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Yeah, yeah, I know I’m supposed to be on vacation.  But this article in the Amarillo Globe-News came to my attention when I checked emails and such after landing in Fort Lauderdale:

Chris Hayes and his wife Michelle watched a documentary online nearly two years ago called “Fathead.” And while hard to describe, they said something just clicked after watching the 104-minute film.

“People call it different things, but you wake up and have one of those ‘eureka moments,’” Chris Hayes said. “You see something you identify with, and something just made us want to do this.”

“Fathead” was a rebuttal to the highly popular “Super Size Me,” in which a man ate at McDonald’s three times a day for 30 days, gained 24 pounds and looked horrible.

In “Fathead,” Tom Naughton went on an all-fast-food diet for a month, but kept it at 100 grams of carbohydrates a day. The result? A loss of 12 pounds and lower cholesterol.

Let me tell you, that ain’t nothing.

Approaching the two-year anniversary of their low-carb diets, Chris Hayes, the IT director at the Amarillo Globe-News, and his wife have combined to lose the equivalent of an NFL linebacker.

They have lost 232 pounds — 137 pounds for Chris and 95 for Michelle.

Nice plug, eh?  You can read the rest of the article online.

We now return to our regularly scheduled vacation …

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I leave town on Friday for the low-carb cruise.  I’d planned to write one more full post this week, but as usual, I’ve got a lot to wrap up before leaving.

The Older Brother will be taking over the Fat Head chair while I’m gone.  I wasn’t sure he’d be available, since The Middle Son is getting married in a few weeks.  But The Older Brother assured me his main wedding responsibility is to show up on time.

I’ll check comments when I can.  Other than that, I plan to spend my time on the ship relaxing, socializing, reading and sleeping as late as I choose.

See y’all when I get back.  (I’ve lived in the South for six years now, so I believe I’m entitled to use “y’all” without feeling too self-conscious.)

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A reader sent me a link to a Consumer Health Digest article titled Eight Reasons Why Eating Cheese Is Harmful For Health. After I finished laughing at the utter nonsense, I decided the article is a perfect example of what’s wrong with media health reporting. Let’s take a look. (By the way, I changed the quote style with a bit of help from some PHP-savvy readers. Hope it works better on those tablets and whatnot.)

1. Cheese can Contain Bacteria Transferred from the Cows It Comes From

Although it can be a little weird to think about, cheese is a byproduct of cows.

Boy, that is weird. I thought it came from cheese trees.  If it comes from cows, I’m going to stop putting cheese on my burgers.  I only eat non-cow foods.

Made from cow’s milk, cheese can contain anything stuff that the cow it came from had in its system –including synthetic hormones and bacteria.

I don’t know what “anything stuff” is, but as for cheese containing whatever the cow had in its system, I’m pretty sure we can say that about any animal food.

It has long been suspected that synthetic hormones and bacteria transferred from cows to humans contribute to health problems, including memory and mood problems along with infections.

It’s long been suspected, eh? Well, that’s all the scientific proof I need.

2. Cheese is Really, Really Fattening

To many people, cheese seems like a healthy food. People on diets often eat cheese as a “light” snack to get the dairy in for the day. Unfortunately, cheese wrecks diets. Full of saturated fat, cheese instigates weight gain. The body also tends to digest cheese in such a way that it turns into stubborn, hard to lose fat.

I see. So if we check the research, we’ll find that people who eat full-fat dairy products are consistently fatter than people who don’t – because of that saturated fat that instigates weight gain and turns into stubborn, hard to lose fat. Let’s dig into the study files … ah, got one. It’s a meta-analysis of 16 studies. Here’s the conclusion:

In 11 of 16 studies, high-fat dairy intake was inversely associated with measures of adiposity.

That would mean people who ate full-fat dairy are thinner, not fatter.  Back to the Consumer Health Digest article:

Apart from causing weight gain, saturated fat is also known for wreaking havoc in the cardiovascular system. It can significantly influence cholesterol levels as well, which can be a bad for a person’s health.

