A recent study from the Journal of the American Medical Association shows that over the past 40 years Americans have reduced their total cholesterol levels from 222 mg/dl to 203 mg/dl and dropped their LDL cholesterol levels from 138 mg/dl to 123 mg/dl.
The speculation is that this reduction in lipids has come about thanks to an increase in the number of people using statin drugs. Approximately 3.4% of the adult population were taking statin drug in 1988 with an increase to 9.3% of the population by 2002.
I see it a little differently. Although I’m appalled that 9.3% of the adult population is on statin drugs, I believe the decrease in LDL cholesterol has come about due to dietary changes. Over the past 400 years we have seen a significant decrease in the amount of fat in the diet along with a reciprocal increase in carbohydrate consumption. There is no question that if fat in the diet decreases LDL cholesterol falls. In fact, that is the only positive thing that proponents of the low-fat diet can claim. (And it’s only positive if one buys into the lipid hypothesis–otherwise it’s meaningless.) Unfortunately, when LDL cholesterol levels fall as a result of a low-fat diet, the LDL cholesterol particles convert from being the large type A particles to the small, dense type B particles, which are thought (by those believing in the lipid hypothesis) to be much more atherogenic. So the net effect of this fall in LDL levels as a function of a low-fat diet is meaningless because lower levels of more atherogenic particles nets out to not much change in risk.
When people go on low-fat, high-carbohydrate diets they tend to lower their LDL cholesterol levels and increase their levels of triglycerides. Statin drugs have a slight propensity to reduce triglyceride levels, so if the nationwide reduction of LDL cholesterol came as a result of the huge increase in statin drug use, we would see a concomitant fall in triglycerides as well. According to the data presented in this article over the same 40 years triglyceride levels have risen from 114 mg/dl to 122 mg/dl.
I’m quite sure that the drug companies that market statin drugs had a heavy hand in this study because the cholesterol lowering over the past 40 years is already being reported as being due to statin drugs. As reported by the medical news service Medical New Today:
The reason [for the drop in cholesterol levels] is that since the end of the 1980s statins, cholesterol-lowering drugs, have entered the scene. It is definitely not lifestyle that has brought about a drop in cholesterol levels, it is the statins.
According to recent research, statins are the main reason American cholesterol levels have dropped.
In the fine print of the study one finds the following:
Financial Disclosures: Dr Grundy [one of the authors] receives research grants funded by Merck, Abbott, Kos, and GlaxoSmithKline; is a consultant for Pfizer, Abbott, Sanofi Aventis, and AstraZeneca; and receives honoraria from Merck, Abbott, Kos, Bristol-Myers Squibb, and Schering Plough.
No other authors reported financial disclosures.
Not no other authors had financial connections to any drug companies, but simply no other authors reported any financial disclosures. We are left to guess what those financial disclosures might have been had they been reported.
I can’t let this post end without commenting on the piece in Medical News Today. The author, Christian Nordqvist, writes:
Statins lower levels of LDL cholesterol, the bad cholesterol that clogs up the arteries and cause heart attacks.
Notice how it isn’t worded that LDL is the bad cholesterol THOUGHT to cause heart attacks. In Mr. Nordqvist’s mind it is definitive. Irrespective as to whether or not the lipid hypothesis is valid, LDL cholesterol does not clog up arteries, and anyone who writes (or thinks) that it does is ill informed at best, a moron at worst.