A Statin Nation. Dr Malcolm Kendrick
(such as alendronic acid or risedronate) are usually called bisphosphonates and, as an added bonus, you will also take a calcium supplement and vitamin D at the same time.
But that’s far from the end. In the same way that we now have pre-hypertension, pre-diabetes and the inexorable lowering of cholesterol levels, there has been pressure to further widen the market for osteoporosis drugs. This has led to the creation of a new condition called osteopenia, which means thinnish bones, not quite osteoporosis, but getting there. Pre-osteoporosis, if you like. So, guess what, time to start the medications to thicken up the old bones. To be taken forever, for the rest of your life. And you may have noticed a certain trend here …
Now, heart disease. Whilst you’re religiously taking statins, you might as well take an aspirin to add further protection. But aspirin can damage the lining of your stomach, so you should also take an anti-acid drug, such as omeprazole, to prevent this, which gives you two more drugs to take – for the rest of your life. Then, if you are unlucky enough to have had an episode of chest pain, which might or might not have been related to your heart, there are a whole load of other drugs that you will be put on for the rest of your life. An ACE-inhibitor, a beta blocker, clopidogrel, etc. It doesn’t much matter if the pain seemed cardiac, you can’t be too careful you know.
So today, without really trying and without having any disease diagnosed, you can be on at least eleven drugs. Two to lower blood sugar, two blood pressure lowering drugs, aspirin, omeprazole, alendronic acid, the calcium/vitamin D combination, clopidogrel and a statin. In fact, in one of the places where I work I’ve toyed with the idea of getting a large stamp with a list of these drugs imprinted on it. This will save me the time of writing them out for every single bloody patient who comes to my surgery. Just a quick whack on the prescription … all drugs present and correct, sir.
The simple fact is that the medical world that has emerged in the last ten years is not just a statin nation. It is, in my view, a completely bonkers, over-medicated nation. (I did not feel that this might be such a catchy title for the book but, you never know …) And is all this a good thing? A 2017 Cambridge University study on the increasing use of medications revealed that:
Almost half of the over-65s in England are taking at least five different drugs a day
Some were taking up to 23 tablets every day (and I’ve have known them take far more)
The proportion taking no pills at all is just 7 per cent
Heart disease pills, such as statins, accounted for nearly half the medicines taken
Taking up to five tablets a day increased the danger of premature death by an estimated 47 per cent
Those taking six medicines or more a day were nearly three times as likely to die prematurely1
In fact long ago, when I was a medical student, we were told that no one should be on more than five medications, due to potentially damaging drug interactions, etc. The harms would overwhelm any benefits. Today … prescribe five drugs minimum or you are not really trying. ‘An undermedicated patient … off with his doctor’s head!’
Some voices protest at this dystopian brave new world, and there is now a growing movement called Too Much Medicine supported by medical journals and an increasing number of doctors. The basic theme is, ‘Can we stop prescribing so many damned drugs – please. And can we also stop, or at least reduce, all this screening and monitoring and measuring.’
Unfortunately, although I view this movement with benign approval, I rate its chances of success as equal to that of King Canute (now, rather disappointingly, called King Knut) in holding back the tide. Most people, it seems, love to take drugs and submit themselves to every possible screening test known to man. You cannot be too careful, you know. Oh yes, you can.
Most doctors love to prescribe drugs. It gives them something to do, I suppose, and is the fastest way of getting patients out of the surgery. Furthermore, the major medical societies, the experts, the guideline writers, those advising governments around the world want more, more and even more medicine. And so, to no one’s great surprise, do the pharmaceutical companies.
I can see the attraction. Pop a few pills and all your health concerns simply disappear. Don’t bother to exercise, continue to work far too many hours, drink far too much and relegate good personal relationships to a waste of precious time. Never mind … all health problems are banished if you swallow a few pills every day. Good luck with that, my friend.
A more recent phenomenon, which has grown rapidly alongside mass medication, is the highly contentious and censorious world of nutrition. Eat this, don’t eat that and absolutely never, EVER eat that … Fortunes are made promoting various, completely mad diets. People used to eat pretty much what they liked but, in the last decade or so, nutrition has become a battleground with various foods becoming the enemy, feared and distrusted. Food has always been an emotive issue with different foods being viewed as good and bad, but there has never been a time of such unrestrained warfare.
Whilst writing this introduction, a documentary was released by Netflix called ‘What the Health’. The programme reported various claims, including:
The World Health Organisation (WHO) has classified bacon and sausage as carcinogenic to humans, on the same level as smoking
Eating one egg a day is as bad as smoking five cigarettes a day
The risk of heart disease is 50 per cent for meat eaters, 45 per cent for vegetarians and 4 per cent for vegans
One serving of processed meat a day increases risk of developing diabetes by 51 per cent
I must remember to warn my pussycat to stop eating so much meat, but he doesn’t seem keen on vegetables. I have no doubt that these claims are the purest, refined, organic baloney. Equally, according to The Times this documentary cited two pro-vegan organisations among its frequently listed sources,.
It is true to say that similar warnings about a range of foodstuffs are unnervingly common. The American Heart Association (AHA) majestically proclaimed a ‘Presidential Advisory on Harms of Saturated Fat’. Commenting on it David Katz, MD, director of the Yale University Prevention Research Center, and founder and president of the True Health Initiative described the new AHA advisory as ‘one of the most important papers addressing the topic of saturated fat and health outcomes’. He added, ‘The conclusion is perfectly clear and entirely decisive: saturated fat from the usual dietary sources increases the risk of heart disease, and its replacement with wholesome foods and unsaturated fats reduces that risk.’2
I nearly choked on my cornflakes. Except, of course, I do not eat cornflakes because they taste of nothing and are instantly converted to sugar in your digestive system. My breakfast of choice is full fat Greek yoghurt with walnuts and honey. Failing that, bacon, eggs and sausages or sometimes a cheese and ham omelet, which is much more difficult to choke on and, as I shall demonstrate, far healthier and less likely to cause CVD. But back to this ‘Presidential Advisory’; let’s compare it with a Swedish review from 2013, which stated that:
Butter, olive oil, heavy cream, and bacon are not harmful foods. Quite the opposite. Fat is the best thing for those who want to lose weight. And there are no connections between a high fat intake and cardiovascular disease.
On Monday, SBU, the Swedish Council on Health Technology Assessment, dropped a bombshell. After a two-year long inquiry, reviewing 16,000 studies, the report ‘Dietary Treatment for Obesity’ upends the conventional dietary guidelines for obese or diabetic people.
For a long time, the healthcare system has given the public advice to avoid fat, saturated fat, and calories. A low-carb diet (LCHF – Low Carb High Fat, is actually a Swedish ‘invention’) has been dismissed as harmful, a humbug and as being a fad diet lacking any scientific basis.
Instead, the healthcare