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Following up briefly on yesterday’s post regarding dietary fat and its effect on mental health, I have found a few articles to share with you.

The first is ‘The Risks of Low Fat Diets’ from Psychology Today dated April 29, 2003 (reviewed in 2012).

The article by Hara Estroff Marano reveals (emphases mine):

The first clue that low-fat diets might have anything to do with depression or self-directed violence turned up a few decades ago, quite by surprise. Large community-based studies of heart disease prevention strategies showed that among persons with the lowest cholesterol levels, there was a increased incidence of death not caused by illness, primarily to suicide, accidents, and violence.

the link between cholesterol lowering and suicide may run directly through brain serotonin pathways, with side stops to depression, irritability, impulsiveness, and aggression. Or it may run more indirectly through metabolic pathways of brain serotonin, the neurotransmitter most associated with depression. Whatever the link is, it’s complex, because it hasn’t been easy to pin down.

The article says that researchers are reluctant to delve too closely into this possible correlation because of the push for everyone to adopt a low-fat diet. No one wants to upset the apple cart.


Several studies have shown that low cholesterol is linked to depressed mood and to impulsivity, although it isn’t clear whether the link to depression is as true for people whose cholesterol levels are lowered by diet as in people with naturally occurring low cholesterol levels

But some problem in serotonin function seems always to be at the center of the story.

In nonhuman primates, high cholesterol levels enhance serotonin function. They lower levels of overt aggression. And they promote social behavior.

The article concludes that low-fat diets alter serotonin function. It is thought that lower fat levels in nerve-cell membranes could inhibit serotonin receptors.

Serotonin receptors help us function in society by regulating our moods and reactions. Low-fat diets could well have knock-on effects on all of us, directly or indirectly.

I seem to be acquainted with a number of bipolar people in the offline world. I’d never met any until a few years ago. Some of them were diagnosed in middle age.

It makes one wonder whether these people have been following low-fat diets for a long time. It also raises the question of whether adding a small amount of animal fat and/or omega-3 and omega-6 to their daily diets would help alleviate their symptoms.

More on low-fat diets and their effect on the body next week.

I’ve written about statins before, highlighting the bad science behind them and Professor Philippe Even’s verdict on them as well as THINCS’s theories on cholesterol.

Recently, the Daily Mail featured a guest article by Dr Aseem Malhotra, a British cardiologist. One of Malhotra’s patients, John, had had heart surgery during the past year, went on statins and then complained of chest pains.

Malhotra performed various tests on John (emphases mine):

But after numerous investigations found nothing untoward, we recognised the real problem: his statins. So I told him to try going without them for two weeks.

The doctor explains:

These drugs, taken by eight million Britons, are routinely prescribed to anyone who suffers a heart attack as they lower the likelihood of a second attack. They have an anti-inflammatory effect, which reduces the risk of a clot forming in the heart arteries.

Statins are also prescribed to patients with high cholesterol. As has happened in the United States, the reading for a ‘high’ cholesterol level in Britain is much lower than it was several years ago. Consequently, more people are being prescribed statins:

High (Total) Cholesterol:

Old Definition: Cholesterol > 240 mg/dl total cholesterol
People under old definition: 49.5 million
New Definition: Cholesterol > 200 mg/dl total cholesterol
People added under new definition: 42.6 million
Percent increase: 86%

The definition was changed in 1998 by U.S. Air Force/Texas Coronary Atherosclerosis Prevention Study.

However, as Malhotra’s patient’s case illustrates, statins can bring a variety of alarming and unexpected aches and pains. They can also result in memory loss.

Yet, whilst patients who stop their statin treatment often experience relief from these side effects, family doctors are less happy. As Malhotra relates:

John … was elated. For the first time in months his chest pains had gone. But he now had a new concern: his GP had since told him: ‘You must never stop your statin!’

The cardiologist says that, although statins can reduce cholesterol, so can changes in diet and lifestyle.

He explains that overhyped clinical trials in the 1980s put the buzz factor into statins, perhaps unwisely:

increasingly the medical profession is discovering that the health benefits of lower cholesterol have been exaggerated.

