THE HEALTHY SKEPTIC
Inflating the cholesterol shark
March 25, 2008
Alan Cassels
SPECIAL TO THE STAR
Quick, what do these things have in common: a rhino hiding around a blind corner, a shark in a swimming pool and pair of feet peeking from under a sheet, with a toe tag?
1. They're a wave of cutesy ads by Telus.
2. They're Gary Larson comic reruns.
3. They're fear-mongering ads designed to get you running to your doctor for a cholesterol test.
If you chose Number 3, it is because your disease-mongering radar is well-tuned and you know when someone is hawking fear to try to sell you something.
Let's face it, fear sells. The constant bombardment of fear-mongering messages drive us to buy the latest maladies du jour and the latest chemical cures. In the shark ad, a guy who could be any of us is just floating in his pool with a tall drink, minding his own business. The tagline says it all: "Living with high cholesterol. You could be surprised at what's lurking beneath."
But what is lurking beneath these ads? Diseases are often sold under the camouflage of groups such as the Canadian Lipid Nurse Network and the Canadian Diabetes Association, whose logos festoon the ads to get otherwise healthy people to buy into the cholesterol paradigm. Drug companies in Canada aren't allowed to advertise their products directly to consumers, so they do the next best thing – they advertise the disease that will lead to what they call in the business a "drug-successful visit."
A growing number of people within the scientific community aren't buying it, though, and say much of the cholesterol orthodoxy (which assumes lower cholesterol means a lower risk of death) should be swallowed with a large swig of skepticism. The International Network of Cholesterol Skeptics (thincs.org), a global network of physicians and scientists, says that for most people the cholesterol shark is about as harmful That brings me to Dennis who takes drugs to defeat death. He's in for a surprise, because drugs, at their best, will only delay death. Drugs may be worth taking for the pain relief they offer, but what if they otherwise shorten your life through unforeseen adverse reactions? Any decision to take a drug involves a trade-off: your chances of dying from one cause have to be weighed against your chances of being harmed by the drug itself, or of accelerating your death by a different cause.
Many drugs treat symptoms such as the pain of arthritis and such pain-relieving treatments can make life more comfortable and worth living. Yet drugs for high cholesterol, for which there is no symptoms, come with a range of known dangers, and you may be making a trade-off between lower cholesterol and the risk of a muscle-weakening disease or kidney failure. The problem is that we often don't know the true dangers associated with drugs before they get used by millions of people.
For a drug like the infamous Vioxx, the slightly elevated risk of a heart attack or stroke might be worth the pain relief the drug brings, but that drug debacle – responsible for thousands of deaths – starkly reminded us that no one knew the magnitude of the risks that lay behind all the hype.
Next time you think there may be a shark swimming in your backyard pool, remember that the sharks you don't see may be a lot more dangerous than the one the drug ads are selling you.
Alan Cassels is a drug policy researcher and author of The ABCs of Disease Mongering: An Epidemic in 26 Letters (Emdash, 2007). cassels@uvic.ca.
Toronto Star
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