The Diet Delusion
BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b5604 (Published 23 December 2009) Cite this as: BMJ 2009;339:b5604All rapid responses
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"The idea that cholesterol plays a key role in heart disease is so
tightly woven into modern medical thinking that it is no longer considered
open to question." [1]
And yet, Gary Taubes went ahead and interrogated the cholesterol
hypothesizers and found that things are not really as simple as hitherto
hypothesized. I wonder if Professor Colquhoun and the rest of the
scientific and medical establishments have really listened to what the
evidence has said.
Gary Taubes, a journalist, is an acknowledged scholarly writer on
topics of scientific controversy. Apart from the obesity and diet
delusions; he has also challenged the conventional wisdoms on heart health
and the cholesterol hypothesis. Professor Colquhoun, of course, is
absolutely right – the problem of cholesterol, the statin drugs and diet
and health – all revolve around cause and effect – or causality – as the
professor puts it in that more sciencey way.
Zocor, Lipitor and the rest of the statins, all lower LDL cholesterol
and also help prevent heart attacks to some extent. The higher the
strength of statins, the greater the cholesterol lowering effect and the
fewer the infarctions, fatal or otherwise. As Taubes says, this is
perceived as implying cause and effect - or causality. Statins reduce LDL
cholesterol and prevent heart disease, so reducing LDL cholesterol
prevents heart disease. Apparently, this belief is held with such
conviction that the drug licensing authorities now approve drugs to
prevent heart disease solely on the evidence that they lower LDL
cholesterol.
However, the real scientific evidence appears to challenge the role
of cholesterol in causing heart attacks: that simple hypothesis appears to
need rethinking. A different hypothesis may turn out to fit the facts
better, as Gary Taubes says, and another pathway may one day help prevent
many more cardiovascular deaths as well as avoid the expense of so many
worthless cholesterol levels.
[1] What’s Cholesterol Got to Do With It? Gary Taubes. The New York
Times. January 27, 2008.
http://www.nytimes.com/2008/01/27/opinion/27taubes.html
Competing interests:
None declared
Competing interests: No competing interests
Nothing to gain?
"It took Taubes five years to write this book, and he has nothing to sell apart from his ideas. No wonder it is so much better than a scientist can produce"
Is that all he has to sell? I suppose he won’t be too unhappy if its controversial nature makes it a best seller - whatever the merits of the book and the research it's still not correct to say that he has no potential financial conflict of interest.
Competing interests:
None declared
Competing interests: No competing interests