David Diamond on Deception in Cholesterol Research: Separating Truth From Profitable Fiction

Thank You Karan for handling all the details and your great crew especially thank you Greg I only for invited me but for all the great work you're doing changing the world getting us out of the mess that we're in so following a theme of the mess that we're in I'm going to elaborate a bit on what you've already heard from both Gary and Zoey a bit about dietary guidelines that are way off but then really do a deep dive into the mess that we've seen with cholesterol information or misinformation so I have a personal stake in why I'm up here I'm a neuroscientist been neuroscientist for 40 years I'm not talking about my neuroscience research I'm talking about how this has affected me personally 1999 I was diagnosed with a genetic anomaly called familial hypertriglyceridemia which means I'm extremely efficient at producing fat first with my kind of genotype can be obese very easily and so this is 1999 and you see that through 2007 so I battled this hypertriglyceridemia I have my triglycerides for example where 800 HDL was extremely low at about 30 so you want your triglycerides HDL ratio to be maybe to no more than 3 to 1 my ratio is 25 to 1 this is extremely dangerous so I took it very seriously I exercise like crazy and I followed the dietary guidelines but you can see right here and I'm sure Zoey will cringe at this this was my guide 1999 I knew a whole lot about the brain but basically nothing about diet and heart disease and so the American Heart Association website I'm looking at reducing my saturated fats went low and meat exercise like crazy I owed meal so I could lower my cholesterol a bean so I could lower my cholesterol and so I followed these guys was very concerned about my cholesterol concerned about saturated fat by 2007 the only thing I'd accomplished was my triglycerides went higher my HDL went lower and I fat I was never obese but I was about 30 pounds heavier than I am now I remember that moment and it's actually at diet dr. calm which they interviewed me that moment in 2007 when my doctor sat me down and said you've done your best you follow the diet recommendations you've exercised and you haven't been able to improve you gain weight and your triglycerides are still sky-high you must go on a statin to which I was actually amenable at the time you didn't know what statins were but I do remember that moment when I said well I've got a PhD in biology the least I can do is read about what is a triglyceride and what I should do about it and I remember that moment in my office when I read a few papers on the physiology of triglycerides and it just struck me I said damn it's the bread and the potatoes and the sugar I've been eating I've been so happy eating bread without butter and so it's the bread that's driving up my triglycerides so at that time then I was struck by this epiphany that I'd been given the wrong information a few papers led to a few thousand papers and that's what led me to here to you today talk both about a little bit about diet because you've heard plenty from Zoi already but also about cholesterol so as a result of what I've learned now this is now about 10 years in which I've been sharing this information what I've realized is everything you see up here is bogus absolutely bogus how's my European UK friends it's just rubbish and so that's part of what you've already heard this is just not right and I want to cover it just a little bit that's that's where this come from this fear of saturated fat and so I think it's important to point out that to a great extent there is one man that owns that misinformation Ancel keys so in 1961 here you see in cover of Time magazine a man who knew nothing about nutrition knew nothing about heart disease and this man was in charge to a great extent of nutrition and heart disease research in America man who out of bachelor's in economics and I've heard he had two PhDs but frankly neither one had anything to do with nutrition or a heart disease and what did keys say 1961 American too much fat too much saturated fat you eat saturated fat you raise your cholesterol you damage your arteries so Americans have to reduce their fat consumption especially saturated fat to almost nothing and he stated this as a fact this is what's so important this was stated as Dogma not as a hypothesis and there was absolutely no basis whatsoever for these recommendations now that's 1961 here it is now 2019 that same information is now being put forth you know the American Heart Association website the same information is still there they a demonizing saturated fat they're recommending an ultra low fat diet they are still recommending margarine over butter at this present time and why the American Heart Association is a private organization not beholden to anybody but their sponsors they have no interest in the health of Americans they have an interest in supporting their sponsors which includes the corn and soybean oil industry and the pharmaceutical this is what I have now learned in the past 10 years and I'll elaborate on that a bit later so I want to point out also that it's not as if we've learned something new about saturated fat and triglycerides that information was all there before so this is an incredibly important paper it's coincidental it's the same year that Ancel Keys is seen as the expert in the world at least in the country on diet and he's demonizing fat well here Pete Aaron's at Rockefeller University published a paper studying people on low carb or low fat diet and what they've come up with is carbohydrate induced like tamiya which means you consume carbohydrates you increase fat in your blood and that's related then to obesity 1961 and the effect was so profound that they showed the serum from a person on the high carbohydrate diet the like quemic plasma related to consuming carbohydrates and you see this thick serum right here carbohydrate induced like Kimia the same person who has this thick plasma is now put on a low carbohydrate diet and they're now pointing out the clear plasma occurs when someone has put on a high-fat diet so this is really nothing new I mean we are getting enlightened by talks such as Zoe and talks that Gary has given but this information was out there decades ago and so I also want a credit Zoe and I don't want to need to go into any further because her work is just magnificent review not only of the current literature but she actually looked back at what did we know in the 1970s and what we knew in the 1970s did not justify the Dietary Guidelines we were misinformed and she stated and her group of authors stated not only was it inaccurate at the time those Dietary Guidelines should not even have been introduced so the misinformation has been out there for decades and only now I think we're getting so many people studying this that we're catching up to that misinformation so what we have is clearly money the food drug companies have proposed this cholesterol theory which ultimately was the end of the diet heart hypothesis and it's