Why is America Obsessed with Total Cholesterol?

I found an article on Yahoo about the national average cholesterol reading. On average America’s total cholesterol is now at 199, the article reports, "Doctors like patients to have total cholesterol readings of 200 or lower." Why they like that number is not reported nor is it actually at all important. But lets look at a few things here. The article reports, and the mainstream medical establishment agrees, "The growing use of cholesterol-lowering pills in people 60 and older is believed to be a main reason for the improvement, experts said." Those cholesterol-lowering pills are from a class of medicine called "statins," and no one has ever proved that statins or a lower total cholesterol can prolong life.

At the beginning of this year an article appeared in the Lancet, a British medical journal, showing that statin drugs provided ZERO protection from developing cardiovascular disease (CVD) in women of any age or men over the age of 69. Here is what the article says,

Our analysis suggests that lipid-lowering statins should not be prescribed for true primary prevention (emphasis mine) in women of any age or for men older than 69 years. High-risk men aged 30–69 years should be advised that about 50 patients need to be treated for 5 years to prevent one event. In our experience, many men presented with this evidence do not choose to take a statin, especially when informed of the potential benefits of lifestyle modification on cardiovascular risk and overall health. This approach, based on the best available evidence in the appropriate population, would lead to statins being used by a much smaller proportion of the overall population than recommended by any of the guidelines.

Wow, who has the guts to tell America to stop taking Big Pharma's pills? The authors are J Abramson from Harvard and JM Wright from the University of British Columbia. What does the article tell us about them?

JMW declares no conflict of interest. JA is an expert consultant to plaintiffs’ attorneys on litigation involving the drug industry, including Pfizer for its marketing of atorvastatin.

Neither author is on Big Pharma's payroll, how refreshing. People who are not being paid by Big Pharma recommend "lifestyle modification" over medication.

What other tid bits of misinformation can we pull from this Yahoo/AP article? I like this one:

High cholesterol is commonly linked to obesity: Eating an abundance of meats, dairy products and other foods rich in saturated fats contributes to both problems, as does lack of exercise.

Ouch. That sounds pretty damning of meat and dairy. Also, it is completely wrong. Current Biochemistry textbooks have cleared this problem up, but the media has it's head in the sand (as does any doctor who graduated more then 5 years ago). In the absence of saturated fat and in the presence of glucose the liver will take the available glucose, turn it into triglycerides, attach them to an LDL particle and send it off to the fat cells for storage. The presence of insulin, due to elevated glucose, orders the body to store fat and with out dietary fat present the liver HAS TO CONVERT SUGAR TO FAT. When fructose is available (from high fructose corn syrup or table sugar) the body skips metabolizing the sugar for energy entirely, hence the term "fat forming sugars."

Is there more bad or misleading info in the Yahoo/AP article? Of course! Try this:

The drugs dramatically reduce levels of LDL cholesterol, which can clog arteries and lead to heart attacks.

So what if they reduce LDL cholesterol, I thought this article was about total cholesterol! If LDL cholesterol clogs arteries then what's with this national obsession with total cholesterol? Don't look at me for an answer, I don't have one. Total cholesterol means nothing. Where have I heard that before?

A Ban on High Fructose Corn Syrup and How the Public Miss The Point

How messed up is America's thinking when it comes to nutrition? When I read the following headline I got very excited:

Amid debate, grocery chain bans high-fructose corn syrup

Then I started to think about it. "Amid debate...?" I didn't realize anyone thought high fructose corn syrup was good for you. I did expect a great number of people not to know exactly how bad for you it is but I had no idea there was debate. Then I read this gem,

"I'm completely happy about that," said Karen Hunt, 42, when told of PCC's decision. She said it will makes it easier to pick out healthier cookies and chips for her two young children. (Emphasis mine)

Jesus wept.

I don't know if Karen Hunt's words echo the rest of America's but they probably do. What EVER made a mother of 2 think ANY cookies or chips would be OK for her young children!? Is there any nutritional value to cookies or chips? Well, the label says no high fructose corn syrup! It must use some all natural added sugar to addict my child!

The article goes on to report

"...consumer advocates such as the Center for Science in the Public Interest, believe the problem is the amount of sugar Americans eat, not the type. Swapping out HFCS for other sweeteners, they believe, is no more beneficial than the 1990s craze for fat-free (but still calorie-laden) snacks whose fat-free labels gave consumers a false sense that they could overindulge without harm."

Wow, the Center for Science in the Public Interest (CSPI) are rarely the voice of reason but for once I have to agree with them. That 1990's craze that was so misleading was driven by the CSPI as well as a move away from saturated fat. Saturated fat which has never been proven to be detrimental to our healths was promptly replaced by the now toxic trans fats. Big thanks to the CSPI for that!

A REAL Study Showing the Effects of a REAL Low Carb Diet on Inflammation and Blood Lipids

I love this. Only days after I start my blog a second study reveals the first "study" I blogged about is true garbage. The Abstract of this new study can be found here. It is a bit over my head in some spots but I get the idea. Why should we believe this study over the previous? Well, for starters, it will be published in a peer reviewed journal but is currently available on PubMed.com. PubMed is "A service of the U.S. National Library of Medicine and the National Institutes of Health."

