EUGENIZATION.

Do you lift weights? If you do, do you also take a statin (such as Zocor or Lipitor)? If so, you may be shooting yourself in the foot (from a muscular standpoint), and not doing yourself a whole lot of good from a health standpoint. In fact, you’re likely worsening your health.

Bold words; I know. Read on.

If you’re a regular reader of this blog, then you’ll know I’m no fan of the lipid hypothesis (namely, that cholesterol/saturated fat/LDL cause cardiovascular disease such as heart attacks).

Often, clients, trainers, friends, and random internet folk question how I can take such a hard-nosed stance on this issue since it’s widely accepted by doctors that the lipid hypothesis is true, i.e., high cholesterol/saturated fat intake/LDL causes heart attacks. The answer? If it’s true, then you should be able to prove it. But, when examining the so-called evidence for the lipid hypothesis, you quickly discover several things:

1) The data don’t support the hypothesis.

I’ve previously blogged about how major studies dealing with cholesterol and mortality show a higher risk of death with lower levels of cholesterol. This trend holds true across the board. And if you think about the etiology of heart disease and the different functions of fat and cholesterol in the human body, then this makes sense. After all, humans have been eating stuff like eggs, animal flesh, and animal organs almost since our origins. If we really weren’t supposed to eat this stuff, how would we have survived?

2) There are too many “black swans” for the hypothesis to be true.

Nassim Talib has a great book out now called The Black Swan, the subject of which is a classical fallacy from logic. Talib doesn’t use it in this way, but a black swan is that one example that renders your theory invalid. The classic example:

Your theory is “all swans are white.” To defeat your theory, I merely have to produce one black swan. If one black swan exists, then logically all swans cannot be white.

Similarly, if your hypothesis is, “high consumption of saturated fat causes heart disease”, then I merely have to say, “The French eat more fat than us, and they have much less incidence of heart attack. So do the Swedes (who eat a completely different diet from the French). The Masai and Inuit eat fat almost exclusively, yet incidence of heart attack is virtually nil.”

That’s a veritable flock of black swans, if you ask me.

3) When looking at interventions that are supposed to help (i.e., by lowering cholesterol), they end up killing more people.

This article from the NY Times caught my attention, and it’s been the most discussed topic between my clients and I. Some of them are confused - how can a drug that lowers cholesterol cause an increase in arterial plaque? - but many of them have heard the soapbox tirade before (See #1).

Dr. Eades, in his usual way, wrote an incredible blog post about the ENHANCE study, so I won’t bore you with the details. As usual, the quick hits:

The most telling facet is that the effect was most dramatically seen in those who took Vytorin vs. just Zetia; those who had the lowest LDL levels (the lower the LDL level, the more plaque was present).

The ENHANCE study was completed in 2006. And it’s….2008? Why did they delay publication? Is it because Merck and Schering-Plough went looking for some white swans and came up with a whole bunch of black ones?

“‘LDL lowering, however it occurs, delays development of coronary atherosclerosis and reduces risk for heart attack,’ Dr. Grundy said this week.” Does it really, Dr. Grundy? Or are you just sidestepping the data?

and finally,

“Because the link between excessive LDL cholesterol and cardiovascular disease has been so widely accepted, the Food and Drug Administration generally has not required drug companies to prove that cholesterol medicines actually reduce heart attacks before approval. They have not had to conduct so-called outcome or events trials beforehand, which are expensive studies that involve thousands of patients and track whether episodes like heart attacks are reduced. ”

In other words, shoot first, apologize later - if they apologize at all, that is. Seeing what happened in the VIOXX case, that apology’s not likely unless it comes from the business end of a court docket.

Does this kind of stuff make you want to tear your hair out too? Post to comments.