Dietary Fat and Heart Disease

Here's a provocative article at the British Medical Journal on cardiovascular outcomes and diet. Now, I free admit that the BMJ has a tendency towards controversialism, but I'm hardly in a position to throw stones. The author, Aseem Malhotra, says "Saturated fat is not the issue". Human lipidology is a very complex field, and anyone who tells you that they have the definite answers needs to be treated with caution. As has been well documented, the consensus advice about dietary fats of all kinds has varied quite a bit, and I don't think it's anywhere near settling down. The role of pharmaceutical intervention isn't settled, either, despite the huge success of the statin drugs. There's room to argue about their broad effects on cardiovascular morbidity and mortality, and how much of it is mechanism-based: A meta-analysis of predominantly industry sponsored data reported that in a low risk group of people aged 60-70 years taking statins the number needed to treat (NNT) to prevent one cardiovascular event in one year was 345. The strongest evidence base for statins is in secondary prevention, where all patients after a myocardial infarction are prescribed maximum dose treatment irrespective of total cholesterol, because of statins’ anti-inflammatory or pleiotropic (coronary plaque stabilising) effects. In this group the NNT is 83 for mortality over five years. This doesn’t mean that each patient benefits a little but rather that 82 will receive no prognostic benefit. The ...
Source: In the Pipeline - Category: Chemists Tags: Cardiovascular Disease Source Type: blogs