Men's Health Friday December 23, 2011

Questioning the ‘Great Cholesterol Con’

Most people have heard about 'The Great Cholesterol Con' which is basically a conspiracy theory that states that cholesterol isn't really a cause of cardiovascular disease in men and women and that medications such as statins, which is taken to lower cholesterol can't really save your life. There has even been a book written about it, which, to clarify, I haven't read.

Although reading about it online made me wonder whether such a great conspiracy would be possible. Especially with all the efficacy and safety testing medications have to undergo before they are approved. And what about the reports that show that taking statins can be beneficial to your health?

Understanding cholesterol

Most doctors in the UK prescribe statins to people who need it to lower their cholesterol. Before a doctor can prescribe statins to a person, a blood test needs to be performed to assess a person's LDL and HDL as well as triglyceride levels. LDL stands for low-density lipoproteins, while HDL stands for high-density lipoproteins.

Lipoproteins are the vessels that transport cholesterol around the body to and from cells. LDL is also known as 'bad cholesterol' because if there are too many of them within arteries, they can saturate bodily cells' need for cholesterol, which means that cholesterol is left inside the artery, unused, eventually leading to a build-up and plaque. Unless HDL 'good cholesterol' is able to carry it back to the liver where it can be processed and removed from the body. Triglycerides are different types of fat that are present in the body and if these levels are high within the blood, it can also be a problem.

If a doctor feels that your blood cholesterol levels are too high and there is no risk to your health within the next ten years, he'll recommend that you make dietary and lifestyle changes before actually prescribing statins, so unlike many reports are painting it, it's not like doctors are handing it out like candy to people who reach an ages where they are more prone to cardiovascular problems.


What do statins do?

Most experts believe that too much cholesterol travelling towards cells and remaining in the arteries unused is a bad thing, placing strain on the arteries or leading to conditions such artherioschlerosis, which could lead to cardiovascular disease. Statins work to lower LDL and triglyceride levels in the blood and also increase HDL levels.

The 'con' theory

The Great Cholesterol Con states that statins aren't effective at preventing deaths as a result of cardiovascular disease, because high cholesterol and saturated fat aren't the causes of the condition. In fact the research behind the 'con' theory found saturated fats and cholesterol are actually good for us because we need it. Statins are apparently only useful in young men and in men who have already had heart attacks, but not because of their cholesterol lowering abilities. According to the con, they have no benefit to women who in particular benefit from saturated fats.


Is something like this really possible?

One of the arguments posed by the cholesterol con is that the initial research which leads to the discovery of the harmful effects of cholesterol was conducted more than 100 years ago on rabbits, which share a different diet from us. However, is it really likely that all research since then has simply religiously followed this early research? I don't think that scientists involved in clinical research about the effects of medications on people would simply disregard logical information to suit their purpose as it's simply not in their interest to advocate something that could potentially be damaging to the public.

The same goes for drug companies. Past lessons have shown that it's simply not worth the risk to create medications that are damaging to patients' health. In any case, medications take years of development and testing before they are approved by health authorities such as the MHRA and FDA. During these tests companies need to be able to provide proof of the efficacy as well as the safety of medications, so it's unlikely that they would get away with it if they tried. But even if the health authorities are in on it, as the theory implies, I am sure the financial benefit provided by pharmaceutical companies, would be outweighed by the sheer strain placed a country's health service and economy by people with heart disease and logic would therefore dictate that it's simply not worth it.

As tantalising as a good conspiracy is to debate, the aim of my post was not to pick a side and argue it, but to explore whether it's likely that all the research showing the benefits of using statins are wrong. Would health officials really continue approving the use of statins if they were harming our health and they didn't have any kind of benefit? What about charities such as the British Heart Foundation who are involved in research concerned with people's heart health and who are independent from pharmaceutical companies and still feel that statins are effective at lowering cholesterol? I'd like to think that if there was any reason to doubt these medications, the appropriate action would have been taken by now and that adequate time and money would have been spent into looking into the link between cholesterol and cardiovascular disease.

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