Last week, the Food and Drug Administration proposed banning transfat—partially hydrogenated oil—from restaurants and grocery shelves because it raises bad cholesterol and lowers good cholesterol, contributing to heart disease. This week, the American Heart Association and the American College of Cardiology released groundbreaking new guidelines on cholesterol treatment that could double the number of patients taking cholesterol-lowering drugs known as statins.
BrandeisNow spoke with Professor Emeritus K.C. Hayes, a nutrition expert and the inventor of Smart Balance, about how these new regulations will impact public health in the U.S.
Let's start with cholesterol. New guidelines lower the threshold to prescribe statins to patients at risk of developing heart disease. Under these recommendations, the number of Americans taking a statin could double from 15 million to 30 million. What are statins and how do they lower cholesterol?
Back in the 1970s, scientists looked to herbal medicine to find a way to control cholesterol levels. Statins are chemical compounds synthesized from a prototype identified in red yeast rice. They target and inhibit cholesterol synthesis in the liver. Most importantly, statins lower LDL, or bad cholesterol, but leave HDL, good cholesterol, alone. Statins were found to lower risk of heart disease, stroke and even some forms of cancer. However, there are side effects if you block body cholesterol production too much. Muscle aches and weakness can develop because your body needs cholesterol to make membranes and sterol hormones, among other things. So there are some risks.
Is the medical industry relying too much on drugs, focusing on treatment instead of causes?
Well, statins have saved millions of lives. Their use could be considered the biggest public health advance since fluoridation. But by focusing on treatment we often overlook cause. In many people, heart disease and diabetes are lifestyle diseases. Eating a Mediterranean diet and exercising would help, too, but unfortunately, people don't have much of an inclination to change lifelong habits.
Unless the government intervenes, as the FDA is doing by banning transfat, nothing will happen. You've been a long-time advocate for banning hydrogenated oils. How do you feel now that it is finally happening?
It's about time. We've known about the negative effects of transfat since the early 1990s—some would argue even sooner—so it's really 20 years late.
What will be the ramifications of these two changes in public health policy?
By using statins and eliminating transfat, at the very least, we will end up improving the LDL to HDL ratio and reducing the risk of heart disease and diabetes. One thing to be careful of, however, is the increasingly common alternative to transfat known as interesterified fat, which may be just as harmful. If that becomes the replacement—instead of saturated fats like palm and coconut oil—the FDA may be banning that in 30 years.
Explore further: Early statin therapy helps kids with inherited high cholesterol