Oops, they got it wrong about cholesterol

[claig]

"We've all spent time worrying about our cholesterol levels, but what if it was all... a conspiracy! What if the truth was that eating lots of fat doesn't clog your arteries and kill you, and that there's been a deliberate effort to ignore that evidence in order to secure the financial fortunes of Big Pharma's major anti-cholesterol drugs?"

www.cbsnews.com/news/dawn-of-the-cholesterol-skeptics-big-pharma-conspiracy-theorists-get-a-turn-in-the-spotlight/

"Flawed science triggers U-turn on cholesterol fears"
...
Its Dietary Guidelines Advisory Committee plans to no longer warn people to avoid eggs, shellfish and other cholesterol-laden foods.

The U-turn, based on a report by the committee, will undo almost 40 years of public health warnings about eating food laden with cholesterol. US cardiologist Dr Steven Nissen, of the Cleveland Clinic, said: 'It's the right decision. We got the dietary guidelines wrong. They've been wrong for decades.'

Doctors are now shifting away from warnings about cholesterol and saturated fat and focusing concern on sugar as the biggest dietary threat.

The Daily Mail's GP Martin Scurr predicts that advice will change here in the UK too.
...
He added that the food industry had effectively contributed to heart disease by lowering saturated fat levels in food and replacing it with sugar.

Matt Ridley, a Tory peer and science author, yesterday said there should be an inquiry 'into how the medical and scientific profession made such an epic blunder'.

He described the change of advice in the US as a 'mighty U-turn' and said studies linking high cholesterol and saturated fat in food to heart disease were 'tinged with scandal'."

www.dailymail.co.uk/health/article-3096634/Why-butter-eggs-won-t-kill-Flawed-science-triggers-U-turn-cholesterol-fears.html

I wonder if a similar thing will happen in about 40 years to the "save the planet" climate change warnings.

Oops!

I wasn't a guninea pig!

These were licenced drugs prescribed by a GP with some common side effects. And some less common ones. I was unlucky to have suffered one of the very rare ones which to date had not been as severe as when I got it.

and the steroids I had which are prescribed for people with the condition I developed (ITP) also had horrible side effects. Most people develop ITP for unknown reasons they might still also be treated with steroids though there are other drugs available with less problematic side effects so these are generally used as a first line of defence. So there is a balance to be looked at between side effects and illness.

In my case the choice was easy - death or drugs because I had no platelets at all (you can google it if you like - no platelets is generally considered to be not a good idea). Mostly ITP results in lowered platelets count sometimes not even dangerously low so patients who aren't "cured" by the drug as I luckily was have constant decision to be made about drug vs no drugs, what dosage etc

As it happens one of those dreadful Pharma companies have since had 3 new drugs licenced for ITP which has fewer side effects than high dose steroids and give alternatives, Lord knows why they bothered because apparently they don't really care two hoots about patients suffering side effects

That's right Kewcumber. Kitten punching bastards the lot of 'em.

As I said, correct me if I am wrong. I was wrong. I thought kewcumber meant that she was taking part in a trial as she said it was a fairly new drug. That's all.

Oh dear... GPs & incentives... GPs are paid via a series of relatively complex payment agreements. One of those is QoF (quality outcomes framework) which includes gathering lots of info about their patient population (have you recorded this person's bp?) and prompts them to offer best treatment options.

It's not an incentive programme. And even if you're not convinced, there is a clear option to opt patients out (& recording that they've opted out is counted, for QoF reasons, as if they have had the appropriate interaction and chosen an informed way forwards, without X treatment). GP still gets QoF 'points'.
The world would be nicer if we stopped bashing GPs - they generally work really hard and are mostly trying their best for their patients.

You'd almost think there were some ill informed people on this thread who hear something and come to the wrong conclusion because they don't know all the facts (they just read them in the Daily Mail) and they confirmed their bias.

en.wikipedia.org/wiki/Confirmation_bias

The statin target on it's own isn't even worth very much is it? A very small drop in the entire annual budget.

