So what's the truth about Cholesterol

jopar · Jun 20, 2012

I think individuals should read all the evidence concerning statins and make their own mind up, rather than listening to one individual's opinion on them!

As Sid said, Briffa background is basically selling a particular diet to individuals, so does have an vested interest which could mean that he's reading the evidence of research in a biased fashion, but to be fair the same could be said for Pro supporters of statins though, vested interests giving a biased opinion..

So you need to check out the research, see who's behind the research, what the conclusions says, and then check out all the data that the conclusion has been built on... So is there an vested interested (i.e company providing the funding or carrying out the study) as this could effect how the conclusion is written or even concluded, hence why the need to look at the data the conclusion is based upon! As an bias opinion can easy turn, negative into a positive and vis versa.... for example, you can portray 3-10 both as a negative and a positive, If you looking to create a low impact negative, you say in 3-10 cases it failed, but if you want it to be a positive then you say in 33% of cases it worked!

So it's a case for people to decide for themselves, what is best for them...

borofergie · Jun 20, 2012

jopar said:
I think individuals should read all the evidence concerning statins and make their own mind up, rather than listening to one individual's opinion on them!

You don't need to read all the evidence. The Cochrane Collaboration did it for you:
http://summaries.cochrane.org/CD004816/ ... ar-disease

Statins are the first-choice agents. Since the early statin trials were reported, several reviews of the effects of statins have been published highlighting their benefits particularly in people with a past history of CVD. However for people without a past history of CVD (primary prevention), the evidence is less clear.

Guess what? They're not selling books...

Scardoc · Jun 20, 2012

borofergie said:
In the early 80s Robin Warren and Barry Marshall discovered that peptic ulcers (and some stomach cancers) were caused by a bacteria in the stomach. By 89 they'd developed a cure and had papers published in 5 top peer reviewed journals, but were widely riducled by the mainstream medical community who thought that no bacteria could survive the acid environment of the stomach. In frustration Marhall even infected himself with the bacteria to prove that he would develop an ulcer.

Despite this the medical community refused to change their opinion and ulcers continued being treated with ineffective diets antacids until about 1997, when the consensus suddenly changed and doctors started treating ulcers with antibiotics.

They received the Nobel Prize for Medecine in 2005...
http://en.wikipedia.org/wiki/Barry_Marshall
http://en.wikipedia.org/wiki/Helicobacter_pylori

My point here is that, even in the light of excellent evidence, it takes some time for the consensus to change. Sometimes solutions that were widely riduculed are eventually adopted by the mainstream. That's just the way that science and medicine progress.

Hmmm.... from the Wiki article - "Although there was some skepticism initially, within several years numerous research groups verified the association of H. pylori with gastritis and, to a lesser extent, ulcers". Doesn't sound too much like ridicule but that the research was soon accepted. Again, depends what slant you put on it.

My original point, in agreement with Mr Bonkers, is that I'd rather take advice from people who are experts in the field. Clearly, Barry Marshall and Robert Warren were experts in the field and their work was backed up with hard evidence - doesn't get much better than proving it in your own body. After initial skepticism other researchers verified the work. Scientific consensus changed and Marshall and Warren were still alive to receive their award.

RoyG · Jun 20, 2012

The Book was only £3.49 on Kindle, hardly a fortune?

borofergie · Jun 20, 2012

Scardoc said:
[
"Firstly the "fat in your mouth = fat in your arteries" thing isn't true - paticlarly on a low-carbohydrate diet - and it's much more likely that "carbs in your mouth = fat in your arteries."

The words much more likely indicate that it has not yet been proven so why should scientific consensus change?

Nothing in science in certain. If you think that it is, then you are fundamentally misunderstanding how scientific progresses.

But if you need the evidence, here it is:
http://dl.dropbox.com/u/37202414/Volek_ ... s_2008.pdf

Although I must warn you all, that Jeff Volek once published a book or two, so that probably means everything that he says is a lie. Or something.

borofergie · Jun 20, 2012

Scardoc said:
[
Hmmm.... from the Wiki article - "Although there was some skepticism initially, within several years numerous research groups verified the association of H. pylori with gastritis and, to a lesser extent, ulcers". Doesn't sound too much like ridicule but that the research was soon accepted. Again, depends what slant you put on it.

Yes. That's might point. The scientific community verified the solution, but that didn't change the medical consesnus.

Scardoc said:
[My original point, in agreement with Mr Bonkers, is that I'd rather take advice from people who are experts in the field. Clearly, Barry Marshall and Robert Warren were experts in the field and their work was backed up with hard evidence - doesn't get much better than proving it in your own body. After initial skepticism other researchers verified the work. Scientific consensus changed and Marshall and Warren were still alive to receive their award.

Then trust the Cochrane Review, or Jeff Volek.

15 years is a long time to be handing out potentially harmful advice while the medical consensus catches up with the scientific consensus. I'd rather cut out the middle-man and take the advice directly from the real experts, but then I'm lucky in that I have a scientific education.

