Transcript: Cholesterol: The Great Bluff | Jun 12, 2017

(jolly music plays)

An inserted clip shows people having fun on a beach. Captions over people
exercising read "Push-ups 75, Sit-ups 100, Daily laps 50, Total cholesterol 258."

A full-screen caption reads "Quark and ARTE G.E.I.E. present...

(Lyrical music plays. A voice sings and says "ARE THE STARS
OUT TONIGHT?"

The caption continues "A film by Anne Georget."

"I DON'T KNOW IF IT'S
CLOUDY OR BRIGHT."
'CAUSE I ONLY HAVE EYES
FOR YOU..."

An athletic looking young man does a racing dive into a pool. The screen fades
to black. A full-screen title caption reads "Cholesterol... The Great Bluff."
Over a clip of the champion swimmer, the Narrator speaks.
[splash]

(lyrical music)
"DEAR
THE MOON"

A female Narrator says THIS AMERICAN
ADVERT FOR AN ANTI-CHOLESTEROL
DRUG TELLS US THAT AN INSIDIOUS
EVIL CAN EAT AWAY AT US, EVEN
IF WE FEEL HEALTHY.
FOR THE LAST 60 YEARS,
CHOLESTEROL HAS BEEN THE
SUBJECT OF FIERCE SCIENTIFIC
DISPUTES AND HUGE INDUSTRIAL REVENUE.
WHICH ARGUMENTS AND WHICH
INFLUENCES LEAD US TO BELIEVE
THAT CHOLESTEROL HAS A HARMFUL
EFFECT ON OUR ARTERIES?
HOW HAS CHOLESTEROL EARNED
ITSELF A NEGATIVE REPUTATION
WHEN IT'S A SUBSTANCE THAT IS
ESSENTIAL FOR OUR SURVIVAL?

(lyrical music)
"YOU ARE - ."

An old-fashioned T.V. screen shows a black and white image of a formally dressed
newscaster. A caption reads "1955." A clip shows a sign reading "Laboratory of
Physiological Hygiene."

The Reporter says THE STORY WE
WANT TO TELL YOU TODAY IS
REALLY SORT OF A DETECTIVE
STORY AND IT HAS A COMPLICATED PLOT.
THE KILLER IS CARDIOVASCULAR
DISEASE == HEART FAILURE AS SOME
OF US CALL IT.
THE VICTIMS OR POTENTIAL
VICTIMS ARE YOU AND ME.
AND THE DETECTIVES ARE A TEAM
OF SCIENTISTS OPERATING AT THE
UNIVERSITY OF MINNESOTA.

On the old TV screen, over a man in his forties wearing a white shirt and tie,
a caption reads "Ancel Keys."

Ancel Keys says THE FACTS ARE
SIMPLE... YOU KNOW THE CHIEF
KILLER OF AMERICANS IS
CARDIOVASCULAR DISEASE...
DISORDERS AND DEGENERATION OF
THE HEART AND BLOOD VESSELS.
OF TEN MEN, WE CAN EXPECT FIVE
TO GET IT.

He stands up and flicks over five out of ten standing test tubes.
[clunking]

A woman in her fifties with shoulder-length brown hair speaks. A caption reads
"Nina Teicholz, Investigative Journalist."

Nina Teicholz says FROM THE
1950s, THERE HAD BEEN THIS
RISING TIDE OF HEART ATTACKS,
OF HEART DISEASE.
MIDDLE-AGED MEN WERE HAVING
HEART ATTACKS IN THEIR PRIME,
AND THERE WAS A REAL SENSE OF
PANIC IN THE COUNTRY.
THESE ARE MEN WHOSE FATHERS
HAD NOT HAD HEART ATTACKS.
IT WAS A NEW PHENOMENON FOR PEOPLE.
IN 1955, PRESIDENT EISENHOWER
HIMSELF HAD A HEART ATTACK. AND
WAS OUT OF THE OVAL OFFICE FOR TEN DAYS.
YOU CAN IMAGINE THE PANIC OF
THE ENTIRE NATION.

(dramatic music plays)
An old TV Archive clip runs. The Reporter says THE EYES OF THE NATION AND THE WORLD WERE
FOCUSED ON FITZSIMONS ARMY
HOSPITAL IN DENVER WHERE MAJOR
JOHN EISENHOWER AND WHITE
HOUSE PRESS SECRETARY JAMES
HAGERTY ARRIVED DURING THE
FIRST HOURS AFTER WORD THAT THE
PRESIDENT DWIGHT D.
EISENHOWER HAD SUFFERED A HEART ATTACK.
BOSTON SPECIALIST, DOCTOR PAUL
DUDLEY WHITE ARRIVING WITH
Mister HAGERTY DESCRIBED TISSUE
INJURY TO AN ANTERIOR HEART
WALL AS A MODERATE ATTACK.

