The dangers of high cholesterol are exaggerated, the ability of diet and drugs to lower cholesterol is oversold and the link between cholesterol and heart attack for most people is inconclusive, says Thomas Moore, an author and journalist who spent the last several years researching heart disease.
Moore - a guest speaker Monday at the University of North Carolina at Greensboro and a former investigative reporter in Washington - recently published in The Atlantic Monthly an article entitled ``The Cholesterol Myth.'``The myth is that a simple dietary step or taking a pill every day is going to make a dramatic change in your risk of dying of a heart attack. Unfortunately, that is not true,' Moore said in an interview.
``We're dealing with an overzealous campaign. (Cholesterol) is hardly a conclusive answer for why people have heart attacks. The majority of heart attacks occur in average- or low-cholesterol people. I think we're really going overboard trying to make it the single, focused, tunnel-vision concern about our health.'
Dr. John LaRossa, chairman of the American Heart Association's cholesterol task force and an internist at George Washington University, said: ``Mr. Moore is very selective in what he looks at, and in some cases, he interprets it incorrectly. Actually, he may have done us a favor. He's made this issue more visible.'
Four years ago, Moore began researching heart disease for a book he was writing. He intended to include a chapter warning of the dangers of high cholesterol. But after reviewing research from the National Institutes of Health, Moore said, he ``was shocked to see how flimsy the case was.'
His findings - published in his recent book ``Heart Failure' - include:
A change in diet lowers cholesterol, but not by the 15 percent claimed by the American Heart Association. A 5 to 10 percent reduction is more realistic.
Drugs also lower cholesterol. But drugs represent a huge expense, carry serious side-effects and bring only marginal benefit. One study that showed drugs lowered the increased risk of heart attack from 4 percent to 3 percent had researchers claiming ``a dramatic 30 percent reduction in your chance of having a heart attack.'
Cholesterol research has focused on young and middle-aged men. ``In women under age 55, there is no evidence of a cholesterol relationship and in the elderly, where most heart attacks occur, the cholesterol relationship is either weak or non-existent. Nevertheless, the same evidence that is striking in one group is being used as a basis to treat others who may get little benefit.'
Cholesterol hype deserves attention, Moore says, because health experts say a fourth of all Americans need drugs or diet changes to lower their cholesterol. A nationwide campaign to lower cholesterol may save thousands of Americans, but it would subject millions of Americans to major lifestyle changes without any benefit, he says.
Greensboro cardiologist David Grove and internist Stewart Rogers agree that for most individuals, lowering cholesterol will bring only marginal benefit.
``There is no question that cholesterol is related to heart disease. But as an individual health risk, the risks are not nearly as great as one is led to believe,' Rogers said.
Moore says ``There is nothing wrong with the kind of diet being recommended. We could all use more fiber and less saturated fat and fewer calories. That's good health advice.
``But to believe that this is a medical treatment that is going to dramatically affect your risk of heart attack ... is really to be misled, because it's not going to happen.'