Two recent studies have cast serious doubt on early clinical trials into statins in the 1980s. These trials overplayed how good for us they could be, which contributed to a culture of over-prescribing the drug. The studies also suggested significant side effects of statins may have been underplayed.

Last month [April 2013] one of the world’s most respected sources of medical information, the British Medical Journal, presented serious doubts. According to its report, GPs have put an extra three million people on statins in the UK over the past ten years – and have received extra funding for meeting these targets.

There has, though, been a 40 per cent reduction in the number of heart attack deaths. But while statin prescriptions may have played a role, there have been no studies that prove this link.

Studies have shown a connection between reduction in deaths and the now-routine practice of undergoing emergency angioplasty as soon as someone suffers a heart attack – unblocking the artery with a stent or balloon through keyhole surgery.

Big Pharma is largely responsible for this. How often can it be said? Never often enough.

You might have to give up your job because you can’t walk anymore or because your memory is failing you, yet Big Pharma have managed to convince your GP, also culpable for not thinking critically, that you can never give up your statin! Low cholesterol levels are king!

Think about the logic behind that. You cannot function as a normal human being but as long as you have low cholesterol levels, hey, you’re right as rain.

Statins, as I’ve said before, are another case where the cure is worse than the disease.

Fortunately — and this might come as news to Britons reading this post, as it did to me — the British Medical Journal is currently running a campaign called Too Much Medicine to combat over-prescribing of unnecessary drugs. Finally. Let’s hope it is a success.

In the meantime, it was heartening to read Dr Malhotra state that the health benefits of lower cholesterol levels have been exaggerated.

A number of Americans have been following low-fat diets for decades, some since the 1950s. It is interesting that today we have so many elderly suffering from Alzheimer’s disease. Some physicians maintain that we need a regular intake of animal fat in order for our brains and bodies — including the nervous system — to function properly. As we consume less animal fat, more of us are losing our memories. Could this be a coincidence?

Conventional thinkers in the medical field counter that by saying we’re all just living longer and that a diminished memory is a sad eventuality. Yet, I remember my paternal grandmother and maternal grandfather who both lived to a ripe old age — in great mental health — on food they ate when they were children. This included plenty of meat, animal fat, eggs and butter. All of those are on the verboten list today. Should they be? One wonders.

Dr David Diamond’s hour-long lecture is useful testimony which debunks the taboo surrounding meat and animal fat. He actually lost weight on such a diet.

It wasn’t that long ago when scientists discovered that bacteria can cause certain ulcers. It is also thought, although it is not yet proven, that oral bacteria may cause heart disease in older people. If so, regular flossing could be more effective than statins.

The point is — we just don’t know. And neither do doctors, especially general practitioners who spend at best 10 minutes in a patient consultation.

Therefore, we should be approaching prescription drugs with the same scrutiny that we would when purchasing a new house or a new car. Why don’t we?

Yesterday’s post gave a summary of Professor Philippe Even’s new book which debunks the cholesterol myth, particularly where statins are concerned.

The book has just come out and is available only in French, by the way.

However, I mentioned a group of doctors and researchers, THINCS — The International Network of Cholesterol Skeptics — who have a website with fascinating and inconclusive findings on the subject.

Uffe Ravnskov, a Swedish physician and independent researcher founded THINCS and is their spokesman.

What follows are excerpts from a few of the THINCS discussion pages by topic (emphases mine, some editing in brackets).

Disclaimer: This is not intended as medical advice, rather food for thought.

The Paleo Diet and longevity

Is the Paleo Diet the magic formula? It is popular and, undoubtedly, nutritious, if spartan. But is diet alone responsible for health?

Based on what we know, the major causes of death among primitive humans were infectious disease and violent death. This applies even to many recent hunter-gatherer/nomad societies. Mann’s autopsy study of Masai men showed that the most common causes of death were “homicide” and syphilis. The Masai were well-known for their war-like attributes, raiding neighboring tribes, stealing their cattle and women…if you live that kind of life, don’t expect to live to a ripe old age, no matter how fit you are or how much pristine free range food you eat!