Nina says AND THERE WAS
A SENSE OF CRISIS, URGENCY
ABOUT FINDING OUT ABOUT WHAT
CAUSED HEART DISEASE, AND THERE
WERE A NUMBER OF IDEAS ABOUT IT.
ONE WAS, IT MIGHT BE A VITAMIN
DEFICIENCY, MAYBE IT WAS AUTO=EXHAUST.
THERE WERE A NUMBER OF IDEAS.
BUT THERE WAS ONE IDEA PROPOSED
BY ANCEL KEYS WHO WAS A
RESEARCHER AT THE UNIVERSITY OF
MINNESOTA... HE WAS A
PATHOLOGIST, AND IT WAS HIS
IDEA THAT IT WAS SATURATED FATS
THAT CAUSED HEART DISEASE.
SATURATED FATS WOULD CAUSE YOUR
TOTAL CHOLESTEROL TO GO UP -
WHICH WAS THE ONLY THING THEY
COULD MEASURE IN THOSE DAYS.
AND THAT WOULD CLOG YOUR
ARTERIES AND GIVE YOU A HEART ATTACK.
IT WAS CALLED THE DIET-HEART HYPOTHESIS.

In the 1955 clip, a Doctor, standing in front of a blackboard, says HERE ARE VITAL STATISTICS.
THEY SHOW THAT THIS PROBLEM
HERE IN AMERICA IS THE WORST IN THE WORLD.
PROBABLY OUR MODE OF LIFE AND
OUR DIET ARE INVOLVED.
BUT THE TROUBLE IS WE JUST
DON'T KNOW ENOUGH ABOUT IT... IT
STRIKES WITHOUT WARNING, BUT WE
CAN'T SAY...

A balding man in his seventies with gray hair and beard stubble speaks. A caption
reads "Harvey Levenstein, Food Historian."

Harvey Levenstein says WHEN
PRESIDENT EISENHOWER HAD A HEART
ATTACK, KEYS CAME TO THE FORE
BECAUSE THIS DOCTOR WHO WAS
FLOWN IN TO TREAT EISENHOWER
IMMEDIATELY PUT HIM ON A
LOW-FAT DIET, AND SAID IT WAS
HIS DIET THAT HAD CAUSED THE
HEART ATTACK... NOT THE FACT
THAT HE SMOKED LIKE A CHIMNEY.
[chuckling]
NO, NO.

Nina says THE SOURCE OF
KEYS'S IDEA CAME FROM THIS IDEA...
THERE'S A DISEASE WHERE YOU GET
FATTY DEPOSITS UNDER YOUR SKIN;
THEY'RE CALLED XANTHOMAS, AND
YOU CAN SEE THEM.
PEOPLE GET THEM ON THEIR EYELIDS.
AND THEY HAVE CHOLESTEROL IN THEM.
AND SO THE IDEA WAS... THAT SAME
CHOLESTEROL WOULD BE INSIDE
YOUR ARTERIES AND THEY WOULD
BLOCK YOUR ARTERIES.
AND IT CAME FROM THIS CHOLESTEROL.
SO CHOLESTEROL WAS THE FIRST
KIND OF EVIL DEMON.

A man with graying hair in his sixties speaks. A caption reads "Gary Taubes,
Scientific Journalist."

Gary Taubes says KEYS PROVIDES
THIS HYPOTHESIS.
AND PEOPLE STARTED TESTING AND
SCIENTISTS STARTED TESTING IT,
BUT SIMULTANEOUSLY THE RESEARCH
COMMUNITY STARTS TALKING ABOUT
IT AS IF IT'S PROBABLY TRUE...
IT JUST NEEDS TO BE CONFIRMED.
WHAT THEY LIKE TO SAY IS "WE'RE
TRYING TO CROSS THE T'S AND DOT
THE I'S ON THE EVIDENCE."

An old clip shows Greek children.
(old film projector noise)

The Narrator says IN 1958, ANCEL
KEYS LAUNCHED A STUDY ON AN
UNPRECEDENTED SCALE ACROSS
SEVEN COUNTRIES... GREECE,
YUGOSLAVIA, ITALY, THE
NETHERLANDS, FINLAND, THE
UNITED STATES AND JAPAN.
AT THE HEART OF THESE
OBSERVATIONS REMAINED THE
STATISTICAL LINK BETWEEN FOOD,
PARTICULARLY FATTY FOODS,
CHOLESTEROL LEVELS AND THE RISK
OF CARDIOVASCULAR DISEASE AMONG POPULATIONS.

A man in his seventies with a full beard and glasses
looks through a file containing hospital photos. A caption reads "Henry Blackburn,
Epidemiologist... Ancel Keys's Assistant."

Henry Blackburn says A STEP-TEST
FOR EXERCISE IN A VILLAGE IN
CENTRAL SERBIA WHERE THE MEN
HAD NEVER RIDDEN A BICYCLE.
SO WE HAD TO USE A STEP TEST
INSTEAD OF A BICYCLE ERGOMETER.
THIS IS THE PREPARATION OF THE
DIETS WE COLLECTED.
THIS IS MARGARET KEYS WHO SET
UP THE CHOLESTEROL LABORATORIES
FOR THESE PILOT STUDIES.
WE EXAMINED ABOUT 12,000 MEN
IN 14 AREAS OF 7 COUNTRIES.