I'd note that almost every single bit of advice I've had from the NHS on dealing with my diabetes has been wrong. I sorted myself out by doing my own research.

Sid Bonkers · Jun 20, 2012

borofergie said:
Statins are the first-choice agents. Since the early statin trials were reported, several reviews of the effects of statins have been published highlighting their benefits particularly in people with a past history of CVD. However for people without a past history of CVD (primary prevention), the evidence is less clear.

Click to expand...

Can you qualify "less clear" borofergie as less clear hardly sounds definitive to me?

------------------------------------------------------------------------------------------------------------

Oh and BTW I never ever said:

Sid Bonkers said:
Scientific consensus doesn't change because of the impact of new evidence, but because those that cling on to the old dogma die.

That was borofergie not me Scardoc :thumbdown:

Dillinger · Jun 20, 2012

Scardoc said:
My original point, in agreement with Mr Bonkers, is that I'd rather take advice from people who are experts in the field.

We are all here because the experts in the field have given us almost completely the wrong advice in how to manage diabetes. A post earlier today detailed how someone's success (in terms of blood sugars, weight loss and lipids I believe) was dismissed by their resident 'expert in the field' because it was achieved by not listening to the approved advice (i.e. they were low carbing). Being an expert is the kiss of death for an enquiring mind; people get territorial with their knowledge and resent outsiders intrusion.

One constantly hears the argument being raised that people who publish books are somehow besmirched by that; as if writing a book was an evil money grabbing activity preying on the feeble minded. Most authors I would imagine will tell you it's no such thing; it is a labour of love. Saying because someone writes books or makes money from giving an alternative view means I will flat out not trust them is just abandoning reason to prejudice. Listen to what they are saying and judge that on its own merits. It's like saying if you have got red hair or are Mr Bonkers I won't believe a word you say. It doesn't matter why people are saying what they say it is what they are saying that counts.

Dillinger

dawnmc · Jun 20, 2012

Dr Malcolm Kendrick is another British doc oops he wrote a book too about how statins were not the panacea everyone thought/thinks.

borofergie · Jun 20, 2012

dawnmc said:
Dr Malcolm Kendrick is another British doc oops he wrote a book too about how statins were not the panacea everyone thought/thinks.

Writing a book makes everything you say a lie. Apparently.

dawnmc · Jun 20, 2012

:shock: really

cuillie · Jun 20, 2012

dawnmc said:
Dr Malcolm Kendrick is another British doc oops he wrote a book too about how statins were not the panacea everyone thought/thinks.

Iv just started Dr. kendrick's book so I am hoping it will help me make up my mind about my statins, my Dr. just gave me the party line when I mentioned I wanted to stop taking them, it's because i have diabetes, and different to everybody who doesn't :?

IanD · Jun 20, 2012

Dillinger said:
Scardoc said:

My original point, in agreement with Mr Bonkers, is that I'd rather take advice from people who are experts in the field.

Click to expand...

We are all here because the experts in the field have given us almost completely the wrong advice in how to manage diabetes. A post earlier today detailed how someone's success (in terms of blood sugars, weight loss and lipids I believe) was dismissed by their resident 'expert in the field' because it was achieved by not listening to the approved advice (i.e. they were low carbing). Being an expert is the kiss of death for an enquiring mind; people get territorial with their knowledge and resent outsiders intrusion.

Exactly - though I must say the original information I was given was absolutely correct - "even if you follow our dietary advice carefully, your diabetes will progress...." So much for "experts in the field." They don't even realise their advice is dangerous & will destroy our health.

dawnmc · Jun 20, 2012

Its a good book, think you might just change your mind. I was offered them - I refused. My mum who was prescribed them now can't walk. My partner was prescribed them he had panic attacks. My brother in law is on them he can't work, seriously he's just a lazy sod and hasn't bothered working since the miners strike, but he's fine on them. Mind you he's not diabetic I don't think.

borofergie · Jun 20, 2012

Sid Bonkers said:
borofergie said:

Statins are the first-choice agents. Since the early statin trials were reported, several reviews of the effects of statins have been published highlighting their benefits particularly in people with a past history of CVD. However for people without a past history of CVD (primary prevention), the evidence is less clear.

Click to expand...

Click to expand...

Can you qualify "less clear" borofergie as less clear hardly sounds definitive to me?

Yes. There is no-clear evidence that statins have a benefit in people without a history of CVD (that includes me and you, I hope). That's as definitive as science gets, you could never show that there was absolutely no benefit. (Google "Null Hypothesis").

Only limited evidence showed that primary prevention with statins may be cost effective and improve patient quality of life. Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk.

