IN LATE 2013, young UK cardiologist Aseem Malhotra created a flutter in the medical community and the media by publishing an article in the British Medical Journal. The article argued that the fear of saturated fat and cholesterol as bad for the heart was unsubstantiated and had, paradoxically, made the population more susceptible to heart disease (as sugars soon replaced saturated fat, demonized for raising cholesterol, in food products). The obsession with lowering total cholesterol in people, he lamented, had led to the overmedication of millions with statins, a class of cholesterol-lowering drugs with common side effects and exaggerated benefits. Statin risks stated by Malhotra and another paper in the journal were contested and the debate on the drug raged for months.
Controversy has been a familiar affair for Malhotra, a vocal campaigner against added sugar, low-fat advice, overmedication, and the pharma industry’s influence on drug regulation and health guidelines. For over a decade he has been disputing the science and evidence behind the cholesterol-focused approach to preventing and treating heart disease in medical journals and the media. While academic debates are good for science and policy, they are of little use for the patient in need of practical advice.
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