clearly wrong so the first phase which I've only touched upon since we've covered this all today is clearly saturated fat consumption does not contribute to either obesity or heart disease and on a low-carb diet okay so now let's do a deep dive further into LDL so does LDL this is the meat of the talk does cholesterol actually cause heart disease and specifically LDL all right this is an incredibly important study this is a powerful influential study it is still cited even though you're looking at total cholesterol this is a study that is repeatedly cited to the present day that cholesterol causes people to die as a result of artery blockage so this is mr. fit study in which you have middle-aged men that were followed large number of middle-aged men over the course of many years about seven years or so and you're looking at their vulnerability to die as a result of their cholesterol level and so this is got the rate of death beginning with 1.0 is your reference you with the lowest cholesterol and so as you go to higher levels of cholesterol you are looking at higher rates of death from coronary heart disease so from the one to the two you're looking at twice the rate of death two to three three times so at 4.0 you're looking at 400% deaths from coronary heart disease as a function of cholesterol so the point of this article is it's not just people with super high cholesterol that die of heart disease any small increment of cholesterol brings you closer to your deathbed so I looked at this paper and I look at the raw data okay so I was curious as to what was the actual rate of death for the individuals in the study I'm going to show you then the raw data in the study that shows the actual rate of death of the population because this is just a ratio so what percentage of people actually died as a result of their cholesterol levels so on the this scale here you're looking up to a hundred percent you're looking at now at the percent of people that did not die as a function of their cholesterol levels and that's in blue just take that in for a moment okay these people were horribly uncooperative they're almost nobody died in a study and so the blue shows you the percentage of people that did not die and they're almost all at a hundred percent so for ease of viewing I'm gonna put a line across at 99 percent so 99 percent of the people did not die so at the lowest level of cholesterol you have slightly more than 99 percent did not die and at the most extreme level of cholesterol slightly less than 99 percent did not die how do you get the same data originating to make the blue bars as to make the red bars how do you get from the blue bars to the red bars well what you have here are the raw data again 0.3 percent of the people with the lowest cholesterol died of coronary heart disease if we go to the farthest extreme where you've got the 4.0 meaning 400% increase in deaths most extreme value is 1.3 percent of the people and coronary heart disease across the entire essentially almost the entire spectrum of cholesterol levels you have a difference of only 1% and what did they do well to calculate this level you take the 1 point 3 percent divided by 0.3% and you get 4 point 13 and that's how you create a 400% difference in the rate of death based on cholesterol but the real difference is 1% now why was it that standler used the data in red and not the data in blue in promoting the study and continuing to promote it because the cholesterol hypothesis was failing numerous studies have been looking for an association of cholesterol - heart disease death and they had failed studies had been lowering cholesterol for decades and they had failed this was desperation time cholesterol hypothesis was dying and so they had to promote this because they couldn't admit that looking at cholesterol itself is not associated with death now let's go to the highest level this is what people fear extremely high cholesterol that's total cholesterol over 290 which means you are now into that range in which is a genetic susceptibility familial hypercholesterolemia and just pause for a moment these are men that have extremely high cholesterol and yet almost none of them died and so this is a problem if you think of familial hypercholesterolemia people as dying at a relatively high rate so let's look further into FH or familial hypercholesterolemia and so this has been very well studied first half of the 20th century what you see is its genetic anomaly in which is impaired LDL receptor functioning which ultimately results in extremely high cholesterol levels you have high cholesterol levels and you have cholesterol within the artery wall right here so that's cholesterol in the artery wall and you see some individuals died at a relatively young age you put that all together and it's pretty obvious cholesterol must be killing people okay the high cholesterol nfh causes heart disease well very simple as a scientist I just tested the hypothesis if people with FH are dying young then you just look for evidence of premature death and people have extremely high cholesterol levels and second then if it's the cholesterol causing death from heart disease then all you have to do is bring the cholesterol down and you're gonna see these people live a lot longer well here is the first major paper studying an enormous number of people over a thousand people diagnosed the familial hypercholesterolemia and what you're finding is a normal distribution of these people with FH and the population and they made it very clear in Journal Medicine 1966 our studies provide no evidence that being diagnosed with FH shortens the life affected individuals men or women these people have a normal lifespan and they live into the seventh and eighth decades now you don't hear about this in your medical education and this kind of study they want to ignore but this has actually been replicated numerous times in which you find actually people have extremely high cholesterol have extraordinary health people with high cholesterol have a significantly lower rate of cancer infectious disease and live overall normal lifespan because elderly people with FH do not have a higher rate of cardiovascular disease here's this up more recent study I don't depend on saving from 50 years ago there's more recent study people genetically confirmed to have FH their cholesterol levels are about three times normal LDL is over 200 and you're looking then at death overall all cause mortality you looking from birth through over 80 years of age and what you find here is this slight increase in the first few decades of life is because you do see an increased rate of cardiovascular disease and these people which I'll get to mechanism later but it is not statistically significant and realize when you are looking here this is the rate of death in the general population there is almost no deaf individuals in the first few decades of life rate of death is typically 1% or less so this is relative to the general population so relative to general population almost none other people with FH are dying young and it's not