Very.
The single most striking result in the history of the cholesterol controversy . . . passed without comment by the authorities: those Framingham residents whose cholesterol declined over the first fourteen years of observation were more likely to die prematurely than those whose cholesterol remained the same or increased. They died of cardiovascular disease more frequently as well.
Around 1990, nineteen studies found that both women and men had higher total mortality at the lowest cholesterol levels (< 160). The increase came from more “cancer, respiratory and digestive diseases, and trauma.” From Gary Taubes’ fascinating new book Good Calories, Bad Calories.
I expect these results are corrected for income but I’m not sure. A friend of mine is very poor. “You have the cholesterol level of a Chinese peasant [i.e., very low],” his doctor once told him.
Interview with Taubes (October 9).
I find this all very confusing. The big question, or several questions: How seriously should we take the plethora of correlational studies about all kinds of stuff? Most nutritional claims are basically grounded in such studies. Since you can’t ethically do double blind controlled studies that may well hurt people; and it’s so hard to do such studies over a 10 or 20 or 30 year etc. period that might tell us something, we’re left with these correlational observations, plus scientific causal research and theory. After watching my girlfriend and other women feel seriously betrayed by science and the HRT debacle, where they were assured by their doctors that the good effects of HRT mostly outweighed the bad, and then told, “Sorry, oops, we got it all wrong,” it’s all very confusing.
Or take vitamins; my impression is that the attempts to give specific vitamins to people to help them with specific risks are largely a failure.
I want to see good intellectual work that tells me when to trust correlational research and when not to. Is there an algorithm or a heuristic that helps? How do we ever really know that we have controlled for all of the relevant confounds? My guess is that it will take more centuries of experience with this kind of science before we can answer this. When we can make effective prescriptions based on correlational research that clearly have the intended effect then we know the conclusions we draw from such research were more or less correct, or at least useful.
I don’t really know how to think critically about this. But I welcome enlightenment of any kind…
A fascinating though frustrating interchange last night on Larry King Live between Taubes, Mehmet Oz and Dr. Weil (the frustrating part being the ‘moderator’s’ maddening irrelevant interruptions). Dr. Weil was barely restraining his annoyance with Mehmet Oz’s closed-minded, convention-wisdom, know-it-all, inside-the-box thinking. I had recently purchased the book and am still reading it. This is important, leading-edge stuff, and we all need to pay attention. That’s all Gary Taubes wants.
I hope you invite your friend for dinner once in a while ; )
He’s a science *journalist*. He corrects for nothing, except for intrigue. I mean, come on, he left in “trauma”. Like anyone cares if a fatty diet makes a compound fracture more deadly.
Timothy, for every correlational study there will be someone waving their hands and screaming that some huge bias is selected for or uncorrected. They only way to know for sure is to A) test it yourself, a la Seth [not so great an idea as far as heart attacks go] or B) make sure a ton of money has been thrown at the study by people concerned enough about their scholarship and reputation to care about the results.
People with “cancer, respiratory and digestive diseases” are more likely to have low cholesterol as a consequence of their illnesses, because they cause wasting. Likewise, the people in the Framingham Study whose cholesterol declined could have experienced the decline as part of their illnesses, which are often hidden until they become major problems.
Citations, Dennis?
“Cancer patients often die with a serum cholesterol between 100 and 150. The same holds true for many other chronic illnesses, especially those associated with bodily wasting (cachexia). It is as though, in the wasting process, as all the fat is “burned,” so too is the cholesterol.” From one of your favorite sites: https://www.westonaprice.org/askdoctor/lowcholesterol.html
That makes a lot of sense, Dennis.
Doesn’t taking flax oil/fish oil lower your cholesterol as well? Mine’s gone down to 170 from 190 since doing the SLD for 3 months.