December 27

Still promoting the lipid hypothesis

14  comments

hyperlipidemia.jpg
I received an email today containing the December edition of the E-newsletter from the International Atherosclerosis Society. Right there on the first page was a announcement for a new book and a link to Amazon.com for it. The new book is

Hyperlipidaemia: Diagnosis and Management – 3rd Edition

The review of this book states the following:

The third edition of this well-received text provides a state-of-the-art treatise on modern clinical practice relating to hyperlipidaemia and lipoprotein disorders, conditions responsible for a huge amount of morbidity and mortality in Western countries and, increasingly, the developing world. The clinical evidence underlying the treatment of hyperlipidaemia has burgeoned since the second edition published in 1994, with the publication of the results of several clinical trials on statin drugs, and the subsequent appearance of national and international guidelines for cholesterol lowering in coronary prevention. There has also been considerable development in the definition of cardiovascular risk, and the methodology for identifying high-risk patients. [My italics]
All of these aspects are addressed fully in the new edition. In addition, the book offers helpful summaries of the background biochemistry of lipoprotein metabolism and atherosclerosis where relevant, putting the subject in the context of its pathophysiology and epidemiology. The text relating to clinical aspects has a strong evidence base, reviewing, in particular, areas of uncertainty and controversy. Drawing on the wealth of experience of the author, and representing his widely respected views on the subject, readers will find this comprehensive, well-referenced and accessible book invaluable.

This book was written by: Paul N Durrington BSc, FRCPath, FRCP, FMedSci, FAHA, Professor of Medicine, University of Manchester, Division of Cardiovascular and Endocrine Science, Honorary Consultant Physician to the Manchester Royal Infirmary, UK.
When you take a gander at Dr. Durrington’s impressive list of merit badges you may notice that paid consultant to Pfizer (the maker of Lipitor, the most widely prescribed statin drug) is not among them. Yet when you read the disclosures on one of Dr. Durrington’s recent papers you can see that it says that he has

received travel expenses, payment for speaking at meetings, and funding for research from Pfizer.

I wouldn’t say that Dr. Durrington is a totally unbiased author. In fact, I would imagine Dr. Durrington promotes statin drugs quite avidly. I’m not going to drop the $75 or so it takes to find out by purchasing his book, but I would bet a pretty substantial sum that he is a statinator of the first order.
It just stuns me that an worldwide group of scientists such as the International Atherosclerosis Society would promote a book by stating that hyperlipidemia and lipoprotein disorders are “conditions responsible for a huge amount of morbidity and mortality in Western countries and, increasingly, the developing world” when the whole idea that lipids cause any problems whatsoever is still at the level of an hypothesis. Dr. Durrington has written a 400+ page text, highly touted in the cardiology community, expressing what is an hypothesis as fact. And recommends treatment that has not been shown to be effective for the vast majority of people receiving it, a treatment that is not without severe side effects including death.
As long as statin drugs are a $30+ billion industry, this is the kind of propaganda we’re going to get posing as legitimate medical textbooks. These are the books young physicians-in-training are learning from. Think about that. And shudder.


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  1. Doesn’t stun me. The American Diabetes Association is still telling people with diabetes to “make starch the star.”
    Pretty bizarre. Let’s give sugar to people who have a disease of too much sugar. It beggars belief.
    Cheers–
    MRE

  2. There is a good side to that situation: it fills me with anger, that I dispense by breaking personnal records in the gym.
    When will the medical community wake up?
    Maybe sometime over the next 25 years…?
    Cheers–
    MRE

  3. Not “give,” Doctor — sell. Let’s sell sugar to people who have a disease of too much sugar. And let’s cut in the ADA, the drug co’s, and the rent-a-docs…we’ll all be rich!
    Hmm. I wonder if that is in conflict with the Hippocratic Oath I took?
    Cheers–
    MRE

