NilsGLindgren wrote:
Mark Hyman has some 40 articles to his credit,

I can only find 30 - there are an additional 10 by a MA Hyman in the 1950s and unlike the more recent ones they are not simply opinion pieces. None of the recent Hyman articles are anything other than parasitic assessments of others work.

I just thought I would check in and see if there were any new insights into the topic of nutrition, or anything close since I left this morning.

Nope. Just bitching! All the bitching is really adding to what people know about this stuff, huh?

This site is supposed to be about rational skepticism.

I don't think that means stop thinking and derail everything possible over the issue of "you can't say anything without peer reviewed, double blind....blah blah.." and I don't think blindly defending "conventional wisdom" (with no proof) is good practice for a skeptic.

I brought up a legitimate issue in the OP and added some additional insight of a skeptical nature, and this turned into nothing but a stupid ass bitchfest. Nice going.

Apollonius wrote:I just thought I would check in and see if there were any new insights into the topic of nutrition, or anything close since I left this morning.

Nope. Just bitching! All the bitching is really adding to what people know about this stuff, huh?

This site is supposed to be about rational skepticism.

I don't think that means stop thinking and derail everything possible over the issue of "you can't say anything without peer reviewed, double blind....blah blah.." and I don't think blindly defending "conventional wisdom" (with no proof) is good practice for a skeptic.

I brought up a legitimate issue in the OP and added some additional insight of a skeptical nature, and this turned into nothing but a stupid ass bitchfest. Nice going.

Well, you may not have learned anything, but I did.

Apollonius wrote:I just thought I would check in and see if there were any new insights into the topic of nutrition, or anything close since I left this morning.

Nope. Just bitching! All the bitching is really adding to what people know about this stuff, huh?

This site is supposed to be about rational skepticism.

I don't think that means stop thinking and derail everything possible over the issue of "you can't say anything without peer reviewed, double blind....blah blah.." and I don't think blindly defending "conventional wisdom" (with no proof) is good practice for a skeptic.

I brought up a legitimate issue in the OP and added some additional insight of a skeptical nature, and this turned into nothing but a stupid ass bitchfest. Nice going.

This is just laughable. I don't even know where to begin. I'll suffice in saying that you clearly have no idea about rational skepticism. Just go back and look at your childish dismissals of entirely relevant and informative posts.

Apollonius wrote:I just thought I would check in and see if there were any new insights into the topic of nutrition, or anything close since I left this morning.

Nope. Just bitching! All the bitching is really adding to what people know about this stuff, huh?

This site is supposed to be about rational skepticism.

I don't think that means stop thinking and derail everything possible over the issue of "you can't say anything without peer reviewed, double blind....blah blah.." and I don't think blindly defending "conventional wisdom" (with no proof) is good practice for a skeptic.

I brought up a legitimate issue in the OP and added some additional insight of a skeptical nature, and this turned into nothing but a stupid ass bitchfest. Nice going.

Translation:

People talked about stuff I didn't want them to talk about and didn't uncritically swallow my assertions.

Boo-fucking-hoo.

Next time, try engaging people honestly rather than avoiding all their substantive rebuttals.

Nice example NilsGLindgren, but it looks like it's being treated with the contempt Apollonius reserves for anything that disagrees with him. Remember - you're not giving him credit as he spends all his time looking this shit up.

Considering the quality of the "work" the OP was based on, I could entertain the thought of submitting that too to the 101, but, shit, sun is shining, weather's warm, my wife is beautiful - I'm outta here.

I haven't had time to read the full thread but there is an interesting website here:

http://www.thincs.org/links.htm

Some of the articles show bias, but there are a number of interesting papers which have been published in peer reviewed medical journals. The current medical view that high cholesterol levels are correlated with increased levels of heart disease is well established and is reproducible in many studies. However, the correlation is quite weak and the original Framington study (still the largest single study) had to resort to a one-tailed T test in order to establish any statistical relevance. In spite of this, the medical and pharmaceutical industries have persuaded us that the majority of people have to consume statins in order to survive (if I was a cynical person, I might believe that this would have something to do with the billions of dollars that this generates for the pharmaceutical industry every year). However, correlation does not establish cause and effect. Also, if a wider view is taken and ALL causes of death are considered as opposed to just heart disease, for people over the age of 50 there is an even greater correlation between cholesterol levels and death rate. The only problem is that it appears to work in the opposite direction - the higher the cholesterol, the lower the overall death rate!! This appears to have been ignored (in the UK at least) because doctors are still peddling statins to the elderly. This may reduce their risk of heart disease, but statistics seem to infer that serum cholesterol levels appear to have an inverse correlation with rates of cancer and other causes of death. Until some of these issues are further clarified and the side effects of statins are better understood, the precautionary principle should be applied. However, with the commercial interests of the pharmaceutical industry at stake, I doubt that this will happen.

EDIT: Forgot to include reference for inverse correlation between cholesterol and all cause mortality. Here it is:

http://www.ncbi.nlm.nih.gov/pubmed/11502313
http://www.ncbi.nlm.nih.gov/pubmed/20470020

I would add that there have also been studies which have found an opposite correlation!