I could swear I just saw a study about dairy fat and cardiovascular disease … oh, now I remember! That was the topic of my previous post. Researchers measured biomarkers of dairy-fat consumption in a population of more than 3,000 people and compared that to rates of heart disease. To quote from my quote from an article about the study:

What they found is that the dairy intake of people who had heart attacks was not statistically different than the intake of people who did not. After breaking people into quintiles, based on their dairy consumption amount, there was no significant linear relationship between consumption and heart risk, even among the most voracious consumers.

Even the “most voracious” consumers of dairy fats didn’t have higher rates of heart disease. That was the study that had the researchers fumbling for an explanation … such as perhaps there’s some protective substance in dairy foods that offsets the effects of the saturated fat.

3. Cheese is Very Salty

Another nutrient cheeses are often full of is sodium. Though necessary to the body, sodium is often consumed in excess. Regular consumption of cheese can increase the amount of sodium a person eats drastically. Unfortunately, the excess sodium can cause several health issues, including:

High blood pressure
Diabetes
Kidney Disease
Weak Bones
Stiff Blood Vessels
Stroke and Heart Attack

None of which has ever been proven. However, there have been several studies – like this one and this one – suggesting that low-salt diets might be harmful.

4. Cheese Can Contribute to Cardiovascular Issues

As a result of the high-fat nature of many kinds of cheese, eating cheese regularly can significantly contribute to obesity and thus to cardiovascular issues. Add in the amount of sodium that most cheeses contain and it’s clear that cheese can really be terrible for heart health.

Uh … uh … I know eight reasons sounds more impressive than seven reasons, but didn’t you just cite obesity and heart disease as reasons to avoid cheese up there in reason number two? You’re just as wrong now as you were a few paragraphs ago.

5. Cheese Making Can Be Considered Inhumane

Many kinds of cheese are manufactured with rennet. This is made by taking an enzyme from the lining of a calves’ stomach. Unfortunately, the calves must be very young when the enzyme is harvested. As a result, cheese making in some regions and processes involves the slaughter of young calves.

Holy crap! Next you’ll be telling me hamburger-making involve the slaughter of cattle.

6. Cheese Can Ruin Your Diet

On top of being really fattening, cheese can be a complete diet-wrecker because it is commonly paired with other carbohydrate-rich foods.

Well, that’s it, then. From now on, I’m only buying low-carb cheese.

Generally served with bread, crackers, and other “heavy” carb dishes, cheese often contributes to packing on the pounds.

I see. Cheese is fattening because it’s paired with “heavy” carb dishes like bread and crackers. If only it were somehow possible to eat cheese without all those carbs. When I see Dana Carpender on the cruise, I’ll ask if she can dream up a recipe or two. Maybe she can point me to a kitchen utensil that slices the bread and other carbs off the cheese.

7. Cheese Can Contain Mold Secretly

One of the hidden dangers of cheese is mold. Sure, some people eat moldy cheese as a delicacy. Many people also just cut moldy chunks off of cheese wedges and choose to eat the rest. However, mold can be hiding in the cheese and be invisible to the naked eye.

I looked up “foods that contain mold.” Here’s a partial list: pickles, relishes, green olives, vinegar, mustard, sour cream, beer, sauerkraut, smoked meats, canned tomatoes and dried fruits. So yes, if you want a mold-free diet, you should avoid all those foods. And the cheese too.

8. Cheese Can Make You More Susceptible to Cancer

Some people have suggested that cheese, along with meat, might be bad for people’s heath as a cigarette. Studies on the topic have revealed that the consumption of excessive protein, as occurs when people eat a large and consistent amount of cheese and meat, is risked to links of cancer and to shorter lifespans.

The writer’s source for that last statement is the observational study Dean Ornish was touting awhile back. High-protein diets were associated with higher mortality … but only for people under age 65. After the age of 65 (this is the part Ornish chose to ignore), high-protein diets were associated with a longer lifespan and lower rates of heart disease and cancer.

