talking about a low fat diet and laugh at all the marketing around low fat foods which are usually both full of sugars and low nutrient density carbohydrates.

In a recent review of dietary guidelines, researchers were scathing of the guidelines for critical weaknesses, including use of an incomplete body of relevant science; inaccurately representing, interpreting, or summarizing the literature; and drawing conclusions and/or making recommendations that do not reflect the limitations or controversies in the science. This is a mild way of saying scientific lying.

This is all summed up in a major independent, international review by The Expert Consultation held jointly by the World Health Organization (WHO) and Food and Agriculture Organization (FAO) in late 2008 which found no evidence that saturated fat causes heart disease. The WHO/FAO report states: “Intake of SFA [saturated fatty acids] was not significantly associated with CHD mortality…. SFA intake was not significantly associated CHD events [e.g., heart attacks]…. fatal CHD was not reduced by… low-fat diets.”

For the sake of our health, and the health of our parents and children, it’s time to change our thinking and start questioning what we are told about saturated fats and for that matter a lot of the information we are spoon fed.

Interestingly and as expected Catalyst was approached by a medical professor who called on the ABC to drop the second program -  totally predictable comment - but the AMA head is more supportive and says the profession needs to examine the evidence. About time!

I say BRING it on and watch Catalyst next Thursday.

Statins reduce the effectiveness of exercise.

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Statins are the most widely prescribed drugs worldwide and have serous side effects but the latest study shows they reduce the benefits of any exercise you do. The study found the statin previously sold under the brand name "Zocor," hindered the positive effects of exercise for obese and overweight adults. That means if you’re taking stains then you are not going to get the full benefits (85% less) of the exercise. A lot of research, including this study also found that taking the stain decreased the mitochondria (power house) in the muscles. This has also lead to a number of studies showing increased risks of diabetes type 2 with increasing statin use.

"Fitness has proven to be the most significant predictor of longevity and health because it protects people from a variety of chronic diseases," said John Thyfault, an associate professor of nutrition and exercise physiology at MU. "if patients start exercising and taking statins at the same time, it seems that statins block the ability of exercise to improve their fitness levels."

Participants in the exercise-only group increased their cardiorespiratory fitness by an average of 10 percent compared to a 1.5 percent increase among participants also prescribed statins. Additionally, skeletal muscle mitochondrial content, the site where muscle cells turn oxygen into energy, decreased by 4.5 percent in the group taking statins while the exercise-only group had a 13 percent increase, a normal response following exercise training.

Statins have only been used for about 15-20 years, so we don't know what the long-term effects of statins will be on aerobic fitness and overall health. We are now only just beginning to see some of the long term side effects of statins including increasing the breast cancer rate.

Journal of the American College of Cardiology, Volume 62, Issue 8, 20 August 2013, Pages 709–714

Statins (used to lower cholesterol) use does not reduce the risk of heart attacks

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In a recent study no connection was found between the level of exposition to statins in the population and the incidence or mortality from heart attack (Nilsson et al 2011). The use rate of statins increased almost three times for both men and women between 1998 and 2002. However, the change in statin use from 1998 to 2000 showed no correlation to the change in heart attack mortality. They concluded, “despite a widespread and increasing utilisation of statins, no correlation to the incidence or mortality of AMI (heart attack) could be detected.”  It should be highlighted that all these researchers are medical doctors or working in a medical establishment.

The drugs don’t work but have serious side effects including recent studies showing increases in diabetes and breast cancer.  Although there are many more serous side effects.

In one study Atorvastatin (a statin drug used to lower cholesterol) increases the risk for new-onset type 2 diabetes, according to an analysis of three large trials published in the Journal of the American College of Cardiology. (The trials, as well as this analysis, were sponsored by atorvastatin's manufacturer). Researchers were responding to a 2010 Lancet meta-analysis, which found an increased risk for new-onset diabetes after all statin use and were trying to show their drug was not so bad. In the meta analysis released in the Lancet, using data from 13 randomized trials comprising some 90,000 subjects, found a 9% increase in diabetes risk among those receiving statins compared with controls. The statin-diabetes association was stronger with increasing age and given these drugs are give to older people this is of even more concern. The authors calculate that 255 patients would have to be treated with statins for 4 years to produce an additional case of diabetes. This compares to the need to treat around 300 people with statin drugs to reduce the risk of heart attack (not death) by one or according to the research above no reduction at all.  However, the medical profession continue to use relative statistics and say they benefit by 30 or more percent. Obviously these doctors failed stats at university or more likely did not do them.