Not disputing what you say trevp - but is this phenomenon of people being convinced they need to consume statins really as wide-spread as people are suggesting? Personally, I've only ever heard of them in passing. I don't know anyone who actually buys them, I don't know anyone who is convinced they need to take them. Actually, I thought it was an American phenomena.

In Sweden, statins are on the whole used as secondary prevention (people who already have a heart disease due to atherosclerosis), and in some few cases where several risk factors add upp (diabetes, hypertension with established arterial wall thickening etc). It is not introduced to persons over 70 years of age as far as I am aware, the idea being that, if you were to cotnract a heart disease due to atherosclerosis, it would already be there and give symptoms. That there sis nothing to gain from adding statins.

Spearthrower wrote:Not disputing what you say trevp - but is this phenomenon of people being convinced they need to consume statins really as wide-spread as people are suggesting? Personally, I've only ever heard of them in passing. I don't know anyone who actually buys them, I don't know anyone who is convinced they need to take them. Actually, I thought it was an American phenomena.

I'm not sure how widespread this is on a global scale, but certainly in the UK, the National Health Service in conjunction with the government has set "target" levels for cholesterol and doctors are putting pressure on patients to take prescribed statins if their cholesterol levels significantly exceed 5.0 mmol/l. An article on the BBC website shows these levels:

http://news.bbc.co.uk/1/hi/health/8559751.stm

The targets are 5 mmol/l total cholesterol and 3 mmol/l LDL cholesterol. More than half of the population of the UK has cholesterol levels significantly above this value. I was advised by my doctor that I should take statins because I was at "grave risk" because my cholesterol levels were measured at 6.3 mmol/l. On checking the research, I found the risk to be minimal - so I don't take statins.

Lipitor (Atorvastatin) is (or was in 2008) the world's biggest selling drug with reported sales of 12.4 billion dollars - and this is just one of the many statins available. These drugs can have serious side effects and this aspect tends to be downplayed. Again in the UK there is a large market in foods containing plant sterols which are claimed to lower cholesterol levels (Benecol is one of the brands). I don't know what the total market for cholesterol lowering products is, but I think it is huge. This does surprise me in view of the lack of convincing evidence that statins are effective in primary prevention of heart disease (there is no question that they are effective to limit the probability of a second heart attack in people who have already had one - but there is some controversy as to the mechanism by which this happens. This is because statins also have anti-coagulant properties in addition to lowering cholesterol).

In view of the studies finding an inverse relationship between cholesterol levels and all cause mortality rates in older people and the lack of evidence of the efficacy of statins as a primary preventative measure, I find the current medical guidelines in the UK quite disturbing.

NilsGLindgren wrote:In Sweden, statins are on the whole used as secondary prevention (people who already have a heart disease due to atherosclerosis), and in some few cases where several risk factors add upp (diabetes, hypertension with established arterial wall thickening etc). It is not introduced to persons over 70 years of age as far as I am aware, the idea being that, if you were to cotnract a heart disease due to atherosclerosis, it would already be there and give symptoms. That there sis nothing to gain from adding statins.

It seems that Sweden has a much more sensible policy on the use of statins than the UK, especially with regard to not prescribing them for people over 70. My mother-in law who is over 90 years old is continually pressured by her doctor to take statins! Hopefully, other countries also are following the Swedish policies and not the madness of the US and UK approach.

1. Eating fat causes heart disease.
2. Cholesterol must be lowered with drugs to prevent heart disease.

Neither of those bald statement has been a part of my understanding for over 20 years. Source :Three separate GPs as well as my dietician at the diabetes clinic. I'm not a doctor or health professional.


My understanding:

Cholesterol is not an indicator of heart disease in itself and may be irrelevant. Family history is far more important,Eg if one or both your parents had heart disease,it's as likely as not that you will too,pretty much regardless. Same goes if they did not.

Animal fat is NOT bad for you in itself. The body actually needs some fat.My understanding is fat can become problematic if eaten often together with high GI (Glycemic Index) carbohydrates, such as refined sugars and white flour. The body will use the high gi carbs first and store the fat.No problem as long as you use that energy. IF you store enough fat,you will become obese,and THAT can lead to heart disease. So it's not eating fat per se, it's not using the energy it contains which is dangerous to your health.

THAT is my understanding. I'm perfectly happy to be corrected if my understanding is flawed or just wrong.(I'm assuming the corrector will point me at some evidence.)

trevp wrote:

NilsGLindgren wrote:In Sweden, statins are on the whole used as secondary prevention (people who already have a heart disease due to atherosclerosis), and in some few cases where several risk factors add upp (diabetes, hypertension with established arterial wall thickening etc). It is not introduced to persons over 70 years of age as far as I am aware, the idea being that, if you were to cotnract a heart disease due to atherosclerosis, it would already be there and give symptoms. That there sis nothing to gain from adding statins.