statistically significant and what is so important is these people now over the decades have a lower rate of death as they get older and there is this idea put out there of LDL burden that the LDL then accumulates in your arteries making you more and more susceptible to die of heart disease well this makes no sense at all because that slightly elevated rate of deaths now declines until there was a statistically significant rate reduction in death in people 70 to 79 years of age and they didn't do statistics from 60 through beyond 80 but it looks like if they had combined everybody over 60 years of age you would find a significant low rate of death for people with astronomically high levels of cholesterol and the reasoning is very simple these people don't have a higher rate of heart disease and they have a lower rate of cancer of type 2 diabetes and death from infectious disease to have the diagnosis of FH after the age of 60 means you are healthier than the general population I sure didn't expect to hear that did you okay and again these authors confirm this this isn't just my interpretation they confirm that compared to the general population people 70 to 79 years of age again with cholesterol total cholesterol for 100 LDL 250 these people have a lower rate of death based on their overall improved health now this isn't just the FH population there are numerous studies that have conducted longitudinal analyses of people based on their cholesterol levels when you look at older people 50s 60s 70s and 80s and you look at their cholesterol level in this case you're looking out 20 years you get their cholesterol levels older person and see who's alive 20 years later what you find is the older people who had the highest cholesterol lived longer people with low cholesterol die off at a much higher rate so a low cholesterol is associated with increased risk of death it is unhealthy to have low cholesterol and I love what they have here this is our interpretation this is like this is just so candid about them just saying how they feel we have been unable to interpret our results because everybody told us how bad cholesterol is for you and these damn people were just living longer but they actually provide a really great review it's just one of many studies they review the literature and said you know in fact actually our studies our study is consistent with a large literature that says that having a high cholesterol is healthier is a sign of good health compared to people with low cholesterol and in fact they say right here this work has doubt on the justification for lowering cholesterol especially in an older person and understand talking about people over 60 that are at the highest risk of stroke and heart disease so when you are at the greatest risk of dying of cardiovascular disease that is in fact when having high cholesterol appears to be protective for life since I don't have time to cover the entire literature will point out that I'm now working with an outstanding group of clinician scientists led by goofy Robin scoff and we review the entire literature not just cholesterol but we specifically reviewed the literature on the bad cholesterol LDL cholesterol in which have looked at people rate of death and people with the highest cholesterol we did not find a single study that showed that older individuals died at a higher rate with high cholesterol compared to low cholesterol and in fact over all the people with the highest cholesterol not even just FH in the general population those people that had the highest cholesterol live longer than those people with low cholesterol so our conclusion was this analysis certainly provides reason to question the cholesterol hypothesis that I Pappas's that cholesterol is actually causing harm an individual so when we look at LDL causal as a causal factor in developing heart disease the evidence is not there there are some associational studies but there is no evidence of LDL causing harm so all I can say is you lie this is we have been deceived we've been deceived to call a liar we have been deceived to call LDL bad cholesterol to see LDL as it as something toxic in our bodies LDL is not harmful in fact I said earlier today LDL is a part of our immune system when we have an infection we have a pathogen invasion it is LDL that works with our white blood cells to attack the pathogen and that's what you actually find in the coronary arteries when there is an infection the reason why LDL is in there in part is to work with the macrophage to kill the bacteria and that is why you altima tell DL in the coronary artery it's not only killing the pathogen which is associated with heart disease but it's also used to rebuild the tissue well we get to the big Bugaboo I mean everything I'm saying is if LDL is so good for us then how come lowering LDL is so effective at reducing the rate of heart disease okay so cholesterol reduction it's got to improve cardiovascular outcomes well where did that come from where is the idea that lowering cholesterol is good for us you may be surprised that our fellow Ancel Keys comes up once again not only did he have bad dietary advice he had bad cholesterol advice so in fact he did find something that is correct ansel feet keys was one of the people who discovered that when you consume corn oil that your cholesterol drops in total cholesterol drops and of paper he published in 1957 and he wrote in that paper hypercholesterolemia could be corrected by consuming corn oil and so corn oil in theory would be the first treatment for someone that at hypercholesterolemia if you consume corn oil you will then be less at less risk for developing heart disease the hypothesis was tested in this paper published in 1965 by rose at all what they had where people already had heart attacks at very high risk of dying from heart disease you're had men in which you now have very simple to groups you have men that are given the best treatment of the time they are put on a low cholesterol low fat diet and they were to have a few tablespoons of corn oil every day and I got to believe that the doctors in this trial must have had an ethical quandary about a control group the control group is a very high risk of dying of heart disease but they didn't say this to them but it's equivalent to saying listen you go home we're not getting you any treatment eat your crappy diet we're not going to give you the corn oil you need to go home and die because because you're the placebo group and so what they're expecting is with low cholesterol the control group is going to die to higher rate and they're going to show superior survival with the group that has the corn oil well first the trial was successful in that it did show that those men on the low-fat low-cholesterol corn oil supplemented I did have lower cholesterol so that's right here on the right so they had high cholesterol over 260 which dropped down at 230 so you're dropping cholesterol by about 10 percent the control group showed no change in their cholesterol and this trial is very simple if you die you're out of the trial or