A recent study (McDougall et al September 2013) found current users of statins for 10 years or longer had a 1.83-to 1.97-fold increased respectively for Ductal and Lobular Breast Cancer. In their conclusion they reported that long-term use of statins was associated with increased risks of both IDC and ILC.

In support of t is here is a comment from one of my readers that might interest you.

“I recently stopped my statin drugs as I was experiencing bad muscle pains. My GP actually said that "statins don't really help women anyway". Hello, why has he then prescribed this and wasted all my money? “ GD, Brisbane

Statin and cholesterol update

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In summing up more than 500 articles around cholesterol and the statin drugs used to treat cholesterol all I can conclude is that it is The Great Cholesterol Deception. To sum it up, however, the medical industry fudges the figures to fool the doctors that cholesterol is Public Enemy Number One. In fact, cholesterol is one of the most important bio-chemicals in the body and not a single life has ever been saved by lowering cholesterol. Many people suffer serious side effects as a result of taking statin drugs like Lipitor®, Zocor®, Crestor®, Pravachor and others.

Cholesterol is a normal part of our biochemistry and high levels—above six or seven—may be a symptom of an underlying health condition. But it is not the health condition itself. Elevated cholesterol predicts less than 35% of cardiovascular disease. In fact, most heart attack and stroke events occur in individuals without elevated cholesterol, at least half of all cardiac arrests occur in people with normal cholesterol levels and 20% occur in people without any traditional risk factors. But now the drug industry wants to lower the normal level of cholesterol even further so that almost everyone will have “high cholesterol.” At worst cholesterol is simply a messenger telling us there is stress on the liver, and it is not the killer it is made out to be. Cholesterol is a part of our immune, nervous and endocrine system and if high is only doing its job to protect us.

A significantly better predictor of the risk of heart attack or stroke is the concentration of Omega 3 oils in the blood: the higher the concentrations, the lower the risk ^{1,2,3,4,5,6,7,8}, which predict up to 90% of CVD compared to 35% prediction from cholesterol readings. But there is no money to be made in prescribing Omega 3 oils. Omega 3 oils also reduce triglycerides and other risk factors for CVD, as well as reducing the risk of many other forms of chronic illness, from Alzheimer’s to arthritis and cancer. This is due to the anti-inflammatory effect of fish oils. Imagine if the specialists prescribed a few fish oils to patients. No one would require a specialist.

Millions of people are prescribed cholesterol-lowering drugs, statins like Pravachol®, Zocor® and Lipitor® each year, with no measurable benefit. Despite the media hype from poor and lazy journalism at best these drugs lower the actual risk of heart attack by around 0.3 percent and at the same time have side effects in 15% to 40% of people given statins ^9,10,11,12 and serious side effects in as many as five percent of the population of users. And the studies of the side effects have only been short term. Most doctors will simply tell you that statins are safe and hand you a prescription. However if your GP reads the fine print there are two and a half pages of side effects. In some cases up to 65% of people started on statins stop taking them ^13,14. Unfortunately, far too many people take statins and far too many prescriptions are dished out by GPs and specialists whom they trust but who do not read or understand the scientific literature and who have become the retail arm of the pharmaceutical industry.

One of the side effects of statin drugs is that they lower the levels of CoenzymeQ10 ¹⁵. Coenzyme Q10 is not only required for energy production in cells, but also protects against free radicals by acting as an essential fat-soluble antioxidant. Clinical evidence also shows a beneficial effect of Coenzyme Q10 in cardiac arrhythmias, irregular heartbeats, and lowering the risk of heart attack ¹⁶. A recent study found Coenzyme Q10 (CoQ10) for treating people with severe heart failure reduced the mortality and morbidity by around 50%. In essence CoQ10 is essential for our health and is important in lowering the risks of heart attack or stroke and statin drugs lower levels of this essential nutrient.

