David Diamond- Demonization and Deception in Cholesterol Research

so thank you Bonnie for inviting me to speak tonight I'm truly honored to talk to this group I will share with you that I feel a bit like the elephant on the stage in this cartoon elephants invited this to give a piano recital and he says what am I doing here I I play the flute reason why I feel a bit like that is that most of the introduction you just heard was about neuroscience and so that's my career is really a study of brain and memory but I'm not going to talk about the brain of memory I'm talking about completely different area which is cardiovascular disease nutrition cholesterol and health and so it's clearly something very new to me and so you might wonder what motivates me to take on a second completely different area well it motivated me basically was my own personal health and I'll share with you a bit about my health and my concerns going back 15 years you can see here this red bar shows that 15 years ago my combination of triglycerides and cholesterol put me at greater than 15 times the rate the likelihood of developing a heart attack compared to a person with ideal biomarkers I took this very seriously I was very concerned that I was at a high rate and for developing a heart attack so I'm faced with a problem I get these numbers I'm facing the same problem we all are what is it that I should eat our eggs safe to eat or should we avoid them like the plague the question we ask all the time so I was very concerned should I eat eggs if I eat eggs will raise my cholesterol will that increase the likely - I'll have a heart attack what really concerned me though is at some point after my levels stay at high and I was on a low-fat diet and the only thing that happened with that was that I gained more weight and I was about 20 pounds overweight 20 pounds heavier than I am now and so my doctor sat me down and he said it's time you really need to go on a statin your cholesterol numbers are not good you've done your best just as the commercial here says and so again I took it very seriously but I guess I like to think that instead of going to the pharmacy I went to the library so I decided at this point I needed to learn all I could about cardiovascular disease and nutrition so I could actually treat myself or at the very least understand that maybe it was necessary for me to take the medication so I devoted the past 10 years to learning about heart disease and nutrition and I'm going to share with you what I've learned here tonight so this is what we're bombarded with we see fear of saturated fats saturated fats will raise your cholesterol and in theory then cause you'd have a heart attacks you want any lots of foods that then will lower your blood cholesterol so you see off this obsession here we were covered with advertisements that emphasize that we need to lower our cholesterol and not eat saturated fat and of course where we have our drugs that reduce the cholesterol those are the statins and so we want to take drugs such as lipitor Crestor to lower our cholesterol and therefore reduce the risk that we'll have a heart attack so the two topics that I'll cover tonight are the issue is to limit consumption of cholesterol and saturated fat and also to have serum cholesterol levels as low as possible what I'm going to try to convince you of in the next 45 minutes is that this is entirely wrong I have a so I will have to unfortunately I'm going to cover this very briefly I'm going to cover a few thousand studies in the next 45 minutes but we'll see if I can give it a go and get it done in time so we have a little history here the very first person who actually was obese and did something about it lost weight and then in fact wrote the first diet book was this fellow named William Banting lived in London middle of the 19th century so Banting was overweight he had typical obesity time problems he was over 200 pounds 5 foot 5 his doctor actually prescribed that he limit and completely eliminate carbohydrates so eliminated potatoes bread and sugar but he was allowed to eat as much meat and other animal products as he wanted was a success he lost quite a bit of way to cut down to a good level and lived into his 80s which isn't bad for mid 19th century London the reason why we know about this is he actually wrote a book describing what he ate and his weight loss called the letter on corpulence so 10,000 copies in London a very famous book basically describing the importance of reducing carbohydrates in his diet which was effective you then have in the US doctors are noticing that people are becoming obese becoming prevalent and one doctor who is treating people who are overweight decided to write a book how nature cures and write in the cover of the book you can see here it says a statement of the principle arguments against use of bread cereals pulses which are beans potatoes and other starch foods and he's emphasizing that an obese person can be given a diet of meat and if you exclude the bread and potatoes they will lose weight once they start eating the bread potatoes again their weight will increase so specifically you're saying in the 19th century doctors are noticing the association of consumption of foods high in carbohydrates and obesity now there's a massive amount of literature that I can cover for the first half of the 20th century but I think what's very useful is that we have a leader of the field in the 1950s name was Alfred Pennington ran a clinic to help people who were obese at risk for heart disease published in all major medical journals and here you'll see from one of the papers what he recommended that obese people should eat 1/2 pound or more of fresh meat with the fat in fact he emphasizes the meat does not have enough fat you should buy fat specifically and add it to your food yeah it's it's funny now but this was medical science in the 1950s and what is it that he had said you need to eliminate once again for almost a century no bread flour or sugar okay so you see consistently the emphasis on reducing carbohydrates in the diet for someone who is obese they lose the weight and so when we get to 1972 I think it's important to understand that with Atkins book that came out it followed over a century of research emphasizing that it's the carbohydrates that increase weight and the reduction in carbohydrates in the diet helps obese people to lose weight and in fact if you compare the two they're remarkably similar the Atkins diet was not a fad diet frankly it wasn't revolutionary the idea had actually begun in 1863 with William Banting's book so it's over a century in which doctors have been showing that by reducing carbohydrates