if you have a heart attack you're out of the trial so we're looking at the percentage of people now that didn't die or didn't have a heart attack that are still in the trial three years later so that's what we're looking now at the results and here are the results the placebo group or the basically control group 75% of these men were still in the trial did not have our attack or die but in the treatment group the low-fat low-cholesterol that in Cornell only 50% other people were still in the trial so the experimental group died at basically twice the rate of those that were in the control group and so the the healthy diet and the cholesterol reduction is now associated with more death and I like there's a quote from John Abramson dying with corrected cholesterol is not a successful outcome which is really what happened here and the authors were very clear there's nothing ambiguous about this the author stated we cannot recommend corn oil in the treatment of ischemic heart disease and yet you find corn oil is still recommended American Heart Association website today they recommend corn oil / butter and you see the products now you have heart-healthy corn oil and they're saying corn oil is better than olive oil because it lowers your cholesterol so well and that is because the reason why is they have purchased the rights from the American Heart Association to say corn oil is heart healthy it is heart healthy because it lowers cholesterol coronel lowering cholesterol will cause you to die but it doesn't really matter as long as you've got the lower cholesterol this is the thinking that comes out of the American Heart Association all right so let's now fast-forward to some drug studies this statement in this paper published in 1984 really summarizes the literature up to 1984 cholesterol-lowering trials had failed 1984 at that time now decades of studies there really wasn't good evidence that you can lower cholesterol and people would be healthier people live longer have less heart attacks this was the biggest study ever on record a half a million men were studied here so what you've got is blood samples from once a half a million men and you're getting the men that had the highest cholesterol so only the top 5% averaging 290 total cholesterol and only those that had at least 190 and LDL said is extremely high about twice as much as the Aaron Heart Association now recommends those were the men included in the study so they were an extremely high risk of dying from heart disease so they were treated with rather primitive drug called a sty Ramin which is a bio sequestering agent can make basically a person feel really ill gastrointestinal disease disorder but it does lower cholesterol significantly and so this is a very long try seven point four years and you got men with lower cholesterol compared to men who were given placebo this was the breakthrough people needed this was the first trial that actually showed that less people would die as a result of cholesterol reduction and this is cut and paste right from the study cholestyramine group experienced a 24% reduction in death from coronary heart disease but what's also in the paper is a cut and paste directly from their results the risk of death was not reduced in the co-signer main group so you've got a 24 percent reduction in death from heart attacks and yet the cost I mean people are not living longer how is that possible so we look at the data it's always important to look at the data I'm showing you the data in the study but instead of looking at the number of deaths what I'm looking at is the percent of people that did not have an adverse event an adverse event for example being death okay so if if you didn't die okay then therefore that would be here in survival those people that survived which as you can see pretty much identical and so you're looking at each different event two percent of people that did not have an event such as dying of coronary heart disease and it's like a Where's Waldo kind of thing okay someone I dare you challenge you to find a 24 percent reduction in anything and that 24 percent reduction is right there this microscopic difference right there now what you got half million men get the 3800 that have the highest level of cholesterol half get placebo half get drug the drug app people have reduced levels of cholesterol in the end the difference was eight men across those two groups as 0.4% and the percent of people who died but it's 24 percent which is reported in the paper how can you take 0.4% and then report it as 24% well this is what we call relative risk in relative risk you can amplify miniscule effects near zero effects and they become very large effects like this is an extraordinary manipulation of the data it's sort of like statistical alchemy turn lead into gold with the data you take the 0.4% that's right there between the two death rates divided by one of those reported data that one which is the 1.6 percent which actually wasn't even a correct way to do it but you take the 0.4 divided by 1.6 and what do you get 24 percent you have now created an improvement in outcome from essentially nothing and this was not statistically significant this was in effect again I want emphasize was not statistically significant but reported as a 24 percent change this trial failed it was another trial that absolutely failed at lowering cholesterol and looking at outcomes the the director really should have said listen we have tried it's been decades and we keep failing lowering cholesterol is just simply not helping and what did they do they declare victory the director of the study said this is a turning point in cholesterol heart disease research we now can cure cholesterol that's in this article all we have to do is lower cholesterol and people don't die they also added that cholestyramine has a lot of adverse side effects difficult to take so what we need is medication we need something better than call the star mean because we're right on the way we are curing people of heart disease but we need something more efficient they call us tyranny and that more efficient drug the statins so we've now entered the statin era controlling cholesterol with statins so let's look at the statin trials and of course everybody calls it the wonder drugs statins have huge effects lipitor reduce the risk of heart attack by 36% that's a very important ad and this study was very important because it was this lipitor study that propelled lipitor now to be generating over a hundred billion dollars in revenue so let's look at the lipid to our study and it's right here again it's a Where's Waldo kind of thing this is the study that showed a 36% reduction in events in risk from heart disease and again I'm showing you the percent of people that did not have an adverse effect but it's really what you want to do and garlic you go to your doctor you say well my cholesterol is 300 what's the likelihood that I will not have a heart attack that I will not die well that answers right here the presented people that did not have an adverse event and again placebo and