The new study actually discusses the participants whole diet on each protocol:

Overweight men and women with atherogenic dyslipidemia consumed ad libitum diets very low in carbohydrate (VLCKD) (1504 kcal:%CHO:fat:protein = 12:59:28) or low in fat (LFD) (1478 kcal:%CHO:fat:protein = 56:24:20) for 12 weeks.

Quick math (see previous post) tells us the low carb diet was about 45 grams of carb/day. About 1 and 1/2 slices of white bread. Now that is low carb! The low fat diet served a whooping 207 grams of carb/day. Yikes! That's almost 14.5 tablespoons of sugar!

So what can we take from this? So much of the abstract is over our heads, except the last sentence,

In summary, a very low carbohydrate diet resulted in profound alterations in fatty acid composition and reduced inflammation compared to a low fat diet.

But what is all this talk of inflammation about? Does it have something to do with disease? Ask you doctor someday and see what he says. Hopefully he knows that Total Cholesterol means nothing. Also, I hope he knows it is not the LDL (Bad Cholesterol) that is an indicator of heart disease, its the particle size of the LDL and the triglycerides that are important. Chronic inflammation is actually a far better indicator of heart problems. Dr. Michael Eades has a very interesting post on inflammation here and is one of the reasons I will be seeking some dental work in the new year. I STRONGLY recommend reading this post. Inflammation is such a strong indicator of disease, we could all live a little longer for having this info.

But why has this info been under reported or never reported? Would it grab headlines? Does big Pharma have a pill for it? Is it easy to test for?

It did grab headlines, years ago. Big Pharma does have a pill for it, its called Tylenol or Aspirin, and nobody is getting rich off of those sales. Finally, I don't know about testing, but I do know how to avoid it, a Low Carb diet, the Universal Cure All.

Junk Science and the Media - Can the Atkins Diet Kill You?

A few days ago I got an envelope from Carl and Pat Walent, some of the best people on Earth. Inside was a photocopy of a magazine page with a few sentences reporting that a "study" found the maintenance segment of the Atkins diet causes an increase in LDL, inflamation and "reduced endothelial vasoreactivity and increased expression of biomarkers of atherothrombosis." Now I really do appreciate everyone's concern for my health and well being but the mass media is not really a good source for health advice. In my first blog I will first explain why this "study" is the junkiest of junk science and second why it captured so many headlines.

But first, why should you listen to me and not a magazine reporter or the NYT Health editor or even you doctor who has been through so many years of school? Well, for starters, I care about you and they don't. Media outlets need to get readers and headlines get readers. Your doctor needs to cycle through as many double and triple booked patients as he can to make money. I spend hours a week reading blogs and following links and reading the actual studies themselves and make my own judgment as to the validity of it's findings. I can promise you your doctor doesn't have time for that and health editors only want you to buy their publication. I have a lot more to say about this topic and there will more posts to come.

So back to the "study" itself. The "study" has not been published in any peer reviewed journal so all the data is completely unverified. This "study" was actually a 15 minute presentation of a poster at a side meeting of the annual American Heart Association convention held in Florida. Dr. Michael Eades posts about it here. Here's the bottom line:

"The important thing to understand about these presentations is that they are not peer reviewed as they are if and when they show up in a scientific journal. They are sort of peer reviewed on the spot in the sense that other researchers familiar with the specific field ask questions of the presenters or of the people with the posters. But that’s it. There is no scientific review of the data as there is when it is published in a journal. So people can present all kinds of data with no one looking it over other than the folks who ask questions."

But let's look at what little we actually have about this "study." All that is available is an abstract for the study or the poster if you attended the AHA convention. Dr. Eades was kind enough to make the abstract available on his blog here. I can not manage that on my blog yet. One of the things I noticed when I read the abstract is that my blog posting about the study is longer then the abstract itself. It is only 1 page long, but that is the least of it's problems. Here's the reseacher's methods:

We tested 3 popular diets, including Atkins (50% fat), South Beach (30% fat) and
Ornish (10% fat) in a randomized and counterbalanced, crossover study.

The Atkins Diet is billed as a low carb diet yet the "researchers" don't tell us what portion of the diet was carbs. On the Atkins diet the subjects ate 50% fat, leaving the other 50% to be a combination of protein and carbs. Now, no caloric intake is given so we are left to assume they ate a USDA recommended 2400 calories. So 1200 calories from fat. Lets look at the other macronutrients and try to guess at what else these folks ate. We need to fill in the other 50%. Let's say they ate 20% protein and 30% carbs, some quick math tells us that comes to 120 grams of protein (4 calories/gram of protein) and 180 grams of carb (also 4 calories/gram of carb). There are about 12.5 grams of protein in 1 egg so that's the equivalent of 10 eggs/day. That is a LOT of protein.

But I have moved away from the core issue here. Look at the carb count, 180 grams of carb! That's 2 potatoes or a plate of pasta! That ain't Atkins, not even in maintenance. It would be difficult for me to pack in that much carbohydrate in a week. Dr. Eades sums it up well, "In summary: no complete study, no peer review and no Atkins diet. Yet it made the news big time."

Now 1 more little thing while I have you. This flawed study looked a LDL, the "bad cholesterol." These "researchers" need to do their homework. LDL is at best a marginal indicator of heart disease. The important thing to look for is LDL particle size and triglycerides. That is something you CAN go to your doctor about. IF he doesn't know that then find another doctor.