in the diet you can lose weight and so the rub on the Atkins diet of course is you lose weight but you're still going to have a heart attack you just leave a thinner corpse and so is it healthy and again I could go over dozens of studies but we don't have the time and so I'm going to cover one study which is very useful for us because it has people with high cholesterol and low cholesterol people with diabetes as well as not with diabetes and so it shows the actual diet what it is that they ate and we also have biomarkers which can tell you whether or not the Atkins diet puts people in peril and so here we have once a very low carbohydrate diet also called the ketogenic diet and this is what you can eat on a ketogenic diet basically anything that is protein in fact so any animal food you hear you see here on the left side fish meat poultry and especially full fat cheese okay there are no non fat foods on the left side basically any vegetable that is in potato or corn so it isn't anything that will raise your blood sugar and these people would have five tablespoons of oil per day as a part of their diet in this case it's olive oil but it could be butter it doesn't really matter and what is it that they could not eat basically the same thing you see from Banting it's high carbohydrate foods so you eliminate foods that raise blood sugar no fruit juice no soft drinks with sugar and so you look at the results and basically this is now 150 years confirming weight loss this is in kilograms so in pounds you're looking at these people over about 200 pounds and so this over the course of a year whether they have high cholesterol or normal cholesterol their body weight dropped dramatically and so the diet works now the question about biomarkers well here you have all the basic biomarkers and rather go into great detail each one goes in the right direction there is no drug that can produce a change in the biomarkers like a low carbohydrate diet you look here on the opposite end this is the HDL right here HDL is called a good cholesterol because when it is higher you're less likely to have a heart attack and so it is only the low carbohydrate diet that you'll actually find an increase in the HDL but you have here on the right are triglycerides which are fat in the in the blood and the fats and the blood declined when you reduce carbohydrate consumption and over here on the far right on the bottom that is blood glucose fasting blood glucose drops dramatically just by reducing carbohydrates in the diet so every biomarker moves in the right direction with a low carbohydrate diet and again just to summarize a vast amount of research we have here just published this year the work of over two dozen scholars in the field of nutrition published in the journal nutrition basically they're emphasizing carbohydrate restriction is the best approach for someone whether they have type 2 diabetes they also apply it to heart disease and obesity in general and here you see summarize on the bottom the benefits of carbohydrate restriction in diabetes this applies other diseases as well are immediate and well documented there are no justifiable concerns about reduction of carbohydrates in the diet so with all that science I've just shown you I just gave you basically a summary of 150 years of research coming to a very clear conclusion its carbohydrates the demon on your plate it's the carbohydrates that are making you fat that is what you need to be aware of and so now you go to the store and you're looking to lose weight and what is it dietitians nutritionists and the American Heart Association will recommend that you eat fat-free cheese fat-free yogurt fat-free butter and cholesterol free eggs and if you look in the middle you've got cookies isn't it fantastic they're fat-free so it almost makes it look like a health food right it's just pure sugar and what does the American Heart Association recommend basically low fat food lean meat low-fat dairy products skim milk why is it the recommendations are completely out of touch with the science well here I think is the origin of why we've been given such misinformation the low-fat food mania I would say began in 1955 when President Eisenhower had a heart attack and you see along with this graph as well and increase incidence of heart attacks and Americans over the course of the first 50 years of the 20th century so there was great concern at the increased incidence of heart attacks occurring and here with Eisenhower having heart attack it just made it so much more personal now the fact that Eisenhower was a chain-smoker didn't seem to become realized to people no one said well gee the guys have changed he actually was diagnosed with heart disease before he became president and Americans had become smokers there's a dramatic increase in smoking which of course now we know is associated with heart disease as well as lung cancer but no one was talking about him being a smoker as contributing to his heart attack what we had was a man who came forward and he worked with Eisenhower's doctor and he went on national television supported by the American Heart Association and he said what's killing Eisenhower causing him to a heart attack is the sausage he's eating with breakfast and so it's this man named Ancel keys said it is fat in the diet particularly animal fat in the diet that causes people that a heart attack because it raises your cholesterol and this is now you can see is in the news who was Ancel keys very important to understand who this man was he had no education at all in heart disease or nutrition he had a bachelor's degree in economics and a PhD in oceanography Ancel Keys had languished in obscurity for decades he studied fish physiology he conducted one study basically I consider unethical in which he starved conscientious objectors of World War two this is basically the extent of Ancel keys experience with nutrition and cardiology which is nothing what was his actual experience well while he was on sabbatical after World War two he visited Italy and he saw thin Italians and he was told that they didn't have heart attacks so he decided and that it was because they weren't eating much meat they didn't have much saturated fat that is why they weren't having heart attacks and his Ancel keys who came up with the idea for the Mediterranean diet basically on Italians living in post-world War two in which there was a depression basically you couldn't really afford the fat animals at the time so he also pointed out one of his papers to support his idea that it's fat in the diet that causes people to have heart attacks this is paper published in 1953 think about this contrast to where Pennington