But your health where your faith is!
Since evolution is paramount to almost all fields of biology and is the same science as medicine I think anti-evolutionists need to make a firm point. They should be like the Amish and reject anything related to evolution on their faith. When they are sick they shouldn't take medicine they should pray and see holy people! If you are going to fight that the science is wrong don't use it! I will (and do) feel bad bout the brainwashed kids who will end up getting hurt (or have such as the unvaccinated religious people in southern Ontario), but one of the prices of freedom is stupidity. Nice article.
posted by Eddie | 6:28 PM
17 Comments:
"Since evolution is paramount to almost all fields of biology and is the same science as medicine"
Exactly, yet you make fun of people who dismiss evolution because of their personal beliefs, then you dismiss the cholesterol-heart disease link because of yours. The fundies can disagree with biologists claim that evolution can never really be proven since we can't know what happened millions of years ago, what's your excuse for disagreeing with the experts in medicine?
Nonsense! Your compairing the evidence from molecular biology to that of medical research where 1/3 of studies are later found to be weaker than reported or simply wrong. Medical research deals with a huge number of variables since all people are different, where as a molecule is a molecule regarless of it's space coordinate. You can't compare the two.
Also, as opposed to intellegent design, there are research reviews and published data: Inceased risk for Russians with low cholesterol. If you want ot rebuttle take a look at Uffe Ravnskov's web site and read the scientific arguments (with references) about cholesterol. Be open minded (since these are pushed material or verifiable criticisms about popularly quoted works) and judge for yourself. When I brought it up with my doctor he agreed! So it's not a consensus. Pay special attention to the people with hypercholesterolemia. Let me know ;-)
I have looked at Ravnskov's arguments and commented on them, but you ignored it.
What, you mean it's not a consensus because not every single doctor agrees with it? Are you tring to tell me that the vast majority of doctors agree that high cholesterol is a cause of heart disease? Obviously not, so why are you any different from the bible-thumpers when you disagree with them?
"Medical research deals with a huge number of variables since all people are different, where as a molecule is a molecule regarless of it's space coordinate. You can't compare the two."
Yeah, but we're talking about evolution, not molecular biology. You can do an autopsy of someone who died from heart disease, cut open their heart and *see* the plaque blocking their arteries. You can see it with your own eyes and stick your finger in there and touch it! That's much more direct evidence than we have for evolution, yet you still ignore it. Do you think those pictures are all part of a giant corporate conspiracy to sell statins?
I'm not saying that the plaque is fake (I'm not religious/mad)! I'm saying that just because people say high cholesterol causes it doesn't make it so! That plaque can happend because of a parasite. So all you've got is that some people died from heart desease regardless of their cholesterol.
As for evolution the vast amount of data for evolution is from molectlar biology (see wiki for more under molectular evolution).
And you guys sound like Bush talking about Global Warming!! LOL!
Despite how it may look/sound I was quite content with my "healthy" diet. It's not that I want to eat bacon etc everyday, it's more a worry about the effects and the promotion of bad science. Many people in my family are on statin drugs and I was slated for them too. Even if you think cholesterol causes heart disease, the potential side effect of the statin drug are not much of a trade off. Is that paranoia, or concern?
I submit two things to suggests this is only government dogma: research in this area is still being done, and no one has made a dispute of Dr. Ravnskov's claims (that I can find).
In the end I worry about what would happen if Dr. Ravnskov is right. After telling people for years that cholesterol is bad a reversal of position would shake peoples confidence in science. In the current political climate (global warming, evolution etc) it would be fuel for the wrong people and may severly hurt science economically and its image. That's what worries me.
Thinking about what you said Igor (about cranks) fits every athiest I know. Luckely I;m not paranoid about the Spanish inquisition...
"I'm not saying that the plaque is fake (I'm not religious/mad)! I'm saying that just because people say high cholesterol causes it doesn't make it so! That plaque can happend because of a parasite."
What do you mean, "causes it"?! The plaque *is* cholesterol! When it's floating around in your blood, it's called blood cholesterol. When it sticks to the walls of blood vessels, it's called plaque.
You may want to verify that. From what I find that is a not even a over simplified version:
"Atherosclerosis involves the development of a plaque composed of variable amounts of lipoproteins, connective tissue matrix (collagen, proteoglycans, glycoseaminoglycans), vascular smooth muscle cells, calcium, inflammatory cells (chiefly monocyte-derived macrophages, T-lymphocytes, mast cells, and dendritic cells) and new blood vessels (neoangiogenesis)." Taken from here, but a google of: atherosclerosis plaque gives plently of pics and diagrams. The plaque is more like a zit than a lump of cholesterol. Let me know if I'm wrong or a "crank." lol
Read the first word of your definition: lipoproteins. Cholesterol is a lipoprotein. The fact that other stuff gets stuck in the big lump of cholesterol as it builds up doesn't change anything.