So if we’re going to believe observational studies prove cause and effect, we have to believe that meat and cheese cause cancer up to age 65, then prevent it after age 65. I’m 57 now, so I only have to hang on for eight more years. And I will … partly because I know better than to listen to media health writers.

The amount of protein a person should eat from cheese is also related to their age, indicating that cheese can be consumed in moderation at any age, but should be limited during many stages of life as well.

If anyone can make sense of that last sentence, please tell me what it’s supposed to tell me.

 

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Suppose you were an idiot. And suppose you were a nutrition scientist. But I repeat myself.

Sorry, just couldn’t resist borrowing from Mark Twain. Let me try again.

Suppose you’re a nutrition scientist. And suppose you conduct a study, all the while expecting the results to support a hypothesis you already believe.  But then  — @#$%!! the results undermine the hypothesis.

Oh, dear, what to do?

We saw one way to handle that sticky situation in our last episode: just don’t publish the results. Ancel Keys conducted a clinical study in which people who consumed vegetable oils instead of arterycloggingsaturatedfats!! had higher mortality rates – including higher mortality from heart disease. Keys didn’t like that result, so the data gathered dust for 40 years.  Nice move, Ancel.

Here’s another way to handle results you don’t like: explain them away. I found a couple examples of that method while looking through my database of studies recently.

In one study, researchers looked for a link between consuming dairy fat and heart disease. Here are some quotes from a Brown University press release:

Dairy products can be high in harmful saturated fat but not necessarily in risk to the heart.

Okay, let’s stop right there. Take a moment and wrap your head around that sentence. Saturated fats are harmful. Why? Because according to the Lipid Hypothesis, they cause heart disease. But they don’t necessarily pose a risk to the heart.

A newly published analysis of thousands of adults in Costa Rica found that their levels of dairy consumption had nothing to do statistically with their risk of a heart attack.

To conduct the study, [researchers] Aslibekyan and Baylin analyzed data on 3,630 middle-aged Costa Rican men and women who participated in an epidemiological study between 1994 and 2004 by co-author Hannia Campos of the Harvard School of Public Health.

Ah, so it was an observational study. Perhaps the researchers would be justified in explaining away their own results.

The researchers looked not only at the subjects’ self-reported dairy intake, but also at measurements of dairy fat biomarkers, namely 15:0 and 17:0, in their bodies.

Whoops. Not just an observational study. They actually measured biomarkers that told them how much dairy fat the participants consumed. Let’s look at the results.

What they found is that the dairy intake of people who had heart attacks was not statistically different than the intake of people who did not. After breaking people into quintiles, based on their dairy consumption amount, there was no significant linear relationship between consumption and heart risk, even among the most voracious consumers. The highest consumption quintile consumed an average of 593 grams of dairy foods a day.

Once again, stop and wrap your head around that. We’ve been told for decades to stop consuming cream and butter because the saturated fats cause heart disease. But in this study of more than 3,600 people – a study in which researchers directly measured biomarkers of dairy fat consumption – there was no relationship between consuming those arterycloggingsaturatedfats!! and heart disease.

So how do we explain this result?

Rather than suggesting that the saturated fats in dairy products are harmless, Aslibekyan and co-author Ana Baylin, an adjunct assistant professor of community health at Brown, hypothesize that other nutrients in dairy products are protective against heart disease, for all but perhaps the highest dairy consumption quintile in their study. The potentially beneficial nutrients include calcium, vitamin D, potassium, magnesium and conjugated linoleic acid (CLA).

Well, there you have it: saturated fats cause heart disease, ya see, but people who consume a lot of saturated dairy fats — even the most voracious consumers — don’t have higher rates of heart disease because … uh … because something else in the dairy products is protecting their hearts!

Awesome. Coming soon: nutrition scientists decide there must be heart-protective substances in bacon, eggs and sausage that offset the heart-killing effects of the arterycloggingsaturatedfats!!

Here’s another example of explaining away embarrassing results. In a 2010 study, researchers randomly assigned subjects to one of three groups: no change (the control group), 60 grams of whole grains for 16 weeks, or 60 grams of whole grains for 8 weeks followed by 120 grams of whole grains for 8 weeks.

