Wednesday, 19 March 2014

Pill-pop nation

They're not sweeties
One of the big news stories last week featured reports of a study by Imperial College, London, showing that statins have almost no side-effects.

It came hot on the heels of a report from NICE – the National Institute for Health and Excellence, which among other things, provides guidelines on medical treatments in the UK – announcing that, in order to reduce death from heart disease further, the threshold for prescribing statins should be lowered from a 20% risk over 10 years to a 10% risk over the same time.

Now: a disclaimer. I am not now nor ever have been a scientist or medical expert. So what follows are merely the personal conclusions of someone who might be judged to fall within the latest category that NICE is talking of.

And after the disclaimer, a statement.

I have never had a cholesterol test (I haven’t been near a doctor in years) and, on the basis of what I have read, I do not believe that cholesterol is the big problem or that high cholesterol is the cause of the UK’s rates of heart disease – and I would not willingly take statins myself.

Cholesterol is a vital building block in the body. Evidence suggests it is actually dangerous to drive it down – especially after the age of 50.

Mind most doctors have big doubts about the latest NICE announcements. According to other research by Pulse, the GPs’ magazine, of 511 GPs polled on a variety of issues, 57% opposed the NICE proposal, and 55% would not take a statin or prescribe one for a family member based on the new NICE-proposed lower threshold.

What we seem to be seeing is what Dr Phil Hammond – GP and comedian (and do see him if you get the chance: he’s very good) – has described as the “medicalisation” of society.

Statins have made vast profits for Big Pharma over the years – due to patents and stuff running out, those have reduced of late, so the NICE advice must be, err, nice for these same corporates.

However, it’s worth noting that eight out of the 12 members of the NICE panel that recommended the change have declared ties to the manufacturers, including Pfizer and AstraZeneca.

On only a very slightly different note, a quick glance at thelist of the NHS website’s partners-in-public-health list – (hat tip to Zoë Harcombe o Zoë Harcombe) – gives an indicator of just how much the country’s health has become utterly tied in with corporate interests and, therefore, with the search for profits.

As I explained three years ago, the current government decided to involve more Big Food representatives in making public health policy – and one of the earliest examples of this sawgovernment health ‘advice’ effectively providing free advertising for branded, processed foods.

It’s not difficult to begin to see where problems lie – or where they can be seen or suspected.

Last week’s research from Imperial College was a meta-analysis: in other words, a meticulous survey of previous surveys – in this case, 29 different studies.

But while the meta-analysis itself had no corporate backers, who knows who backed all those other studies?

Not only do we know that research is often produced that has been financially supported by the industry, but it’s also known that Big Pharma is most secretive with trial data – it doesn’t like sharing it with anyone, even in the medical profession – and there are plenty of people around who will assert that the same companies skew trials to start with by using ‘pre-trial trials’ to weed out anyone who obviously shows signs of side effects.

So the ordinary GP has little chance themselves of knowing all the details of any drug – they have to rely on the companies who sell them, just as we have to rely on our doctors.

The thing with statins, though, is that there is no substantial evidence for the big claim that levels of cholesterol cause heart disease.

That myth came into being because of the American researcher, Ancel Keyes.

After WWII, heart disease among men in the US reached epidemic proportions.

Keyes thought he knew why – that a diet rich in saturated fat caused high cholesterol caused heart disease – and he set out to prove it.

After a small study in the US, using men only, he looked further abroad and eventually produced what has become known as the Seven Countries Study, which bore out his great theory.

The trouble is, Keyes didn’t study seven countries. He studied 22 – and ditched most of the findings because they did not tally with what he wanted to find.

This is not a natural product
It ignores the French Paradox – only a paradox if you believe Keyes – that sees the French eat more dairy produce than anyone else on Earth, never mind all that foie gras and duck confit, and yet still have far lower rates of heart disease than exist in the UK or US where the low-fat mantra has been so willingly churned out and gobbled up.

Yet Keyess work became the foundation for the health and diet advice of the last 40 years: cut out fat and fill up with starchy carbs.

It’s almost certainly been a contributory factor in the rise of obesity, but on a positive note, it’s provided Big Food with wonderful opportunities for creating and marketing as healthy, artificial fats and fat substitutes.

We now have a position where the British Heart Foundation has links not just with the NHS – see that previous link – but also directly with Unilever, which produced Flora.

And Flora is now able to be marketed as ‘heart healthy’ – watch out for the link between the foundation and the product in advertising. Unilever is also on that list of NHS ‘partners’.

In recent months, an increasingly desperate-sounding British Heart Foundation has taken to making statements on health stories that have the ring of a siege mentality about them.

When Sweden become the first country in the West to ditch the low fat diet advice last October, the foundation was sticking its fingers in its ears and claiming that low fat was still best.

With each new piece of research that is slowly rehabilitating natural saturated fats, it does the same.

The cynic might speculate on how, were it to do otherwise, that relationship with Unilever could become strained.

An increasing number of doctors are voicing concerns about medicalisation, just as increasing numbers of doctors are also stepping away from the diet mantras of the last four decades.

We’re starting to see the issue of sugar being raised much more, in terms of the serious damage that high consumption can do.

And it’s worth noting that, in the case of sugar, much of it is hidden.

I was in M&S a few weeks ago, looking for a yogurt for breakfast. I couldn’t find one that didn’t have sugar in it – not least the ones that are sold on the basis that they are ‘low fat’; healthy, in other words.

