Tuesday, April 12, 2011

Brody Statins Reverso World

Mike Eades Summary of Brody's Story, from an article he cites.

Key points?  She is a long term advocate of the high carb, low fat, low cholesterol diet and widely viewed as an authority.  I'll let Mike take it from there:

She has been bopping along for most of her 65 years slowly following her own idiotic nutritional advice. And, I’m sure, feeling very full of herself for being so very, very good. She goes in for a routine check up and discovers – GASP! – that her cholesterol is slightly elevated. It was 222 mg/dL with a high normal being 200 mg/dL. Never mind that her HDL is nicely positioned at 69 mg/dL or that her triglycerides are pretty low at 99 mg/dL, she freaks out over her total cholesterol (a meaningless reading) and her minimally elevated LDL levels (134 mg/dL). 
Translation from Eades-ese:  she finds her fasting lipid panel is good but not GREAT.  Since her entire diet is designed to give her a GREAT fasting lipids panel, she's quite upset.
Eades:  Now if she were a reader of this blog – or even of the pertinent medical literature – she would know that a low triglyceride level and a high HDL level means that her LDL is of the large particle variety that is not only not dangerous, but actually beneficial.
What do you reckon she’s gonna do?  You’re right. She’s gonna go whole hog on a low-fat diet. She’s going to cut out the cheese; she’s going to take some over-the-counter plant stanol cholesterol-lowering supplements; she’s going to lose some weight.
And she does it all. But when she returns for a recheck in three months her cholesterol has gone up even more. It is 236 mg/dL and her LDL is 159.
Now she’s in big time gotta-get-serious-about-this mode. Gotta get the fat down, gotta cut the red meat, gotta go for the low-fat ice cream, gotta ratchet up the fiber, gotta, gotta, gotta…
She goes back in three months later for another blood test and AAAAAARRRRRRGGGGGGHHHHHHHH. Her total cholesterol is at 248 and her LDL is 171.
She is now in blind panic mode. What can she do? 
Ultimately, she takes statin drugs to treat not her health, but her fasting lipid profile NUMBERS.  There's no research to indicate she's can reduce her risk of disease with statins, nor is there for any woman under any circumstance.  The only proven beneficiaries in all cause mortality for statins are men, under age 65, with a prior cardiac event.  As Mike Eades puts it:
...women over the age of 65 (she is 65) who have high cholesterol live longer than those who have normal to low cholesterol. And she missed the studies that show that both men and women over the age of 65 who take statins have an increased incidence of cancer.
Much like the case of Clarence Bass, the low fat is best conjecture leads to wretched conclusions and poor decision making which negatively impacts these folks' lives despite their passion and dedication to their own health and wellness.  The low fat conjecture as a model for health is like trying to drive through Detroit with a map of Memphis.  You can't get to where you want to be using that map except by accident.
There are many lessons to be learned besides the apparent folly of "statinating," or  the now dis-proved conjecture that low fat protects from heart disease.  One is that there is no proof about what we humans ought to eat, and one should always be scanning for more complete answers.  
But the biggest lesson to learn is that if you want a better fasting lipids profile, carbs are what you must limit.  Carb restriction will give you a smaller abdomen, lower triglycerides, higher HDLs, lower blood pressure, and a better glucose number.  What you lose in a "perfect" LDL number you gain in better LDL particle type.  The irony that smart people became convinced that reducing fat and cholesterol intake would result in a better fasting lipids profile can't possibly be lost on you if you read the rest of Mike Eades' post.  Perhaps it'll be another torpedo in the side of the Bismarkian low fat conjecture.

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