  4. I finished Gary Taubes’ book not too long ago, and I think I walked around with my jaw dragging on the ground for days in disbelief. He has done the clear thinking public an amazing service by compiling the facts in such an organized fashion that we can use to stand up to drug pushing, lab value treating, medical professionals (however well meaning). Have you ever considered adding a directory of caregivers who agree with the health benefits of low-carb to your website? It seems like the average patient has to get the equivalent of an advanced degree to retain control over their own treatment, and having a way to search for an enlightened professional would sure help!
    In addition to medical schools only teaching the assumed-to-be-true hypotheses rather than presenting the actual science, the other thing I am increasingly alarmed by is the presentation of pseudo-medical “facts” in innocuous seeming features in popular magazines. Not only are the standard fat-is-bad, starch-is-good, and soy-cures-all messages repeated diligently, but they also have started making their own leaps in logic a-la-Keyes that boggle the mind and present their own conclusions as fact along with the recipe.
    For example, in the latest January 2008 issue of Sunset magazine, a feature entitled “Power Starts” has a “Cran-berry green-tee smoothie” which follows all of the current popular recommendations. It has an assortment of berries along with green tea, which are touted for their antioxidant, fiber, and vitamin content. OK so far. But then we add a whole banana, soy milk, and honey or brown sugar (hey, if brown rice is better, ergo brown sugar?) which, along with the berries, bring us to a whopping 92g of carbs (11g fiber). In the editorial description, this smoothie is “a refreshing, satisfying, and healthy way to begin your day”. Yeah – I find that kind of insulin load dumping into my bloodstream extremely refreshing. Their assumption seems to be that as long as you keep fat low (2g) and toss in some known “healthy” items, any concoction is considered, and stated to be, healthy.
    My problem here is that random “facts” are being lumped into seemingly logical groupings and being presented authoritatively as “healthy”, in a format where most people will not be particularly critical. Yes, berries and green tea contain potent levels of antioxidants, but the amount of berries alone in this recipe would wipe out almost my entire day’s carb allotment. Now let’s add soy for all of its “known” health benefits. And what could possibly be wrong with a banana and a bit of those “good” sweeteners honey and brown sugar?
    Many people are naturally suspicious of drug advertisements, and maybe even take the advice of their physician with a grain of salt – second opinions are pretty common. But when pop-culture mediums not only perpetuate the cascade-effect of hypotheses being repeating until they are assumed to be fact, but also enhance the latest telling each time, we wind up with a truly insidious result: a seemingly well-educated public that has no idea their information source was more on par with the tabloids than scientific references.
    p.s. Thanks for the book offer last month and keeping your blogs current and timely. I’ve managed to get some of my loved ones started down the road to better health because of all that you’ve done!
    Hi Leslie–
    Thanks for the astute comment. I agree with you across the board. And I, too, get extremely annoyed with the constant barrage of incorrect ‘health’ information peddled by most everyone these days. Since the majority of people love carbs, it’s easy to please them by recommending foods crawling with carbs that also have a couple of good things in them. This is called the ‘health halo’ effect. You find something that is good for you, say, berries, then you add to them a ton of stuff that’s dreadful, i.e., brown sugar, and all anyone focuses on is the health-benefit of the berries.
    The concept of the ‘health halo’ has been recently exploited to great success with the Jared commercials for Subway. Jared lost a ton of weight eating at subway, so therefor anything Subway sells must be a food that helps people lose weight. Brilliant from a marketing perspective, but not so brilliant as a health perspective.
    I’ve thought about putting up a directory of caregivers, but haven’t actually taken steps to do so yet.
    Cheers–
    MRE

  5. I wondered what was up with the pinch faced lady on the book cover. The poor lady’s face is marked with hypercholesterolemia. Wow, not only will cholesterol kill you, but it will make you ugly. Good cover choice on their part.
    An excellent choice in cover art.
    Cheers–
    MRE