What is most telling from Mann’s studies is that the Masai were in far better physical condition and their cardiovascular systems were far healthier than age-matched Americans. “Age-matched” is the key word–if the Masai were able to combine the healthier aspects of their lifestyle with a more sanitary and civilized mode of living, then there is little reason to believe they would not live as long if not longer than the average westerner …

The longevity we enjoy today is primarily a result of improved sanitation and hygienic living conditions. Our control over microbes has progressed to the point where most of us are now living long enough to die from other causes.

The polypill

This story has hit the headlines at least annually in the UK for the past 10 years. Prominent physicians propose that the NHS give this powerful all-in-one medication to every Briton over 55.

These two British epidemiologists suggest that every human being above age 55 should take a polypill containing statin, a thiazide, a betablocker, an angiotensin converting enzyme inhibitor, folic acid, and aspirin every day for the rest of their life. Say Law and Wald, a pill with these ingredients could prevent 80% of heart attacks and strokes…

on the basis of a horribly flawed analysis Law and Wald [the epidemiologists who made the suggestion in 2003] recommend that everyone in the Western World should be taking six different drugs for the rest of their lives. Any moment now I am expecting an article to appear in the BMJ written by the Red Queen, entitled ‘Everyone is ill, and all shall have medication.’

From the get go, the beta blocker and thiazide will raise insulin resistance and the risk of developing type 2 diabetes–28% by the beta blocker alone (according to an NEJM article –Gress et al 2000) …

It is a basic principle of medicine to start medication (when necessary) one prescription at a time so that when a patient develops an adverse effect it is simple to identify the offending agent. The Polypill proposes three anti-hypertensive drugs: 

– Thiazide diuretic:  may give rash, sun sensitivity, leg cramps and potassium depletion.
– Beta blocker:  may give fatigue, impotence and dyspnea
– ACE inhibitor:  may give cough

Along with that is aspirin which may give allergic reactions, GI distress and iron deficiency anemia and then of course the Polypill would contain the most insidious toxin ever prescribed to man:  a statin drug.

Statins are the most dangerous class of drugs ever promulgated upon man. At least commonly toxic drugs, such as chemotherapeutic agents, are obvious in their rather immediate side effects.  Statins, on the other hand, bring about a gradual, insidious state of fatigue, muscle soreness and eventually heart muscle weakness which comes on after many months or years. Furthermore, there is evidence for statin-related increases in cancer, peripheral neuropathy and cognitive impairment.

Low-dose statins or no statins at all?

Some of the THINCS contributors, Ravnskov among them, believe that low-dose statins are the answer. However, others think that there are still too many variables to say for certain whether statins offer any benefit at all.

Duane Graveline: In my mind a priority exists to evaluate this [low-dose] possibility for the benefits might be substantial especially in the reduction of side effects of all types ie cognitive, liver damage, myopathy, neuropathy,cardiomyopathy and even of cancer provocation.

Many THINCS members feel that statins have no justification and I must admit there is little research documentation for statin effectiveness on cardiovascular risk reduction. But some studies such as that of Collins do show specific risk reductions in MI’s or strokes, which seem to be real and not completely offset by all cause mortality data.

Although I have prescribed more than my share of statins during my last decade of family practice, no longer would use statins for cholesterol or LDL reduction

Malcolm Kendrick: I share your belief that a small dose of statin may be as effective as a high dose of statin in reducing CHD risk, if statins work in the same sort of way as aspirin. But the pharmaceutical companies manufacturing statins have made billions of dollars on the concept that the more LDL lowering the better. They are never, ever, going to fund a low dose trial – just think what they might find. And no-one else has the money to fund such a trial.

Even if they did, I am certain that such a trial would be considered unethical by any ethics committee as the committee members will be convinced that it is absolutely true that the lower the LDL level the better, and so a trial where LDL levels are not lowered to their ‘optimal’ level in the  control arm would not be allowed.