An old clip shows Margaret Keys with doctors from Finland and Japan.

Henry continues AND WE HAD PEOPLE CALLING IN
FROM FINLAND SAYING THAT THERE
ARE MORE HEART ATTACKS THERE
THAN ANYWHERE IN THE WORLD.
AND WE HAD JAPANESE VISITORS
SAID, COME SEE US.
SO... THAT COMBINATION OF
CIRCUMSTANCES.
AFTER THAT, AFTER YOU CHOOSE
THE VARIATION AND THE VARIABLES
YOU'RE GOING TO STUDY, IT'S
ENTIRELY WHERE YOU GET THE
COOPERATION AND WHERE YOU HAVE
A CHANCE OF GETTING IN A COMMUNITY.
THE CONCLUSION OF THE
SEVEN-COUNTRY STUDY ARE THERE
ARE VERY LARGE DIFFERENCES IN
THE RATE OF HEART ATTACKS
BETWEEN THESE CULTURES, ON THE
ORDER OF FIVE TO TENFOLD, WHICH
WE COULD ALREADY FIND IN FIVE YEARS.
WE FOUND DIFFERENCES THE FIRST
TIME WE EXAMINED, WE WERE MUCH
MORE SURE OF IT WHEN WE
FOLLOWED AT FIVE YEARS, WE WERE
MUCH MORE SURE AT TEN YEARS.
THERE WERE REMARKABLE
DIFFERENCES IN THE DISTRIBUTION
OF SERUM CHOLESTEROL, YOUR
TOPIC OF THE DAY.
I'M SORRY I DON'T HAVE THE SLIDE.
THE DISTRIBUTION OF CHOLESTEROL
IN JAPAN WILL GO LIKE THIS AND
IN FINLAND GOES LIKE THIS.

Henry marks a rising bell curve in the air with his index finger.

Henry continues AND THERE'S A TINY LITTLE OVERLAP.
THE HIGHEST CHOLESTEROLS IN
JAPAN, BARELY OVERLAP THE
LOWEST CHOLESTEROLS IN FINLAND.
IT'S ONE OF THE MOST ELEGANT
SLIDES AND IT TELLS YOU SO MUCH.

A balding man in his fifties speaks in French. Captions translate him.
(speaking French)

The French doctor says "Ancel Keys created a bad science, in which he'd doctor results to
validate his hypothesis. He came up with a curve as you can see on the graph.
This is the number of people dying, and this is the fat consumption within
each population. Here you have Japan, Italy, England, Australia, Canada and the
U.S. Looking at it, you'd conclude that the more you eat fat, the more heart
attacks you get. It's proven. However, something was wrong with this, because he
only used data that validated his point of view. If you look at it, there are
other countries... here's France which has a level-one heart attack rate, and
here's Finland, which has a level-seven heart attack rate. They're on the same
line in terms of fat consumption... so there's something wrong with his hypothesis.
How can the heart attack rate vary from one to seven when the fat consumption rate
remains the same? It doesn't validate the direct link between the consumption and
heart attack rates... someone had to dispute these results, and they did. Two
statisticians said, "hang on, that doesn't work... you'vejust picked out the
data that supports your hypothesis... that's bad science!" So they published
research to contradict Keys. So he took that quite badly... he got lots more
funding, and launched another study. Now he took doses of cholesterol, and published
the study in seven countries. This time, he discovered a correlation... a statistical
link between the average cholesterol level within a population and their heart
attack rates. Once again, he formed a line along points on a graph that seemed
to support his theory. The problem was that he didn't use all 22 countries. He
only used countries that supported his theory, for example, France. It caused
confusion, because the average cholesterol levels were higher than the international
average, and yet it suffered from the lowest number of heart attacks! So he
didn't use France's statistics. He was still manipulating data... he wasn't trying
to validate his hypothesis... he was trying to prove his hypothesis was right by
manipulating facts. that's very bad, and it started a war against cholesterol
in Europe and other regions which had serious implications and wasn't even based on
solid facts.

Nina says IT'S A NORMAL
HUMAN INSTINCT TO SEE WHAT YOU
WANT TO SEE, RIGHT, AND THEN
KIND OF NOT SEE ALL THE
ARGUMENTS TO THE CONTRARY.
BUT, OF COURSE, SCIENTISTS ARE
TAUGHT TO FIGHT THAT NATURAL
INSTINCT TO RIGOROUSLY TEST
AND DISTRUST THEIR OWN IDEAS.
THAT IS THE TRAINING OF A SCIENTIST.
AND WHAT YOU SEE IN THIS FIELD
REPEATEDLY THAT THAT'S JUST
SIMPLY NOT THE CASE...
ANCEL KEYS IS THE MOST
INCREDIBLE EXAMPLE OF THAT.
HE SAYS "I'M RIGHT AND I'M
WAITING FOR THE INFORMATION TO
PROVE ME WRONG."