  6. It seems pretty clear that this author has been bought and paid for by Pfizer. I wonder…. who do they think they’re kidding? The word is starting to get out about this sort of thing, on your blog and elsewhere. And it seems to me that Gary Taubes and Malcolm Kendrick, with their recent books (and PPLP too, out there on the leading edge), have so thoroughly and effectively debunked this kind of propaganda, more physicians will have no choice but to sit up and start to take notice….at least I hope so. The medical profession has their reputation at great risk here; and one would reasonably expect that sooner rather than later most of them will elect to disassociate themselves from the corrupt pharma industry business model and that industry’s unconscionable marketing practices. (To make this a more balanced rant, I acknowledge it will also be necessary for some significant reforms to be undertaken in the medical insurance and legal systems.)
    As one example of the mainstream medical profession starting to wake up, I’ll submit a link to “Hooked Ethics” by Dr. Howard Brody http://brodyhooked.blogspot.com/ which you will find of interest if you haven’t already run across it.
    Thanks again Dr. Mike for the public service you perform every week. And happy new year to you and yours.
    Best,
    W
    Hey Wil–
    Thanks for the link. I wasn’t aware of that one.
    Cheers–
    MRE

  7. Here is a scenario that I would like to see: A man, who is severely diabetic, follows the advice of the ADA (making carbs the star, limiting fat,etc.) suffers a nightmare of medical problems from years of uncontrolled blood sugar swings. He sues the ADA for big bucks because their recommendations are bad,bad,bad and because of conflict of interest issues..(many of the donations the ADA receives are from outfits that produce or sell sugar laden products). Anyway this whole things goes to court and the ADA shows itself to be the rotten, irresponsible, money grubbing outfit that we know it to be.
    Hey Gerard150–
    Unfortunately, the first part of your scenario takes place thousands of times each day in this country and throughout the world.
    I, too, would love to see the second part. But, it’s doubtful that it will take place because all the big names in research would spring to the front to testify on behalf of the ADA, saying that the ADA was only presenting that information that had been confirmed in research studies that they, the big names, had done themselves. A jury would probably be too confused to render the proper verdict.
    Cheers–
    MRE

  8. It further shows the hypothesis is no Vegas neon light in needing to be propped up by never ending waves of literature, campaigns and medicine.
    If the hypothesis was all it was cracked up to be, and because people are willing to heed advice, heart disease would be a history book chapter.
    I’ll be following your blog with great interest. You, Dr. Uffe Ravnskvov, Dr William Davis and Dr. John Cannell have mentioned things which are simple to digest and make sense. No one I know really understands the hypothesis as it’s cloaked in mumbo jumbo to make you feel stupid and think “well, I’m not a doc, so they must be right.”
    Happy New Year!
    Thanks. Same to you.
    Could it be cloaked in mumbo jumbo to keep those statin scripts selling?
    Cheers–
    MRE

  9. Why is the lady on the book cover so sad? Oh, that’s right. Her doctor insists she take Lipitor when she doesn’t need it, can’t afford it, and will suffer lots of side effects.
    Undoubtedly the cause of her bilious look.
    Cheers–
    MRE

  10. I have recently experienced the poisoning induced by the hypertension medicines out there. I read many cases where they slap a cuff on you and take the 1st reading, which will of course be higher than your baseline, and if it’s over 120/80, they begin feeding you crap like Lisinopril, which actually raised my BP and gave me palpitations, for which I was then given Toprol, which made me violently ill. When I went off all the crap my BP returned to normal. (The whole BP hike was due to Progestins injected in me repeatedly along with a Lupron shot before a fibroid removal.) Norvasc made me burn all over which produced anxiety attacks. The last attempt was HCTZ which made me sick because I cannot tolerate sulfa drugs. I’m sure the statins would have been next.
    More faith in the state of cardiology.
    Yeesh. What a terrible run of physician-induced bad luck. Hope it improves.
    Cheers–
    MRE

  11. Ugh, that is one ugly picture.
    We recently got a pamphlet in the mail from our HMO with “Preventive Health Recomendations.” Amongst the usual screening recommendations, it’s no longer High Cholesterol Screening, it’s Lipid Disorder Screening (a nice way to make it sound even scarier and more disease-like.) And under Diet and Exercise, beginning at age 2, it recommends: “limit fat and cholesterol, maintain caloric balance and emphasize fruits, vegetables, and grain products containing fiber.” With those recommendations, it’s would be very easy to create that ‘health halo’ mentioned in a previous comment.
    Needless to say, those pamphlets usually go straight from the mailbox to the recycle bin.
    God help us all.

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