These are the markers of cardiovascular health the researchers measured, according to the abstract:

BMI, percentage body fat, waist circumference; fasting plasma lipid profile, glucose and insulin; and indicators of inflammatory, coagulation, and endothelial function.

If whole grains are the wunnerful, wunnerful, health-enhancing food we’ve all been told they are, the second group should have shown improvement those health markers, and the third group should be well on its way to immortality. So let’s check the results:

Although reported WG intake was significantly increased among intervention groups, and demonstrated good participant compliance, there were no significant differences in any markers of CVD risk between groups.

No significant difference in any markers. That would mean not one.

Oh dear … and here we have our beloved USDA telling us all we need to eat more whole grains. How do we explain this result? Here’s how:

A period of 4 months may be insufficient to change the lifelong disease trajectory associated with CVD.

Riiiiiiight. Four months of consuming large servings of whole grains doesn’t affect BMI, percentage body fat, waist circumference, fasting plasma lipid profile, glucose, insulin, or indicators of inflammatory, coagulation, or endothelial function. But those whole grains may still have a positive effect on the lifelong disease trajectory associated with CVD.

Yeah, that makes perfect sense.

Well, at least these studies were published. If Ancel Keys had conducted them, the data would still be sitting in a dusty attic somewhere.

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Several people posted comments or sent emails with links to articles about a “rediscovered” study from the 1960s. Let’s look at some quotes from the Washington Post article:

It was one of the largest, most rigorous experiments ever conducted on an important diet question: How do fatty foods affect our health? Yet it took more than 40 years — that is, until today — for a clear picture of the results to reach the public.

The fuller results appeared Tuesday in BMJ, a medical journal, featuring some never-before-published data. Collectively, the fuller results undermine the conventional wisdom regarding dietary fat that has persisted for decades and is still enshrined in influential publications such as the U.S. government’s Dietary Guidelines for Americans. But the long-belated saga of the Minnesota Coronary Experiment may also make a broader point about how science gets done: it suggests just how difficult it can be for new evidence to see the light of day when it contradicts widely held theories.

The difficulty lies in the fact that scientists are freakin’ liars.

The story begins in the late 1960s and early ’70s, when researchers in Minnesota engaged thousands of institutionalized mental patients to compare the effects of two diets. One group of patients was fed a diet intended to lower blood cholesterol and reduce heart disease. It contained less saturated fat, less cholesterol and more vegetable oil. The other group was fed a more typical American diet.

Just as researchers expected, the special diet reduced blood cholesterol in patients.

Well then, those patients whose cholesterol dropped must have suffered fewer heart attacks and lived longer.

Today, the principles of that special diet — less saturated fat, more vegetable oils — are recommended by the Dietary Guidelines for Americans, the government’s official diet advice book.

And have been since 1980 – because of all the solid evidence supporting switching from animal fats to vegetables oils, doncha know.

Yet the fuller accounting of the Minnesota data indicates that the advice is, at best, unsupported by the massive trial. In fact, it appears to show just the opposite: Patients who lowered their cholesterol, presumably because of the special diet, actually suffered more heart-related deaths than those who did not.

Woops.

The higher rate of mortality for patients on the special diet was most apparent among patients older than 64.

In other words, within the group most likely to suffer a heart attack in the first place. Hooray for vegetable oils that lower our cholesterol!

It’s not exactly clear why the full set of data from the Minnesota experiment was never published.

Oh, I think I can guess.

“Had this research been published 40 years ago, it might have changed the trajectory of diet-heart research and recommendations” said Daisy Zamora, a researcher at UNC and a lead author of the study.

And that’s why it wasn’t published.

The results of the study were never touted by the investigators. Partial results were presented at an American Heart Association conference in 1975, and it wasn’t until 1989 that some of the results were published, appearing in a medical journal known as Arteriosclerosis.