People with low LDL cholesterol don't get the plaque. Do you agree or disagree with this simple statement?
Do I agree? I was told to, but evidence seems to suggest otherwise. So maybe... it seems you can find a multitude of papers (even in the sane journal) that give both views (high LDL causes, high LDL unrelated). I won't agree based on the number of papers (science isn't a deomocracy). So as an unqualified outsider, I don't know, and I don't think anyone does and that's the point.
Eddie, you should read the Russian study you posted or not just look at the title. They found a J-shaped curve, which means that both very high and very low cholesterol were associated with mortality, but high cholesterol was much worse. The researchers don't conclude that low cholesterol itself is dangerous, but that it's associated with dangerous *lifestyle characteristics* : higher alcohol consumption, leaner body mass, and less education.
"The results of disclose a sizeable subset of hypocholesterolemics in this population at increased risk of cardiac death associated with lifestyle characteristics."
They also note that the increased deaths in people with low cholesterol is found ONLY when looking at a specific subgroup of patients: people with less than high school education who died suddenly. We already know that malnutrition leads to low cholesterol, and the study even found that these increased deaths in the low cholesterol group were associated with "leaner body mass". All that's really saying is that skinny, uneducated, malnourished people who drink a lot of booze are more likely to die.
The fact that it only shows up in heart attacks that cause sudden deaths should also make you suspicious. How could something increase heart disease only in people who died before the doctors had time to examine them closely? You were the one who telling me about how often deaths are misdiagnosed as heart disease when the doctors weren't sure about the real cause!
Now, you say you don't know if cholesterol causes plaque and you don't think anybody does. But most doctors do think they know and the American Heart Association agrees with them. So let's get back to my original point: If you're not an expert in the field of medicine and (as you admit) you don't have detailed knowledge about the issue, how can you disagree with the experts and not call yourself a crank?
Igor & Eddie:
On the topic of Ravnskof, think about this for a second and tell me if you don't think there's something weird going on: the guy says that high cholesterol isn't bad for you and that statins do more harm than good. So his argument is that the side effects from statins are so dangerous that they kill more people than they save. That's possible -- we don't have conclusive proof that statins lower overall mortality. We do know that they reduce heart disease, but you'd need a bigger and longer study to show that they don't increase the risk of cancer, for example.
So my question is, how do statins reduce heart disease if it's not caused by cholesterol? It just doesn't make sense. Ravnskov goes on and on about how they haven't been proven to save lives, but he doesn't explain how they prevent heart attacks. He makes all these snide comments about big pharma funding medical research and tries to hint at some kind of suspicious dealings between the doctors and the corporations, but his own conspiracy theories contradict each other. Give me a break.
Igor, just to clarify what I mean when I say cholesterol "causes" heart disease. I don't think that all heart disease is caused by cholesterol or that all people with high cholesterol will get heart disease. It's a weaker link, like saying that drunk driving causes car accidents. That doesn't mean that all drunk drivers will get in an accident or that all accidents are due to alcohol.
Well Konrad I guess we finally agree on something:"I don't think that all heart disease is caused by cholesterol or that all people with high cholesterol will get heart disease. It's a weaker link." That's the important point, they don't know for sure. To tell people what to eat (it's another issue as to whether eating cholesterol changes blood cholesterol, within limits) and how to live. I don't disagree with all the experts. I'll bet that some people have died from Heart disease due to high LDL, but how many. I don't think everything Ravnskof says is necessarily true, but his peer-reviewed papers casting doubt on how strong the link is fair game to agree with and not be a crank, right?
Igor:
(1) probably an oversimplification
(2) again, maybe. here
shows that it may be a big enough leap, clearly it's not just LDL clumping together mechanically. Oxidation plays a large part.
Even Konrad agrees the correlation is weak and might be negliable compared to the effectes of oxidized LDL. Or it's the combination that is strongly correlated. The point is we should draw too much from weak correlations.
(3) no idea.
You may be misunderstanding my writting, I've lost the passion of this issue. I'm convinced that the known results are not enough to make the common conclusions. That doesn't mean they are garbage only exaggerated. This happens, just like the CDC's update about obesity being less lethal (as we've previously argued). My passion is the exaggeraton of correlations or misuse of science. If you think the correlation is strong and so warrents all the current money and public whoha, fine. I don't. Cholesterol is just the latest. For instance there is antioxidants which were great, now not and who knows what they will be.
As for your comment on athiests, preaching non-belief is a funny phrase. Agnostics don't think the argument can be settled either way, most athiests I know think something without any proof isn't worth having a name for (including god). But I may have misinterpreted what you where saying (if so sorry).