experimental groups are virtually identical in their outcomes so where is that 36% reduction in the risk of heart disease it's right there that sliver of a difference is a 36% reduction that was what you saw in the end and so in fact what they had to do was combine the absence of a non-fatal heart attack plus fatal heart attacks to be able to achieve statistical significance either one alone was not significant so I actually I'm looking around the room and I get the same look I get from cardiologists which is kind of like this little guy little guy is saying come on seriously you know I wasn't born yesterday are you telling me this is it that was a 36% difference you told me this so there's no tooth fairy there's there's no Santa Clause and statins aren't wonderdogs that's what I'm telling you so how do you get 36% of the out of that it's the same game they were playing in 1984 so let's look at the real data the real data you find is in actually a 1.1% in this particular manipulation this particular observation the difference between placebo and the drug the lipitor is about 1.1 percent what that means is if you go to the doctor and say if I take the lipitor what's the likelihood I won't have either heart attack or death from a heart attack well with the lipitor 98 percent and then you say well what if I do nothing well you know your likelihood of having either is 97 percent those are pretty good odds if you do nothing you have a 97% chance of not having a heart attack so the real difference is one percent but the ad said 36 percent so they're promoting this as a 36% but I just showed you one percent well did anyone notice in the ad this little part down here let's expand that blue font on the blue background this means in the clinical trial 3 percent taking the sugar pill or placebo had a heart attack compared to 2 percent taking a lipitor I'm sure it's the lawyers that had them put that part in right there right so they're telling you the real difference is one percent you have one percent difference one point difference that means for every hundred people prescribed lipitor only one person will have one less heart attack it will have no effect in 99 out of a hundred people and again how do you get 36 percent you take the 1.1 percent which is the difference divided by the difference of the placebo between one hundred and ninety-seven why who cares it doesn't matter this is just a way to amplify your findings and so you take the three percent on the placebo side that had a heart attack 1.1 divided by 3 is 36 36 percent and that's how you sell this you sell it to physicians you sell to the public by saying these are wonder drugs that they will reduce risk and such a high percentage of the population but it makes a difference in about 1% of the population so if you actually had truth in advertising I mean imagine that the real number is 1% so if you actually had an ad that was accurate that said lipitor reduces the risk of heart attack by 1% how many people would take it especially as we talk later about the adverse effects now another trial and I have heard about Jupiter so much the thing about the Jupiter trial was you had relatively healthy people primary prevention but these are people have high inflammation high CRP and that's another thing statins do is they can reduce inflammation and so there was this phenomenal study New England Journal of Medicine and you see what the director of the study John castling said it's spectacular we have evidence that a statin prevents a first heart attack Steve Nissen director of the Cleveland Clinic Cardiology Cleveland Clinic it's breathtaking it's a blockbuster it's paradigm-shifting it's like he's talking about the next you know Bruce Willis die harder you know die harder 47 on this is the greatest thing ever happened it is a blockbuster so we are looking for great effects from the Jupiter study well even though I'm not an MD I often do take the CME courses to see how the the statin effects are presented to md's so this is from a CME course given to doctors so this is a slide on the Jupiter effect on the benefit which looks really impressive 44% reduction in events and he's relatively healthy people so that's a little Oh closer at this the study was actually terminated at one point nine years I mean almost nobody is in a study out after two years so all the data to the right of one point nine years don't count so we stopped the graph really this is when the study was finished that is the 44% effect now look at the scale I want to show you how we are deceived the actual scale everybody had a heart attack it would be 1.0 so this scale goes up to 1.0 it is our rate of heart attacks notice this scale doesn't even go to point one so you are looking at a fraction of the actual data brace yourselves I'm now going to show you this they cut and paste is not my graph I'm going to show you the graph directly out of the New England Journal of Medicine showing the same data for those two lines that's it okay I'm serious about this this is like a magician you know that right in front of you can do magic and you don't notice it they are doing this right in front of you they are not committing fraud I never accuse Pharma or the public the people who published work of fraud they're doing this right in front of you those are two lines and right there is a 44% now how is that a 44% difference because there were almost no effects only about 0.7 percent of the placebo group had any event and about 0.4% other people giving Crestor had an event when you reduce look at 0.7 down to 0.4 that's a 44% reduction but the real difference was about 0.3 percent benefit so this is deception at the highest level it's deception right before your eyes and I just want to remind you what Steve Nissen said I just can't get past this Steve this and somehow very well paid by Pharma very well supported in his research and personally by Pharma can somehow look at that and call it breathtaking I think it's important to see this it's important to name names to call people out this is ridiculous I mean these are the people who are in a position of authority these are the people who make cholesterol guidelines these are people very well paid by Pharma who are looking at a finding like that and now promoting Crestor which again is now generating billions in revenue for its company uh I often hear people say well I've just shown you primary prevention studies what about secondary Prevention's the doctors are often saying well they may have weak effects for primary prevention but they are really effective in secondary prevention four people have had heart disease so this is one of the studies and I'd like to point out the best studies there's one of studies people often point to there's the British Heart Protection study huge number of people all at high risk for heart disease you know they've already had a heart attack they have hypertension and a subset of them were treated with statin and so you're looking at the outcome now this is secondary prevention it looks remarkably similar to the outcomes you had 1984 and