The media message today and over the past week has been that "obesity is the new smoking".

Meanwhile

"Britain has become the “statins capital” of Europe - and has the second highest prescribing levels in the Western world for the drugs to protect against strokes and heart attacks, an international study has found.

Last night, the former heart tsar said doctors in this country were handing out too many pills to the “worried well” and those living “indolent” lifestyles who were not prepared to take steps to improve their own health.

Increasing numbers of patients in this country have been put on statins in the last decade, amid spiralling obesity and more aggressive prescribing of the medications by family doctors, whose pay is linked to take-up of the pills among their patients.
...
Some cardiologists have suggested they should be automatically prescribed to all patients from the age of 50.

But others have said they are “disturbed” by the trend to dispense the pills ever more widely, exposing millions to potential side-effects.

Research has suggested up to one in five patients taking the drugs suffers some kind of ill-effect, including muscle aches, memory disturbance, cataracts and diabetes.

The new study says that while use of the cholesterol-lowering drugs has more than tripled across OECD countries between 2000 and 2011, levels in the UK are 40 per cent higher than average.

Britain had the highest prescribing levels of all European countries examined, with 13 per cent of the population on the drugs, in a shared position with the Slovak republic. Across all 23 OECD countries examined, only Australia had higher levels of prescribing, with 13.7 per cent of the population on statins.

Valerie Paris, an economist from the OECD’s health division, said Britain’s high place in the tables could be because GPs are given financial incentives to identify and treat heart disease as part of pay contracts which reward doctors for identifying and treating a long list so of diseases.

She said: “The question is whether these people are given advice about improving the lifestyle, or are they put quickly on to statins?”

Prof Sir Roger Boyle, Government heart tsar from 2000 to 2011, said he was concerned that too many doctors were adopting a blanket approach to the drugs, instead of targeting them closely, and offering more patients lifestyle advice."

www.telegraph.co.uk/news/health/news/10537507/Britain-becomes-statins-capital-of-Europe-according-to-study.html

Meanwhile Dr Malcolm Kendrick writes about the situation in the United States.

"You need a statin – now what was the question?

As many of you are aware the American College of Cardiology (ACC) and the American Heart Association (AHA) came out with new guidelines on cardiovascular disease prevention a few days ago. As part of this, they produce a risk calculator. Using this calculator, if your risk of heart attack or stroke is greater and 7.5% over the next 10 years, you should take a statin – for the rest of your life.

I downloaded this calculator, and I have been playing around with it. I think I would tend to agree with the headline in the NY times 18th November 2013:

Risk Calculator for Cholesterol Appears Flawed
...
In summary, using this risk calculator, extremely healthy men will be starting statins at fifty eight, and very healthy women at sixty three. This, then, marks the age at which life becomes a statin deficient state. You can be as healthy as healthy can be. You can do everything right, have no risk factors at all for cardiovascular disease, and yet you still need to take medication to reduce the risk of cardiovascular disease.

Sorry, what was the question again?"

drmalcolmkendrick.org/2013/11/18/you-need-a-statin-now-what-was-the-question/

"obesity is the new smoking" is likely to be heard much more in the media.

There was a news programme yesterday where the news reporter kept prompting about whether there should be a minimum alcohol pricing level. They will bring that one back to the fore with the justification being the new message "obesity is the new smoking" and "obesity is set to be the main cause of cancer".

At the same time, they are on the news saying we need a sugar tax on sugary foods.

So taxation of the public but no mention of regulating what food processors and drinks manufacturers put in their food and drinks.

Of course, we don't want food processors to justify the use of artificial sweeteners to replace sugar using the "obesity is the new smoking" message.

"Obesity is 'the new smoking' says NHS England's chief executive"

www.theguardian.com/society/2015/may/31/obesity-new-smoking-nhs-england-chief-executive

claig

With all due respect, you are just posting stuff from various papers.