Amazing. A big, expensive study is conducted to test the hypothesis that switching from saturated fats to vegetable oils will reduce heart disease by lowering cholesterol. The results show the opposite – at a time when many Americans were being encouraged to follow exactly that advice. What kind of lousy @#$%ing scientist would bury the results instead of publishing them?

The lead investigators of the trial, noted scientists Ancel Keys and Ivan Frantz, are deceased.

You’ve gotta love Ancel Keys. The guy conducts an observational study by giving two dietary questionnaires to a whopping 30 or so people in seven countries. From this itty bitty dataset, he decides he’s proved that saturated fats cause heart disease. Meanwhile, he tries to destroy the careers of other researchers who question his findings.

Then when his own clinical study – involving thousands of patients – shows that switching to vegetable oil increases heart disease and overall mortality, he clams up and doesn’t publish the results. What an awesome scientist he was.

If this story sounds somewhat familiar, perhaps it’s because a similar study was “rediscovered” back in 2013. I wrote a post about that as well and quoted from an article in Forbes:

In an exceedingly strange turn of events, data from a clinical trial dating from the 1960s, long thought to be lost, has now been resurrected and may contribute important new information to the very contemporary controversy over recommendations about dietary fat composition.

“Exceedingly strange” has now happened twice.

One trial that actually tested the hypothesis was the Sydney Diet Heart Study, which ran from 1966 through 1973. In the trial, 458 men with coronary disease were randomized to a diet rich in linoleic acid (the predominant omega 6 PUFA in most diets) or their usual diet. Although total cholesterol was reduced by 13% in the treatment group during the study, all-cause mortality was higher in the linoleic acid group than in the control group. However, in the original publications, and consistent with the practice at the time, deaths from cardiovascular (CVD) and coronary heart disease (CHD) deaths were not published.

Now, in a new paper published in BMJ, Christopher Ramsden and colleagues report that they were able to recover and analyze data from the original magnetic tape of the Sydney Diet Heart Study. The new mortality findings are consistent:

• All cause: 17.6% in the linoleic group versus 11.8% in the control group, HR 1.62, CI 1.00-2.64)
• CV disease: 17.2% versus 11%, HR 1.70, CI 1.03-2.80
• CHD: 16.3% versus 10.1%, HR 1.74, CI 1.04-2.92

People who switched to the vegetable did worse all around: higher all-cause mortality, higher mortality from cardiovascular disease in general, higher mortality from heart disease. But as with the Minnesota study, the results didn’t see the light of day for decades. The explanation offered was that a computer data tape was misplaced and only found 40 years later.

What a strange coincidence. We have two large, well-controlled studies conducted around the same time. Both show that switching from saturated animal fats to vegetable oils actually leads to higher mortality rates (including deaths from heart disease), despite lowering cholesterol significantly. A total poke in the eye for the Lipid Hypothesis.  And somehow, the results of both studies were buried for 40 years.

No wonder the researchers who crunched the “lost” Minnesota data wrote this:

Findings from the Minnesota Coronary Experiment add to growing evidence that incomplete publication has contributed to overestimation of the benefits of replacing saturated fat with vegetable oils rich in linoleic acid.

I interpret “incomplete publication” as a polite version of scientists are freakin’ liars.

Naturally, researchers who’ve spent years promoting the switch from saturated fats to vegetable oils immediately called a press conference to offer their apologies and a promise to re-evaluate their positions.

Kidding! Of course that didn’t happen. Here’s what did happen:

“The bottom line is that this report adds no useful new information and is irrelevant to current dietary recommendations that emphasize replacing saturated fat with polyunsaturated fat,” Walter Willett, chair of the nutrition department at Harvard University, said in a blog post from the school. “Many lines of evidence support this conclusion.”

He characterized the new analysis of the old experiment as “an interesting historical footnote.”

So Willett, like Ancel Keys, considers his observational studies to be rock-solid evidence, but dismisses clinical trials if the results undermine what he already “knows.”

As Max Planck said, science advances one funeral at a time. Ancel Keys is dead. A few more funerals, and we may finally see the Lipid Hypothesis end up on the Scrap Heap of Wrong Ideas, where it clearly belongs.