Eddie, when I say it's a "weak link", I don't mean that the evidence is weak. The evidence is very good and I believe proves the LDL/heart disease connection beyond any reasonable doubt.
It's exactly the same case as with drunk driving. We obviously know it causes accidents, but it's not a 1:1 to correlation. You can get heart disease because of a birth defect even if you have great cholesterol, and you can have a car accident even if you're not drunk.
Igor's third question is certainly true:
"High LDL cholesterol is necessary for atherosclerosis."
Not all heart disease is caused by atherosclerosis, but you can't have atherosclerosis without cholesterol.
Agreed. Maybe thios was the misunderstanding. It's not that the studies that where done that correlate high-LDL with heart disease are all crap, its that the correlation is weak. Such a weak correlation suggests that atherogenisis is not well understood yet.
I doubt that there has never been someone who has died form heart disease who's had low-ldl. A lot of studies talk about the role of certain parasites (like this). If it's a combination of oxidation and parasites then perhaps a weak enough immune system will fail to prevent the parasite from spreading too far and even with low-ldl atherosclerosis may ensue (just theorizing). I agree with your last sentence but since you can't have 0 ldl it's the "high" part I disagree with Igor's statement. Just like you need arteries to have atherosclerosis.
Not well understood?! How many more thousands of studies do you want? I can't think of a single medical problem that has been studied as closely as artherosclerosis. Do you think that the weak correlation between drinking and car accidents means that we don't really understand why drunk driving is dangerous? Not all accidents are caused by alcohol, so no matter how much we study it we'll never see a perfect correlation.
I was out of date on one fact though: now there is a study which shows a significant reduction in overall mortality. See "Heart Protection Study Collaborative Group" in Pubmed. It was a huge study with 20 000 people that reported "a significant reduction in all-cause mortality (p = 0.0003)".
Do you see that p value? Does that look like something that's "not well understood yet"? The facts speak for themselves. Give people a drug to lower their cholesterol and they get less heart disease. Period.
You're free to ignore the evidence, of course, and try to make yourself an example of evolution in action. Reminds of what Robert Heinlein once wrote: "Stupidity is not a sin, the victim can't help being stupid. But stupidity is the only universal capital crime; the sentence is death, there is no appeal, and execution is carried out automatically and without pity."
I looked over the study and don't understand some of , but it was for people who already have a problem.
From this:
1328 [12.9%] deaths among 10,269 allocated simvastatin versus 1507 [14.7%] among 10,267 allocated placebo; p=0.0003), due to a highly significant 18% (SE 5) proportional reduction in the coronary death rate (587 [5.7%] vs 707 [6.9%]; p=0.0005), a marginally significant reduction in other vascular deaths (194 [1.9%] vs 230 [2.2%]; p=0.07), and a non-significant reduction in non-vascular deaths (547 [5.3%] vs 570 [5.6%]; p=0.4 from here
It seems like the death rate from coronary desease went down only 1.2% and that's in people who already have problems. I admittably don't know what the 'p' rating means. So again I'm not saying it's useless but for not-at-risk people (myself included) to take statins just in case and rish the serious side effects for a 1.2% reduction in death seems extreme. You could probably get the same reduction by getting in a car a few times less a year. That being said I agree there is some effect, but it's small (or I'm misinterpreting what's written).
Igor the logical equivilence (as I understand it) requires the relationship between LDL concentration and the chance or CHD to be completely correlated. Isn't it entirely possible that with low LDL another effect takes place. I'm not saying it does and I'm not claiming you are wrong, I'm claiming the correlation seems weak.
Eddie, it's very misleading to say that there was only a 1.2% reduction in coronary death rate. If 2% die in one group and 1% in the other, would you call that a 50% reduction or only 1%? In fact, that exact same sentence you got those numbers from calls it an 18% reduction.
Igor, the term CHD that Eddie was using stands for coronary heart disease. There are three things you have to keep in mind when estimating the fraction of heart disease that's caused by cholesterol:
1. Statins alone will not necessarily lower your cholesterol enough to get it to the ideal range.
2. Even if you stop the formation of new plaque, it won't necessarily remove the plaque that's already there. Pieces of that can break off at any time and cause a fatal blockage.
3. The study lasted for 5 years. If it takes 50 years to cause the damage, then you probably won't see the full effect of the statins in only 5.
We saw an 18% reduction in heart disease deaths after 5 years of treatment, but that only means that 18% is the lower bound on the fraction of heart disease caused by cholesterol. An ideal study would have to lower cholesterol levels to the ideal range, start the treatment *before* signifcant amounts of plaque had already formed and continue until all participants died.
I believe epidomological data shows that people with cholesterols of 150 have less than 50% as much heart disease as those with 220. And 220 is fairly close to the *average* level in North America. Lots of people have over 300 and the risk goes up more than linearly.
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