It seems that Sweden has a much more sensible policy on the use of statins than the UK, especially with regard to not prescribing them for people over 70. My mother-in law who is over 90 years old is continually pressured by her doctor to take statins! Hopefully, other countries also are following the Swedish policies and not the madness of the US and UK approach.

Not to be picky or anything, but is this representative of a government policy as apparently claimed by several people in this thread, or is it particular doctors believing that they are efficacious?


Edit: Sorry, I didn't even see your previous post until after I'd replied. I'll go read that now.

Ok, so I went to look for the government source and found this:

http://www.nhs.uk/conditions/Cholestero ... ction.aspx

http://www.nhs.uk/Conditions/Cholestero ... tment.aspx

If you have been diagnosed with high cholesterol, the first method of treatment will usually involve making some changes to your diet (adopting a low-fat diet) and doing plenty of regular exercise.

After a few months, if your cholesterol level has not dropped, you will usually be advised to take cholesterol-lowering medication.

They show 4 forms of cholesterol lowering medication: Statins, Aspirin, Niacin, and Ezetimibe (apparently used for patients who have problems with statins).

So apparently the UK govt does have some policy with regards to prescribing statins, but it appears that these are only supposed to be prescribed after other life-style changes have been trialed, and there are also alternatives to statins suggested.

Spearthrower wrote:Ok, so I went to look for the government source and found this:

http://www.nhs.uk/conditions/Cholestero ... ction.aspx

http://www.nhs.uk/Conditions/Cholestero ... tment.aspx

If you have been diagnosed with high cholesterol, the first method of treatment will usually involve making some changes to your diet (adopting a low-fat diet) and doing plenty of regular exercise.

After a few months, if your cholesterol level has not dropped, you will usually be advised to take cholesterol-lowering medication.

They show 4 forms of cholesterol lowering medication: Statins, Aspirin, Niacin, and Ezetimibe (apparently used for patients who have problems with statins).

So apparently the UK govt does have some policy with regards to prescribing statins, but it appears that these are only supposed to be prescribed after other life-style changes have been trialed, and there are also alternatives to statins suggested.

You are correct, this is the policy. However, diet and exercise tend to have little influence on serum cholesterol levels (with the exception of people with metabolic syndrome). Thus following a diagnosis of cholesterol levels above 5 mmol/l, a doctor will normally suggest diet and lifestyle changes and a "follow up" test. Following this, statins will be prescribed (assuming that the levels have not fallen). Of the other medications listed, aspirin does not affect cholesterol levels and is given as an anti-coagulant, Niacin is very rarely used as when taken in the doses necessary to produce cholesterol lowering, the side effects can be severe and (as you say) Ezetimbe is only used in cases where side effects from statins have been a problem. I notice from reading the links you provided that I have underestimated the percentage of the population having cholesterol levels above 5 mmol/l - the NHS website states that two thirds of the population have cholesterol levels above 5 mmol/l.

What this means is that many people in the UK are taking medication which is probably unnecessary - and the pharmaceutical industries are making a good profit! Of the people I know over the age of 50, around half of them are taking statins.

The website also notes that the UK has one of the highest cholesterol levels in the world. As I've said throughout, I don't have the necessary knowledge to make any judgment here, but surely the OP is just plain wrong - there's no deception going on here, medical authorities are doing what they consider to be the best course of action based on experiments. Whether ultimately other links cause these cases, we have to recall that knowledge is provisional and as a rule these people have the best interests of the patient at heart. They're not all in cahoots to profit from sick people.

Spearthrower wrote:The website also notes that the UK has one of the highest cholesterol levels in the world. As I've said throughout, I don't have the necessary knowledge to make any judgment here, but surely the OP is just plain wrong - there's no deception going on here, medical authorities are doing what they consider to be the best course of action based on experiments. Whether ultimately other links cause these cases, we have to recall that knowledge is provisional and as a rule these people have the best interests of the patient at heart. They're not all in cahoots to profit from sick people.

I agree with what you say, but the fact that the UK has one of the highest cholesterol levels in the world does not also mean that the UK has one of the highest rates of coronary heart disease. The video below shows data from the World Health Organisation and it is difficult to see any correlation.

I also agree that the medical authorities and the government are not setting out to profit from sick people and are taking what they consider to be the best course of action, but the pharmaceutical industry certainly does profit from sick people! Perhaps I'm just being too cynical.

[youtube]http://www.youtube.com/watch?v=i8SSCNaaDcE[/youtube]

trevp wrote:

I also agree that the medical authorities and the government are not setting out to profit from sick people and are taking what they consider to be the best course of action, but the pharmaceutical industry certainly does profit from sick people! Perhaps I'm just being too cynical.

As much as I'd love to be an idealist, and wish that such companies could operate on a benevolent basis, at the end of the day they need to pay for their R&D and achieve profits for their shareholders. The only way you'd get such a non-profit type of research is if the government controlled the research of pharmaceuticals, which would directly equate to all the population paying for medical developments regardless of whether they need the treatment or not. Would you recognise that as being true?

Without a doubt, in regards to pharmaeutical companies and their approach to 1) R&D and 2) sales, I am, as a blanket statement, extremely cynical.