Please take all that follows with a grain of salt. I certainly am not an MD. None the less I do take health and nutrition very seriously. I stake much of my professional advice and personal well being on my opinions. What I write below is in response to the paper: LDL Cholesterol: “Bad” Cholesterol, or Bad Science? published in the Journal of American Physicians and Surgeons.
I will say upfront that my long standing bias is towards whole foods and away from pharmaceuticals. ‘Let thy medicine be thy food and thy food be thy medicine’ is a time tested philosophy I put a lot of stock in. At the same time, I have been doing a lot of reading lately of peer-reviewed medical journals to understand the actual science behind public and medical opinion. The ‘truth’ that scientists report is actually far removed from public opinion, media reporting and medical prescribing. Statins are the biggest money maker in pharmaceuticals right now. This is an incontrovertible fact. The scary thing is that this does not appear to be based on a comprehensive understanding of available data. For the first time in history we have scientists doing meta-analysis of many years of research and assumption. Finally they are able to take a step back from all of the studies and get a bigger perspective than any one scientist could in the past. The results of this are the most educated guesses current science has to offer. The results of this also point towards statins as being a dangerous gamble that the average American is being advised to take part in. Currently it appears to be a gamble which, like most casino games, is not set up to support the gambler. Profits do appear to be seriously clouding the picture.
The claim is that cholesterol levels are an accurate measure of the risk of heart disease and therefore lowering cholesterol reduces the risk of heart disease. More recently we have been led to believe that LDL cholesterol is the culprit. According to this paper (and its 99 citations), the science does not point to a direct correlation between lowering LDL cholesterol levels and the reducing risk of heart disease. The problem appears to have more to do with oxidized cholesterol and their contribution to plaque. Even this is a guess based on a vague understanding of complicated processes. LDL cholesterol may actually be a part of the bodies attempts to manage an unbalanced situation. In other words, LDL likely correlates with plaque/heart disease the way that antibodies correlate with bacteria and viruses. Lowering LDL does not prevent heart attacks just as removing antibodies does not cure a disease. Just the opposite may be true. LDL may be a part of our bodies immune response.
More importantly and more clearly, statin drugs appear to increase the risk of a number of illnesses including Alzheimer’s and diabetes. The only thing we know for certain is that statins exert a vast number of biochemical effects that we know very little about. The ongoing trend of labeling certain minimally understood naturally occurring substances in the body ‘bad’ or ‘good’ has been repeatedly proven ill-advised. Largely the science does not point to such absolutes, it is the public and media glamorization that does so. Unfortunately, the research in any given year is far too much for any one doctor to follow and thus popular beliefs do influence even doctors.
In the end I always come to the same conclusion. The body is still far more complex than any model science has developed. What we do know is that organic whole foods are good for the body. We have spent millions of years evolving to digest and absorb them. The problem with the American diet is a move towards refined/processed foods. Few dispute this. I would add that drugs are the most refined food of all. If all food is a drug and all drugs are food, playing with the most refined foods possible (not high-fructose corn syrup, but drugs such as statins) is a gamble that most doctors writing prescriptions clearly don’t understand enough about. I don’t intend to be judgmental. I offer my voice only to provide some degree of corrective balancing to the current trends. The medical system provides very little in the way of nutritional education. “Medical students received an average of 19.6 contact hours of nutrition instruction.” (AAFP) The only thing we really know is that both nutritional and pharmaceutical science are in their infancy. I’m suggesting that we take a step back from the high stakes tables and simply earn our health the old fashioned way, slowly; making careful decisions on a moment to moment basis, trusting the earth and our bodies to know the most.
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