[scotch_drinker]

There have been a lot of people saying this for quite awhile. Malcolm Kendrick wrote an entire book about the poor science behind our current belief that cholesterol causes heart disease. There are many others. But in the current medical environment where doctors want to prescribe a pill to fix everything and the biogen companies have enormous influence over public policy, dissent never rises above the level of a whisper.

Smoking, cocaine, stress, these things cause heart disease. Saturated fat probably isn't even a minor issue as it relates to heart disease. Every day, millions of Americans take a pill to reduce cholesterol when it's not even an issue. But don't expect that to ever change no matter how many doctors start saying saturated fat isn't the major issue.

[yetanotherphd]

You are ignoring the medical researchers who advocate for a diet low in saturated fat, and ridiculously characterizing mainstream doctors as not caring about prevention, and perhaps even wanting to cause disease so that they can treat it.

I'm on the fence on saturated fat, but it is an issue that is being debated by people who on both sides want to discover the best diet for preventing disease and lengthening life.

[scotch_drinker]

I'm not ignoring them, I'm specifically speaking to that population who advocate a diet low in saturated fat as a preventative measure for heart disease when there is NO causal evidence linking the two.

Also, I said nothing about them wanting to cause disease, I said they wanted to prescribe a pill to fix it, glossing over the known issues with the pill (statins in this case) in populations with no elevated risk of cardiovascular disease. I don't have any hard evidence of this other than the fact that in 2005, 29.7 million people in America purchased statins.

Why are you on the fence? What evidence have you seen that causes you doubt that saturated fats are unrelated to heart disease?

http://meps.ahrq.gov/mepsweb/data_files/publications/st205/s...

[yetanotherphd]

First, I'm still not clear on your logic.

On the one hand, there is a debate about whether consuming saturated fats cause heart disease.

On the other hand, there is the issue of whether statins prevent heart disease.

To me these are logically separate issues, yet you seem to think they are related, and my best guess at what you were hinting at seems to be wrong. So can you tell me: how would whether a doctor wants to prescribe a pill for X instead of preventing X, have anything to do with whether Y causes X.

On the evidence of saturated fat and heart disease, I will as usual defer to Wikipedia:

"Whether saturated fat is a risk factor for cardiovascular disease (CVD) is a question with numerous controversial views. Although most in the mainstream heart-health, government, and medical communities hold that saturated fat is a risk factor for CVD, some recent studies have produced conflicting results."

http://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascula...

[tghw]

Read the article. It fairly clearly demonstrates that it is not nearly the risk factor it has been made out to be. Controversy is not science, and just because there is controversy does not make scientific results less valid.

On your second point, they are very much linked issues if X is something that does not need to be treated or prevented. That's what the article is really getting at: high cholesterol is not the primary risk factor for heart disease. They are correlated, sure, but there's not a causal link.

Saturated fat has been demonised since the 1970s when a landmark study concluded that there was a correlation between incidence of coronary heart disease and total cholesterol, which then correlated with the percentage of calories provided by saturated fat, explains Malhotra. “But correlation is not causation,” he says. Nevertheless, we were advised to “reduce fat intake to 30% of total energy and a fall in saturated fat intake to 10%.”

He points out that recent studies “have not supported any significant association between saturated fat intake and risk of CVD.” Instead, saturated fat has been found to be protective.

Seriously, read the whole article.

[yetanotherphd]

The wikipedia article I linked references about a dozen studies or meta-analyses, most of which establish a link between dietary saturated fat, and heart disease.

All of them were done after the 1970's.

Seriously, get back to me when you have read all of them.

[tghw]

A causal link, or a correlation? Because it matters, and that's what the article is making clear. Those correlation links lead to bad guidelines because the cause is not understood.

[Volpe]

Those with higher cholesterol have a higher percentage of heart attacks.

Doctors (in Australia at least) prescribe when your risk (calculated on your cholesterol, smoking, stress, exercise, etc) is lowered by reducing your cholesterol, and dietary restriction hasn't worked (i.e. your liver just isn't as good as it used to be). Is that not how its done in the U.S?

[vixen99]

It's the HDL/Cholesterol and triglyceride/HDL ratios that predict risk. Check it out.

[vonmoltke]

Not usually, no. Here, doctors usually reach for the script pad as soon as an issue with blood pressure, cholesterol, or such is detected, THEN work on the dietary and lifestyle changes to get the patient off the drugs.

[droopyEyelids]

Just want to add for any 'seekers' in the audience, some new hallucinogens probably do too.

http://en.wikipedia.org/wiki/5-HT2B_receptor