Tuesday, 21 July 2015

Michael Mosley misses the whole point on Cholesterol

Michael Mosley’s latest attempt at popular science airs on the BBC this week as part of the Trust Me I'm a Doctor series. http://www.bbc.co.uk/news/magazine-33601171 This time he is investigating different diets for lowering cholesterol. The program looks serious and appears to employ a reasonable but limited experiment comparing three different diets using a randomly allocated sample group and then observing the effect of each on total cholesterol levels.

One of the diets was a low cholesterol diet, any yet we have known for a long time that dietary cholesterol has very little impact on blood cholesterol, in fact the US Dietary Guidelines Advisory Committee recently removed it from their list of bad things to eat! A second group ate high fibre diet as fiber binds with cholesterol in the gut and stops it getting absorbed; this is even dafter as the premise is still based on the role of dietary cholesterol. The third group added nuts to their normal diet; this approach is known to lower cholesterol.

Mosley then trumps the lot with a "Portfolio" diet where he creams off the best bits of each diet, adds some other changes and lowers his cholesterol by more than the guinea pigs.

But here’s the thing. Total cholesterol is almost meaningless number when it comes to risk of heart disease!Why? Because it includes the "good" HLD cholesterol, and apparently the more of that we have the better. And because the role of LDL is misunderstood.

Mosley then quotes some out of date information on LDL cholesterol from the NHS Choices web site which still maintains that Total LDL is the enemy, despite consistent evidence showing that there is practically no relationship between total  LDL and heart disease. Heart surgeons have been pointing this out for decades but they have been silenced by the makers of statins.

Why, oh why couldn’t Mosley have done a bit more research and looked into the fact that LDL particle size is the real culprit? Smaller LDL particles are more dangerous and larger ones are safe, and hence their total mass is of no consequence. 

He could then have made the quantum leap back to his favorite subject of diets and announced to the world that high-carb diets promote small LDL particles and high-fat low-carb diets promote larger safer LDL particles.  

The funny thing is that diet is the answer, it's just that the question is wrong. Now if he had asked "Can you lower your triglycerides by changing your diet" then he might really have been onto something.

Missed again Michael!

In fact I ought to say "Missed again BBC!", I am amazed by the low quality of the science provided on the BBC when it comes to the subject of diet and obesity. There are dozens of top scientists who understand the subject infinitely better than Michael Mosley does, but the BBC's commissioning editors do not appear to be interested in discovering the inconvenient truth that the NHS's advice on cholesterol and heart disease might be wrong.





5 comments:

  1. So I just watched the program and it was poorly done. For a series that claims to go behind the headlines and leave no stone un-turned it completely avoided the big stories of the last year: Saturated fat is no worse than other fat (Cambridge University meta analysis) and dietary cholesterol has no influence on blood cholesterol. No mention of LDL particle size either, what a shame.
    What the program did do was to reasonable sounding hypothesis (lowering cholesterol is a good thing) support it with a professor who agrees (but then says that statins are 100-200 times safer than Asprin - this is insulting to the intelligence and the testimony of thousands who have suffered on statins), then create a 'radical' experiment where you lower your own cholesterol. Job done. This is either amazing, or it is missing the point.
    What of triglycerides? Well his were 0.4 at the start and 0.4 at the end, so no change to his LDL particle size and probably no change to his already low change of getting heart disease.

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    1. I have been on the 5:2 fast as has my husband for three years. I've never felt better and never felt
      more alert, so I am thankful for the Doc putting it out in an excellent format. I am always reading, reading,
      about fasting, epigenetics, the thought of changing markers on DNA is just so exciting. Dr Mosley is only human though and he had a Dad that was not well. However statins are a curse from what I read and thank goodness my cholesterol count is not a biggy and my HDL is high. Good comments Malcolm and most welcome!

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  2. If you had to guess...

    Which of these points do you press
    to relieve a your migraine?

    Or to lower cholesterol?

    To reduce pain from arthritis?

    Or to reduce high blood pressure?

    Find out here: To lower cholesterol?

    Best rgs

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  3. What about Dr Kendrick's thesis/theses re CVD : https://drmalcolmkendrick.org/2017/02/13/what-causes-heart-disease-part-xxv/

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  4. I agree with Malcolm on many things - although I can only claim to agree on those that I actually understand.

    Lead is certainly nasty stuff!

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