Major side effects associated with statin drugs include muscle wastage including a form of muscle disease, rhabdomyolysis, that is fatal, memory loss and amnesia. Not only is cholesterol not the enemy but also it is essential to good health and wellbeing. Every cell in the body needs cholesterol in its membrane where it plays a critical role in cell communication. Without cholesterol, cell membranes are incomplete and as a result their functional role deteriorates.

Cholesterol is also used in the mitochondria, the powerhouse of the cell, and plays a vital role in cell energy production not to mention its essential role in the brain structure and function. Cholesterol is the starting material of many essential chemicals including vitamin D, steroid hormones and bile acids for digestion. Cholesterol is metabolised into vital body steroids such as the steroid hormones, these include: sex hormones, oestrogen, progesterone, testosterone and DHEA, as well as the adrenal hormones aldosterone and cortisol. When you lower cholesterol levels you reduce your production of your hormones. As a result statin use can induce gynecomastia, an abnormal enlargement of one or both breasts in men and the proliferation of the glandular component of the breast tissue ¹⁷.

Numerous studies have shown that cholesterol is an important part of your immune system. Low cholesterol levels have also been shown in studies to increase a person’s susceptibility to infections ¹⁸ This is due to cholesterol’s functional role in preventing infections in the body. The lipoproteins that carry cholesterol through our bloodstream aid in our protection against the harmful effects of bacterial endotoxins that are released during infection. Studies have also found cholesterol may have protective properties against some cancers ¹⁹.

Cholesterol is the most abundant organic molecule in the brain and is a vital component required for synapse function ^20,21,22. In fact the person who discovered this essential role in the brain won a Nobel Prize in biochemistry. Cholesterol is also required for the function of serotonin receptors in the brain. Serotonin is the chemical in our brain that makes us feel happy. Cholesterol is a significant component of the cell membrane that influences its fluidity. It therefore indirectly affects neurotransmitters by interfering with their membrane bound receptors ²³. It also forms part of the myelin that surrounds our nerves aiding in the fast transmission of nerve signals. Lower cholesterol levels in the blood are correlated with slower visuomotor speed ²⁴ and has potential implications for some diseases like multiple sclerosis and motor neurone disease.

Statin statistics: lies and deception

Various independent studies in prestigious, peer-reviewed journals have shown that statin use in primary prevention—that is to prevent heart attacks—have minimal or no value in reducing mortality. It does not matter how one processes the statistics, the results just aren’t there. In data gathered in 2009 from six trials, a review of their ability to lower the risk of death with statins found virtually no difference between the treatment group who received the drug and the control group ²⁵. And there are many more of these studies.

The problem really comes down to vested interests and the abuse of statistics. As readers of the scientific journals we should not get confused between statistical significance and clinical significance. Statistically significant means that the outcome was likely (95% chance) a result of the treatment whether it was 100% effective or less than 0.1% effective. That is, if you treat 1,000 people to save one life (0.1%) it may be statistically significant but it is not clinically significant. Clinical significance refers to the expectations doctors and patients have for the success of the treatment and is usually 30% or more. That is, if ten people get the drug at least three will benefit. The best studies on statins by the drug companies report statistical significance, mostly less than half of one percent usually around 0.3%, around 100 times less than our expectations of clinical significance and none at all have so far found any clinical significance. GPs just do not understand the difference between statistical and clinical significance. So if the professionals don’t understand how do we expect the media or public to understand?

Interestingly, the use of other cholesterol lowering drugs (non statins) that reduce cholesterol just as effectively as the statins don’t even reach clinical significance, that is they don’t even reach 0.1 percent. So we know the effect of the statins is not the effect of lowering cholesterol that gives the drugs their incredibly small but statistically significant 0.3% effect. Otherwise the other cholesterol lowering drugs would work at the same rate. As the statin drugs are a synthetic mimic of a natural cholesterol treatment, “red rice yeast,” which had been used successfully for decades before the drug companies patented the statins. Red rice yeast works just as effectively as the statins but with many fewer side effects. Red rice yeast also has small anti-inflammatory and anti oxidative properties. It seems the small benefit the statins have (0.3%) is because they act like nutrition. Not because they lower cholesterol.

