4 ms·

The mainstream theory about dietary fat, cholesterol & CVD that started in the 1960s is mainly based on epidemiological studies, not randomized controlled trial

by ArchD 5y ago

The mainstream theory about dietary fat, cholesterol & CVD that started in the 1960s is mainly based on epidemiological studies, not randomized controlled trials. Additionally cholesterol is used for many bodily functions, including maintaining cell membranes. Cholesterol is so important that the brain produces its own. Yet, some doctors are very enthusiastic about pushing statin to people who have high LDL-C but are not sick. Because of studies like tho following, I decided to not believe in the mainstream cholesterol narrative: https://bmjopen.bmj.com/content/6/6/e010401 https://bmjopen.bmj.com/content/6/6/e010401 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1519391 https://www.tandfonline.com/doi/full/10.1080/17512433.2018.1...

RockyMcNuts 5y ago
The evidence that cholesterol is implicated in heart disease is quite strong. For one thing, people with genetic predisposition to very high cholesterol get heart disease early and die, and are now successfully treated with cholesterol-lowering drugs. For another, people who are at risk and take statins have fewer heart attacks (strong evidence), and live longer (limited evidence). It's likely true that we don't fully understand the dynamics, other factors may be implicated, stress, hormones, microstructure of coronary arteries. But I would caution against 'deciding not to believe' things about which there is a great deal of empirical work and a medical consensus. Small dense LDL and triglycerides may be better biomarkers for CVD than the typical calculated LDL-C. Calcium scans starting in middle age may be a good idea for people with CVD in the family or higher than normal cholesterol. Then if arteries are getting blocked you can consider dietary intervention, drugs, bypass before a heart attack. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/
- ArchD 5y ago
  The claims in the 4S study paper referenced by the first paper is not generalizable to the general populration. The studied patients were as follows: - 75% smokers or ex-smokers - already had AP or MI episodes - 51% at least 60 yo - 57% were on beta-blockers. (How do you know that the statins are not mainly protecting against some unknown side effects of beta-blockers.) These patients are not healthy people. The observations do not constitute evidence that cholesterol itself is a risk factor. These days, a lot of doctors are pushing statins to people without any risk factor like age or high-blood pressure, simply because of high LDL-C. As for the second paper about sdLDL, the mainstream dogma is laser-focused on LDL-C, not sdLDL.
  - RockyMcNuts 5y ago
    the 2 links cover a bit of ground, if those are the only 2 cherry-picked criticisms it would seem to validate the rest?
    - ArchD 5y ago
      A full criticism would take a book. There are such books and presentations you can find easily and the papers I linked to are a start. I was just giving examples to show that there are flaws. The appearance of scientific rigor and trustworthiness disintegrates as you find more and more flawed studies or unsubstantiated arguments from the orthodoxy.

by ArchD 5y ago

RockyMcNuts 5y ago

The evidence that cholesterol is implicated in heart disease is quite strong. For one thing, people with genetic predisposition to very high cholesterol get heart disease early and die, and are now successfully treated with cholesterol-lowering drugs. For another, people who are at risk and take statins have fewer heart attacks (strong evidence), and live longer (limited evidence). It's likely true that we don't fully understand the dynamics, other factors may be implicated, stress, hormones, microstructure of coronary arteries. But I would caution against 'deciding not to believe' things about which there is a great deal of empirical work and a medical consensus. Small dense LDL and triglycerides may be better biomarkers for CVD than the typical calculated LDL-C. Calcium scans starting in middle age may be a good idea for people with CVD in the family or higher than normal cholesterol. Then if arteries are getting blocked you can consider dietary intervention, drugs, bypass before a heart attack. - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525717/ - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174280/

ArchD 5y ago
The claims in the 4S study paper referenced by the first paper is not generalizable to the general populration. The studied patients were as follows: - 75% smokers or ex-smokers - already had AP or MI episodes - 51% at least 60 yo - 57% were on beta-blockers. (How do you know that the statins are not mainly protecting against some unknown side effects of beta-blockers.) These patients are not healthy people. The observations do not constitute evidence that cholesterol itself is a risk factor. These days, a lot of doctors are pushing statins to people without any risk factor like age or high-blood pressure, simply because of high LDL-C. As for the second paper about sdLDL, the mainstream dogma is laser-focused on LDL-C, not sdLDL.
- RockyMcNuts 5y ago
  the 2 links cover a bit of ground, if those are the only 2 cherry-picked criticisms it would seem to validate the rest?
  - ArchD 5y ago
    A full criticism would take a book. There are such books and presentations you can find easily and the papers I linked to are a start. I was just giving examples to show that there are flaws. The appearance of scientific rigor and trustworthiness disintegrates as you find more and more flawed studies or unsubstantiated arguments from the orthodoxy.