is publishing in the New England Journal of Medicine Keyes is publishing and barely better than a newsletter out of a hospital but he published this paper which shows a relation between fat in the diet and people dying of heart attacks and so what you can see here is that the more fat in the diet going along here you have more deaths from heart disease so in the US you have the most fat in the diet and you are the most heart attacks and so this clearly is evidence as you said that it's fat in the diet that causes people to have heart attacks the problem with this graph is it is a result of him cheating okay this is not real Ansel keys actually had data from 22 different countries he chose six data points to create this graph this is not a secret that I just discovered I have to reveal that to you this was known at the time that he had cheated in fact here is a paper published in 1957 basically saying that Kees had cheated they introduced the paper quite politely by saying no information is given by Kees as to why he chose six out of 22 data points so we're going to show you all 22 data points so they actually start off by showing his graph then they show their graph of all the data points now here are all the data points and it's important to understand these are data that came right out of World War two and so you have post-war Japan in Italy which basically have very thin people you do have a low rate of heart disease but you really don't have much fat which people could be eating at the time too so it's a bit artificial but anyway if you look at the overall curve which I've surrounded 20 of the 22 data points with the rectangle you can see a random scatter that when you have all the data points there is no relation between fat and diet and heart disease and in fact that's exactly what the authors concluded he suggested association between death rates and heart disease and fat in the diet cannot be accepted as valid but it's very clear that Ancel Keys doesn't know what he's talking about as far as diet he doesn't know anything about heart disease and he lied when he published that paper in 1953 so what is the result he gets to be on the cover of Time magazine Ancel Keys became the leader of nutrition and cardiovascular research in America in the 1950s and into the 1970s he was a member of the board of directors of the American Heart Association he basically controlled to a great extent funding in heart disease in the u.s. he served on the editorial board on cardiovascular journals yet he knew nothing about heart disease he was seen as the expert in America on heart disease and diet and what did he say in that paper in 1961 Americans eat too much fat too much saturated fat that's the kind of fat you get from animals it raises cholesterol damages your arteries and leads to coronary disease the only way sure way to control cholesterol is reduce the fat in your diet to 15% of total cow and you got to cut saturated fat the 4% it's really important to point out he made up these numbers there were no studies that supported this idea at all he didn't propose this as his idea he proposed this as fat now to me this would just be sort of a footnote to history to show that Ancel keys ignorance followed by good science means we no longer follow it but what happened was he was such a dominant figure in the American Heart Association that you see in their current recommendations you go to the American Heart Association website it still follows keys original recommendations that if you eat saturated fat you'll raise your cholesterol you'll increase the likelihood you'll have a heart attack the American Heart Association currently recommends that you have only 5 to 6 percent of your calories from saturated fat they continue to recommend that people have margarine rather than butter the same thing he said in 1961 without any justification and the remarkable thing is if we actually look at the data of what were people consuming in the 20th century and up until the 1950s specifically looking at butter and margarine what you find here on the blue line is in the 20th century consumption of butter was stable up until World War two in which it declined dramatically margarine on the other hand is increasing in consumption with World War two and this is when you're finding increase in heart disease so if anything it's the margarine that people are consuming in conjunction with smoking that explains why there's an increase in heart disease in the u.s. in the first half of the 20th century now let's see what Kees recommended basically we're all we should all eat like starving Italians okay that's the Mediterranean diet very low-fat 15% of the calories from fat 4% from saturated fat based on what he saw in Italy well let's actually look at the data okay this is published in 2012 British Journal of nutrition and here you are seeing individual countries all the countries of Europe and plotted basically on their the amount of fat they consume it specifically is a saturated fat amount of saturated fat they consume versus the rate of death from heart disease and what you actually find here is more fat in the diet is associated with less deaths from heart disease a complete opposite of the graph that Keyes created in 1953 let's look at the data point that's at the very extreme right here the people who eat the most fat and have the least heart disease France okay the French are truly horrible people they don't respect the American Heart Association at all they have an absolutely anti American Heart Association diet and keys refused to acknowledge that the country even existed in France they have over 40% of their calories are from fat and over 15% of the calories from saturated fat and I like the quote here th Huxley who said basically it's a tragedy of science when you can slay a beautiful hypothesis by an ugly fact the ugly fact is the French and what do we call that ugly fat that ugly fact let's move the data over and that ugly fact is called the French paradox you know as scientists we develop hypotheses and I thought these are supposed to enable us then to do tests and when I pottsy's fail we change the hypothesis but only in the field of nutrition and all the history of science when you have data that are opposite that don't support the hypothesis you dismiss them and you call it a paradox paradox is always used in nutrition when the findings are not consistent with what the American Heart Association Ansel ki said what you've got with the French is they don't have olive oil they don't need all of all they butter and they pate a bad diet heavy on liver and saturated fat and look at this is so horrible this woman here this is what