Paul Rosch: There is little doubt that statins may be effective medications, but as I have long maintained, this is not due to any lipid lowering effects and is more likely related to anti-inflammatory activities.

Alena Langsjoen: … The only legitimate use that statins can possibly have is to treat cholesterol neurotics, created by the whole anti-cholesterol propaganda.

Fred and Alice Ottoboni: … it is clear, certain vitamins, minerals, and foods act to inhibit harmful end products and stimulate beneficial end products.  It is not wise to use a blunt instrument like the statins on these delicately balanced systems.  Much better to use the vitamins, minerals and foods that are known to act positively with no side effects …

In short, the statins, and even aspirin, are simply not in the same league as a well-selected and supplemented diet.

Eddie Vos: Statins lower squalene [anti cancer], CoQ10 [anti cancer] and may promote angiogenesis [pro cancer if one has “dormant or incipient” cancers just waiting for blood supply to grow] … Younger people would not have so m[any] cancer nodules in their bodies [AND produce more CoQ10 and probably squalene] so that statins may not be as cancer promoting in the younger.

Herbert Nerlich: … The ‘war on cancer’ that Richard Nixon announced in 1973 is not being won, we add new cancer-causing chemical concoctions to the food chain and the environment every day, so do we really need to introduce another potent medicine which is apparently capable of humonguous deeds?  I agree with you that the  potential to act as carcinogens should seal the fate for statin therapy.   Statins work by creating damage to the liver if you look at it in a practical way. If there is or ever will be a role for the statins in the treatment of human beings I would suggest to apply the same amount of extreme caution that SHOULD be used in the introduction of genetically modified foods.   Do the homework first, prove your point and remember the   “Above all – do no harm”   and perhaps a disease will be found that can be treated with statins.


‘Athersclerosis’ discusses the composition of arterial plaque. THINCS member Bogdan Sikorski posits that fats which withstand high temperatures actually help to clear arterial plaque instead of, as we currently believe, encouraging it. This means clarified butter (ghee), lard and beef dripping.

Bogdan Sikorski: … Anyway, contrary to popular modern dietary habits, I and my family must be just about the only human beings, apart from the remnants of  traditional Northern Indians, who are happy to consume buckets of ghee, which as a rule must be relatively high in oxchol. We (well, my wife) make our own, to which we also add some coconut oil, which makes it a perfect frying, non smoking, fat.

Oh well, this week for a change we will have a bucket of freshly melted lard … Hopefully, that should also be oxchol rich due to the high-temp melting process. Here[‘]s hoping for clear arteries!  

Leib Krut: I should have liked to give you a reference to a paper published in the British Heart Journal many years ago by someone named Malhotra … He wrote on the difference in the incidence of Coronary Heart Disease between Northern and Southern Indians in India. He reported that the southerners were vegetarian and lean and had a CHD incidence 7+ times that of the northerners who were much heavier and who ate a considerable amount of fat (10-20 times that in the south), that this fat is mainly from animal sources, including ghee, and therefore largely saturated. In the south the small amount of fats are mainly from seed oils and therefore largely polyunsaturated.He described the way ghee was made, something your wife clearly knows well, and I have no doubt that oxysterols are generated in the process since they are found in butter made by traditional methods in which cream is allowed to “ripen” simply by holding it at ambient temperature for 3-4 days. This cream is then churned to make butter. I suspect that in making ghee even more oxysterols are generated. I might add that the northerners smoke 8 times as many cigarettes as do their southern neighbours. They would seem to be doing all the wrong things in the north, according to the standard dogma, and yet are protected from CHD, save for the fact that must have a considerable intake of oxysterols, or at least must have done so when Malhotra wrote that paper … The reference is: Malhotra SL. Brit. Heart J. 1967;29:895-905.

