A Statin Nation. Dr Malcolm Kendrick
amounts of sugar or artificial sweeteners, the latter a dangerous trigger for the sugar-addicted person.
This report turns the current concepts upside down and advocates a low-carbohydrate, high-fat diet, as the most effective weapon against obesity.3
Back and forth the argument goes, with no one listening on either side whilst facts are twisted and manipulated on all sides. I can see this battle going on for another fifty years, at least. Yes, the Lilliputians and Blefuscans do like a pointless war.
If the authorities have failed to make you sufficiently worried about eating fat, you can be made to fear drinking alcohol as well. Years ago, the recommended limits for safe alcohol consumption were 52 units for men and 28 for women, per week. Oh, happy days. However, as with everything else, these limits have tightened and tightened. It is difficult to keep up, but I think we are now down to two units a day as the absolute maximum for men. This issue was reported in The Guardian:
England’s chief medical officer has defended tough new drinking guidelines, insisting that the updated advice is not scaremongering but based on ‘hard science’. The new recommendation of only 14 units of alcohol, or seven pints of beer, a week means that England now has one of the strictest drinking guidelines in the world.
Dame Sally Davies, the chief medical officer for England, robustly backed the advice in a round of broadcast interviews on Friday, saying that other countries would follow suit because of new research on the health risks of even moderate drinking.
Speaking on BBC Breakfast she said: ‘My job as chief medical officer is to make sure we bring the science together to get experts to help us fashion the best low-risk guidelines.
‘If you take 1,000 women, 110 will get breast cancer without drinking. Drink up to these guidelines and an extra 20 women will get cancer because of that drinking. Double the guideline limit and an extra 50 women per 1,000 will get cancer. Take bowel cancer in men: if they drink within the guidelines their risk is the same as non-drinking. But if they drink up to the old guidelines an extra 20 men per 1,000 will get bowel cancer. That’s not scaremongering, that’s fact and it’s hard science.’4
Anyway, the direction of travel is abundantly clear. Not drinking at all, ever, is ‘journey’s end’ for the experts on alcohol. And not eating saturated fat, ever, is ‘journey’s end’ for our dietary experts. At the same time, new limits for cholesterol, blood pressure, diabetes and suchlike will mean that everyone will be on multiple medications from ever younger ages, with new lifelong drugs being added on a depressingly frequent basis.
Left to their own devices, experts drift inexorably to extremism. After all, what is the point of having an important new guidelines meeting if you can’t then tighten, ban, enforce or demand that everyone must do something different. The inevitable end result being either ‘nothing’ or ‘everything’. This is now a well-defined phenomenon of ‘group-think’, as outlined in this article in the Spectator: ‘To become an extremist, hang around with people you agree with. Cass Sunstein – co-author of the hugely influential Nudge and an adviser to President Obama – unveils his new theory of ‘group polarisation’, and explains why, when like-minded people spend time with each other, their views become not only more confident but more extreme.5
Over the last ten years, I have watched a large branch of medicine heading in a very strange and extreme direction. I had hoped that various guidelines would become so ridiculous, so distanced from reality, science and logic, and anything else that there would be some kind of backlash. But backlash there came none. Not yet, anyway.
I am not the first person to notice the direction of travel. Well over twenty years ago an article appeared in The New England Journal of Medicine. It was called ‘The Last Well Person’ and with remarkable prescience it covered pretty much everything that needs to be said on this matter. I shall quote a couple of passages.
I have not met a completely well person in months. At this rate, well people will vanish. As with the extinction of any species, there will be one last survivor. My guess is that the extinction will occur sometime in late 1998. Before we can speculate about the last well person, we need to understand what is happening. Why are they vanishing?
The demands of the public for definitive wellness are colliding with the public’s belief in a diagnostic system that can find only disease. A public in dogged pursuit of the unobtainable, combining with clinicians whose tools are powerful enough to fine very small lesions (a lesion is just a damaged, or diseased bit of the body) is a setup of diagnostic excess …
What is paradoxical about our awesome diagnostic power is that we do not have a test to distinguish a well person from a sick one. Wellness cannot be screened for. There is no substance in blood or urine whose level is reliably low or high in well people. No radiological shadows or images indicated wellness. There is no tissue that can undergo biopsy to prove a person is well.
This magnificent article then goes on to describe the last well person in some detail. A man who has chosen a job with as little stress as possible, living in an area of the US with a mean wind-chill factor, in a temperate range, in January. He has a screening test for blood sugar, cholesterol, carcinoembryonic antigen, prostate specific antigen and occasional stool tests. He did have two unnecessary colonoscopies because of false positive tests for blood in his bowel movement, and now abstains from meat for a week before any stool test. Also …
He consumes 15 per cent of his calories as fat, with the remainder split between protein and carbohydrates. He completely avoids saturated fat, salt, sugar and red meat, and all but trace amounts of vegetable oil, which he uses in his wok to stir-fry his vegetables. He was a regular eater of tofu until he heard Garrison Keillor say on the radio that Tofu did not extend anyone’s useful life, but only that last few weeks in a terminal coma.
Every day he takes vitamins C, E, B6, and a small amount of D, several doses of kelp; and a concoction of dried seaweed mixed with desalinated sea water, along with a baby aspirin. He takes three doses of bulk laxatives, eats a bowl of bran, and drinks eight glasses of water daily…6
Who’d have guessed that this beautifully constructed, somewhat tongue in cheek account of the horribly dystopian lifestyle of the last well man is now almost mainstream behaviour?
Amongst the many doctors I meet, there has been much grumbling about this ever-increasing medicalisation. I regularly hear such phrases as ‘bloody monkey medicine’. But those in charge of the medical research complex are highly resistant to any change of direction, and very few people risk popping their heads over the parapet. Dare to challenge the experts and you can expect a vicious reaction.
Fairly recently, a few of us mad cholesterol sceptics were proving more successful than usual in criticising mass statin prescribing. This was not to be allowed. One of the big names of cardiology, Professor Steven Nissen, was stung into action. He wrote an article in the Journal of the American Medical Association entitled ‘Statin Denial: An Internet-Driven Cult With Deadly Consequences’, which gives a good sense of the scientific tone of what followed. I presume he felt that his mighty Olympian thunderbolt would keep me, and my fellow cult leaders, firmly in our place. I wish I had known I was running a cult, I could have made some real money.
Tom Naughton, a fellow cholesterol sceptic, writer and humorist, wrote a blog on the Nissen article, and most amusing it was. One of the comments in his article made me laugh and laugh. So, dear reader, I nicked it (with permission):
You didn’t really tell about the worst part of the cult.
Don’t forget how cult members are initially recruited with flattery and promises of magnificent rewards in order to get them to pledge nearly all of their family’s assets to the cult. Having ‘proven worthy,’ they are taken to ‘education camps’ where they