The studies on statins also report relative risk not absolute or real risk. This really fools the GPs. The relative risk reduction is highly misleading and deceptive. An example of relative risk is if you have four people out of 1,000 in a study who die in the placebo group (no drug) compared to three people out of 1,000 who die in the drug treatment group, that is four were likely to die but only three did, then for most of us it is a change of 0.1% (1 in 1,000, not much) but when you use relative risks it shoots up to 25%. They compare three to four and say four is 25% higher than three so the relative risk is 25%. It is still only one person in 1,000 a reduction of 0.1% but the doctors who believe the drug companies obviously never mastered statistics. Relative risk is like adding 1+1 to get 11 or 2+5 to get 25 or more.

The well known JUPITER Study (which I like calling the STUPITOR study if you believe the sales hype) found that treatment with statins went from 68 heart attacks in the placebo group (no drug) to 31 heart attacks in the drug treatment group a 58% relative risk reduction and 64 strokes in the placebo group to 33 strokes in the treatment group a relative risk reduction of 48% ²⁶. Sounds good doesn’t it? However, the drug treatment group had 8,901 participants in it.  In real terms the heart attack risk went from a very low 0.76% to 0.35% and the risk of stroke went from 0.72% to 0.37%. That is, they had about a 0.35% reduction. Effectively if you treat 300 people with expensive and dangerous drugs you might save one life. Under the best possible scenario the real risk reduction was well under one half of one percent. Interestingly while the heart attack risk was reduced by around 0.35% the number of deaths increased with the drug use. Oops… no one reported this.

References

1.     Kris-Etherton et al. 2002;

2.     Wang et al. 2006;

3.     Schacky and Harris 2006;

4.     Psota et al. 2006;

5.     Harris et al. 2006;

6.     Robinson J.G. and Stone 2006;

7.     Reiffel J.A. and McDonald 2006;

8.     Jacobson 2006

9.     Wierzbicki et al. 1999;

10.  Nawrocki et al. 1995;

11.  Bertolini et al. 1997;

12.  Marz et al. 1999

13.  Jackerviciua et al. 2002;

14.  Benner et al. 2002

15.  Folkers et al. 1990

16.  Rosenfeldt et al. 2005

17.  Romao 2007

18.  Leardi S. et al. 2000

19.  Goldstein et al. 2009

20.  Mauch et al. 2001;

21.  Koudinov and Koudinova 2001

22.  Göritz et al. 2002

23.  Heron et al. 1980

24.  Zhang J. et al. 2004

25.  Bartolucci et al. 2009

26.  Ridker et al. 2008

Mediterranean diet lowers Alzheimer’s and depression.

The Mediterranean diet has been associated with lower risk of various age-related diseases including CVD, some cancers and Alzhiemer’s. A recent review of twelve studies found that following a Mediterranean diet is associated with slower cognitive decline and a significantly lower risk of developing Alzheimer disease. In an older study of 2258 elderly New Yorkers with no dementia they found a higher adherence to the Mediterranean diet was associated with significantly lower risk of developing Alzheimer's disease. More importantly the more they followed the Mediterranean diet the lower the risk. They found that each increasing point on the Mediterranean diet score was linked with a 10 per cent drop in Alzheimer's risk and individuals whose diet closely resembled the Mediterranean diet had a 40 per cent lower risk of Alzheimer's than those who adhered the least to the diet (Scarmeas et al, 2006).  In support of this a number of studies have also reported the benefits of eating fruit, vegetables and oily fish for reducing your risk of Alzheimer's disease.

In other research following a Mediterranean-style diet is also associated with lower risk for developing depression. After a 4 year follow-up, people who followed the Mediterranean diet had lower hazard ratios for incident self-reported depression. High consumption of fruits and nuts, legumes, monounsaturated- to saturated-fatty-acids ratio and fish were each separately associated with lower depression risk (Sánchez-Villegas et al 2009).

However, the Mediterranean diet is not pasta, pizza and lots of cheese. The Mediterranean dietary is high in fruits, vegetables, fish, nuts and legumes; low in dairy, meat, junk food, trans fatty acids; moderate alcohol intake; and high ratio of monounsaturated-to-saturated fatty acids. Moreover, a particular feature of the diet is the abundant use of virgin olive oil in everything from cooking to spreading on bread and salads. Not vegetable oils or margarine. In fact, the exact opposite. The diet's is rich in many nutrients including beta-carotene, vitamin C, tocopherols, polyphenols, and essential minerals.