Paul Rosch: Sustained hypertension [high blood pressure] causes stroke but is an associated “risk marker” rather than a causative “risk factor” for coronary atherosclerosis and the same is true for cigarette consumption, which can cause cancer of the lung and emphysema.  The MRFIT study clearly showed that lowering elevated blood pressure, cholesterol and reducing smoking alone or in combination did not lower the rate of heart attacks.  On the other hand, heart attacks were higher in men with certain Type A traits and the WCGS clearly showed that Type A behavior as assessed by the structured personal interview was as significant a “risk factor” for CHD as hypertension, cholesterol and smoking and was also completely independent of these.  What is important about this observation is that although hypertension is not a hallmark of Type A, such individuals do show hyperactive and exaggerated blood pressure responses to stressors and it is these repeated surges that probably damage the intima [part of the arterial structure] and predispose to the development of plaque.  As Jim Lynch and I have shown, everybody’s blood pressure spikes as soon as we start to speak and the magnitude of this is affected by speed and volume of speech, the perceived relative social status of the audience, the content of the conversation, presence of a pet and other factors.  Although these elevations can be alarming at times, patients have no perception of this and are not aware whether their blood pressure is high, normal or low.  The higher the resting blood pressure, the greater the rise when you start to talk.  No antihypertensive medications are capable of blunting these surges and beta blockers actually accentuate themConversely, blood pressures fall below basal levels when one is listening to someone else or is silent and attending to something in the environment, such as watching tropical fish in a tank.  Note also that the customary rise in blood pressure with age is not seen in secluded orders of nuns who rarely speak and occupy themselves mostly by tending to their plants or crops …

Jim and I are quite confident that the link between Type A and coronary heart disease will prove to be these repetitive spikes in blood pressure that damage the inner surface or adventitia of coronary vessels that result from Type A vocal stylistics and poor listening habits.  These and some of our other research findings have led to the development of a very successful non pharmacologic treatment for hypertension by teaching patients to get in touch with their feelings and how to reduce blood pressure surges while talking.

Paul de Groot: … We all know that sclerotic changes of the arterial wall is not per se age dependent and so is not a fact of life. There ought to be one or more causes and possibly the causes are not the same for different arteries. Why would elastic arteries change in the same way as muscular arteries from the same agents? and why would a different “organ” such as the aorta react in the same way. We just don’t understand the differences and still we think that there is just one disease called atherosclerosis which is responsible for the changes of all arteries.

Leib Krut: It may be that the experience in South Africa, where I saw these cases [hereditary high cholesterol], was unusual. Homozygous familial hypercholesterolemia [FH] was unusually common among a distinct segment of the population. It was among Afrikaners, who are mainly of Dutch origin. They were a group of people who for cultural, and other reasons, tended to sequester themselves from the rest of the community. And like in all small groups of people who embrace and foster their cultural identity, and spend their lives amongst their own people, e.g. Ashkenazi Jews, certain genetic disorders, where they happen to exist, are given the opportunity for homozygous expression. It was once estimated that there were more people with homozygous FH in South Africa, in a segment of the population drawn from a very small pool, than there were in the whole of the USA. It was clear that they do have myocardial infarctions at a young age and seemed to be afflicted with a more fatal disease than in Americans with FH. And yes, CHD was especially common in the Afrikaners in general. Perhaps there were lots of heterozygotes amongst them. One cannot know. As I have already indicated, heterozygotes are not readily distinguished by their cholesterol level from those not so afflicted, and there may be no other features to distinguish them. This is especially so when the plasma cholesterol level in the general population from which they are drawn tends to run high.

Uffe Ravnskov: Your desciption of FH may possibly be correct in South Africa; there is evidence that FH and its varieties are much more common in that country. However, in other countries, at least in Scandinavia and the US homozygotic FH is very rare, about 1:1 000 000, and the cholesterol levels in heterozygous FH are often much higher than in normal individuals. I have myself met at least seven “patients” in the age range 50-85 with total cholesterol above 400 (and with a normal heart) and I have been told about many more.

Stress, lifestyle and heart disease

This discussion from March 2002 on the role of physical and emotional strain in heart disease was excellent, even if it was — rightly — impossible for THINCS members to come to a conclusion.

