Tuesday, January 29, 2008

What does cholesterol have to do with it?

Gary Taubes disputes the connection between saturated fats and heart disease and the connection between lowering LDL cholesterol and reducing heart disease.
Because medical authorities have always approached the cholesterol hypothesis as a public health issue, rather than as a scientific one, we’re repeatedly reminded that it shouldn’t be questioned. Heart attacks kill hundreds of thousands of Americans every year, statin therapy can save lives, and skepticism might be perceived as a reason to delay action. So let’s just trust our assumptions, get people to change their diets and put high-risk people on statins and other cholesterol-lowering drugs.

Science, however, suggests a different approach: test the hypothesis rigorously and see if it survives. If the evidence continues to challenge the role of cholesterol, then rethink it, without preconceptions, and consider what these other pathways in cardiovascular disease are implying about cause and prevention. A different hypothesis may turn out to fit the facts better, and one day help prevent considerably more deaths.

5 comments:

conrad said...

There must be approximately a billion data points looking at this issue, with "medical authorities" being a rather sweeping generalization (does he mean, all over the world?). Perhaps someone should point him to the way of scientific journals or at least search engines.

GK said...

conrad,

If you know anything about Taubes you'd know that he is a fanatically tireless researcher who has read more journals than you can shake a stick at.

It is also fascinating to understand how such a big fraction of those "billion data points" are based on flimsy evidence.

conrad said...

gk,

when I see the paper in Nature telling me that the last 1000 papers on it are all wrong and that the relationship between cholestrol and heart disease is just a correlation and not causation I'll believe it (I love the tasty fatty bits on steak and crackling from roast pork, which I now manage not to eat too much of).

Note that I believe things should be questioned and do accept when they are wrong -- lactic acid and muscle tiredness is a good example from a similar area where people were wrong all along -- but thats a big difference between saying how all medical authorities (in presumably every country) treat these sorts of things.

GK said...

Hi conrad,

When that paper does come out in Nature, I'm not so sure you will; dogma falls hard.

I found Taubes book Good Calories, Bad Calories to be just as convincing as any article in Nature. That book plus my own experience says more to me than any 1000 papers you'd care to find which may predict my imminent demise from a heart attack.

I'm betting that Taubes and Atkins are on the right track. For 30 years I was a fat-avoider, mostly vegetarian.
Unlike you, I added back a lot of animal fat to my diet, while cutting sugar, starches, and processed foods. The result is I went from slim to lean in six months. My LDL increased somewhat, but overall, the bloodwork was good.

I am very interested to see what comes of all this. I hope that in ten years, the tide will have shifted, and more research will come out against the cholesterol/heart-disease link. I am betting my health on it!

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