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NEWS: Roger Dobson Europe’s agriculture policy seriously damages people’s health BMJ 2008; 336: 526-b-527-b [Full text]

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The FAT hypothesis strikes again

Evan Llewelyn Lloyd   (12 March 2008)

The FAT hypothesis strikes again 12 March 2008
Evan Llewelyn Lloyd, Retired Consultant Anaesthetist EH12 6NQ Send response to journal: Re: The FAT hypothesis strikes again	Dear Sir Dobson (1) summarises the report published in the Bulletin of the World Health Organization (doi; 10.2471/ BLT. 07.042069). This claims that the European common agriculture policy (CAP), by increasing the availability, and therefore consumption, of fat, has resulted in an excess of 7000 deaths from Coronary Heart Disease (CHD) and 2000 from strokes. The authors base this estimate on their calculations that, without the CAP, there would have been 1% less fat eaten, and therefore in a lowering of cholesterol by 0.06 mmol/l. It is impossible to accept these figures since in the MRFIT (Multiple Risk Factor Intervention Trial), despite the very stringent dietary restrictions (fat in the diet reduced by 25%), the cholesterol showed only a small (5%) fall, and there was no difference between the control and the trial groups in the incidence of CHD or deaths (2). A similar European trial (3) also reported similar negative results. . An analysis of nine MRFIT type studies (4) showed that none had been effective, making a total of over 170,000 subjects studied with no ‘positive’ results. Finally a review (5) found many papers which further destroy the grounds on which the WHO estimates were based, 1. In studies on Civil Servants, and others, (5) there were many instances where there is a complete dissociation between cholesterol levels and CHD deaths. 2. Cholesterol levels change with seasons, climate, and stress e.g. accountants workload patterns, or shift work (5). 3. In a town on the South Coast of England there was a far higher intake of saturated fat, but a much lower level of CHD deaths, than in a town in the North of England (5). 4. An analysis of worldwide figures (5) shows that climate is a much better predictor of cholesterol levels and CHD deaths than diet. It is time this fat intake/cholesterol/CHD consensus hypothesis is discarded and buried. Yours faithfully Dr Evan L Lloyd References 1. Dobson R, Europe’s agriculture policy damages people’s health. BMJ 2008; 336: 526-7, (8 March) 2. MRFIT Research Group. Multiple risk factor intervention trial. JAMA 1982; 248: 1465-77. 3. WHO European Collaborative Group. Multifactorial trial in the prevention of heart disease, incidence and mortality results. Eur Ht j. 1983; 4: 141-7. 4. Ebrahim S. Systematic review of randomised controlled trials of multiple- risk factor interventions for preventing coronary heart disease. BMJ 1997; 314: 1666-73. 5. Lloyd EL. The role of cold in ischaemic heart disease: a review. Public Health 1991; 105: 205-15. Competing interests: None declared