Have you got any actual points to make - it's very very hard to see your points when you just have a long article.

Can you summarise your points in your post without just quoting stuff?

Obesity is harmful. No shit. You don't need to quote lots to make that point. Obesity - poor diet, lack of exercise etc all contribute to health and poor health outcomes.

That's no great surprise.

I can't quite see what you are adding to the conversation. You are just copying and pasting stuff.

What point are you trying to make that we don't know already?

I am saying that "obesity is the new smoking" is a new message that will be promoted. News reporters will then use it to promote a sugar tax and a minimum alcohol pricing level, on the media so that politicians can say we have to act as there is a demand because all the TV news channels are saying it. I am saying, I don't think food processors will be told to cut the sugar in food, but that people will be taxed more.

I have posted the articles to show that Britain is the highest prescriber of statins in Europe and I wonder if this will increase further as "obesity is the new smoking".

"Increasing numbers of patients in this country have been put on statins in the last decade, amid spiralling obesity"

I post the articles for the benefit of sceptics.

I don't think food processors will be told to cut the sugar in food, but that people will be taxed more

So.... should people have free choice or should Government intervene?

Smoking - bad for you.
Alcohol - harmful to access.
Sugar - bad for you.

What is the role of Government in public health - especially when it comes to regulation?

You know that Farage wanted to bring smoking back in pubs.

'So.... should people have free choice or should Government intervene?'

I said earlier in the thread, that there is no douby that government should intervene for public health and public safety over food and drugs. It is about time the government stopped legal highs, it should have been done years ago, but good on the Conservatives for acting now.

They should regulate all food processors over the amounts of sugar and salt they put in food, and they should clobber them with huge fines if they do not comply. However, they shouldn't try to tax the people or introduce a mimimum alcohol pricing level which all the newscasters and metropolitan elite will be clamouring for on our TV screens.

'What is the role of Government in public health - especially when it comes to regulation?'

To ban all the harmful additives and restrict what food processors can put in food in order to increase the quality of our food. After that they should let the public choose without using the media to promote messages of higher taxation.

'You know that Farage wanted to bring smoking back in pubs.'

In separate rooms and areas and that is fine. That is free choice.

''You know that Farage wanted to bring smoking back in pubs.''

The new message they have is "obesity is the new smoking". Does that mean Farage will soon have to campaign to bring back cakes in restaurants?

However, they shouldn't try to tax the people or introduce a mimimum alcohol pricing level which all the newscasters and metropolitan elite will be clamouring for on our TV screens

Why not? Alcohol is a massive issue.

They should regulate all food processors over the amounts of sugar and salt they put in food

Why salt?

What about smoking?

That is free choice

Isn't it free choice to eat crap food. If people are aware of the effect of sugar, isn't that enough?

Either you have free choice in stuff or you don't. You can't argue for regulation about sugars but say that regulation is not needed for smoking and alcohol.

I'm not sure looking at that telegraph report that we are the statin capital. You could argue that based on some of the figures we are underprescribing compared to the rest of Europe.

If we assume that obesity raises cardio-vascular risk to a level that statins might be advised, look at the difference between France and BRitain. France has an obesity level of 12%, Britain's is double that at 24%. However 9% of the French population is on statins. You might expect that the rate of statin prescriptions should also be about double i.e. about 18%. They aren't, they are about 13%. Possibly there's some other lifestyle factor that is applicable in France and not here that is affecting those numbers a bit, but it doesn't on the face of it look like we are overprescribing.

he OECD study also shows that the UK is in the top three countries for prescribing drugs for diabetes - a disease which is often linked to high level of obesity. - This sentence is an irritatingly bad piece of science reporting as well. I know what the paragraph means to say, but it could be better written for those that don't to understand.