Paul Rosch: It seems quite clear that TB was precipitated by the stress of sudden change and relative absence of family ties and social supportThe role of stress in accelerated atherosclerosis, coronary heart disease and sudden death is also well established, particularly with respect to depression, acute and chronic anxiety states, etc. as I have pointed out elsewhere.

Morley Sutter: any intervention must be selective and do only one thing if the intervention (e.g. drug) is to be used as a tool to assign causation.  This is the problem with the statins: they have more than one pharmacological action and their ability to alter lipids might or might not be involved any modestly beneficial effects they possess …

Dear Doctor Rosch,   …   As you can tell, I think that stress as a causal factor in disease, is not a very useful concept.  “One man’s stress is another man’s thrill”.

The word “stress”, or more accurately, “Generalised stress reaction” was introduced into medical parlance by Hans Selye at the University of Montreal in relation to his production of severe pathology in rats given large doses of cortisol and made potassium deficient.   The word stress is usually used as a misnomer for anxiety. The latter is a problem for all of us in terms of our ability to function.

I suggest that attempts to causally link the presence of “stress” and more importantly its reduction or removal, to any disease have been singularly unsuccessful.  I realise that certain activities called stressful such as high level exercise put people at some risk of heart attacks, perhaps due to high sympathetic nervous activity.  But such precipitating factors are not what most people think of as the “stress of daily living”.

Paul Rosch: … I was a Fellow at Hans Selye’s Institute of Experimental Medicine and Surgery at the University of Montreal in 1951, shortly after his magnum opus Stress was published,   co-authored several papers and chapters with him, including the lead chapter Integration of Endocrinology for the AMA Textbook of Glandular Physiology and Therapy and enjoyed a close personal and professional relationship with him until his death.    The term stress was deleted from his original 1936 article in Nature (A Syndrome Caused By Diverse Nocuous Agents) by the editor because it was confusing.   At the time, the general consensus was that every disease had a specific cause based on Koch’s postulates.  The tubercle bacillus caused tuberculosis, anthrax bacillus caused anthrax, etc.  What Selye proposed was quite different, namely that many difference agencies both physical and mental could cause the same pathology. (This was not based on injecting cortisol or compound F (which was not available at the time) or potassium depletion.)

Unfortunately, he was not aware that stress had been used for centuries in physics to explain elasticity, the property of a material that allows it to resume its original size and shape after having been compressed or stretched by an external force.  As expressed in Hooke’s Law of 1658, the magnitude of an external force, or stress, produces a proportional amount of deformation, or strain, in a malleable metal.  The maximum amount of stress a material can withstand before becoming permanently deformed is referred to as its elastic limit.  This ratio of stress to strain is a characteristic property of each material, and is called the modulus of elasticity.  Its value is high for rigid materials like steel, and much lower for flexible metals like tin.  Selye several times complained to me that had his knowledge of English been more precise, he would have gone down in history as the father of the “strain” concept.             

This created considerable confusion when his research had to be translated into foreign languages.   There was no suitable word or phrase that could convey what he meant, since he was really describing strain.  In 1946, when he was asked to give an address at the prestigious Collège de France the academicians responsible for maintaining the purity of the French language struggled with this problem for several days, and subsequently decided that a new word would have to be created.  Apparently, the male chauvinists prevailed, and le stress was born, quickly followed by el stress, il stress, lo stress, der stress in other European languages, and similar neologisms in Russian, Japanese, Chinese and Arabic.  Stress is one of the very few words you will see preserved in English in these latter languages.  Selye’s concept of stress and its relationship to illness quickly spread from the research laboratory to all branches of medicine, and stress ultimately became a “buzz” word in vernacular speech.  However, the term was used interchangeably to describe both physical and emotional challenges, the body’s response to such stimuli, as well as the ultimate result of this interaction.  Thus, an unreasonable and over demanding boss might give you heartburn or stomach pain, which eventually resulted in an ulcer.  For some people, stress was the bad boss, while others used stress to describe either their “agita” or their ulcer.

