“There are three kinds of lies; Lies, damned lies and statistics” 

Mark Twain discovered this sad truth, way before the big pharmaceutical companies truly began to bamboozle us with statistics.  This week’s headline in The Daily Mail claimed, “Taking statins could slash your risk of dying from Covid by up to 12%, study claims”. Now, I have a problem with this because I have a problem with the over prescription of Statins.  

Before I go into details, let me start by saying that this headline was based on research carried out by studying a cohort including all Stockholm residents aged 45 or older. This cohort was 963,876 people of which 2,545 sadly died of covid during the period they were studying. This in percentage terms is 0.0026%. That is a quarter of 1%.  So do you see how the headline is already very misleading?   

Misrepresentation and Research  

In 2012, Derren Brown flipped ten coins in a row and all were heads – everyone thought it was pure magic. However, it took thousands of coins to be flipped and nine hours for it to happen. On TV we saw only the final minute of Derren Brown’s attempt and not the previous nine hours of failure. Why is this relevant? Simply because much of the health and safety guidance we receive about the food we eat and the medicines we take is based on research funded by the food and pharmaceutical industry. And as we can see, if you take snippets of information in isolation, you can manipulate research to show only the results you want to show. If you want ten heads in a row, then just isolate and measure the last ten flips to prove your case. If you produce cereals and want to demonise fat and praise sugar, you can always twist research to support your case. If you can’t, then keep on doing more and more research until a small selection can be isolated to back up your claim.  

Still don’t believe me? In the 1940s, cigarette manufacturers were still using research papers proving that smoking had health benefits! One advert even claimed, ‘More doctors smoke Camels than any other cigarette’, while another stated its product was ‘for your throat’s sake’. And in 1949, if you really wanted to be healthy and at the top of your game then you simply needed to ‘smoke a Lucky to feel your level best’. Even though by this time there was lots of scientific evidence that smoking was harmful, the cigarette powerhouses kept on standing by their own research, which must have been conducted Derren Brown style.  

In 2016, news broke that, 50 years previously, the sugar industry funded Harvard University scientists to conduct research that downplayed sugar’s role in heart disease and to instead put the spotlight on dietary fat. Globally, the food industry spends millions of pounds on so-called nutritional research. One recent report in America suggested that as much as 90% of the studies that food giants fund result in outcomes that favour the sponsor’s interests. Lobbyists, in-house laboratories and misguided research is both big business and it is rife.  

I’m not normally a sceptical person, but when it comes to any nutritional or biological research, if it is in any way funded by someone with vested interests, I just don’t believe it’s of any substance. There is a great book by my good friend Dr Malcolm Kendrick called Doctoring Data, and it’s a fascinating insight into how we - the general public of Great Britain - have been misled and misguided over recent decades. One of the things that Malcolm tries to stress is how, by linking correlation with causation, so many pieces of research arrive at the wrong conclusion. Maybe you read a newspaper headline that says something like, ‘Eating Red Meat Causes Heart Disease’, yet what the article doesn’t state is that it reduces the chances of other diseases. Or another headline, ‘Wine Increases Cancer Rates By 12%’, yet what it doesn’t tell you is that moderate consumption decreases the chances of heart disease and that in hotspots in the world where there are more centenarians than normal, red wine consumption seems an integral part of their longevity! Plus, these studies are nearly always anecdotal and based on surveys and questionnaires, not controlled trials. For example, there was one newspaper headline that read, ‘Eating Bacon Kills’. What a load of rubbish. These types of negative headlines are just to sell newspapers and the research is often supplied by someone who is trying to sell the opposite of bacon, i.e. the cereal companies. One of two things might have occurred in this research: firstly, the correlation might be that people who eat bacon might be most likely to never fast, or might always have it with bread, or use it as a hangover cure, or are eating breakfast when others are exercising. Are you with me on this? Secondly, it might just be fake news!  

