Tuesday, April 26, 2016

Science Tuesday: Statins are harmless until they're not

Gals vs Guys at the evening class.
Last week we looked at the tenuous (at best) connection between dietary fat and heart disease. We've also been told that there's a connection between dietary saturated fat and high cholesterol. We've been told for years that saturated fat drives high cholesterol which drives heart disease.  That is "a causes b" and "b causes c" so "a causes c" (I doubt the non-linear human body really follows transitivity, but I digress.)

So if you reduce your saturated fat intake, your cholesterol will go down, and your risk for heart disease will go down. We saw last week how that whole two-degrees-of-separation worked. Cutting out the saturated fat had little to no effect on heart disease, and a bad correlation with all cause mortality. So what's going on? Well turns out that fat is good for you.

But what if you've bought into to the diet-heart hypothesis and still think that cholesterol is the devil? Or better yet, what if you're make millions selling statins to lower the evil cholesterol?

Well, you try to prove the cholesterol is bad for you.  Today's science article is from the New York Times about a series of studies to show that cholesterol is bad. Spoiler alert: they couldn't do it.

At least this time they published the findings rather than burying the research. But after years of saying statins are so good for you they should be in the water supply, even though there is significant side effects like brain and muscle wasting, why would they admit that lowering cholesterol doesn't protect your from heart disease?

Well, reason number one is that they still don't think that they showed that low cholesterol has no effect on heart disease, it's just that statins don't help. I quote: "It may be that the LDL level is less important than how it gets changed." Huh? So years of low cholesterol is critical for your health, except when it isn't - then it matters how you got there?

Or could it be that statins "cost pennies a day" and there's a new class of drugs (PCSK-9 Inhibitors) that cost $14,000/year that will lower your cholesterol in a better way?

So rather than admit that maybe we were wrong about this whole cholesterol and heart disease thing, we have to come up with more complicated explanations for why we can't stop the heart disease and invent even more expensive drugs (that we all pay for).

Bonus chart: cholesterol vs all cause mortality. It sure doesn't look like lower is better and we should dump statins in the water supply.
Click to embiggen.
Are you tired of Science Tuesday actually being Rant about Bad Science Tuesday? Well, we're just picky and it turns out that with base rates, there's so much more bad science than good science being reported, so we end up ranting. Maybe we should start a new version of BSSC (Barbell Strategy Science Consulting) that can help design experiments - we do have years of experience doing that.

Workout
strength - add weight from last time (more info) 

3 attempts for max push-ups 

then

5 rounds:

farmers carry to the stop sign and back
sprint to the stop sign and back
paddle (or jog) easy for 2:00




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