In an old clip from Framingham, Massachusetts, Jules Bergman says TWENTY-TWO YEARS AGO THE NATION'S FIRST
MAJOR PROGRAM AIMED AT FINDING
HOW WIDESPREAD HEART DISEASE
IS, HOW IT DEVELOPS AND WHAT
ITS CAUSES ARE, MORE THAN 5,000
PEOPLE WERE EXAMINED REGULARLY
AND THE FRAMINGHAM STUDY JUST
RENEWED AFTER PRODUCING
REMARKABLE RESULTS IS NOW
TESTING A SECOND GENERATION.

The French doctor continues "The Americans were clever... they took a community in
Framingham and decided to monitor all its inhabitants. People don't move around much.
They monitored everyone for 30 years, and analyzed everything they ate and did in
order to find any links between food and cardiovascular attacks to establish a
hypothesis.

Another French doctor, gray-haired in his sixties, speaks. A caption reads "Doctor
Michel de Lorgeril, doctor and researcher at CNRS, The European Society of
Cardiology."

Doctor de Lorgeril says "The Framingham study absolutely confirmed that tabasco was
a cause, that high blood pressure and sedentary living were causes. But the
researchers were disappointed to find that there was no connection between
cholesterol and cardiovascular diseases.

A white-haired man in his seventies wearing glasses reads from a paper.
A caption reads "Doctor Uffe Ravnskov, The International Network of
Cholesterol Skeptics."

Doctor Uffe says FOR EACH
1 MILLIGRAM PER DECILITRE PER YEAR DROP IN SERUM
CHOLESTEROL VALUES OVER A
14-YEAR PERIOD OF CHOLESTEROL
MEASUREMENT, THERE'S AN
11 PERCENT INCREASE IN OVERALL
DEATH RATE AND THE
CARDIOVASCULAR DEATH RATE.

Doctor Uffe continues speaking in a foreign language and says "Among the people whose
cholesterol evels had decreased over 30 years there were more deaths caused by
heart attacks than among those whose cholesterol had remained stable or had
increased. What were the Framingham investigators supposed to do with these disappointing
results with regard to cholesterol? they were lucky because, just at that time,
medical biologists were introducing a new technique that made it possible to
separate different parts of lipoproteins which transport cholesterol. they identified
what are known as H.D.L.s and L.D.L.s, with different densities. They were lucky
because they realised that H.D.L.s... "good cholesterol"-- were associated with lower
risk of cardiovascular disease... not significantly so, but a little... then the other
type of cholesterol, the L.D.L.s, are lipoproteins, and not just cholesterol, and
they were known as "bad cholesterol."

A clip shows a whjte-haired doctor. A caption reads Doctor William Castelli,
Framingham Heart Study."

Doctor Castelli says WE
THINK THE BAD CHOLESTEROLS ARE
ALL IN PART OF A SYSTEM THAT GO
OUT AND DEPOSIT THIS IN THE
ARTERIES OF YOUR HEART, IN THE
BRAIN, ALL THESE CHOLESTEROL DEPOSITS.
WE THINK THE GOOD ONE GOES OUT
AND TRIES TO TAKE THAT AWAY AND
TRIES TO UNDO ALL THAT.
SO WE FEEL THAT HOW YOU TURN
OUT IN LIFE IS THE OUTCOME OF
THAT BATTLE BETWEEN THE GOOD
AND THE BAD.

A clean-shaven French doctor in his forties speaks. A caption reads "Sylvain Duval,
Nutritionist, author of the "Guide des Aliments" Food Guide."

Doctor Duval says "Cholesterol is an essential molecule for the body. Most of our
cholesterol is produced by the liver. According to studies, between 70 and 80
percent of body cholesterol is produced by our liver, and the rest is provided by food.
We'll start with the liver..."

He sketches a triangle representing the organ, then proceeds to fill in a diagram,
explaining as he goes.

Doctor Duval continues ."..which produces the first type of cholesterol, called L.D.L.
In fact, L.D.L. is a lipoprotein... a combination of fats and proteins... I think
of it as a little submarine. there are cholesterol molecules both on the outside and
in the inside... we'll call it the cargo. On the inside are vitamins... fats in the
form of triglycerides... vitamins A., D., E. and K. and cholesterol. This little
submarine travels to the organs ah/nd docks onto a cell. The cell then emits a receiver,
in order to tell it what it needs in terms of triglycerides, choesterol or
liposoluble vitamins. Sometimes a cell might have too much cholesterol, so we'll
do the same thing, and tell the submarine to help get rid of the excess cholesterol.
or slightly damaged elements, wjicj is where the other type of lipoprotein, the
H.D.L., comes in. It's the same kind of submarine, and it comes and latches onto
the cell and takes any damaged elements away from the cell and back to the liver.
that's why it is said that these H.D.L.s play a "de-slagging" role, as they take away
things that the cell no longer needs. That's also why people believe that H.D.L.s
have a "cleaning" role. And L.D.L.s have a "clogging" role, because they deposit things.
A way of proving how absurd this "good and bad" cholesterol narrative is would be to
say that this is a hospital. This is an accident. It's like calling the ambulance
going towards the accident "bad," and the ambulance going back to the hospital "good."