the French people all look like huh well alright they don't all look like her but the French paradox of course is these people eat so much fat as a percentage of their calories and yet they have a very low rate of heart disease not only that they're annoyingly thin here you see countries around the world and you've got the Americans up here the fattest people in the world eating lots of low fat food and here are the French down here less than 10% of them are obese if you go to France and you see an obese person is probably an American on vacation so it gets worse now we have politicians telling us what to eat George McGovern in 1977 got a committee together to tell people what kind of food they should eat and so George McGovern against actually recommendations by experts at the time because he was on a low-fat diet he decided Americans should all be on a low-fat diet so his committee came up with a book dietary goals for the United States they basically said it's saturated fat that is causing people to become fat and to have heart disease it was McGovern's goals for the United States that then led to the food pyramid it's produced by the way by the US Department of Agriculture and so if you look at the base of this pyramid 6 to 11 servings of bread and cereal and other grains per day ok and so this is what was guiding Americans in the 1970s the 1980s and so what happened well people started eating fat-free food and what we also had was high fructose corn syrup developed at this time and the great thing about high fructose corn syrup is you keep going back and get refill after refill and it doesn't cost you anything super cheap sugar led to increased consumption of carbohydrates beginning around 1980 and whereas the fat and protein relatively stable and the result of increasing consumption of carbohydrates and overall more calories is it people got fat Americans got fat as a result of the demonization of fat and so you see we now have increasing obesity that basically began at the time when people are now increasing consumption of carbohydrates people got fat now the good thing is science ultimately prevails good science prevails and so what we've had actually in the last five years or people coming on basically saying you do not need to fear fat in your food you need to fear the carbohydrates restrict the carbohydrates here is a recent editorial in the Journal of American Medical Association emphasizing the limit on fat presents an obstacle the sensible change it actually promoted consumption of harmful low-fat foods what we need to target are the carbohydrates what this is showing and there are now numerous studies coming out emphasizing that the guidance has been wrong and in fact I'm kind of chronicles this we began with Ancel keys and the misinformation the 1950s and now we have the cover of time saying eat butter it's safe to eat again okay so the fat has been exonerated it's now really the carbohydrates anything that raises blood sugar rapidly ultimately causes harm and that is a summary of the first part okay that what we need to do is target carbohydrate consumption reduce carbohydrates the science has been bad okay and it's been promoted ultimately by the low-fat food industry and the American Heart Association next section now let's talk about cholesterol and cholesterol phobia everybody's afraid of cholesterol in their blood clearly cholesterol must be toxic for whatever reason the liver makes this cholesterol and it has one goal one goal only that is to block your arteries and so here you see cholesterol which is like some sludge in your arteries you got to lower your cholesterol here as your heart is afraid of the cholesterol and of course we now have almost half of all Americans aged 60 years and older that are taking some kind of medication to reduce their cholesterol so let's talk about why it is that we fear cholesterol well we look at the origin it actually began the first half of the 20th century and perhaps the primary science was that you have people have what's called disease which is hypercholesterolemia but you have very high cholesterol when you also have cholesterol in your arteries and so when you find a blockage in the artery you find cholesterol within that blockage so therefore cholesterol in the blood seeps into the arteries causes a blockage and therefore causes a heart attack and you do see an association of people who have high cholesterol and they have more heart attacks that's reported in this paper so it's really very simple that is the association of cholesterol with heart disease is it a causal influence so I have appeared to police cause crime wherever you see crime you also see police so very simple police must be causing the crime you want to eliminate crime just eliminate the police well the same kind of logic applies to cholesterol so if cholesterol actually causes heart disease then people with high cholesterol should die from heart disease at a relatively young age that's rather straightforward and if cholesterol is actually causing heart disease then lowering cholesterol should be very consistently found to reduce the incidence of heart attacks two very straightforward predictions so let's look at that well here is the first major study and so the largest study ever on people with extremely high cholesterol over a thousand people studied over a long period of time 1966 general medicine and what does it say we found no evidence that high cholesterol shortens the life of people either men or women and in fact it's clearly compatible with survival into the seventh and eighth decades so one of the most important studies ever publish that actually follow people over a long period of time says that having high cholesterol does not kill you at a young age does not cause you to die of a heart attack there's another study in which people with extremely high cholesterol well over 300 so they're diagnosed with hypercholesterolemia these are people sixty to seventy four years of age cholesterol total cholesterol is about 330 and so we have here it's in the danger zone the American Heart Association recommends actually be below 200 so you're 60 years of age you now follow for 10 years to see who will die of a heart attack will die of any cause that's how this study is conducted you follow them for 10 years and look at their rate of death from a variety of different causes so we have here on 100 100% is 100% is the rate of death in the general population and everybody's dies eventually everybody dies but what this is actually saying is the rate of death over that 10-year period and so if the rate of death of this group of people is greater than the general population then they