The Cholesterol Scandal

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Who Will Tell the People? It Isn’t Cholesterol!

by Bill Sardi by Bill Sardi

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Doctors are breaking ranks to tell a story to the world. You may stand in disbelief as you read it here.

The sudden disclosure by a Harvard Medical School doctor in the British journal Lancet (Jan 20, 2007), that cholesterol-lowering drugs are of no benefit for three-quarters of the people who take them, has been followed by an even more stunning revelation in the New York Times where Dr. Arthur Agatston MD, a Florida cardiologist who is better known as the author of a diet book (The South Beach Diet), stated that "my patients don’t have heart attacks any more." Dr. Agatston is not known as the cholesterol-lowering doctor, he is better known professionally for having developed the severity scoring sheet for calcification of the arteries, now known as the Agatston score. [New York Times, Jan. 24, 2007]

The skeptics of the cholesterol theory of heart disease are growing and Dr. Malcolm Kendrick of Aberdeen, Scotland, has just published a book, The Great Cholesterol Con, wherein he calls the cholesterol theory "an amazing beast" and cites an investigation conducted by the US Surgeon General’s Office in 1988 that was launched to quiet the cholesterol nay-sayers. Dr. Kendrick says that investigation was cancelled 11 years later for lack of evidence. [Daily Mail UK, Jan 23, 2007]

According to Dr. John Abramson, of Harvard Medical School, in his article titled “Are Lipid-Lowering Guidelines Evidence-Based?” in Lancet, no studies have shown statin cholesterol-lowering drugs to be effective for women at any age, nor for men 69 years of age or older, who do not already have heart disease or diabetes. Better than 50 adults have to take a cholesterol-lowering drug for 1 patient to avoid a mortal heart attack, and that figure only applies to high-risk patients. There is a vanishing benefit to lowering cholesterol for healthy adults. Dr. Abramson calls for cholesterol treatment guidelines to be revised. [Lancet 2007; 369:168-169]

What to tell patients?

Dr. James M Wright of the University of British Columbia, Vancouver, co-author with Dr. Abramson, thinks physicians should be honest with their patients about the lack of evidence for the use of cholesterol-lowering drugs in low-risk patients.

Says Dr. Wright: "If you take a male who is 50 years old, a smoker, with high blood pressure, who eats the worst diet in the world . . . then if I were an honest physician, I would tell him that maybe he should be taking a statin. And if he asked how much would that reduce his risk, I would have to tell him that it would only reduce his risk by 2% over the next five years. If he understood that information, he would say, You’re expecting me to take a pill everyday for five years? And it’s going to cost me two dollars a day? You’re crazy! I’m not going to do it.” If physicians were truly honest with their patients, the doctor says, “I think there probably would be very few people being treated for primary prevention with a statin drug.” [HeartWire Jan. 27, 2007]

The cholesterol theory of cardiovascular disease is far from explaining what causes most heart attacks and strokes. Some 500,000 Americans die of a sudden-death heart attack annually with low-to-normal cholesterol.

Dr. Harumi Okuyama of Nagoya City University in Japan, writing in the World Review of Nutrition and Dietetics, says the direction of modern medicine needs to move away from the cholesterol hypothesis of coronary heart disease. Once cases of genetic/familial high cholesterol are removed from population statistics, he claims that high cholesterol is not found to be a causal factor for coronary heart disease. High total cholesterol is not positively associated with high coronary heart disease mortality rates among general populations more than 40—50 years of age, says Dr. Okuyama.

Okuyama points out that higher total cholesterol levels are associated with lower cancer and all-cause mortality rates where the incidence of familial high cholesterol is low (~0.2%).

He notes that the rate of heart attacks differs by approximately 4 to 8-fold at the same total cholesterol level in some populations. Dr. Okuyama says while Western countries have accepted the cholesterol theory of heart disease and the use of statin drugs, "little benefit seems to result from efforts to limit dietary cholesterol intake or to total cholesterol values to less than approximately 260 mg/dL." Dr. Okuyama says there is an urgency to change the direction of current medical practice away from cholesterol-controlling medications. [World Review Nutrition Dietetics, Basel, Karger, 96: 1—17, 2007]

Is it calcium?

It was cardiologist Dr. Stephen Seely who in wrote, in his treatise entitled "Is calcium excess in western diet a major cause of arterial disease? published in the International Journal of Cardiology in 1991, that excess calcium intake is a major cause of atherosclerosis in Western countries.

He contended that young adults need only 300—400 mg of calcium daily, and older adults need even less. In countries where the daily calcium intake is 200—400 mg, arterial diseases are non-existent and blood pressure does not increase with age.

Dr. Seely said, in countries where the daily calcium intake is 800 milligrams (USA, New Zealand, Scandinavian countries, Ireland), arterial disease is the leading cause of mortality. Dr. Seely pointed out that cholesterol only represents 3% of arterial plaque, while calcium makes up 50%. [International Journal Cardiology 1991 Nov; 33 (2):191—8]

Don’t think the American Heart Association (AHA) isn’t paying attention. After six years of debate, the AHA has finally approved CT scanning for arterial calcifications for high-risk individuals. Just a few years ago the AHA dismissed the use of CT scanning for any reason, so this is a big change.

