Bogus Research and the True Cause of Heart Disease

If you'll excuse me I'm going to post something that's not about the financial crisis.

Malcolm Kendrick is an English physician (a collection of his articles is here), a noted cholesterol skeptic, and the author of The Great Cholesterol Con. If you want to know what the heart disease establishment got wrong - which is pretty much everything - you could do a lot worse than read through Dr. Kendrick's articles.

But first, here's what he has to say about bogus medical research:

In April 1992, the BMJ published a randomized controlled trial on the effects of dietary intervention to prevent further heart attacks in susceptible patients. One of its key findings was that a year of a low-fat, fibre-rich diet almost halved the risk of death from all causes.

This study went on to become a "citation classic," cited 225 times (at the time of writing), including in guidelines, and its lead author, Dr. Ram B. Singh, went on to publish many papers in other journals.

And Dr. Ram B. Singh made it all up.

And this study nicely highlights another problem. Dr. Ram B. Singh published a paper that supported the current scientific prejudice. Namely, that a high-fat diet causes heart disease. So, no one would have been motivated to question it at the time. If he had tried to publish a paper (like a certain Robert Atkins) claiming that a high-fat diet prevented heart disease, then he would have been hung out to dry.

Actually, as I sit and think about it, my blood starts to boil. There is so much that is wrong. Science relies on a number of things. Accurate, believable information is probably number one. But there is no system in place to provide this. Even now, although that we know Ram B. Singh made up his research, nothing will be done to remove his papers from libraries. Nothing will be done to remove his citations from PubMed.

A recent news item (HT: Seth Roberts) reports:

Fewer than 20% of cancer trial results are published in peer-review journals, a new study says. And industry-sponsored trials only achieve publication one time in 20. The reason? Scientists seeking success and media-hungry journals don't want to publish negative results, analysts say—even if they would aid other cancer studies.

In other words, scientists and their drug company sponsors simply do not publish the results of studies that don't turn out the way they thought they would, so bogus research also includes the absence of negative results. Looks like much of the medical/scientific world is more interested in keeping the funding coming than in finding the truth. Big surprise.

As for heart disease, Malcolm Kendrick's "true causes" are:

Therefore, any ‘factor’ that causes either endothelial damage or increased blood coagulability will increase the risk of dying of CHD.

Factors that have been shown to damage the endothelium include:

* High blood sugar levels
* High levels of insulin
* Smoking
* High levels of cortisol (and other stress hormones)
* High levels of triglyceride
* High levels of homocysteine
* A lack of certain vitamins e.g. vitamin C, or B

Factors that make the blood more prone to clotting include

* High blood sugar levels
* Smoking
* Insulin resistance — Metabolic syndrome
* High levels of triglycerides
* High levels of stress hormones

There you have it: smoking, high blood sugar, and stress. Smoking needs no comment; high blood sugar is caused by insulin resistance, brought on by the obesity epidemic and high-carb diets; and stress increases the levels of stress hormones.