Low-fat diets and exercise ‘don’t lower cholesterol’

HEALTHY diets and exercise are a waste of time for people trying to make a meaningful reduction to high cholesterol, an expert said yesterday.

Dr Adrian Brady, consultant cardiologist at Glasgow Royal Infirmary, said high cholesterol was mostly hereditary and the only effective remedy was drugs. Individuals who struggled with super-healthy low fat diets or put themselves through gruelling gym work-outs were largely suffering in vain.

Although eating well and taking exercise could benefit all-round health, it would never make a big impact on their cholesterol levels, said Dr Brady.

“Cholesterol is made by the liver and it’s very much something you’re born with. It’s a genetic thing. Healthy diets and exercise of course are good, but they don’t lower cholesterol an awful lot,” he said.

Dr Brady’s controversial remarks came after he presented new research results which indicated that thousands of lives could be saved with better use of cholesterol-lowering drugs.

The study of more than 80,000 heart disease patients showed that even with treatment, between about a quarter and a half fail to reach cholesterol targets.

Half of the 120,000 deaths caused by heart disease each year in Britain can be attributed to high cholesterol levels. Current British government guidelines under the National Service Framework for heart disease recommend that the population’s blood cholesterol levels should be lower than 5 millimoles per litre (mml/l).

Treatments are supposed to achieve that figure, or at least reduce cholesterol by 25%. But Britain may soon have to fall into line with tougher new European targets which set a cholesterol limit of 4.5 mmol/l.

Dr Brady led the Performance for Life study, which not only looked at patients but also GP practices.

Of the 80,096 patients investigated, 14,424 were being given cholesterol-lowering drugs called statins.

The drugs are difficult to administer because they require a number of attempts at building up to the correct dose for the patient.

The findings showed that only 48% of patients achieved 25% cholesterol reduction the first time they took the drug. Just over half reached the 25% target after further treatment. But even then, 23% failed to lower their cholesterol to 5mmol/l.

Analysis of 220 GP responses showed that 67% felt that a great deal of time was taken up reviewing treatments of high cholesterol patients.

More than half admitted they did not have time to identify and review patients potentially at risk of cardiovascular events, such as a heart attack or stroke. Dr Brady said thousands of lives were being lost as a result of poorly managed high cholesterol.

“We are going to have to grasp the nettle that these people are going to have to be treated,” he said.

“Lifestyle changes on their own will just not work. If you have a cholesterol level of 8mml/l you might get it down to seven or 6.8 with diet, but to reduce it to four you really need a good statin.