This IS a natural product – and it will not harm you
And then there’s high-fructose corn syrup that manufacturers have taken to shoving into all manner of processed foods to make them more palatable and to make the consumer buy them again and again.

Again, this is not obviously sweet foods we’re talking about. High-fructose corn syrup is used in breads, cereals, breakfast bars, yogurts again and soups.

Who thinks of sugar in soup or in bread? Cereals have been sold to the public for decades as a healthy breakfast, and breakfast bars come into the same category.

This is what hidden sugars means.

As an increasing number of people raise the issue of these hidden sugars, and as an increasing number of comparisons are made between the attitude of Big Food and that of Big Tobacco, the industry is fighting back.

Those links with the likes of the NHS and the British Heart Foundation should make us skeptical of any defences of what has become the status quo on health and diet advice.

Just as those links between NICE members and Big Pharma, and between Big Pharma and disease, should make us equally skeptical.

What is needed is far greater transparency in all these cases – and far better regulation, properly enforced.

There’s nothing inherently wrong with profits. But when the search for profits trumps people, then it’s a sign that something is very wrong.

And what is also needed is an honest and thorough approach to dealing with the problems caused by a national approach to food that includes using takeaways and ping food to the extent that the UK does, not taking time to eat properly, constant snacking, the demise of cooking skills, a prevailing attitude of food as fuel, vast amounts of media space given over to faddy diets, new homes built without proper kitchens etc etc – and not just a rather lame sense of correcting it all my medicalising the populace.

That won’t be as easy as sticking fingers in ears and endlessly intoning the low-fat mantra, irrespective of the body of evidence against it, but it would be a damned sight more effective than the equivalent of the three little pigs inviting the wolf to join them for dinner.

Further reading:

The Great Cholesterol Con by Dr Malcolm Kendrick
Bad Pharma by Dr Ben Goldacre
Bad Food Britain by Joanna Blythman

Worth following on Twitter:


The above-mentioned may not agree with all I have written here, but are all very much worth reading and following on the matter raised in this post.


  1. Great summary of the links between statins sugar and their respective damaging impacts on our health

  2. Perhaps the reason you couldn't find yoghurt without sugar is because its made from milk and therefore has intrinsic sugar in the form of lactose.

    Also how much HFCS do you think is used in the EU?

    1. I was not referring to natural sugars, but to added ones – hence the use of "hidden sugars".

      Entirely coincidentally, I was in a small Sainsbury's at Euston this morning and looked again.

      I picked up a yogurt that was apparently probiotic and fat free. But there, hidden away in the smallest possible type on the side, was the information that it had "added sugar and sweeteners". So something that is being marketed as healthy is coming as close as dammit to hiding not just sugar, but other sweeteners in it. That's what I mean.

      In Europe, HFCS can be known as isoglucose in sugar regime, Glucose-Fructose Syrup or even Fructose-Glucose Syrup.

      And expect more of it in the future, because according to this, fructose has now been declared healthy:

    2. The reason I ask is that there is no requirement to identify "added sugar" in food labelling (only total sugars) hence it is difficult in some products to distinguish between added and intrinsic sugar.

      I'm fully aware of what HFCS is.

      You dont seem to be aware that HFCS / isoglucose historically hasn't been widely used in the EU because there was a production quota - typically <5% of sugar production in the EU, and as that won't be lifted until 2017. This makes your assertion...

      "...that manufacturers have taken to shoving into all manner of processed foods to make them more palatable and to make the consumer buy them again and again"

      ..both bizarre, and obviously wrong. Looking at your sources however (Lustig, Malhotra) its not difficult to see where this erroneous information is likely to have come from, but the UK is far different to the US where HFCS production is subsidised.

      Also, the ANH are essentially a paid for lobby group funded by the supplement/herbal industry - I'm sure with your concerns about vested interests you are skeptical of their claims?

    3. As I said, the yogurt pot said "added" in terms of sugars and sweeteners.

      You assume too much re HFCS. But then as you say, "hasn't been widely used". Not 'hasn't been used'.

      The link mentioned above was one I came across quickly when responding (quickly) to your previous comment.

      I assume you're as sceptical about the behaviour of big food and big pharma?

      Mind, I'm also sceptical of people who hide their own identity amid claims of avoiding persecution. It does rather leave you open to questions of vested interest or at the very least who you defend and why.

  3. Not sure what significance you place on the fact that HFCS has been used in the EU, no one is arguing otherwise. As I noted there is a quota.

    The point is, it is not used widely because only 5% of total sugar production in the EU is HFCS. This is at odds with your assertion food manufacturer put it in a wide variety of foods to enhance palatability and for repeat sales. This idea is wrong and is a hang over from people who quote Lustig about the US without engaging their brains.

    I am sceptical of the claims made by many people but prefer not to use label like 'big food' and 'big pharma' because its sloppy thinking to assume all behave in exactly the same way. I am also sceptical of claims made by people who claim to be independent, yet make a tidy living from opposing mainstream views. These should be accountable to exactly the same standards.

    You don't seem to understand the difference between being anonymous and being private for good reason (I have a persistent private identity), nor do you seem to understand that throwing baseless accusation at people simply because they correct your misinformation makes you look rather pathetic.

    1. Nit-picking over the words people use as a way of attempting to discredit their core claims looks pathetic too.

      And may I remind you that you're the one who 'started it', with patronising comments and questions as to my scepticism after I responded to you entirely politely.

      But I find your attention most flattering. It begins to make me feel I've hit a nerve somewhere/