Joe works for a company where health insurance premiums are based on the results of an annual physical exam. Joe isnâ€™t overweight, doesnâ€™t smoke, and he works out at the company gym several times each week.
This yearâ€™s tests, though, measured Joeâ€™s LDL cholesterol rate as â€œvery high.â€ That will mean an extra hundred dollars or so each month out of Joeâ€™s already slim paycheckâ€”a reality that has his wife insisting he â€œDo something about it.â€
Joe is in trouble. And he is probably at an increased risk for heart attack. But itâ€™s not because of the cholesterol.
Which came first: the disease or the cure?
Smart marketers know one of the best ways to sell a product is to convince the would-be customer of a serious problem in need of a solution. And the more severe the problem is made to appear, the more appealing the solution (the marketer’s product) will be.
Are your floors so dull and lackluster you are ashamed to have company over? Use our super-duper floor shine to impress your friends and family.
Do you feel tired much of the time, causing you to miss out on all that life has to offer? Take this new improved energy-boosting miracle of modern science.
Are your cholesterol numbers askew, putting you at risk of heart attack or stroke? We have a pill for that.
The evolution of a drugstore phenomenon
Dull floors and low energy are real and observable problems. People have suffered from them for years, prompting marketers to come up with “new and improved” solutions. But what about the cholesterol number crisis? Where did that come from?
The truth is that, prior to the mammoth advertising campaign urging people to â€œKnow your numbers,â€ few people (if any) ever thought about quantifying their LDL, HDL, TC and triglycerides. Once national hysteria set in, however, statin drugs became the best-selling legal drugs ever.
But, does driving down your LDL cholesterol actually prevent you from having a heart attack? That would seem to be a germane question. It turns out that many medically savvy voices insist the cholesterol numbers focus is based more on hype than on sound medical reasoning.
It could even be that Joeâ€™s â€œhigh numbersâ€ are a good sign, not a harbinger of doom, and the biggest health threat Joe has isnâ€™t cholesterol, but stress. Joeâ€™s employer, by pushing employees to worry about â€œtheir numbers,â€ may inadvertently be helping bring on the very things the company is hoping to prevent: employee medical problems and higher healthcare expense.
A brief history of the Great Cholesterol Scare
The argument is severe, with both sides making impassioned pleas. There is a wealth of information available to those who wish to perform an exhaustive study of the cholesterol controversy. Iâ€™ll mention the basics, point out a few links, and move on to a discussion of potential solutions, rather than get caught up in the mire.
Something to keep in mind: My expertise is in research, thinking, and writing. All I can do is relate what I have discovered. Heart attacks are serious business. If you’ve been told your â€œnumbers are high,â€ you would be wise to seek the advice of a capable, informed M.D.
Here are the basics:
- The grandfather of studies naming cholesterol as the main culprit in heart disease is Ancel Keysâ€™ famous Seven Countries Study. Critics, however, say there are severe holes in the research. Dr. Paul Rosch, for example, says â€œAlthough Keys had data from 22 countries, he selected only the 7 that supported his theory. Had he picked 7 others, he would have concluded that the more saturated fat consumed, the lower the incidence of coronary deaths.â€ Purposely skewing results never looks good in science.
- Another foundational work, the Framingham Heart Study, determined the three primary factors in heart disease to be smoking, hypertension, and high cholesterol levels. One of the many unheralded results of Framingham, though, was the discovery thatâ€”for men over 47 years of ageâ€”the participants with low cholesterol exhibited a higher mortality rate than those with high cholesterol. Moreover, a 26-year follow-up survey showed the incidence of heart disease to be the same for both the high and low cholesterol groups.
- Those wanting to defend the hypothesis that lowering cholesterol is a direct path to preventing heart attacks found their champion in the Lipid Research Clinics Coronary Primary Prevention Trial. Based on those results, the National Institutes of Health (NIH) published an article in the Journal of the American Medical Association declaring the benefits of LDL cholesterol reduction. That set off a media blitz of predictions about how the wonders of medical science would soon eradicate heart attacks, and it prompted the pharmaceutical companies to move quickly to formulate drugs aimed at solving the “cholesterol problem.” Other researchers found flaws in the data. A Vanderbilt Professor of Biochemistry, Dr. George Mann, said, â€œThe managers at NIH have used Madison Avenue hype to sell this failed trial in the way the media people sell an underarm deodorant.â€
Caught in the whirlwind of advertising and media attention that followed, patients rushed to the doctorâ€™s office for a solution to their â€œhigh numbersâ€ problem and sales of cholesterol-lowering drugs flourished, reaching Â $83 billion in 2011. One-fourth of all Americans over 45 years old now take a drug for cholesterol control, and the pharmaceutical companies are raking in the profits. And that would be fine, if the pills really were prolonging the lives of those paying for the drugs. That doesn’t appear to be the case, however.
High cholesterol levels may not be the problem
Proponents of the cholesterol-promotes-heart-attacks theory point to the sure ability of cholesterol medication to lower cholesterol levels. There is no doubt they do that. And they may certainly be advisable for those who have already suffered a heart attack. For most of us, though, the primary benefit of statin drugs may be that they help lower inflammation, not that they lower cholesterol.
Current research is pointing to a much more serious factor in heart disease: Stress.
While there does not appear to be one identifiable factor making heart disease the number one killer worldwide, there are a number of contributing factorsâ€”and stress is the one thing tied to all of them. Whether in the form of worry, depression, anger, uncontrollable changes, or the biggest stress of allâ€”getting and keeping a jobâ€”stress can cause an alarming rise in blood pressure, promote inflammation, constrict arteries’ and disrupt the function of nerves. Improperly managed or unmanaged stress can kill. You would be hard-pressed to find a physician or scientific researcher who would dispute the role of stress in a multitude of health problems.
A 2012 study on stress in the U.S.A. by the American Psychological Association found that 77% of Americans regularly exhibit physical symptoms from stress and 48% report lying awake at night due to stress. Moreover, that same study put the cost to employers from stress-related health problems at $300 billion.
Joeâ€™s employer has good intentions in the requirement that all employees undergo an annual physical examâ€”but it may well be that they would do more to increase the health of their people by launching programs aimed at reducing on-the-job stress, by teaching their employees how to deal better with stress, and by dropping the fixation on cholesterol levels.
Consider the advice from Dr. Michael Haley, who advocates Aloe veraÂ as a natural means of treating a bevy of ailments, both internal and external:
Taking drugs to merely change a number is like putting on a blindfold to make the fire go away. Rather, you should ask yourself, “How can I improve my diet, exercise, rest and thoughts?”, then get busy making the necessary changes to effectively and naturally optimize your health for the long run.
Cholesterol doesn’t kill; but unmanaged or mismanaged stress definitely can.