Because it was clear that most people viewed stress as some unpleasant threat, he had to create a new word, “stressor”, in order to distinguish between stimulus and response

The American Institute of Stress was formed in 1978 and my involvement in this was at Selye’s request and you can find out more about this on our web site  Sorry to have gone on for so long and as you wrote “At any rate, if you have read this far, I am grateful.” Paul J. Rosch, M.D.  President, The American Institute of Stress.

Bogdan Sikorski: Stress appears to be a very complicated topic, particularly when one takes into consideration interaction with nutrition. For instance, it is well known that both animals and humans can die of stress. Animals which are being chased and humans who have lost hope. The latter have been described in the literature (factual), for instance concentration camp inmates in German (not Polish as a certain “group” insists on calling them) camps during WWII. Surprising as it may be, many concentration camp inmates “cured” themselves of different diseases, but most of them ended up with different ones (mainly infectious) when they were lucky to survive (nutrition?). Surprisingly also, JK [Jan Kwasniewski] insists that not many, if any, had problems with stomach or duodenal ulcers while in camps.

Malcolm Kendrick: … it can be shown that patients in a state of depression and vital exhaustion (VE) also demonstrate raised levels of stress hormones. (This is also true of anxiety). Depressed patients develop insulin resistance (sometimes frank diabetes), which recovers when the depression is cured (or just goes away). Which shows that there is a clear causal association between depression and insulin resistance (mediated by the hypothalamic pituitary adrenal axis HPA-axis and – mainly – excess cortisol secretion).   So it is possible to see the connection between acute, physical stress, and longer term psychological ‘stress’…and the abnormal secretion of the stress hormones. This, I believe, is where the link between ‘stress’ and CHD [coronary heart disease] is made via syndrome X.

Morley Sutter: First the infecting agents should not be limited to bacteria: the term microbe seems preferable.   Viruses could well be culprits in initiation of inflammation leading to atherosclerosis.    

Second, any disease where the etiolgy involves a microbe, is subject to the vagaries of host-parasite interaction.  The latter clearly involves pathogen load, nutrition, immune status and genetic makeup of both host and parasite.  We don’t get a cold each time we are exposed to the cold virus.   

Third, the pathology of atherosclerosis must be more accurately staged and/or defined than at present.   For instance do all “fatty streaks” lead to plaques at that site? …

Malcolm Kendrick: The stress of social dislocation is a primary cause of CHD (there are other things as well, but you don’t want a one hundred a seventy eight page e-mail, I suspect).     Thus, Japanese who move from Japan to the USA (and don’t change their diet) suffer a rate of CHD of about four times that of native Japanese. Those Japanese who maintain a traditional Japanese lifestyle in the USA retain native Japanese rates of CHD     Asian Indians – who emigrate, suffer very high rates of CHD wherever they go, and whatever they eat. And  Indians living in cities in India suffer much higher rates of CHD than rural Indians (with no change in diet)The USA had an explosion of immigrants in the early part of the twentieth century, this was followed by an explosion in the rate of CHD in the middle part of the twentieth century. And is now followed by a fall, as the first and second generation immigrants are being replaced by third and fourth generation immigrants – who are better integrated into American society, and have better develop social structures in place.      The breakdown of communism in Eastern Europe has been followed by huge change, destruction of old ways of life etc. and the rate of CHD has exploded.     Finns with Eastern Orthodox religion are ‘immigrants’; Lutherans are well-established Finns. Lutherans suffer one fifth the rate of CHD.   The social dislocation in Japan following the second world war is now gone, and Japanese society is more settled.       In short, when you tear apart the social support network, you create levels of chronic stress that lead to HPA-axis abnormalities, syndrome X, insulin resistance, abdominal obesity and a very high rate of CHD.

From these exchanges we can see that nothing is as cut and dried as Big Pharma and the medical establishment would have us believe.

Contradictions abound everywhere. There is no magic tablet which cures heart disease. And, as some THINCS members point out, once a stressful or depressing period of time passes, so do health problems — in some cases.