The accumulation of calcium plaque in coronary arteries continues despite aggressive cholesterol reduction (—53% LDL cholesterol) with a statin drug. [Heart 2006; 92:1207—1212]

Dr. Stephen Seely recommended the best remedy for this problem would be prevention, by reducing calcium consumption only to the level needed by the body. “This could be achieved only by drastic cuts in consumption of milk. Failing that, we could utilize nature’s own calcium antagonist, IP6 phytate (rice bran extract),” he said. The author argues that currently available calcium antagonist drugs are less desirable. IP6 phytate is available as a dietary supplement, extracted from rice bran by Tsuno Foods & Rice Co. in Wakayama, Japan, and sold under various brand names (Source Naturals, Jarrow Formulas, Purity Products). (For instruction on how to conduct a rice bran cleanse, search under this term at www.knowledgeofhealth.com )

Prevalence of Coronary Artery Calcification by age and sex Coronary Artery Calcification Begins Earlier in Males With Onset of Menopause, Women Lose Calcium From Bones and Increase Their Risk For Cardiovascular Disease by 360%

Other natural antidotes to arterial calcifications include vitamin K, vitamin D and magnesium.

Groups who consume the highest amounts of vitamin K from dietary sources exhibit more than a 50% reduction in coronary heart disease mortality and aortic calcium scores.

[Journal Nutrition 134: 3100—05, 2004] Vitamin K is naturally rich in spinach, broccoli and turnip greens.

Vitamin D has also been shown to be correlated with the absence of extensive arterial calcification. [Circulation 96: 1755—60, 1997] But the public is going to have to overcome mistaken advice usually offered by health professionals about vitamin D.

Most physicians, pharmacists and dieticians will warn the public away from so-called high-dose vitamin D supplements because of the false notion that vitamin D actually induces calcifications. But this effect has only been demonstrated in animals at lethal doses (~2.1 million units of vitamin D). [Current Opinion Lipidology 18(1):41—6, 2007]

Dr. Reinhold Vieth, PhD, at the University of Toronto, says the toxicity of vitamin D doesn’t begin till 40,000 units are consumed. [American Journal Clinical Nutrition 1999 May; 69(5):842—56] Dr. Vieth notes that an hour of total-body skin exposure to unfiltered sunlight in the summer at a southern latitude would produced about 10,000 units of vitamin D without any known side effects. He says the risk for toxicity is remote.

Vitamin D is a vitamin/hormone produced in the skin upon sun exposure. It is widely known that more heart attacks occur in winter months when vitamin D levels are low.

Dr. Joe Prendergast, a practicing endocrinologist in Redwood City, California, now treats his patients with 5000 units vitamin D and a blood-vessel widening amino acid (arginine) to successfully reverse hardening of the arteries. Vitamin D’s anti-calcifying effects are working for this doctor’s patients.

Magnesium is a natural calcium blocker and is another natural antidote to arterial calcification. [The American Journal of Clinical Nutrition 2004 Oct; 23(5):501S—505S] Magnesium is rich in foods like almonds, spinach and pumpkin seeds. Magnesium oxide in dietary supplements is poorly absorbed and other forms (citrate, glycinate, malate) should be consumed.

The most convincing evidence

The most convincing evidence for the calcium theory of heart disease is this. In a study of adults over age 55 years, coronary artery calcifications were ranked by the Agatston scoring method. Blood pressure, cholesterol, smoking and blood sugar, all common risk factors for cardiovascular disease were measured over a 7-year period along with the calcium artery scores. Disturbingly, 29% of the men and 15% of the women who had no cardiovascular symptoms and exhibited no other common risk factors (elevated cholesterol, hypertension, etc.), had extensive coronary artery calcification. [European Heart Journal 25: 48—55, 2004] This is alarming. These patients had a low-to-normal cholesterol number and mistakenly thought they were at low risk for a heart attack

An angiogram (an x-ray/dye photo of coronary arteries), commonly used by cardiologists, cannot detect calcifications. Ultrafast computed tomography (CT scanning) and intravascular ultrasound can measure arterial calcification. Better than 90% of patients who experience a heart attack have coronary artery calcifications.

Modern medicine has never been able to explain why some 45—60 percent of patients with hospital admissions for a heart attack have a "normal level" of cholesterol. [Atherosclerosis 149: 181—90, 2000; Medical Hypotheses 59: 751—56, 2002] If your cholesterol is low-to-normal you are still at great risk to have a mortal heart attack. But if your calcium artery Agatston score is zero, your risk for a mortal heart attack is almost zero. [Cleveland Clinic Journal Medicine 49: Supp 3 — S-6-11, 2002]

Bill Sardi [send him mail] is a consumer advocate and health journalist, writing from San Dimas, California. He offers a free downloadable book, The Collapse of Conventional Medicine, at his website. Bill Sardi is a spokesperson for various dietary supplement companies.

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