will be greater than 100 percent they will be dying at a greater rate than the general population but if they're dying at a lower rate than the general population then their rate will be less than 100 look at the rate of death of people whose cholesterol is 330 and what we find is a 31% reduced rate of death if you are sixty years of age and your cholesterol is 330 and you go to your doctor and you say if I don't lower my cholesterol what's the likelihood that I will die in the next 10 years compared to someone who lowers as cholesterol well doctor saying forget about it don't even think about it you need to get your cholesterol down but the answer is right here you have a 31% reduced rate of death if your cholesterol is screamingly high if you are 60 to 74 years of age and this did not escape the notice of the authors they made it very clear men and women over 60 with super high levels of cholesterol did not have an increased rate of death either from heart disease or any other cause a striking finding was the reduced rate of death from heart disease with advanced age and I don't have time to go over the dozens of other studies that are consistent with this finding that you will live longer you will be healthier if you have high cholesterol and you're over the age of 60 than if you have low cholesterol just to show you it's not just one anomalous study and I'm not making this stuff up another study follow people for 20 years very famous Honolulu heart program follow people for 20 years and look at their cholesterol levels compared to mortality and what you find is increased mortality and older people who had low cholesterol they died at a much higher rate than the people who had high cholesterol and I like their interpretation we have been unable to explain our results that's about as candid as scientists will get and they go on further to say these data cast doubt on a justification for lowering your cholesterol levels and another thing about low cholesterol levels is you are less healthy if you have low cholesterol and you're over the age of 60 low cholesterol has been repeatedly been shown be associated with a significantly higher rate of cancer and here is just one of the studies showing increased risk of cancer in this study hemorrhagic stroke and heart failure you are less healthy if your cholesterol is low than if it is high now if not cholesterol then why is it some people with high cholesterol do have heart attacks well here's a very important study that helps us to understand what actually causes heart disease so here again we have another study so it's in the priest at an era in which people with extremely high cholesterol were not treated they were studied in these experiments and at that time it would have been considered unethical now if your cholesterol is over 300 you have to be on a statin it will be considered unethical but in this study we look at these people who have very high cholesterol total cholesterol is over 300 and we actually can look at the different components as well the LDL which is called the bad cholesterol is equivalent these two groups HDL and triglycerides they're all equivalent this two groups the same levels of cholesterol but the one in red has heart disease the one in blue does not have heart disease so what's the difference between the two groups the difference is clotting factors that people who have more clotting factors are the ones that had more heart disease those the ones diagnosed with heart disease so what you have here is FB is fibrinogen and factor 8 is another clotting factor so these people can have high cholesterol but what matters is how much in a way to have in their clotting factors that is due their platelets get sticky and then block their arteries so the clotting factors are crucial fact if you look at clotting factors independent of age you find a very consistent relation between fibrinogen which is the major clotting factor and death from heart disease as well as stroke so here you have fibrinogen levels of people of a broad range of age for stroke as well as heart disease in either case what you find is a strong association of clotting factors with death from cardiovascular disease this is independent of the cholesterol levels so ultimately then what we're looking at is activated platelets every risk factor for heart disease comes down to the common factor of activated platelets and so whether it is smoking smoking causes coagulation high blood sugar increases collect coagulation metabolic syndrome and which person is overweight high blood check my blood sugar activates platelets and stress activates platelets so you're looking at a common factor which is the activation of platelets it causes them to get sticky you end up having clots moving around your blood vessels which ultimately then causes damage so why is it after all I've just told you about that people want to have their cholesterol as low as possible it actually began with this critical study in 1984 for decades studies have been going on lowering people's cholesterol and there all were failures this was the first study that would propel the industry then to emphasize people that they had to lower their cholesterol this published in the Journal of the American Medical Association in this study over a hundred million dollars was spent to find almost a half a million people four hundred eighty thousand men had their blood tested they took the men who had the highest cholesterol on the top 5% averaging 290 those are the ones that were included in this study this study would show ultimately that if you take the people with the highest cholesterol lower the cholesterol with a drug you would save lives and so that path sis was then the risk of dying of a heart attack would be reduced by lowering their cholesterol so they targeted the men basically we're on their deathbed with having such high cholesterol they lower the cholesterol with a rather primitive drug called cholestyramine but it very effectively does lower blood cholesterol or they're given placebo and then followed for about seven and a half years this was the groundbreaking study the group that had lower cholesterol had a 24% reduction in death from cardiovascular disease coronary heart disease this was the turning point in cholesterol history there was one problem with the study there's always one problem with these studies but the problem with the study was and I've copied this directly from the paper the risk of death was actually not reduced in the cholestyramine group that doesn't make sense you lower their cholesterol you've reduced death from heart disease by 24 percent but overall these people are not living longer why is