Interesting thread. I've only just caught up and would like to go pages back to Charis's claim that humans have evolved to not eat fish. Charis (or anybody else) do you have a link for this? I have googled and have found nothing to suggest this is true. On the contrary, I have only found links suggesting that eating fish could be an important factor in the evolution of our large brains, which is what I had previously thought.

'Why not? Alcohol is a massive issue. '

So they tell us. Most people drink in moderation and should not be taxed just because some MPs and other people are binge drinkers.

'Why salt? '

Because too much of it is put into food to make it taste and it could easily be reduced and regulated, just as the strength of alcohols is regulated.

'What about smoking?

They already tax smoking highly and warn against it and have even banned it in pubs and some of the metropolitan elite are even talking about banning it in parks. They have done enough on smoking and now it is for people to make a free choice. As David Hockney says smokers contribute more in tax than they take out of the system.

'Isn't it free choice to eat crap food. If people are aware of the effect of sugar, isn't that enough?'

No it's not enough. It is the duty of government to regulate what is on our shelves and they have a duty to make sure it is of the highest quality possible for the benefit of public health. We pay them to regulate what is really for our good and health, not to tax us for choosing to eat cakes.

'Either you have free choice in stuff or you don't. You can't argue for regulation about sugars but say that regulation is not needed for smoking and alcohol.'

You have free choice to buy what is on the shelves. You aren't allowed to purchase alcohol of ridiculous strengths, and ready meals stuffed full of additives and excess sugar and salt should not be allowed on the shelves by the government either.

Let the government tax the food processors, not the hardworking people who pay for their subsisdised House of Commons canteens.

We pay them to regulate what is really for our good and health, not to tax us for choosing to eat cakes

But what they think is good / bad for your health and what you think is good / bad for your health may be different.

And if they regulated something that you thought was ok, you'd be the first to complain about Big Brother.

But you want them to regulate stuff that you do believe is bad for your health and you're complaining if they don't.

That is a contrary position.

'That is a contrary position.'

No that is what living in a free society is all about. We are allowed to question and criticise the metropolitan elite and say whether we think they are spinning us or "oops, they got it wrong again #" on dietary advice, on Tamiflu, on statins or anything else.

'And if they regulated something that you thought was ok'

They very rarely do that, it's usually the other way around with the metropolitan elite. Finally they have regulated legal highs which I think should never have been allowed in the first place.

If they don't take account of real public opinion instead of only listening to metropolitan opinion, then new political parties such as UKIP will be formed which will attract millions of voters and that will make the metropolitan elite admit they got it wrong and were out of touch.

Let them have Big Conversations with the public in focus groups to see if we believe what they are doing is for our own good or not.

Rafa said

"France has an obesity level of 12%, Britain's is double that at 24%."

I have just googled and we are told that we have the highest level of obesity in Europe (and also the highest prescription rate for statins too).

I am a bit of a sceptic and I wonder if we really do have the highest level of obesity in Europe, but I don't doubt that we have the highest level of prescriptions for statins in Europe. Do European countries have a National Child Measurement Programme like the one introduced by the New Labour socialists?

How do they measure obesity and is it done to the same standards across Europe? Do they include children as young as five in the obesity figures?

Here are some Daily Mail articles, because the Daily Mail is the only paper that even bothers to discuss any of these issues.

"Why are hundreds of healthy and happy children like these being branded OBESE by the NHS?

They're happy and healthy - but to the fury of their parents, the NHS insists they're dangerously fat...

To all outward appearances Logan Knowles is a healthy, active little boy. The football-mad four-year-old loves nothing more than kicking a ball about in the garden after school, and if he’s not practising his goal-scoring skills then he’s usually to be found tearing around on his bike.

So imagine his mother Stefanie’s shock — and outrage — when in January this year she received a letter from the NHS saying her son was ‘clinically obese’ and warning that he was at risk of heart disease, cancer and diabetes.

‘I was absolutely furious — there’s nothing of him,’ Stefanie says. ‘If anything, he is skinny for his age. He still wears clothing labelled for a three-year-old, although he is nearly five. There’s not an extra ounce of fat on his body — sometimes you can see his ribs.’