A clip shows an ad for a spread called "Promise."
(jolly music plays)

An Announcer says PROMISE PRESENTS
TOM AND JERRY IN BUTTER TROUBLE.

Jerry leafs through a cookbook whose cover reads "Lower Fat Foods." Tom peers
through a hole in the baseboard. He looks pleased and an idea cloud shows a pat
of butter. Another shows a disconsolate Jerry. They perform antics around a toaster.

The Announcer says PROMISE BUTTERY LIGHT
HAS 85 PERCENT LESS
SATURATED FAT AND
NO CHOLESTEROL!

Tom throws the butter away and spreads his toast with the Promise. Jerry dumps the pat
of butter in Tom's food dish. Tom eats, then realizes what has happened. Jerry,
inside his mouse hole, stands by a package of Promise and looks cute.

The Announcer continues SO IT'S A BETTER
CHOICE THAN BUTTER
TO HELP REDUCE THE RISK...
OF HEART DISEASE.
A caption at the end of the clip reads "Are you still eating butter?"

Over an image of the first French doctor, a caption reads "Doctor Dominique
Dupagne, General Practitioner, Medical Journalist."

Doctor Dupagne says "This cholesterol issue was immediately met by
interest, particularly industrial interest. In its early days, the agro-food
industry started choosing and promoting food types recommended by Ancel Keys,
who kept reiterating that people should eat less fat. There was a merging of interests
between the agro-food industry and what were referred to as "cholesterol prohibitionists,"
who considered cholesterol as public enemy number one.

Nina Teicholz says THIS LITTLE BOOK,
"YOUR HEART HAS NINE LIVES,"
IS BY JEREMIAH STAMLER M.D.
AND IT WAS SENT OUT TO
THOUSANDS OF DOCTORS ALL OVER THE COUNTRY.
AND HERE IS IT, IS SAYS, "THIS
SPECIAL EDITION IS PUBLISHED BY
POCKETBOOKS IN ASSOCIATION WITH
THE CORN PRODUCTS COMPANY..."
UH, AS AN ADVERTISEMENT FOR CORN OIL.
AND HERE IT IS IN THE BACK, AN
ADVERTISEMENT FOR MAZOLA,
MARGARINE AND MAZOLA CORN OIL
AS PART OF THIS BOOK.
THE REST OF THE BOOK IS
DEDICATED TO TALKING ABOUT
SCIENCE AND HEART ATTACKS.

In an old clip a man says HEART DISEASE IS THE
NATION'S NUMBER ONE KILLER.

Another clip with an ad for Promise appears. People dance.
(lyrical music plays)

A male voice sings and says "YOU MAKE ME FEEL SO YOUNG..."

The man continues AN ESTIMATED 60 MILLION
AMERICANS HAVE HIGH SERUM CHOLESTEROL.

The voice says "YOU MAKE ME FEEL THERE
ARE SONGS TO BE SUNG..."

The man continues TOO MUCH SATURATED FAT -
SATURATED FAT MAY BE ...BAD FOR YOUR HEART.

The voice says "AND EVERY TIME I SEE
YOU GRIN..."

The man continues ...BAD FOR YOUR HEART.

The voice says "I'M SUCH A HAPPY INDIVIDUAL"

The man continues ...FOR YOUR HEART.

Nina says IN 1948,
PROCTOR AND GAMBLE, WHICH IS
THE COMPANY THAT'S THE MAKER OF
CRISCO OIL... VEGETABLE OIL, THEY
DESIGNATED THE AMERICAN HEART
ASSOCIATION AS THE BENEFICIARY
OF A RADIO CONTEST CALLED THE
"WALKING MAN CONTEST."
AND OVERNIGHT... THIS IS IN THE
AMERICAN HEART ASSOCIATION
OFFICIAL HISTORY... OVERNIGHT,
THEY RECEIVED MILLIONS OF DOLLARS.
AND THERE'S LITERALLY QUOTES
ABOUT HOW THAT LAUNCHED THEM
INTO THE NATIONAL ASSOCIATION
THAT THEY ARE TODAY.
THEY THEN SPREAD OFFICES ALL
OVER - OPEN CHAPTERS ALL OVER
THE COUNTRY. AND MONEY POURED IN.
THOSE ARE LITERALLY THE WORDS
IN ITS OWN OFFICIAL STORY.
AND THEN SUBSEQUENTLY, THE
AMERICAN HEART ASSOCIATION
STARTED TO SAY THAT YOU SHOULD
REPLACE SATURATED FATS WITH
POLYUNSATURATED FATS, WHICH ARE
VEGETABLE OILS, WHICH WAS A
TREMENDOUS ENDORSEMENT TO A
PRODUCT LIKE CRISCO OIL.

A white-haired scientist looks through an electron microscope in his office.