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Bacterial pneumonia, once a leading killer of the old and the very young, is caused by (duh) bacteria.  If you kill the bacteria, the pneumonia goes away.  It doesn’t really matter how you kill the bacteria, either.  If a patient is allergic to one drug that kills the bacteria, a doctor can prescribe a different drug that kills the bacteria and – bingo! – the pneumonia goes away. Why?

BECAUSE THE PNEUMONIA IS CAUSED BY THE BACTERIA, FOR PETE’S SAKE!  

And how do we know that?

BECAUSE IF WE KILL THE BACTERIA, THE PNEUMONIA GOES AWAY, FOR PETE’S SAKE!

Okay, but let’s suppose we kill the bacteria we believe causes the pneumonia, but the pneumonia remains and the patient dies.  And let’s suppose this happens with multiple patients.  Then what would we conclude?

IF KILLING THE BACTERIA DOESN’T MAKE THE PNEUMONIA GO AWAY, THEN THE PNEUMONIA ISN’T CAUSED BY THE BACTERIA, FOR PETE’S SAKE!  WHAT ARE YOU, AN IDIOT?

No, I’m just pointing out some basic logic here.  If we kill the bacteria but the pneumonia remains, we have to conclude that while a bacterial infection may be associated with pneumonia, it isn’t the cause.  That’s what we’d expect any honest scientist to say.

But strangely, this basic logic seems to escape researchers when a cholesterol-lowering drug fails to prevent heart attacks. Here are some quotes from a New York Times article:

It is a drug that reduces levels of LDL cholesterol, the dangerous kind, as much as statins do. And it more than doubles levels of HDL cholesterol, the good kind, which is linked to protection from heart disease.

That’s the Lipid Hypothesis in a nutshell: LDL is dangerous.  It causes heart disease — just like that nasty bacteria causes bacterial pneumonia.  HDL, meanwhile, protects against heart disease.

As a result, heart experts had high hopes for it as an alternative for the many patients who cannot or will not take statins.

Everybody sing: “Oh, we’ve got hiiiigh hopes.  Yes, we’ve got hiiiigh hopes …”

But these specialists were stunned by the results of a study of 12,000 patients, announced on Sunday at the American College of Cardiology’s annual meeting: There was no benefit from taking the drug, evacetrapib.

No benefit?  But LDL causes heart disease!  Did the drug fail to lower the LDL that causes heart disease?

Participants taking the drug saw their LDL levels fall to an average of 55 milligrams per deciliter from 84. Their HDL levels rose to an average of 104 milligram per deciliter from 46.

Well now, that is an amazing improvement in lipids.  The American Heart Association would be delighted with those numbers … although strangely, I can’t find recommended LDL levels on the AHA site anymore.  Perhaps they hired the former KGB artists who used to make people disappear from official photos once they became an embarrassment to the Kremlin.  Anyway …

Yet 256 participants had heart attacks, compared with 255 patients in the group who were taking a placebo.

In other words, no difference.  A total fail.

“We had an agent that seemed to do all the right things,” said Dr. Stephen J. Nicholls, the study’s principal investigator and the deputy director of the South Australian Health and Medical Research Institute in Adelaide.

Yup.  If high cholesterol – and specifically high LDL – causes heart disease, then you did indeed have an agent that seemed to do all the right things.

“It’s the most mind-boggling question. How can a drug that lowers something that is associated with benefit not show any benefit?” he said, referring to the 37 percent drop in LDL levels with the drug.

Boy, that’s a real head-scratcher.  Let me think for a minute … uh … uh … perhaps the fact that two things are associated doesn’t mean one is causing the other?  I seem to recall a good scientist or two saying as much.

“All of us would have put money on it,” said Dr. Peter Libby, a Harvard cardiologist. The drug, he said, “was the great hope.”

And how are those Enron shares working for ya?

Researchers have hypotheses, but no one is certain what went wrong. “It may be that the LDL level is less important than how it gets changed,” said Dr. Paul Thompson, a cardiologist at Hartford Hospital.

