Brothers in arms in the assault on the shibboleths of commercial medicine exchange views during a break in proceedings at the King of Organs conference in Hofuf on Tuesday. (L-R) David Diamond, Malcom Kendrick, Carlos Monterio and Paul Rosch. — SG photo Saudi Gazette report
HOFUF — The subjects of cholesterol, statins and statistics, the hot topics of debate in an increasingly sceptical medical world, came under attack at the King of Organs heart conference in Hofuf Tuesday. The overall impression that evolved from the presentations was summed up in the words of Dr. Malcom Kendrik, “The whole cholesterol thing is bunk”. A phalanx of speakers and researchers qualified to present such a controversial stance against the mainstream medical establishment what was, in the esoteric world of cardiovascular specialists, a declaration of turf war. “The war against manipulation of data starts here, and about time too,” were the un-attributable words of one professor of cardiovascular medicine. Prof. Paul Rosch, Clinical Professor of Medicine and Psychiatry, launched the opening salvo of the Hofuf campaign. In a systematic analysis of the published figures and claims supporting statins, he highlighted the flaws and contradictions in the claims by manufacturers of the drug and reviewed the semantic confusion he found in works about statins. “There is a confusion between association and causation,” he said and identified it as an underlying factor in what he saw as the current misinformation about statins. As a coup de grace in his presentation he stated: “All statins are carcinogenic in laboratory animals when used in clinical doses.” Dr. Malcom Kendrick, Executive Member of the International Network of Cholesterol Sceptics, opened a second campaign, this one aimed at myths about high fat diets and the dangers of cholesterol. “We are told that if we eat a high fat diet and have high cholesterol we will have a heart attack.” He presented a powerful case, from wide ranging statistical evidence and constructed an argument that countered the contention. He detailed the impossibility of cholesterol lining arteries in the way fat lines a pipe and demonstrated that in fact the nature of the epithelium, the layer of cells that forms the lining of arteries, “lets nothing past it does not want to. To say that it lets stuff through is as stupid as my saying I can walk through walls.” He showed that in reality the epithelium has to be damaged to allow the formation of fat behind it and then the “skin” grows back. He noted that despite the evidence, the popular image of “fat in pipes” was the one that sold and stuck. That, he said, was important as campaigns had been mounted with equally specious “facts” to support them and gave the example of an anti-smoking campaign in the UK that linked smoking to the buildup of fat in arteries, “but offered no explanation to support it”. Even more importantly although cholesterol, fat and strokes have been inextricably linked by campaigns and in the public mind, “no one has ever found a link between cholesterol and stroke death.” To illustrate that “the whole cholesterol thing is bunk,” he pointed to the case of Japan, among other nations as proof. In 50 years, fat consumption has risen by 200 percent, cholesterol by 60 percent but cases of heart disease have dropped by 40 percent. Kendrick went on to make a case for the part that stress played in heart disease and showed positive links between lifestyle and both chronic and acute points of stress in life. Causes varied from combat trauma through bullying to child abuse – all were factors in stress and were all important factors. Using his own dietary challenge as an example, Prof. David Diamond looked critically at the relationship between bad science, politics and commercial profit as he traced the history of diets from the 19th century onward. He came to the conclusion that fat, far from having a deleterious effect has in most cases the opposite. The idea of the meat, fat and vegetables diet he thought was neither new nor incorrect. It had been recycled several times in history. Indeed, an all animal-product diet was standard for several cultures – Inuit in Alaska, Sami in Finland and Masai in Kenya – where heart disease and cancer were almost unheard of. The idea that fat food was linked to arteriosclerosis he contended was propagated originally by Ancel Keys, who became the national food guru during the McCarthy era in the 1950s. One essential factor left out of Keys' research into the cause of heart conditions was sugar. It was carbohydrates that were the real enemy, said Diamond, in the form of sugars and starches. The idea of fat and heart disease stuck with the public and a whole industry developed promoting fat-free foods; the net effect is that because the majority contain high quantities of sugar and carbohydrates in other forms, that obesity in the US, for example, has risen, not declined. With this, Diamond opined, arose a whole industry to control the effects of a diet that caused the problems. He concluded that there was a choice between statins or low to zero carbohydrate diet – leaving out bread, potatoes rice and sugar. “Dark chocolate is a far better drug to take than statins,” he said. Kendrick concluded his campaigning day by asking the conference to consider the methods of and reasons behind data manipulation. It was, he said, outrageous and largely unchallenged and should be stopped. His presentation drew loud applause after he detailed the extent of the habit in commerce, the publication of papers and research. Kendrick showed published statistical samples were manipulated to prove a case, unsupportive data hidden, accurate research that was not acceptable to mainstream thought published in low circulation minor publications, threats of funding withdrawal from research projects that seemed to be producing the “wrong” results and outright peer pressure – bullying by another name. The solution he thought includes independent review bodies with statutory powers to impose effective sanctions, a common statistical method so that results could be compared accurately and great personal skepticism. On its final day (Wednesday) the conference moves into more esoteric areas of debate on the outer fringes of research into the electromagnetic aspects of the heart and body taking center stage.