The Narrator says SEVERAL THEORIES
EXIST THAT DISPUTE THE
OVERWHELMING CHOLESTEROL THEORY.
KILMER McCULLY DISCOVERED SOME
CASES OF VERY YOUNG CHILDREN
WHO DIED OF HEART ATTACKS.
HAVING SUFFERED FROM A RARE
GENETIC DEFECT, THEY WERE NOT
ABLE TO REGULATE THEIR
VITAMIN B. INTAKE WHICH LED TO
AN EXCESSIVE QUANTITY OF A
SUBSTANCE CALLED HOMOCYSTEINE
WITHIN THEIR BODIES.
McCULLY CAME UP WITH THE
HYPOTHESIS THAT THE PLAQUES IN
THE ARTERIES GREW BIGGER WHILE
THERE WAS AN EXCESS OF THIS SUBSTANCE.

The scientist, in his seventies, speaks. A caption reads "Doctor Kilmer McCully,
Pathologist."

Doctor McCully says I BEGAN
TO DO EXPERIMENTS WITH ANIMALS
AND WHAT WE DID WAS FIRST WE
INJECTED HOMOCYSTEINE INTO
RABBITS AND THEN WE LOOKED AT THE ARTERIES.
AND WE FOUND THAT WITHIN TWO OR
THREE WEEKS, WE COULD SEE
PLAQUES IN THE ARTERIES.
WELL, I CAN'T TELL YOU HOW
EXCITING IT WAS TO SEE THE
PLAQUES IN THE ARTERIES.
I MEAN, TO HAVE A THEORY AND TO
TRY IT OUT IN ANIMALS AND THEN
TO SEE IT WITH YOUR OWN EYES IS...
IT'S INDESCRIBABLE.
WHEN I PUBLISHED MY FIRST
ARTICLE IN 1969 ABOUT THIS
OBSERVATION IN CHILDREN WITH
HOMOCYSTEINEMIA, I WAS AMAZED
THAT I RECEIVED OVER 400
REPRINT REQUESTS.
AND I WAS VERY CAREFUL WHAT I SAID.
AND WHAT I SAID WAS, "I FELT
THAT THE CHANGES PRODUCED BY
HOMOCYSTEINE WERE THE PRIMARY
CHANGES, AND THE DEPOSITION OF
CHOLESTEROL AND FATS IN THE
LESIONS WAS LIKELY TO BE SECONDARY.
AND SO, THIS DID NOT GO WELL
WITH THE "CHOLESTEROL PEOPLE."

A black and white photo shows Doctor McCully at the time of his discovery.
(dramatic music plays)

With a wry expression, Doctor McCully continues
AND I WASN'T REALLY PREPARED
FOR WHAT HAPPENED NEXT.
THE FIRST THING THAT HAPPENED...
I WAS PUT DOWN IN THE BASEMENT,
DOWN WITH THE SPIDERS AND THE
COCKROACHES IN THE BASEMENT OF
THE BULLFINCH BUILDING WHICH
WAS BUILT IN 1811.
SO, HERE I WAS IN A WINDOWLESS,
INADEQUATE LABORATORY.
AND MY COLLEAGUES SAW THE
HANDWRITING ON THE WALL AND
WERE LEAVING. AND I WAS LEFT WITH ONE
TECHNICIAN AND MYSELF.
AND THEY SAID, WELL, YOU HAVE
TO RENEW YOUR GRANT OR WE CAN'T
SUPPORT YOUR SALARY.
YOU'LL HAVE TO LEAVE.
AND I STILL REMEMBER GETTING
A CALL FROM THE DIRECTOR OF
PUBLIC RELATIONS AT
MASSACHUSETTS GENERAL HOSPITAL.
HE TOLD ME TO "JUST SHUT UP."
AND THAT HE DIDN'T WANT THE
NAME McCULLY ASSOCIATED WITH
THE NAME HARVARD OR
MASSACHUSETTS GENERAL HOSPITAL
AT ANY TIME IN THE FUTURE.
AND I TOLD MY WIFE AT THE TIME
THAT IF THERE WAS SOMETHING
WRONG WITH THE THEORY, IF THIS
WAS NONSENSE, IF THERE WAS
NOTHING TO THIS THEORY, NOBODY
WOULD CARE. THE ONLY REASON THAT PEOPLE
CARED WAS THERE WAS A THREAT TO
SOMEBODY, OR THERE WAS SOME
IMPORTANT FACTOR THAT I DIDN'T
UNDERSTAND THAT WAS CAUSING
THIS BLACKBALLING THAT HAPPENED TO ME.

Doctor McCully plays the violin in his sitting room.
(fiddle music)

An old T.V. broadcast shows a formally-dressed reporter in front of a Program
title board reading "Segments... Heart, Diet and Exercise." A clip plays.

The Reporter says OUR SEGMENT 3
THIS EVENING, THE SECOND IN THE
SERIES ON HEART ATTACKS AND
WHAT CAUSES THEM.