that well let's actually look at the data so I've taken this directly from the paper and I've graphed this in terms of there not being a negative outcome like death is a negative outcome so so you you live instead of dying so that's here survival how many people didn't die and you're looking out of a hundred percent almost all people basically survived and there is no difference between the groups that is why there's no difference in mortality how many people did not die of a heart attack that's out here coronary heart disease death almost nobody died of our attack so what you see all along here is this is an incredibly and disturbingly healthy group so there are very few adverse events at the end of the seven and a half years so where is that 24 percent reduction in heart disease death what's right there that difference is a 24 percent difference between the group and it is statistically significant how can that be you say this is how you do it the actual data are ninety four ninety eight point four percent of the people given the drug did not die of a heart attack in ninety eight point zero percent of people given the placebo did not die of a heart attack the actual difference is zero point four percent eight men you start with half a million you take the top 5% 1900 each group give one the drug the other doesn't and you end up with a difference of eight men so how do you turn 0.4% into 24% well it's really quite simple it's called relative risk reduction is basically a way of using statistics to cheat to greatly amplify a very small effect so you take the difference between the groups which is 0.4% and you divide it by the rate of heart attacks in one of the groups so you got a ratio into a ratio and you can then turn that 0.4 percent into 24 percent yeah I responded the same way when I first saw her that's not right okay so that's your 24 percent right there this was basically a hundred and fifty million dollar study that failed miserably what they should have said was we've been barking up the wrong molecular tree it's not cholesterol really that we should be following instead they declare victory the directors of the study declared victory this is a turning point in cholesterol heart disease research they said that it's the cholesterol in the food that the men were eating which has had nothing to do with a diet study was a drug study on Time magazine you're saying you see bad news with cholesterol and they said now what we need to do is develop drugs to be able to lower cholesterol in people because people didn't like taking the colas tyramine this is the turning point that forms the basis of why they developed the statins it was this drug that overall had no real effect on heart disease so now we move into the statin Europe and I don't have time to cover all the statin shows studies all that you'd probably be amenable we could spend the next couple of hours here talking about statins but I'm going to show you one of the best findings ever and one of the most highly prescribed drugs is Libet or and this is a finding that's been promoted very heavily so I'm going to show you the best finding with a statin and that is this 36% reduction in heart attacks with lipitor and so let's look at that study and here again I want to confirm for you this is how this is presented to physicians in the world a 36% reduction in fatal heart attacks and non-fatal heart attacks so what did the data actually look like in the study remarkably similar to the colors thyromine study this is actually what the data look like and you see those asterisks those are statistically significant differences between the groups and here what we have is on the left this is the 36% the absence of fatal and non-fatal heart attacks right there that is a 36% reduction as a result of drug treatment where is the 36% it's right there at the beginning now how do they do that so again you start with the real data ninety-eight point one percent of the people on lipitor did not die of a heart attack ninety seven percent of the people on placebo did not have a heart attack or die so this study is very straightforward if your cholesterol is high and you go to the doctor and you say I think I'll just take a placebo thank you and you can tell the doctor I have a 97 percent chance of not having a heart attack if I take that pretty good drug called the placebo but the way you calculate the 36 percent is to take that difference which is one point one percent and how do you take the 1.1% and turn it into 36 percent it's the same game that was played 1984 but let's look closely at this ad it's right there the 1.1% is actually in that ad in blue font on a blue background and it says it right here the difference is 3% death in the sugar pill 2% in those taking lipitor clearly the lawyers must have gotten that little blue font in there because they had to show you all the data so you've got 36% and you've got 1% in the same ad from the same data so how do they do that but you take the 1.1 percent that's a difference between the groups and you're divided by 3% that's the rate in the placebo that amplifies the 1.1 percent and turns it into 36 percent then you are legally allowed to put in the ad that you've reduced heart attacks by 36 percent but the actual effect as you can see is right there that is a 36% reduction in heart attacks with Libet or that is what the wonder drug does it actually changes the rate of heart attacks by 1 percent compared to placebo you so it's also important to realize one percent means that you have to have a hundred people who are given lipitor that have one less heart attack in one of those hundred people in three years so when you take that lipitor you know it's a line for the movie do you feel lucky okay are you the one person that will have one less heart attack in three years that's what this study really showed and so how about if the ad actually has the real data and it says lipitor reduces the risk by one percent would you be as interested in taking the lipitor I think not ah the second study I will cover because the latest drug is Crestor a woman is so excited she's so down with crest star because she's now not going to have a heart attack and when the work came out on crest or it emphasized here cut heart attacks and strokes by 50% and in fact the author and the study John castellón said it's spectacular it actually prevents a heart attack the crest or spectacular effects so let's actually look at it but first understand with all these spectacular effects Crestor is now one of the highest prescribed drugs in the world it's potentially going to overtake lipitor so seven point six billion dollars in sales from this spectacular study