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[CITATION] Serum cholesterol response to changes in the diet. IV. Particular saturated fatty acids in the diet A Keys, JT Anderson, F Grande - Metabolism, 1965
For middle- aged men and women watching their cholesterol, the advice for years has been to follow a low-fat diet and take lots of exercise.
But yesterday a leading heart expert warned that their efforts were probably in vain.
Adrian Brady, consultant cardiologist at Glasgow Royal Infirmary, said high cholesterol was mostly hereditary and the only effective remedy was drugs.
Although healthy eating and exercise could benefit all-round health it would never make a big impact on cholesterol, the blood fat which can clog the arteries and lead to heart attacks.
Dr Brady told a meeting of the Primary Care Cardiovascular Society in Dublin that thousands of lives lost to heart disease could be saved by giving effective drugs to lower cholesterol levels. 'Cholesterol is made by the liver and it's very much something you're born with,' he said. 'It's a genetic thing. Healthy diets and exercise of course are good, but they don't lower cholesterol an awful lot.'
Dr Brady's controversial remarks came after he presented research results which indicated that thousands of lives could be saved with better use of cholesterol-lowering drugs.
Half the 120,000 deaths caused by heart disease each year in the UK can be attributed to high cholesterol levels.
Dr Brady said that about one in ten of all deaths in the UK could probably be avoided if cholesterol levels were lowered.
Findings of Dr Brady's Performance for Life study, which examined 80,000 heart disease patients, showed that even with treatment, between about a quarter and a half fail to reach cholesterol targets.
Of the 80,096 patients investigated, 14,424 were being given cholesterol- lowering drugs called statins. The findings showed that 48 per cent of patients achieved 25 per cent cholesterol reduction the first time they took the drug.
Just over half reached the 25 per cent target after further treatment.
But even then, 23 per cent failed to lower their cholesterol to the recommended level.
The drugs are difficult to administer because they require a number of attempts at building up to the correct dose.
Despite Dr Brady's recommendations, a British Heart Foundation spokesman said that its advice on lowering cholesterol was still a diet rich in fruit and vegetables and for adults to take regular moderate exercise.
The food industry has created a multi-million-pound market out of the desire to cut cholesterol.
Studies have shown that margarines such as Benecol and Flora pro. activ can reduce the level of harmful fats in the blood.
But they are also up to four times as expensive as conventional margarines
Flora pro.activ produced a fall in harmful cholesterol levels by up to 15 per cent after just four weeks, if patients used enough spread to cover four slices of bread daily.
Benecol, which was promoted for a time by health-conscious
TV presenter Carol Vorderman, claims three daily ser vings can cut ' bad' cholesterol by 14 per cent.
Cholesterol is created by the liver from saturated fats found in food. It plays a vital role in how every cell wall works and the body uses it to make important chemicals which help the body's daytoday running.
It uses the blood as a road network to reach cells. However, too much cholesterol can build up in the arteries and increase the risk of heart disease - narrowing and hardening the blood vessels and causing heart attacks.
Doctors have pushed the health message that eating a low-fat diet is a good way to keep cholesterol levels low.
Experts have stressed for more than 20 years that lowering fat intake and increasing consumption of fruit and vegetables, in conjunction with exercise, will help keep it at bay.
An estimated 20 per cent of the population in Britain has dangerously high levels of cholesterol.
A small number - around one in 500 - are diagnosed with a condition called hypercholesterolaemia, meaning their bodies are genetically predisposed to creating high levels of the blood fat.
They are given lipid-lowering drugs called statins to try to bring it under control.
But latest research shows that only a small percentage of those who could benefit from statins are actually receiving them.