Apologies for the length of this post, but it seemed appropriate to put a number of the contradictions in one place to demonstrate the difficulty in understanding and the complexity of cholesterol, coronary heart disease and atherosclerosis.

Last summer, I wrote a post summarising the French physician, researcher and professor Philippe Even’s debunking of the dangers of second hand smoke.

Late in 2012, Even (pron. ‘Ay-vahn’) and noted urologist Bernard Debré co-authored a book called Guide des 4 000 médicaments utiles, inutiles ou dangereux (A Guide to 4000 Useful, Useless or Dangerous Medicines).

Even’s latest work is called La Vérité sur le cholestérol (The Truth about Cholesterol), which has been making quite a stir in the French health community. I’ve heard him interviewed on RTL and, one week ago, on RMC.

The RMC interview went a bit more in depth than RTL’s, probably because Even appeared on Les Grandes Gueules, the lively mid-morning news debate co-hosted by Olivier Truchot and Alain Marschall. I mention this because Truchot introduced the segment by saying, ‘Incidentally, my colleague Alain Marschall is taking Crestor, so he might find this of interest’.

The panellists on the show were all men, which was just as well once Even began going into the side effects of statins. Many of us know of reports of statin patients who experience memory loss and/or severe muscular pain within a short time after they start the medication.

Even advised stopping the statins in such cases: ‘What is the point of continuing with a medication that is giving you pain? These ailments could become much worse in 10 or 20 years’ time.’ He said that patients who stopped statins altogether noticed an improvement in their health within a few days’ time. He added that this included side effects of a ‘sexual’ nature.

At that point, a high-pitched nervous laugh went up in the studio — Marschall? — followed by an uncomfortable silence.

So, we might well add erectile dysfunction to the list of statins’ possible side effects.

The following is a summary of Even’s findings on cholesterol and statins taken from l’Internaute, Le Nouvel Observateur and Atlantico:

– Cholesterol often poses no danger. On RMC, he said that if there is only a high cholesterol reading and no other heart or cardiovascular problems, then the patient should think twice about taking statins.

– High cholesterol alone will not cause a heart attack or stroke: ‘there has been no such example from the beginning of prescription drugs up to the present day’.

– Professor Even studied 50 clinical trials of cholesterol which showed that statins made no difference to the frequency of cardiovascular disease-related illnesses.

– Only patients with a 3mg cholesterol reading should consider statins on their doctor’s advice (also see above caveat — provided something else is present which could indicate a heart condition). Currently, patients with as low a reading as 1.5mg receive a prescription.

– Statins do little to reduce cholesterol in 90% of cases.

– Doctors exaggerate the dangers of cholesterol when talking to their patients.

– Cholesterol-reducing drugs, such as statins, are a €2bn per annum business in France, €25bn worldwide.

– In France, there are only 100,000 people with high cholesterol running in their families who should be taking statins — yet, 5 million French are on them!

Even said that the best way to reduce one’s cholesterol is to make changes to one’s diet, increase one’s amount of physical exercise and, if necessary, modify certain lifestyle habits.

He added that people are becoming increasingly wary of blanket prescriptions for statins and other powerful drugs but warned that it would take ‘probably five or six years’ before pharmaceutical companies feel suitably pressured to change their ways of promoting prescription drugs.

The truth is that there is no firmly established ’cause’ or ’causes’ of heart disease and stroke. I know that will surprise many, but remember that Big Pharma, insurance companies and the medical field  have to have a fear-inducing industry in order to exist.

Ask yourself these questions. We are in the 21st century, yet, a) is there a cure for cancer or b) a cure for heart disease or stroke? No! Big Pharma and health professionals — including researchers — rely on unfounded fear and faulty studies to keep their jobs.

Professor Even admitted — when debunking second-hand smoking — that he had to hold to ‘certain positions’ in order to be able to work in his field.

The Nouvel Obs article mentioned an interesting group — Thincs — The International Network of Cholesterol Skeptics, founded by a Swedish doctor and independent researcher, Dr Uffe Ravnskov. More on that tomorrow.

Tomorrow: More cholesterol-related myths questioned

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