which is called the Jupiter study so let's actually look at what physicians see when they go to a conference this is the effect that they see from the Jupiter study of 44% reduction coronary events it does look spectacular now it is actually important to realize that it's a little more complicated than this the study was actually stopped here at two years very few people are actually out here at the end but it's even more important than that let's actually look at the scale when the study is terminated so that 44% is actually right here before two years because they considered it unethical to continue the study because so many people were being saved by crest or we look at this scale you kind of know what's coming I'm going to be criticizing the study the scale actually goes from zero to one okay so the scale is important let's actually look at the real rate of adverse events in this study this is a graph and I'm not making this stuff up this is a graph I have copied directly from the paper published in the New England Journal of Medicine this actually shows the rate of events in the two groups right inside here if you get out an electron microscope you can you can see the difference this is the effect of Crestor this is the rate of actual events of heart attacks of deaths from heart attacks on it's the actual scale because if everybody died of a heart attack it will be way up here and Crestor could have brought it way down so the actual difference is trivial and yet you've got a 44% reduction right inside here is a 44% effect and again how do you do that I'm gonna actually show you the data this shows what happens okay when you don't take the drug versus taking it with a good outcome again meaning survival so this is the effect right here again you've gotten used to seeing this now you've got the Crestor versus placebo with that microscopic effect right inside there the difference is 1.2 percent between the groups treated versus no treatment 1.2 and here you have 2.8% 1.2 divided by 2.8 is 44% that is how you create a huge effect out of nothing a huge mountain out of a rather small ant molehill all right now you can still get one percent benefit so that's better than nothing right and if there were no adverse effects you might say well it's not a bad drug to take but now let's talk about the adverse effects of statins this was a first study actually that reported that the people who took the Crestor had more diabetes developed type 2 diabetes and it's interesting that when they presented it they call it small it's small but significant well why didn't they call the other effects small why don't they call the reduction of heart attacks small and so it is a significant effect which that frankly is small here more people taking the crust or had developed diabetes but it's important to note they were not looking for diabetes the diabetes happen to be reported by the physicians they to the agency so this was an incidental finding that the people taking the statins had more diabetes when you actually look for diabetes which means you test people's blood sugar at the beginning of the study and they take the statins then for six years then you find a dramatic increase in the incidence of diabetes here is a six-year study showing that people given the placebo about 6% of those developed diabetes but almost 12% of the people taking the statins develop diabetes so these are healthy people taking the statins and you now have almost doubling the rate of type 2 diabetes developing as a result of taking the statins you also find in these statin studies are typically stopped at about two to three years that's relatively early if you want us to be able to see cancer develop we've already know that low cholesterol is associated with a higher rate of cancer this is a very rare study in which actually follow people for ten years to look at adverse effects and what is very clear in this study of women which you find compared with no use of statins to those who use statins for over ten years more than double the rate of breast cancer and those women who use statins for ten years and is a clear association whether it is actually caused by the statin itself or low cholesterol the association is there of dramatically more cancer in people who have low cholesterol and finally there are numerous other adverse side effects of statins that it won't take time to go into each one but it's very clear that it affects brain functioning reduces memory capacity very clear evidence of erectile dysfunction rhabdomyolysis renal failure hemorrhagic stroke and liver dysfunction all to get that 1% better than a placebo effect for heart disease and so sometimes people have said well I can talk about this in a group especially not to physicians but first I'll tell you I have been lecturing to cardiologists a lecture at cardiology conferences I've also lecture 2 diabetes conferences and I just recently published what I've just shown you in a medical journal a peer-reviewed medical journal expert reviews in clinical pharmacology which i've described along with my colleague goofy Robin Scott we have described the deception that has gone on in the cholesterol and specifically the statin research or last several decades and we wrote that the war on cholesterol has been fought by advocates that have used statistical deception the reality is that there are trivial benefits that are offset by their adverse effects this paper came out only a few months ago and has already been cited now by a couple of editorials one in open heart in which they have cited our work emphasizing that there is an exaggerated belief in the modest effects of the pharmacotherapy and they wrote that these exaggerated effects now mislead patients and doctors another editorial just came out this week citing our paper emphasizing that it is clear that the cholesterol heart hypothesis is a fallacy of modern medicine basically saying that ultimately we will see that using statins to lower blood cholesterol is equivalent to bloodletting taking out a vital substance from the body with drugs so I'll finish by saying that I have benefited by the vast amount of work of my colleagues of MDS and PhDs and here is just a subset of the work that's out there outstanding scholarly books written by MDS and PhDs now you have three examples here at the bottom and a colleague of mine dr. Paul Rush wrote that the belief that heart disease is due from high cholesterol and saturated fat has been perpetuated by powerful forces using tactics to preserve the profits and reputations of those who promoted this doctrine that is came from Ancel Keys comment on his Dogma which never really was hypothesis he further