Marci Angell, Editor of the New England Journal of Medicine (regarded as the number one medical journal in the world), wrote under the headline ‘Drug Companies and Doctors, a story of corruption’, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgement of trusted physicians or authoritative medical guidelines”.  

CRIMES 

I have created an acronym to be used when you read a medical-related headline in a newspaper, and it is CRIMES. This stands for Controlled – Randomised – Interventional – Meaningful – Extension – Statistics (more on statistics shortly). If you ever read a newspaper headline linked with a medical study again, ask yourself six questions:  

  1. Was the study group properly controlled 
  2. Was it randomised 
  3. Was it truly interventional 
  4. Was it meaningful (were thousands of similar people involved)?  
  5. Was one group’s life extended 
  6. What type of statistical measurements were used?  

            If you feel even just one of these six didn’t happen, just take no notice of the article at all. It’s just large corporates trying to manipulate your future spending habits using a Derren Brown type technique or newspaper companies using negative stories (sadly bad news still sells more papers than positive) to maximise profits.  

            Oh, and one more thing. The Internet. Sadly, when one of these crazy stories breaks, it spreads like wildfire on the internet. Within days you do a search to see if there is any substance behind the headline and you get back thousands of results saying the same thing. So much so, you believe it must be right. The reality it is just that one bit of (probably fake) research that everyone is regurgitating and claiming as their own!  

            And Now Why I Don’t Like Statins! 

            Here is something else I find bizarre. There is a number in the medical world called NNT, and it’s the ‘Numbers Needed to Treat’ to get one, single positive outcome from taking a drug or medicine. You read that right, just one positive outcome. For example, if your doctor tells you to take statins to lower your cholesterol level, you would take them, right? Surely if they are recommending that you take them for the rest of your life, they must work? But according to medical research, independently confirmed by Bloomberg, the NNT for statins is 300. In other words, you need to treat 300 people with statins just to get one positive outcome! Yet, the negative side effects, which are sometimes severe, are believed to be 15 times higher. So, for every patient with a benefit, 15 people receive an adverse effect.  

            However, if you are a company selling statins, by mixing up the way the data is portrayed, you can create a headline that flips the risk and reward on its head. How so? You use both absolute risk and relative risk in the same report. Surprisingly, the difference between using absolute risk and relative risk is like the difference between addition and multiplication. A big pharmaceutical company, using the above statistics and NNT for statins, could create a newspaper headline that says ‘you are 50% less likely to die if you take statins’ (relative risk) and ‘only 0.05% of people experience side effects’ (absolute risk). How absolutely absurd and misleading is that? And what’s worse, Dr Kendrick says, he rarely meets a doctor, that fully understands the difference between absolute and relative percentages and how they are manipulated in research. 

            And what really cheeses me off, is that so many of my doctor friends say that the best way to avoid heart disease, is not through medication, but through lifestyle changes. For example, if you have diabetes Type II, caused by insulin resistance, then your chances of a heart attack increase significantly. So, let’s deal with the insulin resistance and reduce the incidence of heart disease. Reducing stress, getting out in the sun, better sleep, exercise, foods that increase nitric oxide in blood vessels, all help to reduce the prevalence of heart disease. But if your doctor has just prescribed you to a life of daily medicines, my concern is people think they are taking a magic pill and then don’t adjust their lifestyle and diet. I have talked to dozens and dozens of people who take statins and have yet to find one that knew about NNT. 

            Tim Noakes refers to statins as, “The single most ineffective drug ever invented”. Dr Jeffry Gerber says, “Despite being the most prescribed drug on the planet, they will probably be gone in ten years”. Maybe  

            So, if Dr Gerber is right, and you were a statin producer, what could you do? Maybe get some research done, Darren Brown meets relative risk style and reposition your pills to be a magic cure for the new public enemy number one.  