the other work again looking at percent of people who did not have an adverse event and so down here for any major coronary events you have some separation you have a few percent difference when you combine any possible event and this is what people like to point to but let's look at how this is now presented to the medical community and the public so here is a news report from the director of the study Rory Collins so he's talking about this study which he's now declared statins are now the new aspirin that if we could just give statins to 10 million kairos people we would save 50,000 lives that's a thousand lives a week which is huge it's really great numbers we can reduce the incidence of heart attacks and strokes by a third well it wasn't up there a third and I know people are gonna want to get out their calculators when I tell you this but take my word for it if you take 10 million and divided by 50,000 you get 200 ok that's the number needed to treat these are not my numbers these are Rory Collins numbers the world's strongest debt and advocate what he's telling you is that if you've already had a heart attack and you're the prescribing doctor you need to prescribe the stand to 200 people a very high risk for heart attack for only one life to be saved there will be no benefit for 199 200 people so you see how weak how impotent statins are at really making a difference in survival and overall events I don't just lecture on this is now a second career for me in addition to my neuroscience work I just had a great pleasure in working with Luffy ravans Goff and others and we are publishing what I've just presented to you here's a paper we published about four years ago just on what I told you about and we made the title as clear as possible statistical deception has created the appearance that statins are safe and effective in both primary and secondary prevention we outline first that elevated levels of cholesterol are not after Oh Jenna that in fact you're healthier if you have high cholesterol we have addressed the use of relative risk to deceive people and finally then now I've talked about adverse effects because yes there is a small benefit with statins a one to two percent benefit with the statins but let's talk about adverse effects which have greatly been downplayed and even ignored by those in charge statin advocates so there is a massive literature on adverse effects of statins here are just a few of the studies and reviews it's type 2 diabetes rhabdo cognitive disorders cataracts renal failure liver dysfunction very well described in the peer-reviewed medical literature here's just one example of a study and normally what you see from the statin advocates to say they say well type 2 diabetes is very rare well that's because they're not looking for it if you're not looking for something you're not going to find it this was a beautiful RCT a trial in which you have people who didn't have type 2 diabetes at the beginning of the trial and you're actually getting all the measures you're getting their a1c you're getting their fasting glucose and their home IR and now you're actually studying them over the course of years in placebo to statin treated individuals and you see spontaneously development of type two diabetes and six percent of the placebo but now you got eleven percent of the statin treated individuals are developing type two diabetes so you are adding five percent to that group which now increases their risk of not only developing heart disease but other diseases as well so the type 2 diabetes effect is very real it's very rare to find a study go out more than three or four years where the reason is there is evidence of relation of statins to cancer but it takes years obviously if the tobacco companies could have limited all their studies to three years after you start smoking we never would have associated cigarette smoking with lung cancer but here is a retrospective study of women either who did not use statins controlling for cholesterol levels or those who use statins for over ten years and what you find is over the course of the years you see a significant increase until it's more than twice as many women using statins over ten years for the rate of breast cancer compared to those that didn't use statins and there are other studies as well especially in the elderly you see an association of statin use with cancer and this simply relates to the fact that people with low cholesterol have significantly higher rates of cancer so it may be a direct effect of the statin or it may be increased vulnerability to develop cancer with low cholesterol you simply find that people with high cholesterol have lower rates of cancer people with low cholesterol have lower rates of cancer this is a really important study totally ignored by statin advocates this is a random sample of elderly individuals 75 years of age all on statins all of which had gone to the doctor reporting memory problems so all of which had been diagnosed with mild to moderate dementia and so what you have here is an explicit study on these individuals in which they remove the statin for six weeks at the end of the six week period they now give them a cognitive test and the group has significantly improved to normal cognition and the most important thing now is the reach allenge they now put these people back on the statins six weeks later they are back to having the dementia diagnosis and this is very simple to understand the brain generates its own cholesterol cholesterol cannot get into the brain but statins can subsets of statins can get into the brain the brain must metabolize and produce its own cholesterol and it needs that cholesterol to generate new synapses to make new cells to make memories if you are taking a statin and it gets into your brain it will interfere with brain function and gives you appearance of having dementia now I have the privilege I look at it now that I'm now seen as someone who is in the cholesterol field editor's come to me to review papers and they invite me to write commentaries so the senior editor at PLoS ONE invited me to write a review of a paper that was very supportive of statins for primary prevention and I invited others who I greatly respect Michele the large rural cardiology cardiologist in France Malcolm Kendrick oofy and Paul Roche and we know they reviewed that paper we also reviewed the extensive medical literature on adverse effects and the question was why do people stop taking their statins that was what the paper was addressing well he's not taking their stands because they feel like crap and that is really the perceived adverse effects we review it about 50 published papers that how people feel as a result of muscle pain and the myopathy cognitive effects injuries gastrointestinal disorders that's what people feel when they're on statins a high percentage as much as 40% of people have these overt adverse effects and then you have to delay it effects in which the physiology is hampered type 2 diabetes and as you look through this list all these other effects are well established