Another Reporter says THE JAPANESE HAVE
A LOW HEART ATTACK RATE.
THEIR DIET CONTAINS LITTLE
ANIMAL FAT OR CHOLESTEROL.
AMERICANS GET MANY MORE HEART
ATTACKS AND THEY EAT MUCH MORE CHOLESTEROL.
SUCH COMPARISONS FIRST
CONVINCED MANY DOCTORS THAT
AMERICANS SHOULD CHANGE THEIR EATING HABITS.
Doctor GEORGE MANN, A VETERAN
HEART RESEARCHER, SAYS DIET HAS
NOTHING TO DO WITH HEART DISEASE.
Doctor MANN POINTS TO HIS OWN
STUDIES WITH THE MASAI TRIBE OF TANZANIA.
Doctor MANN THINKS PART OF THE
REASON IS THAT THE MASAI GET A
LOT OF EXERCISE.

In the clip, doctor George Mann from Vanderbilt University speaks.

Doctor Mann says THE REASON
THAT THERE IS NO EVIDENCE ON
THE EXERCISE ISSUE IS BECAUSE
WE'VE SPENT OUR MONEY AND OUR
TIME AND OUR PEOPLE BELABOURING
THIS AILING "DIET-HEART HYPOTHESIS."

Gary Taubes says GEORGE MANN
WOULD GO, YOU COULD GO TO KENYA
AND STUDY THE WARRIOR CLASS OF
THE MASAI THAT LIVE PRIMARILY
ON MILK AND BLOOD AND MEAT FROM
THE CATTLE THEY HERDED AND THIS
WAS AN EXTRAORDINARILY HIGH-SATURATED
FAT DIET AND THEY
DIDN'T SEEM TO GET HEART DISEASE.
YEAH, HIGH CHOLESTEROL AND THEY
DIDN'T SEEM TO GET HEART DISEASE.

Nina says HE WAS BITTER
ABOUT HIS EXPERIENCES.
ONE OF HIS STORIES... WHICH
DOESN'T SURPRISE ME, BECAUSE
I'VE HEARD THIS SAME STORY IN
SOME FORM OR ANOTHER FROM OTHER
RESEARCHERS... WAS THAT HE WAS
IN N.I.H. AND WHERE HE HAD BEEN
A RESEARCHER, A PRESTIGIOUS
POSITION, AND A SECRETARY
CALLED HIM OUT IN THE HALL AND
SAID, Doctor MANN, IF YOU CONTINUE
YOUR OPPOSITION TO ANCEL KEYS,
IT'S GOING TO COST YOU YOUR
RESEARCH GRANT. AND, SHORTLY AFTER, IT DID.

A cartoon plays, showing a track winding through a wooded area. Little figures
move along the track. A figure rides a bicycle uphill.

(speaking French)
A voice says "Right now, the peloton is climbing up the hill on their saddles.
where is the yellow shirt?... I don't see it. There he is! He's paying for all his
efforts of yesterday. He can't take any more. He's stressing. Is he going to give up?
A spectator comes to feed him something. Ah! Sugar! that's a good idea.
(cartoon music plays)

The Narrator says RESEARCHERS NOTED
THAT THE INTRODUCTION OF SUGAR
INTO INDIGENOUS POPULATIONS
PROVOKED HEART DISEASES THAT
HAD HITHERTO BEEN UNSEEN.
CRISTIN KEARNS HAD RECENTLY
UNEARTHED SOME CONFIDENTIAL
INTERNAL DOCUMENTS FROM THE
SUGAR INDUSTRY, WHICH PROVED
THAT THIS INDUSTRY SUBSIDIZED
RESEARCH FROM THE 1960S ONWARDS
TO DIVERT ATTENTION AWAY FROM
SUGAR AND MAKE CHOLESTEROL
SOLELY RESPONSIBLE FOR HEART DISEASE.

A woman in her thirties with shoulder-length blond hair speaks. A black and
white photo shows a man with thinning hair in his sixties.

Cristin Kearns says JOHN YUDKIN
WAS A BRITISH PHYSIOLOGIST WHO
BECAME VERY CONCERNED ABOUT THE
CONNECTIONS BETWEEN SUGAR
CONSUMPTION AND HEART DISEASE.
AND HE REALLY BECAME A
SPOKESPERSON WHO GAINED
ATTENTION IN THE MEDIA, THAT
GAINED THE PUBLIC'S ATTENTION
ABOUT THE POTENTIAL DANGERS OF
SUGAR AND HEART DISEASE.
SO, IN 1964 THE SUGAR INDUSTRY
BECAME REALLY CONCERNED ABOUT
THE EVIDENCE THAT WAS EMERGING
LINKING SUGAR TO HEART DISEASE.
SO, JOHN HICKSON, WHO WAS THE
SUGAR RESEARCH FOUNDATION'S
VICE-PRESIDENT OF RESEARCH,
COMMENTED THAT THERE WERE
FLOWING REPORTS FROM
LABORATORIES SUCH AS YUDKIN'S
LINKING SUGAR TO HEART DISEASE,
AND THAT THEY NEEDED TO COME UP
WITH A PLAN OF ACTION.