            My Good Friend Dr Malcolm Kendrick Told Me… 

            Say you have a clinical study, and you have 200 people - 100 take a blood pressure-lowering tablet, and 100 take a placebo. At the end of the trial, imagine two people have died taking the placebo and only one taking the blood pressure-lowering tablet. So, the difference between two people dying and one person dying is a 50% reduction in death, that’s the relative reduction. Whereas the absolute difference is just 1%. So, the pharmaceutical company is going to say 50% reduction rather than 1% reduction, and they are currently allowed to do this. There is no regulation on how you present the results of your trial. So, the benefits are nearly always portrayed using relative percentages and the downsides absolute. I have asked probably a hundred doctors the question of “What is the difference between absolute and relative risk?” and not one has ever been able to answer it to me.  

            Let me expand on what Dr Malcolm Kendrick is saying. A relative risk is relative only to itself. For example, if you buy two lottery tickets you increase your odds by 100%, yet the number is meaningless unless you know how many tickets there are in total. In medical terms, a 100% increase in baseline risk is irrelevant, if the risk is trivial.  

            Likewise, if your risk of a heart attack in the next year is, say, 1 in 250 and the drug reduces your risk by 100% (to 1 in 500), what about all the other people it does nothing for?, what about the 499 people that it does nothing for? Both relative and absolute benefits and risks are both pointless if you don’t know the individual’s baseline risk of developing a disease in the first place. 

            Back to The Headline 

            Even the researchers didn’t seem that convinced (although it didn’t stop The Daily Mail reporting it – and by the way, they have written previous articles supporting Statins). 

            The actual research paper has some hefty disclaimers…. “However, available observational studies are hampered by study design flaws, resulting in substantial heterogeneity and ambiguities.” Further in the report it suggests, “Limitations of this study include the observational design, reliance on dispensation data, and the inability to study specific drug regimens”.  

            So even if there is a modicum of truth in the headline, and all of those 0.0026% that died weren’t taking statins - which isn’t the case as the numbers were 765 statin users died and 1,780 nonusers died - what could the real reason be?  

            As stated in the research, maybe the statins do reduce inflammation. But so too does vitamin C (not a drug and no side effects), Omega 3 and many more vitamins, plant extracts and minerals. Or could it be something like the statin takers took their health more seriously?  

            But correlation does not mean causation and it could be something as daft as statin takers eat more organic red meat than those who don’t take the drug.  

            Alternative Ideas 

            I have written in previous blogs about how there is lots of evidence to support vitamin C, vitamin D, zinc and omega three for patients suffering from Covid. We even marched in London trying to get people to listen to the evidence specifically around vitamin C. But of course, you cannot patent vitamins and minerals, therefore the big companies won’t do the research and sadly governments just aren’t listening. In my mind the only time medicine (drugs) should become before nutrition is in the dictionary. 

            My Favourite Trustpilot review This Week 

            Written by Helen 

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            Pumpkin & Shallots Soup 

            With Halloween just around the corner, my wife and I took the children out to buy some pumpkins. While I roasted the seeds, Sarah whipped up this amazing soup. 

             

            It is simple to create and tastes yummy. Get a medium size pumpkin (say about 3lbs). Remove the inner pulp and outer skin and boil it in a pan. Chop up four shallots. Once the pumpkin is nice and soft remove it and place both the onion and the pumpkin and 2 garlic cloves into a blender. Give it a good blitz. 

             Get 4 cups of vegetable stock, salt and pepper and put into a pan and heat all together for about 15 minutes. To serve add some roasted pumpkin seeds on the top and you can swirl in some cream if you like too.  

            Tip: To roast the seeds, remove them from the pulp. Add a drizzle of olive oil and lots of salt and then spread them out on parchment paper and put in the oven on high heat for bout 15 to 20 minutes. Keep an eye on them and bring them out just as they begin to go golden brown. Let them cool and you can store them in an airtight container in the fridge for up to a week.   

            If you are on a low carb diet, don’t have too much though, as it is a medium carb vegetable.

            Trustpilot Update 

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