they are in the medical literature so this is the reason why people don't want to take their stuns and yet they tolerated because they'd been told they're now basically been immune from developing heart attack so the third section then yes there are meager benefits have every hundred people one or two will have one less heart attack there is almost no mortality benefit for it by taking statins there's a small rate of improvement in overall outcomes but the adverse effects are so extensive that they more than offset any meager benefits finally just a little bit about well what is it that actually causes heart disease so again I've worked again with oofy we published a paper last year with Michelle as well as Malcolm Kendrick we reviewed the literature on heart disease and cholesterol first course coming to the conclusion that cholesterol does not cause heart disease and we look specifically at familial hypercholesterolemia these people live longer and on average compared to the rest of the population and but a subset of the people with FH do have more heart attacks than the general population and by looking at this what we saw and it was so obvious with decades of research that the subset of individuals with FH have another mutation that is not normally studied that other mutation is hyper coagulation they tend to have more of the proteins that cause platelets to aggregate such as fibrinogen and factor 8 these are people that have extremely reactive platelets that produce clots this comes along with having high cholesterol and so in the studies that have looked at both coagulation and cholesterol what you find is the individuals that have the hyper coagulation are the ones that have the heart attacks and that is independent of their LDL levels and that applies to the general population when you look at risk factors primary risk factors for heart disease the common mechanism for their risk factors is increased coagulation they either activate platelets or they reduce the ability for the platelets to dissolve it's called fibrinolysis and so you've got two processes both can be both impaired in people who have heart disease for example high blood sugar activates platelets when you smoke platelets get activated you get stress your blood literally clots all this is related and oofy mentioned the vasa vasorum this is incredibly important these are microscopic blood vessels inside our carotid coronary artery wall basically blood vessels sort of the size of capillaries and these are the blood vessels that can be blocked as a result of hyper coagulation where the blood just gets thicker when we get stressed or smokes cigarettes and when these micro vessels get blocked the inside of the artery dies through necrosis there's no oxygen the tissue dies and that tissue then becomes susceptible to bacterial invasion and then what happens in comes the white blood cells in the LDL to attack the bacteria and repair the tissue and that is why you find LDL inside the plaque because it is part of the repairing process it is part of the attacking the pathogen process it is not a part of the process that causes heart disease last trial I want to cover the four s trial is very useful especially for this group so this is the most successful trial ever the 4s is people often point to this as being the best statin trial because it actually showed a four literal absolute four percent benefit to the population as a result of using statins this was the trial people criticized it 25 years ago before the standards we have now 25 years ago published so effectively run by Merck data analyzed says in the paper a Merck employee analyzed the data it was kind of a joke but let's forgive them for that okay let's accept that this is real it has never been replicated but it's real a 4% mortality benefit with taking 4 s into the secondary prevention 7 years later it's a really important paper published which is the reanalysis of the data looking at their lipids and so they looking at people either had high triglycerides and low HDL which you find of people who have high blood sugar and don't exercise much and they're also now looking at the people who had low triglycerides and high HDL was what you find when people have low blood sugar and exercise both groups had high LDL so it's really important is you're looking at the difference between high triglycerides low triglycerides which is reflects blood sugar and so there is a real benefit that's this group right here is actually showing reduced survival okay that's the group that has high triglycerides low HDL these are unhealthy people and in fact this was my lipids going back to where I was 20 years ago I fit that group in having high triglycerides low HDL and that is unhealthy and for the people given the statins high triglycerides low HDL there was improvement but what's so important is the other lines that all overlap for the people that had low triglycerides and high HDL meaning they were healthy there is no improvement those lines all overlap there is no improvement for someone that's already healthy taking a statin so for someone that has type 2 diabetes and you've gone low-carb and you've dropped your triglycerides and raise your HDL the question is will you benefit from the statin this trial tells you know if you are exercising if you have low blood sugar if you have high HDL and low triglycerides this trial tells you you will not benefit from taking a statin and that is what's so important especially with this group so for anyone here low triglycerides high HDL and you're exercising and you're not obese and you're not eating lots of fried foods and sugar and ice cream well then there's absolutely no reason that person to take a statin there's no evidence of benefit and that's this group right here they all overlap hi and again they had the same high LDL I really want to emphasize that the high LDL is common between the two groups the difference was the triglycerides HDL so what I want to conclude is not just to rehash what I've told you I want to give you statements from people I respect and they've covered the topics that I've covered here so George man who battled with Ancel keys for decades he battled with people who said saturated fat ultimately causes heart disease and he wrote a generation of citizens has grown up since a diet heart hypothesis was launched as Dogma they've been misled by the greatest scientific deception of our times the notion that consumption of animal or saturated fat causes heart disease that's what you've heard here already from Zoe here from from Gary and now you've had a little bit of that for me there is simply no doubt that high saturated fat consumption in the context of a low carbohydrate diet is absolutely healthful second from Paul Rush published in Scandinavian cardiovascular journal the belief that coronary atherosclerosis is due to high cholesterol has been perpetuated by powerful forces using tactics to preserve the profits and reputations of those who promote the doctrine we have been deceived for decades because lowering LDL lowering cholesterol you can