The letter arrived after Logan was weighed at school as part of the controversial National Child Measurement Programme, which started in 2005 and assesses the heights and weights of children in their first and last years of primary school.

As a result, hundreds of ordinary-looking children, like Logan, have received letters informing them they are overweight or obese, an often distressing experience for both child and parents."

www.dailymail.co.uk/femail/article-2142014/Obese-children-UK-NHS-branding-hundreds-healthy-happy-children-obese.html

"Mother's anger after perfectly healthy schoolboy, 4, is labelled 'clinically obese' by medics based on his BMI
Mari Moore, of Leeds, received warning letter from NHS about her son Teyo
After school health check Teyo was classed in 'very overweight' category
Mother has slammed report insisting he is very active and has healthy diet
She said: 'I think it's despicable. You have to use some common sense'.
...
'I thhink it's despicable they're branding a four-year-old as having a weight problem. No wonder children develop eating disorders when they're told they're fat, even though they're not.

'This will go on his record and that's what makes me most angry. They're giving out the totally wrong impression.'

www.dailymail.co.uk/news/article-2847286/Mother-s-anger-perfectly-healthy-schoolboy-4-labelled-clinically-obese-medics-based-BMI.html

Everyone knows if you want common sense, then you have to vote UKIP and change the metropolitan elite system.

"The fat timebomb: A THIRD of primary school children are now overweight or obese

New NHS figures show 33.9 per cent of year six pupils weigh more than they should
Fifth of children in reception also overweight or obese"

www.dailymail.co.uk/health/article-2246891/A-primary-school-children-overweight-obese.html

The old sugar tax the metropolitan elite are clamouring for looks a near certainty.

OK, so what can be done?

"Why doctors believe children as young as eight should be put on statins

Children as young as eight with high cholesterol should be put on statins, according to a report published last week. This is the latest idea for tackling the obesity epidemic and the fact that it came from the highly regarded American Academy of Pediatrics means many doctors will take the recommendation seriously.

However, it has stirred up a furore in America as well as here, with British experts viewing the suggestion with alarm.

'There are far too many uncertainties involved with giving children these drugs,' said Professor Andrew Neil, a clinical epidemiologist at Oxford University and adviser to HeartUK. 'The way to help them is with lifestyle changes, getting them to eat properly and exercise.'

www.dailymail.co.uk/health/article-1035152/Why-doctors-believe-children-young-statins.html

"So imagine his mother Stefanie’s shock — and outrage — when in January this year she received a letter from the NHS saying her son was ‘clinically obese’ and warning that he was at risk of heart disease, cancer and diabetes."

Remember that "obesity is the new smoking" and

"Obesity Set To Become Main Cause Of Cancer

Doctors at the world's biggest cancer conference say there is a "critical mass" of evidence that heavier people are more at risk."

news.sky.com/story/1493076/obesity-set-to-become-main-cause-of-cancer

So serious measures will be needed. Obviously the sugar tax is only a small part of the solution.

Claig

Again - with all due respect,your posts are just a collection of articles and quotes from the DM.

It's hard to understand what your points are as you seem to be making a lot of random points hidden in a mass of quotes.

It's hard to know and to understand what you are trying to say and it makes it hard to respond because I don't honestly see what you are trying to say.

It would be a hell of a lot easier if you made a point and then linked to an article so people could read it.

Obesity Set To Become Main Cause Of Cancer

Yes - but do you understand the biological causes? I would suggest that "sugar" is not the issue here. The actual diet itself is the issue. It's unhealthy. Sugar is not the causative agent - it's the poor diet and the high sugar part is a factor.

Correlation is not causality. Taxing sugar will not reduce cancer. People who are obese often have poor diets. People who are obese often eat too much sugar. People who are obese have a higher risk of cancer.

I would suggest that looking at the overall diet would be key.