Twenty years ago, I worked for a newspaper that provided its employees with an annual health screen provided by BUPA. Not being one to reject a free gift I went along for my first check up out of curiosity at what it might disclose.
I have always tried to follow a reasonably healthy lifestyle and, being a health correspondent, had a reasonable grasp of what that might involve. But that day changed my life in a way I did not expect. I discovered my cholesterol level was well below the average. As a result I immediately switched from margarine to butter.
I have always loved butter. Not just a smear on my morning toast but carved thickly straight from the fridge. Through the 1970s and 1980s I had resisted its lure because of the warnings that, with its high content of saturated fat, butter was a killer. Discovering that I might enjoy some protection from its risks was a revelation.
So when I saw yesterday’s BMJ report by cardiologist Aseem Malhotra arguing that saturated fats have been unfairly demonised, my heart - still (I hope) atheroma-free - lifted a little.
Dr Malhotra thinks we are taking far too many statins for reducing cholesterol – and with eight million people on the drugs many may agree – and that greater focus should be placed on adopting a Mediterranean diet, which might achieve the same end.
The heart charities disagree. They say it is no surprise that research findings on the link between cholesterol and heart disease are conflicting. People are not rats and much as scientists might like to, it is not possible to control what they eat in order to get clear results.
But this, as ever, leaves you and I in a tricky position. We have to weigh up the evidence and try as best we can to apply it to our own case. That is what I did 20 years ago when I reasoned that the pleasure I derived from eating butter outweighed the small risk to me from consuming that extra saturated fat.
I would not have advised my friend David to do the same, despite our shared passion for butter. He happens to suffer from familial hypercholerestaemia, an inherited condition that pushes his cholesterol level sky high. He is on a large dose of statins, and rightly so.
It is when you get down to more ordinary cholesterol levels that the decision becomes trickier. Research shows that whatever your cholesterol level is, your risk of heart disease is reduced if you lower it. Thus theoretically we would all benefit from being on statins.
But none of us wants to be on drugs for the rest of our lives, with their potential side effects, if we can avoid them. At a population level, the arguments for statins are solidly backed by gold-standard research. At the individual level, however, the chances of any individual personally benefiting from the drugs they take may be smaller than they think.
There is no simple way round this. A high risk to one person may not seem high to another. Ultimately it is for each of us to strike a bargain with our maker.Reuse content