use food you can use drugs and they'll both be able to lower your LDL but ultimately provides you with absolutely no benefit to your health and finally what we have is Luffy published also in Scandinavian cardiovascular Journal that diet heart hypothesis sustained by social political financial institutions which have little do with science or any established success in public health so alas I'd like to point out that there a book I've noticed which is out here available to you you've got chapters by Zoe and Malcolm and I've got a chapter in this book and it's absolutely the best science you can get it confirms sort of what I have presented to you today it is the real science there is no deception in this book you'll find it illuminating fat and cholesterol don't cause heart attacks and statins are not the solution I feel a little bit like Sir Isaac Newton who said I stood on the shoulders of giants and I could see further I have sit on the shoulders of giants in this field which has enabled me to improve my health enable me to see further thank you all right we'll take a few questions give you guys a short break and then we have one more speaker in our final Q&A so we're in the homestretch here well we get the microphones ready I had a question come in via text which says dr. diamond do you have any great easy-to-read study that I can share with my father who refuses to stop taking statins because his doctor keeps convincing him they are necessary yeah I get this question a lot and I emphasize to people the doctor is not putting that pill in your mouth I hear often my doctor put me on statins no your doctor recommended you take a statin your doctor has recommended that his father should take a statin the information is out there I think that book is a great start but it's up to each individual to decide what medication they will take it's up to his father to decide it is not up to his doctor to decide what medication he's going to take so I guess to start start with that book that I just recommended there at the end of my talk any questions from the audience there you go yep shooters choice go ahead hi thank you very much I was hoping you could talk a little bit about the sex differences I know women's HDL tends to be higher I also know that most of the clinical trials don't include women and then on top of that it seems like there is some new research coming out that suggests that women on statins have a much harder time than men yeah if I had more time I would have covered the adverse effects of statins women develop type 2 diabetes at a much higher rate than men that study that I showed of a 5% increase was from men there's a dramatic increase in type 2 diabetes in women on status I don't think it's really understood very well why there's a delayed development of heart disease and women it's about 10 years later than men may have to do with menopause not really clear but you do see more adverse effects of statins and women and in general because most of the studies have been done on men and heart disease rates are so incredibly low in women there's almost no evidence of benefit with statins not in the one not even the 1% we're talking about with men what are your thoughts on HDL levels are elevated above 75 milligrams per deciliter even in the 90s yeah there's a strange paper out there showing the people with an HDL of ninety to a hundred have more adverse effects and so they're now warning people about having extremely high HDL I find it kind of remarkable that study you're referring to those are people who already first were ill I think with some secondary disorder I think it was kidney disease and they're looking at 0.5% of the population that had the highest HDL and they had somewhat increased rates of cardiac events I think it's totally irrelevant to a healthy population so there is no good reason to be concerned at all with extremely high HDL in a healthy exercising person all right one more from texture they'll go back to the audience what are the best markers to measure hypercoagulable coagula ability for the primary prevention of heart disease yeah so well they're two ways to look at this first of all it doesn't matter what you want to do is keep your platelets come you don't want them to coagulate it doesn't matter what your fibrinogen is your factor eight or anything else if you have below low blood sugar you don't smoke you're not obese you exercise the numbers don't matter you're going to keep your platelets nice and calm it is basically a fact the observation that fibrinogen is for the critical factor that has been associated with heart disease independent of whether you have FH or other factors but what's so important is if I Brita gin by itself is benign it's just a protein that's in our blood it is used to activate platelets so that we make clots but if it's not activated it's benign so really your goal is to keep the platelets from aggregating from getting active and they get activated response of stress and smoking and sugar so keep your fibrinogen your platelets happy you don't have to worry about the numbers anything else from the audience we've got one in the far back hey and you mentioned the one study where when they withdrew the medication that there's less dementia afterwards and that it came back is there any other studies that show withdrawal effects whether they're positive or negative and then do you would you recommend us to take our patients off statins well we published paper I didn't have time to show a paper that I published in which we were able to associate adverse events reported to the FDA involving cog impaired cognition and what we were able to associate was that there are statins that can get into the brain because they're lipophilic and their statins they can't get into the brain lipitor for example has an easy time getting into the brain and you find the most adverse cognitive events reported to the FDA come from lipitor Crestor doesn't get into the brain as efficiently and you see fewer cognitive ents from crest or so from this work what we can derive is that if a statin can get into the brain it's going to interfere with brain functioning as to what to recommend I absolutely see no benefit of statins to anybody now with that said if you're the kind of person probably someone was not here may be the kind of person that says listen I just want to smoke I want to eat french fries I want to eat a lot of crap I don't want to exercise I don't give a damn I want to take a pill and I want to be healthier well that kind of person could actually get some benefit from the statins that's from the forest study but that means they've got to tolerate the side effects so the only person that potentially can benefit from a statin is someone that really wants to depend more on medication than a lifestyle change you

Channel: CrossFit®

Views: 97,440

Keywords: crossfit, david, diamond, essentials, health, conference, 2019, madison, ddc, mess, ancel, keys, diet, nutrition, statins, carbohydrate, high

Id: inwfSkSGvQw

Length: 65min 20sec (3920 seconds)

Published: Wed Oct 09 2019