The potential adverse effects of statins among people at low risk of CVD are poorly reported and unclear (Jackson 2001) but, among those with pre-existing CVD, the evidence suggests that any possible hazards are far outweighed by the benefits of treatment. Two reviews of 18 and 35 trials respectively found that there were similar rates of serious adverse events with statins as compared to placebo (Kashani 2006; Silva 2006) and a further review of 26 RCTs concluded that there was no effect on risk of cancer with statins (Dale 2006). Other adverse events have been investigated and may be causal, for example rhabdomyolysis - break down of muscles - which can be serious if not detected and treated early (Beers 2003). However, in a systematic review of statins with about 35,000 people and 158,000 person years of observation in both treated and placebo groups, rhabdomyolysis was diagnosed in eight treated and five placebo patients, none with serious illness or death (Law 2003). One RCT of 621 adults found that statins did not adversely affect self reported quality of life, mood, hostility psychological well being or anger expression (Wardle 1996). Small decrements in scores on tests of psychomotor speed and attention were found by Muldoon et al in an RCT of 209 adults, but Muldoon concluded that more research is needed to fully evaluate this (Muldoon 2000). In addition, a systematic review of five statin trials (N = 30,817) found no evidence that statins increased risk of death from non-illness mortality (accidents, violence or suicide) (Muldoon 2001).

borofergie · Jun 20, 2012

Dillinger said:
"The association with IHD mortality (HR: 1.07; 95% CI: 0.92–1.24) was not linear but seemed to follow a ‘U-shaped’ curve, with the highest mortality <5.0 and ≥7.0 mmol L−1. Among men, the association of cholesterol with mortality from CVD (HR: 1.06; 95% CI: 0.98–1.15) and in total (HR: 0.98; 95% CI: 0.93–1.03) followed a ‘U-shaped’ pattern." My bold.

I'm in the sweet spot of <5.0 and ≥7.0 (where most of the UK is by the way) so I'm happy with that. My other lipids are excellent; i.e. trigs and HDL/total cholesterol ratio.

The "U" shaped thing worries me, because I have very low-cholesterol (3.6 momol/l). However,

I think that it's wrong though. Cochrane says this:

There has been some concern that low levels of blood cholesterol increase the risk of mortality from causes other than coronary heart disease, including cancer, respiratory disease, liver disease and accidental/violent death. Several studies have now demonstrated that this is mostly, or entirely, due to the fact that people with low cholesterol levels include a disproportionate number whose cholesterol has been reduced by illness - early cancer, respiratory disease, gastrointestinal disease and alcoholism, among others (Iribarren 1997; Jacobs 1997). Thus it appears to be the pre-existing disease which causes both the low cholesterol and raised mortality (Davey Smith 1992).

Unless of course I have a pre-existing disease that is causing it.

noblehead · Jun 20, 2012

Sid Bonkers said:
but personally I would take advice from a Professor of Clinical Lipidology and the British Atherosclerosis Society every time over someone who offers diet books and holistic health advice but thats just me I guess.

Agreed :thumbup:

librarising · Jun 20, 2012

jopar wrote
As Sid said, Briffa background is basically selling a particular diet to individuals

well, in his own words :

I’m a naturally-oriented medical doctor, author and speaker. My work is dedicated to providing honest and trustworthy holistic health advice that can be used to combat and prevent illness, overcome everyday ailments, enhance energy and bring a greater sense of wellbeing. The advice and information you’ll find on this site is based on a mix of published as well as what I’ve learned works (and does not work) during 20 years of clinical practice as a doctor.

If you had a GP like that would you distrust them ? I only wish my GP was working in my interests like Dr Briffa claims to.
Oh I forgot he's an author. That's lower than a politician.

Lets shoot the messenger. That's been going on in medical research for decades. Just in a quieter way.

Geoff

dawnmc · Jun 20, 2012

So are we going to ignore Dr Malcolm Kendrick then!!! He's a British GP of over 25 years and worked with the European Society of Cardiology. Or is it because he doesn't agree with you.

Sid Bonkers · Jun 20, 2012

borofergie said:
Sid Bonkers said:

Can you qualify "less clear" borofergie as less clear hardly sounds definitive to me?

Click to expand...

Yes. There is no-clear evidence that statins have a benefit in people without a history of CVD (that includes me and you, I hope). That's as definitive as science gets, you could never show that there was absolutely no benefit.

OK so I understand where you're coming from with the 'less clear' thing, but it sounds so definite when you say it, not less clear at all :lol:

Could it also be that diabetics could be added to that proviso too? Not saying we are (more at risk) but I do hear many people being told that diabetics are at a higher risk of cardio vascular stuff.
As you know my cholesterol is pretty good at 4.1 and although Ive not had a full lipid profile done in the last year or so the last one in 2010 showed my trigs at .4 or something and previous ones were never more than .8, which is why I assume they stopped the fasting blood tests for me in 2010.
But perhaps I may benefit from a statin as some have mentioned for reasons other than cholesterol. Ive never been offered one to date but I would definitely listen to my doctor should he suggest I take one, especially if he gave me good enough reasons

Drifting off a bit here and not aimed at you but - I just dont get this paranoia some members seem to have towards drugs and the medical profession in general, all I have ever been given is good advice and on more than one occasion doctors have actually saved my life for which I am eternally grateful :clap: These same people often seem quite happy to take a selection of vitamins and herbal remedies which have never undergone any testing at all but baulk at the idea of taking a 'drug'. They're all drugs at the end of the day, arent they?

So what's the truth about Cholesterol

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