I got a press release today from the consumer advocacy group Which? informing me that “Misleading health claims to be banned at last”.

Apparently, European Union Member States today voted to adopt a list of scientifically proven health claims that can be made about food and drink products. Claims for green tea and glucosamine (regarding benefits for blood pressure and joint health) are examples of a couple of things that did not make the cut. On the other hand, it seems the following claims will be allowed to be made:

• reduced consumption of saturated fat contributes to the maintenance of normal blood cholesterol levels
• plant sterols and plant stanols contribute to the maintenance of normal blood cholesterol

Cholesterol levels are widely recognised as a marker for heart disease, and so the logic goes that reducing cholesterol levels will help prevent this condition. In this case, cholesterol is being used as what is known as a ‘surrogate marker’. The assumption is that a positive change in surrogate marker levels will translate into benefits for health.

However, is this actually true?

Taking dietary steps to reduce cholesterol has not been convincingly shown to reduce the risk of heart disease or overall risk of death. If this practice does not have benefits for health or extend life, why bother? Eating less saturated fat and swallowing stanols and sterols can reduce cholesterol all they like, but none of it has proven benefits for health.

It is perhaps worthy of note that a PR representative of the Unilever-made Flora Proactiv products commented here ^[1] that:

“We absolutely agree that simply lowering cholesterol without making wider positive changes to one’s diet and lifestyle will not make a significant positive health impact.”

I take this as admission of the general uselessness of cholesterol reduction in terms of its impact on health.

It can be hard for some to make sense that taking dietary steps to reduce cholesterol is not broadly beneficial to health. However, we should perhaps not be too surprised, when we consider that we have plenty of similar experiences regarding pharmaceutical drugs.

For example:

1. drugs called resins reduce cholesterol but do not reduce overall risk of death
2. the drug ezetimibe reduces cholesterol but has never been shown to benefit health
3. drugs called fibrates improve the ratio of ‘good’ and ‘bad’ cholesterol but don’t reduce overall mortality
4. hormone replacement therapy improves the ratio of ‘good’ and ‘bad’ cholesterol but doesn’t reduce overall mortality and increases the risk of cardiovascular disease

The situation with statin drugs is somewhat nuanced. In primary prevention (in essentially healthy individuals) statins do not reduce risk of death. In secondary prevention (those who have already had, say, a heart attack or stroke), they do, but the fact remains that even in high risk individuals, the great majority of people who take statins do not stand to benefit from them at all. There is reason to believe, by the way, that the little benefit statins have is not as a result of their cholesterol-reducing action, but due to other effects including anti-inflammatory blood-thinning actions.

In short, the fact that foods low in saturated fat and/or rich in sterols/stanols may contribute to lowered cholesterol levels is irrelevant. The idea that this translates into benefits for health is simply unproven. My advice? Don’t swallow it.