Cholesterol drama – How much truth, how much hype.
Cholesterol, this one word has become the nightmare for almost all over 30 years of age. Even the young people (in their 20’s) are not completely excused; they are also sometimes haunted by this ghost. This white, powdery, odourless and waxy substance does not even have any taste, but causes so much trouble for almost all those who have the habit of reading today’s health magazines. Even many doctors have been influenced by these. It does not cause so much havoc for human health as it does to human happiness.
But what is the truth? Is it really that bad or it is another propaganda of the companies that are fetching millions of rupees from the sale of ‘cholesterol lowering’ drugs.
Life depends upon cholesterol. All the life giving substances are derived from that chemical and that is why it is found in abundance in hen’s egg. While it is true that all studies showed a direct relationship between rising cholesterol and heart attacks they also showed that extensive and fatal heart attacks could occur even in those with low cholesterol.When I think about this topic I just memorise one old saying – “Truth could influence only half a score of men in a century while falsehoods and mystery will drag millions by the nose” (Said by Aristotle centuries ago).
Cholesterol is found in all foods of animal origin. There is no cholesterol in anything vegetarian. Besides other functions, it is also an integral part of an animal cell wall. If one is acquainted with the knowledge that millions of cells die everyday in the human body to be replaced by the new ones, one would quickly realize the importance and need of cholesterol for man. Various hormones in the body are manufactured from cholesterol. Even if one does not eat cholesterol at all, human liver could make enough for the body’s needs. 90% of the total cholesterol is made inside our liver and only 10% of it comes from the diet. Since cholesterol does not dissolve in water its transport inside needs a vehicle. The latter is usually protein – lipoprotein. Cholesterol is found in all major lipoproteins, the Low Density Lipoproteins (LDL) and the High Density Lipoproteins (HDL). Thus we can clearly say that cholesterol is one essential constituent of body.
Earlier the normal cholesterol range was considered as between 150 - 250 mg per decilitre. But now it is recommended to have cholesterol level below 150 mg per decilitre. The greatest threat of raised cholesterol is linked to chance of Heart attack. It is loudly voiced that increased cholesterol leads to arteries becoming narrower and narrower, much as old water pipes build up scaly mineral deposits. This analogy helps another money spinner of coronary revascularisation. Non-medical person think that blocked coronaries are like blocked pipes that have to be bypassed. Never do they realize that body has its own defence to compensate for those long standing blocks, many of which start in early childhood, by providing collaterals and also remodelling the blocked vessels. The blood supply to the heart muscle does not as much depend on the blocked four large coronaries on the surface of the heart that your doctor shows you on the X –Ray (angiogram) as it does on the capacity of the millions of small vessels going directly into the muscle of the heart having a wide capacity to dilate excessively in case of reduced supply from the larger vessels.
It is not the science of medicine that is bad but the big players in the market that mould it to their benefit. In some instances excess of cholesterol may be bad but the way it is presented before a common man is the main factor for making people fear from it. It is just like a difference between lightening and lightening bug. And why this matter is hyped is because once these drugs are started, like B.P. drugs these have to be consumed for life time, which provides a life long income to the company. It is in contrast to other drugs like antibiotics which are taken for some time only.
In various trials also no significant results have been observed in people treated with cholesterol lowering drugs and untreated groups. A study in America named MFRIT (Multiple Risk Factor Intervention Trial) came out with following results:
1) Drastic changes that the participants were made to make in their diets could not have any effect on the levels of cholesterol in their blood.
2) No significant difference in deaths could be found in the treate group and the control after Nine years of follow up.
3) In fact, slightly more deaths occurred in the treated group.
4) In the control group deaths from heart attacks were 40% lower than expected in the beginning, showing how fallacious future predictions in linear mathematics could be.
It is worth noting that studies have shown that the error rate of reporting HDL, LDL etc. values by different laboratories was around 31%. Moreover due to the influence of various factors lke the time of day, the way the blood is collected, whether taken sitting or supine etc. could change the results by as much as 10 -18%. Therefore it is wise for the doctors to get at least 4-5 times, the test done at different laboratories before initiating any treatment for high cholesterol.
Even though many studies have been conducted world wide concerning this, but even today the wisdom of the medical profession can be summed up in the words of Eliot Corday in his article in the Journal of the American College of Cardialogy in 1989 which is as follows:
· Cholesterol should be checked only if there are sound clinical indications.
· A mixed diet low in calories and saturated fat should be recommended along with some physical exercise.
· It is irresponsible to force public into a costly cholesterol reducing programme without firm scientific evidence.
Author’s advice:
· Do not rely on one reading of the fat profile, check at least five to six times from different laboratories, if original results was high.
· Indian vegetarian diet without much fried foods and other saturated fats and low salt is the ideal one for most people.
· Avoiding alcohol and tobacco is as important if not more important than worrying about cholesterol.
· Recent studies have shown the mind and its effects on the heart are more important risk factors than all the above mentioned ones. Keep your mind at peace. Hostility and depression are real culprits for heart attacks.
· Epidemiology does not tell us who in society would get any disease, as time evolves.
Life depends upon cholesterol. All the life giving substances are derived from that chemical and that is why it is found in abundance in hen’s egg. While it is true that all studies showed a direct relationship between rising cholesterol and heart attacks they also showed that extensive and fatal heart attacks could occur even in those with low cholesterol.