says the advent of statins has fueled this fallacious lipid hypothesis reporting of side-effects has been suppressed and the benefits alleged benefits have been hiked I thank you for your time would anyone care to comment provide any accolades compliments yeah yes very very informative but I have a question on your local low carb is fruit included a question is fruit included yes a good thing about fruit especially in moderation is that the water and the fiber that would be in fruit would slow the increase in blood sugar but you should realize that if you have a 16-ounce smoothie filled with orange juice and fruit that is going to increase your blood sugar but clearly having an apple or a small amount of fruit is not a problem at all you about right here this might be a little off the subject but I'm sure you're familiar with it many of the cardiologists prescribed 81 milligrams of aspirin per day and lately there have been some television programs on this that perhaps it's bad for you I've just wondered if you've looked into that at all and whether it is or is not yeah this is where deception reaches its highest level in the recommendation that people have a baby aspirin you call it a baby aspirin it sounds like it's a harmless bear has been petitioning the FDA for the past 15 years to be permitted to say in advertisements that if you take an aspirin it will reduce the chance you'll have a heart attack your first heart attack and so they very carefully make their television commercials appear as if when you get that note that says your heart attack will happen today if you had taken a bit of baby aspirin you would not have art attack and that is not the case at all so the adverse effects of taking a baby aspirin are bleeding a hemorrhagic stroke as well as all sirs so first of all a healthy person should not be taking a baby aspirin there is evidence that actually after a heart attack are at the time of the heart attack and soon after that an aspirin can help primarily because it's reducing clotting but basically there isn't good evidence that a person should be on baby aspirin for a long period of time yes I'm sure not the only one who noticed the serious lack of bacon on the buffet tonight by the way I kind of have two questions um one is I understand the bias with the pharmaceutical companies but what would be the motivation for the Heart Association or for doctors to perpetuate the myth and secondly I understand sugar is a problem but is there a way to treat the high platelet issue so you covered motivation of the American Heart Association which perhaps the fact that they're very heavily sponsored by the margarine industry is a factor they've been heavily sponsored by the liquid oil corn oil industry for decades but perhaps you know we can leave that to speculation as to why I don't think doctors actually are involved in as doctors being educated by people in authority who are being paid very well by the drug companies was there another oh yeah as I said you have control over platelet aggregation it is smoking being overweight stress so these are all factors that cause your platelets to become sticky so these are factors that are also under your control you since you work with memory also with everybody trying to get lower cholesterol and supposedly heavy lower Klaus for all numbers as this being factored in since the brain is fat and needs all that that to the increase that are having so dramatically thanks so your question is really about cholesterol and brain function the brain is about 25% cholesterol and absolutely needs cholesterol be able to produce new brain cells new connections and it's a very clear connection not only with low cholesterol the cancer you see a connection of low cholesterol to poor cognitive functioning and so the extensive evidence that you find of statins reducing cognitive function is consistent with the idea that basically if you starve the brain of cholesterol it just doesn't function very well you yeah I was curious you there's so many things that affect everything so it's hard to pinpoint one but one thing I've read about is that taking cholesterol producing statins reduces an older person's already reduced production of coenzyme q-10 and that that is a vital heart energy you know so are you hurting your heart by taking them yeah absolutely and there is evidence actually so you raise a very important point part of the metabolic pathway in which statins interfere with a production of substrates is that you not only block cholesterol butcher block Co Q 10 and coq10 is absolutely necessary for good energy production for good health for basically for the mitochondria to function properly and so yes you definitely there's evidence that you're damaging your muscle you're damaging your heart muscle by reducing the coq10 and the industry's response to that would be will then take coq10 supplements which actually have not been shown to reverse the damage to the to the muscles we have time for one more question in the back you alluded to in the beginning the clerestory all and the plaque and hardening of the arteries is there a relationship with in terms of high or low cholesterol or a high or low fat as to whether a person will get plaque buildup in the arteries thank you that's a great question the remarkable thing is that the more fat you eat and in fact the more high fat cheese that you eat the less calcium will build up in your arteries the less your arteries will be stiff the less damage there will be to your arteries it's a remarkable finding actually and what's really important is that along with the high fat cheese another high-fat foods you actually have vitamin k2 which helps to direct the calcium into the bones and if Cal you don't have enough k2 from animal products then the calcium just drifts into the arteries and that contributes to hardening of the arteries the arteries get damaged and then the cholesterol is actually used to repair the damage it's also used by the immune system to attack bacteria and viruses that are causing the damage so the cholesterol really is analogous to what the police are doing at the scene of the crime thank our speaker thank you

Channel: TheIHMC

Views: 409,838

Rating: 4.8585191 out of 5

Keywords: Health (Industry), Cholesterol (Chemical Compound), heart, fat, National Diet (Governmental Body), Diet (Industry), Cardiovascular Disease (Disease Or Medical Condition), cardiovascular

Id: yX1vBA9bLNk

Length: 58min 42sec (3522 seconds)

Published: Sat Sep 26 2015

Reddit Comments

[u/highwebl]

Thanks. I found this really interesting, so interesting I emailed my doctor about it. He was not so impressed--he told me to keep taking my statins.