Nexus - 0602 - New Times Magazine-pages

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finding the media did not report was that deaths from all causes— __ that animal fats were the cause of heart disease. Rarely men- cancer, heart disease, accidents, infectious disease, kidney failure, tioned in the press was the ominous fact that the group taking the etc.—were substantially greater for those men with cholesterol cholesterol-lowering drugs had an increase in deaths from cancer, levels below 160 mg/dL.” stroke, violence and suicide.” What was needed to resolve the validity of the lipid hypothesis A number of clinicians and statisticians, including Michael once and for all was a well-designed, long-term diet study that Oliver and Richard Krommel, who participated in a 1984 Lipid compared coronary heart disease events in those eating traditional Research Clinics conference workshop, were highly critical of the foods with those whose diets contained high levels of vegetable manner in which the LRC results had been tabulated and manipu- oils—but the proposed Diet-Heart Study designed to test just that lated. In fact, the conference went very badly for the NHLBI, had been cancelled without fanfare years earlier. with critics of the lipid hypothesis almost outnumbering support- In view of the fact that orthodox medical agencies were united ers. in their promotion of margarine and vegetable oils over animal Dissenters were again invited to speak briefly at the NHLBI- foods containing cholesterol and animal fats, it is surprising that sponsored National Cholesterol Consensus Conference held later the official literature can cite only a handful of experiments indi- that year, but their views were not included in the panel's report cating that dietary cholesterol has "a major role in determining for the simple reason that the report was generated by NHLBI blood cholesterol levels". staff before the conference convened. Dr Bev Teter, of the One of these was a study, involving University of Maryland's lipid group, 70 male prisoners, directed by Fred discovered this when she picked up Mattson**—the same Fred Mattson _ it is surprising that the some papers by mistake just before the who had pressured the AHA into conference began, and found they con- removing any reference to hydrogenat- official literature can cite only tained the consensus report, already ed fats from its diet/heart statement a A written, with just a few numbers left decade earlier. Funded in part by a handful of experiments blank. Procter & Gamble, the research con- indicating that dietary The 1984 Cholesterol Consensus tained a number of serious flaws. The cholesterol has "aq major role Conference final report was a white- biggest flaw was that the subjects wash, containing no mention of the receiving cholesterol did so in the form in determining blood large body of evidence that conflicted of reconstituted powder—a totally arti- " with the lipid hypothesis. One of the ficial diet. Mattson's discussion did cholesterol levels . blanks was filled in with the number not even address the possibility that the '200'. The document defined all those liquid formula diet he used might with cholesterol levels above 200 affect blood cholesterol differently than mg/dL as “at risk" and called for mass would a whole-foods diet, when many other studies indicated that cholesterol screening, even though the most ardent supporters of this is in fact the case. the lipid hypothesis had surmised in print that 240 should be the The culprit in liquid protein diets actually seems to be oxidised magic cut-off point. Such screening would in fact need to be car- cholesterol, formed during the high-temperature drying process, ried out on a massive scale, as the federal medical bureaucracy, by which seems to initiate the build-up of plaque in the arteries.” To picking the number 200, had defined the vast majority of the give it 'body', powdered milk containing oxidised cholesterol is American adult population as "at risk". The report resurrected the added to reduced fat milk—which the American public has ghost of Norman Jolliffe and his Prudent Diet by suggesting the accepted as a healthier choice than whole milk. It was purified, avoidance of saturated fat and cholesterol for all Americans now oxidised cholesterol that Kritchevsky and others used in their defined as "at risk", and specifically advised the replacement of experiments on vegetarian rabbits. butter with margarine. The NHLBI argued that a diet study using whole foods and The Consensus Conference also provided a launching pad for involving the whole population would be too difficult to design the nationwide National Cholesterol Education Program (NCEP) and too expensive to carry out. But the NHLBI did have funds which had the stated goal of "changing physicians' attitudes". available to sponsor the massive Lipid Research Clinics Coronary NHLBI-funded studies had determined that while the general pop- Primary Prevention Trial in which all subjects were placed on a ulation had bought into the lipid hypothesis and was dutifully diet low in cholesterol and saturated fat. Subjects were divided using margarine and buying low-cholesterol foods, the medical into two groups, one of which took a cholesterol-lowering drug profession remained sceptical. A large "Physicians Kit" was sent and the other a placebo. Working behind the scenes, but playing a _to all doctors in America, compiled in part by the American key role in both the design and implementation of the trials, was Pharmaceutical Association whose representatives served on the Dr Fred Mattson, formerly of Procter & Gamble. NCEP coordinating committee. Doctors were taught the impor- An interesting feature of the study was the fact that a good part _ tance of cholesterol screening, the advantages of cholesterol-low- of the trial's US$150 million budget was devoted to group ses- ering drugs and the unique benefits of the Prudent Diet. NCEP sions in which trained dietitians taught both groups of study par- materials told every doctor in America to recommend the use of ticipants how to choose "heart-friendly" foods: margarine, egg margarine rather than butter. replacements, processed cheese, baked goods made with veg- etable shortenings; in short, the vast array of manufactured foods Or« mouthpieces of the medical establishment fell in line awaiting consumer acceptance. As both groups received dietary after the Consensus Conference. In 1987, the National indoctrination, study results could support no claims about the Academy of Sciences published an overview in the form relation of diet to heart disease. Nevertheless, when the results of a handout booklet, containing a whitewash of the trans prob- were released, both the popular press and medical journals por- lem and a pejorative description of palm oil—a natural fat high in trayed the Lipid Research Clinics trials as the long-sought proof _ beneficial saturates and mono-unsaturates that, like butter, has that animal fats were the cause of heart disease. Rarely men- tioned in the press was the ominous fact that the group taking the cholesterol-lowering drugs had an increase in deaths from cancer, stroke, violence and suicide.” A number of clinicians and statisticians, including Michael Oliver and Richard Krommel, who participated in a 1984 Lipid Research Clinics conference workshop, were highly critical of the manner in which the LRC results had been tabulated and manipu- lated. In fact, the conference went very badly for the NHLBI, with critics of the lipid hypothesis almost outnumbering support- a handful of experiments indicating that dietary cholesterol has "a major role in determining blood cholesterol levels”. after the Consensus Conference. In 1987, the National Academy of Sciences published an overview in the form of a handout booklet, containing a whitewash of the trans prob- lem and a pejorative description of palm oil—a natural fat high in beneficial saturates and mono-unsaturates that, like butter, has Or« mouthpieces of the medical establishment fell in line NEXUS - 37 FEBRUARY — MARCH 1999