Ah, yes, that must be it.  LDL causes heart disease, ya see, but lowering LDL only works if you do it exactly the right way.  And if you have bacterial pneumonia, it’s not wiping out the bacteria that cures you; it’s how you kill them.  Kill them the wrong way, and you’ll still have pneumonia … even though bacteria cause the pneumonia.

Here’s an alternate hypothesis about why the latest study was a big, fat fail:

LDL DOESN’T CAUSE HEART DISEASE, FOR PETE’S SAKE!

That would be the most logical conclusion:  we beat people’s LDL levels down, but they didn’t have fewer heart attacks.  So LDL doesn’t cause heart disease.  But beating cholesterol levels down is a $36 billion per year (and climbing) business.  So we’re getting the illogical conclusion instead:

Cardiologists still have high hopes for a new class of cholesterol drugs, known as PCSK-9 inhibitors, that cause LDL to plummet to levels never seen in drug treatments.

Try to wrap your head around that one:  in a multi-year study of 12,000 people, dramatically lowering LDL levels didn’t prevent heart disease.  But cardiologists have high hopes for a new class of drugs that lower LDL levels EVEN MORE!

Everybody sing: “Oh, we’ve got hiiiigh hopes.  Yes, we’ve got hiiiigh hopes …”

And here’s the reason for those high hopes:

The PCSK-9 inhibitors can cost more than $14,000 a year …

Fourteen grand per patient, per year, year in and year out.  Yeah, that would generate a lot of hope.

… while statins can cost just pennies a day, so determining what portion of patients are truly statin intolerant has become an important question.

Yeah, about that “statin intolerant” problem: funny how research funded by drug companies is starting to demonstrate a real problem with statins isn’t it?  In one of his many great posts, Dr. Malcolm Kendrick predicted this would happen:

For years the experts have informed us that this is utter rubbish, statins are wonder-drugs, and adverse effect free. All of a sudden, now that the pharmaceutical industry is about to launch new cholesterol lowering agents, we are suddenly going to find that, why, after all, statins do cause a whole range of nasty adverse effects.

I watch this stuff with a kind of morbid fascination. The marketing game is on, billions are about to be spent pushing PCSK9-inhibitors. The Key Opinion Leaders who tirelessly promoted the wonders of statins, and who told us that they were virtually side-effect free, are now singing a completely different tune.

Sure enough, a big ol’ study just concluded that lots and lots of people have real problems with statins.  The study was led by Dr. Steve Nissen, one of the long-time pimps for — er, promoters of statins.  Returning to the New York Times article:

A second study presented at the cardiology meeting on Sunday and published online in JAMA, the Journal of the American Medical Association revealed just how vexing the issue is.

The study, directed by Dr. Nissen and paid for by Amgen, a pharmaceutical company, included more than 500 people with extremely high levels of LDL cholesterol who had tried two or more statins and had reported aching or weak muscles so severe that they said they absolutely could not continue taking the drugs.

[The result] indicated that 57 percent of patients actually could tolerate statins. Researchers then randomly assigned the remaining 43 percent to take either Amgen’s PCSK-9 inhibitor, evolocumab, or another cholesterol-lowering drug, ezetimibe, which is often taken by statin intolerant patients but has never been shown to reduce heart disease risk when taken without an accompanying statin. The patients tolerated both drugs.

My, my, my … statins go off patent (thus reducing the cost to just pennies per day), and through sheer coincidence, we get a major new study showing that nearly half of all people can’t tolerate statins – but they can tolerate the new drug that costs $14,000 per year.

And of course, we know this new and very expensive drug will prevent heart attacks because it lowers LDL.  High LDL cholesterol causes heart disease, ya see.  We’ll just continue believing that even when a drug that dramatically lowers LDL fails to prevent heart attacks.

Perhaps someday, after yet another LDL-lowering drug fails to prevent heart attacks, researchers will respond by going before the cameras and announcing that it’s time to bury the Lipid Hypothesis once and for all.

But I don’t have high hopes.

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