Sub-title: Prevent heart attack and stroke and live a longer, healthier life.
This is straight down the line establishment medical advice on prevention and treatment of heart disease and strokes. I am sure that no-one with a conventional view of medicine and coronary heart disease would have any objection to the messages of this book: Be aware of your risk factors, have your cholesterol checked, eat a low fat diet, (recipes are included,) mind your blood pressure, don’t smoke, take your statins, they are good for you (even if you are a child) modern medicine is magical and modern treatment/prevention regimes for coronary heart disease and stroke saves countless thousands of lives.
Certainly I would have to say that a good bit of the advice that Prof H/C gives is sound and you would have to be more than a little daft to disagree with him. Don’t smoke, don’t drink to excess, excercise, reduce sugar consumption, eat decent foods, maintain a healthy weight, take care of blood pressure, stress and the like.
Beyond this, however, if you tend towards the skeptical end of the scale on matters relating to prevailing theories of coronary heart disease, much of what he has to say in the book will be about as popular as a concrete parachute.
Prof H-C is obviously completely sold on the cholesterol theory of heart disease. High cholesterol causes atherosclerotic plaque, which clogs arteries and zap – coronary heart disease. Others have questioned this theory. The reader may wish to take a look at the site for The International Network of Cholesterol Skeptics THINCS and follow some of the articles there, particularly in the “news” section. Dr Malcolm Kendrick, author of The Great Cholesterol Con, (reviewed on this site) also wrote this article on cholesterol and heart disease, which is both controversial and thought provoking.
Throughout the book, I noted a number of statements or assertions which I thought were dubious, in the light of other information I have read, and were not supported by references. For example, on page 99, he states:
“…. saturated fats in the diet have a powerful effect on increasing LDL levels. On average, for every 1% increase of total energy as saturated fats, a 2% increase in LDL levels occurred.”
Thus, we are told to eschew saturated fats, but which research shows this? I would like to know and check it out myself. Malcolm Kendrick in The Great Cholesterol Con, spends quite some time on the saturated fats issue and pokes holes in the notion that saturated fat has a direct link to heart disease. (The Seven Nations study by Ansel Keys was, according to Kendrick, badly flawed.) Kendrick, also points out that some researchers state conclusions that are exactly the opposite of what their data indicate.
In the book we are also told to avoid foods high in cholesterol. Again, from what I have read, the amount of cholesterol in our diet makes very little difference to serum cholesterol levels. Our liver makes cholesterol and adjusts blood cholesterol levels depending on how much of the stuff we eat. (Prof H-C does actually point this out, which seems a little contradictory.)
It is part V of the book, however, which I would imagine would provoke the most howls of dissent from the skeptics. Here prof H-C discusses the statins and other medications for cholesterol lowering, describing them as “magic bullets,” “oldies but goodies” (aspirin, fibrates, resins) and generally considering them to be “life saving drugs.”
Well… maybe, but take a look at this article by Sandy Szwarc on the THINCS site, which raises a few doubts about the efficacy and safety of statins. See also this wonderful rant by Shane Ellison “The Peoples Chemist” on the Amazon site, about the wonders of modern medicines, including those for heart disease.
I am not knowledgeable enough, (or arrogant enough) to say, as some do, that the whole cholesterol theory of heart disease, and its treatment, is a crock of schtook, nor would I say that the alternatives people have got it all right. As always, the truth probably lies somewhere in the middle. I do know, however how such matters can be hijacked by ideologies and obfuscated by big business (with eye watering profits as Malcolm Kendrick puts it.)
And I am putting my own mortality on the line. From the age of 20, possibly earlier, my cholesterol levels have always hovered around the 8 mark and my doctor looks at me with burial casket eyes every time I have a blood test. I am now nearly 60 and refuse to take statins – high cholesterol is my only “risk” factor and I am well aware of some of the nasty side effects of statins. (And yes, I am careful to eat quite a sensible and healthy diet.) I have looked at the mortality figures for a number of studies purporting to show the benefits of taking statins. Long-term there is sod-all difference. Get your cholesterol down and die of something else!
OK, this book contains some good sound advice and I do suspect there is some benefit to taking statins – if you already have heart disease. They seem to be effective not because of their cholesterol lowering properties, but because of their anti-inflammatory effects and perhaps their plaque coating effects. I am all for fully informed choices, however and unfortunately I think we are often not fully informed in this (and other) branches of medicine.
Merlin's Book Reviews 