Volume 13  Number 1  November 21, 2016
Second Opinions

Book review: "Fat and Cholesterol Don't Cause Heart Attacks"

Politically correct medical dogmas like the cholesterol-diet/coronary connection (the lipid hypothesis), continue to haunt us. Propagated by Government, consensus panels, medical journals, the media, and Big Pharma, these ideas continue to drive dietary obsessions and sales of statin drugs. In this aptly named and illuminating book, Fat and Cholesterol Don't cause Heart Attacks and Statins Are Not the Solution Paul J. Rosch, MD, FACP, and a series of noted scientific authors have created this tribute to Uffe Ravnskov, MD, PhD, the founder of The International Network of Cholesterol Skeptics. Their pioneering work has reawakened widespread criticism and reassessment of the Cholesterol heart attack fallacy.

Dr. Rosch in his superb introduction summarizes how media and medical reporting using "manipulated data, dirty tricks, and false advertising" conspire to fix in the public and physicians' minds the dangers of dietary cholesterol and fats. Billions of health care dollars are spent on monitoring blood levels of good and bad cholesterol and its protein carriers, good and bad lipoproteins ("we have to contend now with bad LDL that is good and good HDL that is bad.")

A meta-analysis of cholesterol-lowering trials found that studies supportive of the lipid hypothesis were cited almost six times as often as those that were not, and of similar numbers of trials unsupportive, none of them were cited after 1970. Dr. Ravnskov maintains convincingly that "...Prominent scientists have turned white into black by ignoring all conflicting observations;... by citing studies with opposing results in a way to make them look supportive; and by ignoring or scorning the work of critical scientists."

A cascade of public health problem are emerging from the widespread and increased prescribing of statin drugs. The majority of doctors, especially cardiologists, believe that one way to reduce the risk of heart attacks and strokes is to take statin drugs like Crestor, Lipitor, Zocor, etc. According to the CDC, 17% of those over 40 and 48% over age 75 are taking cholesterol-lowering drugs, an estimated 25 million Americans on statins! 30% of patients have muscle aching, or pain which sometimes leads to fatal rhabdomyolysis. (If you have any such symptoms, you should immediately stop the statin and see your doctor.) Other side effects include digestive disturbances and diabetes while possible increased susceptibility to certain cancers have been added to the warning list.

FDA recently added a black box warning on statins,"There have been reports of cognitive impairment (e.g. memory loss, forgetfulness, amnesia, confusion associated with statin use....". 2.5% of statin users at the very least (3.5 million people) have some type of cognitive impairment. Recall that less than 5% -10% of adverse events are reported in the FDA Adverse Events Registry. Moreover, since almost half of those older patients susceptible to dementia are on statins, shouldn't these drugs be given a trial of withdrawal to see if the dementia disappears or improves? In summary, Fat and Cholesterol Don't cause Heart Attacks is so important, to borrow a phrase, there may well arise accusations that it has been "rigged."

Martin F. Sturman, MD, FACP

Copyright 2016, Mathemedics, Inc.

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