A packet of sugar and a bottle of Coca Cola stand among files in a lab.
[keyboard keys clicking]

Cristin continues IN 1965, A SERIES OF ARTICLES
THAT WAS PUBLISHED IN THE
ANNALS OF INTERNAL MEDICINE
WAS WRITTEN UP IN THE NEW YORK
HERALD TRIBUNE, WHICH WAS A
MAJOR COMPETITOR OF THE NEW
YORK TIMES AT THE TIME.
IT GOT A FULL PAGE ARTICLE IN
THE SUNDAY EDITION.
AND THE NEWSPAPER ARTICLE WAS
QUESTIONING WHETHER IT REALLY
WAS FAT THAT WAS LINKED TO
HEART DISEASE OR WAS IT SUGAR
THAT WAS LINKED TO HEART DISEASE?
AND THE ARTICLE WENT ON TO SAY
THIS LINK BETWEEN SUGAR AND
HEART DISEASE HAD BEEN
THEORETICAL UP UNTIL THIS POINT
BUT THIS NEW EVIDENCE WAS
REALLY STRENGTHENING THAT LINK
BETWEEN SUGAR AND HEART DISEASE.
SO, AS SOON AS THAT ARTICLE
CAME OUT, WITHIN A COUPLE OF
DAYS, THE SUGAR EXECUTIVES
COMMITTED FUNDING FOR PROJECT 226...
THAT WAS A COMMISSIONED
LITERATURE REVIEW.
AND THE INDUSTRY WAS INTERESTED
IN HAVING RESEARCHERS AT
HARVARD TO COLLECT THE EVIDENCE
LINKING SUGAR TO HEART DISEASE
AND TO PUBLISH A REVIEW THAT
WOULD CRITIQUE ALL OF THAT
EVIDENCE TO MAKE IT LESS LIKELY
THAT POLICYMAKERS WOULD
CONSIDER THAT EVIDENCE WHEN
THEY WERE LOOKING AT THE LINKS
BETWEEN SUGAR AND DISEASE.

Documents are seen.

Cristin continues SO HERE, THEY'RE CORRESPONDING
ABOUT THE DRAFTS OF THE PAPER.
AND HICKSON AT THE SUGAR
INDUSTRY WROTE TO HEGSTED
SAYING HE'D EXPECTED TO SEE A
DRAFT BY NOW, AND WAS WONDERING
WHY IT HAD BEEN DELAYED.
AND SAYING, "I HOPE YOU WILL
FIND IT POSSIBLE TO LET ME HAVE
A COPY OF THE DRAFT OF THE
MANUSCRIPT AT AN EARLY DATE SO
THAT I CAN COMPLETE MY OBLIGATIONS."
THIS IS A LETTER FROM
HICKSON AT THE SUGAR RESEARCH
FOUNDATION TO HEGSTED SAYING,
"THANK YOU VERY MUCH FOR
THE DRAFT OF THE MANUSCRIPT.
LET ME ASSURE YOU THIS IS QUITE
WHAT WE HAD IN MIND AND WE LOOK
FORWARD TO ITS APPEARANCE IN PRINT."
IT REALLY FOCUSED ON DOES SUGAR
CAUSE HEART DISEASE?
AND THEY REVIEWED AN ENORMOUS
NUMBER OF STUDIES AND PICKED
APART EVERY STUDY, ONE BY ONE
AND POINTED OUT SOME SORT OF FLAW.
THE PUBLISHED ARTICLE DID NOT
MENTION ANY FUNDING FROM THE
SUGAR RESEARCH FOUNDATION.
SO HERE WE HAVE HARVARD
RESEARCHERS, WE HAVE THE HIGHLY
PRESTIGIOUS NEW ENGLAND JOURNAL OF MEDICINE.
THE SUGAR INDUSTRY COULD NOT
HAVE FOUND A MORE CREDIBLE
AVENUE TO GET THEIR MESSAGE OUT.
(dramatic music plays)

A colourful cartoon dramatises blood components, showing them flowing like
water and forming different coloured waterfalls that feed a river.

The Narrator says IN ORDER TO
DEFINITIVELY PROVE THE ROLE
PLAYED BY CHOLESTEROL IN HEART
DISEASE, DESPITE THE SKEPTICISM
OF MANY SCIENTISTS, THE
NATIONAL INSTITUTES OF HEALTH
LAUNCHED THE L.R.C. IN 1977, WHICH
INVOLVED A CLINICAL STUDY OF
3,800 MEN WITH HIGH CHOLESTEROL LEVELS.
ONE GROUP WAS FED A DIET LOW IN
CHOLESTEROL AND RECEIVED THE
DRUG CHOLESTYRAMINE, WHICH
REDUCES CHOLESTEROL LEVELS IN THE BLOOD.

A man in his forties with short red hair speaks.

Jeremy Greene says SO IT'S
VERY INTERESTING.
YOU HAVE THIS VERY NARROWLY
FOCUSED POINT OF FACT, WHICH
IS, MIDDLE-AGED MEN ABLE TO
KEEP A RIGOROUS DISCIPLINE
OF CONSUMING A PARTICULARLY
NOXIOUS DRUG TO FIND A VERY
SLIM REDUCTION IN
CARDIOVASCULAR DISEASE.
AND WHAT'S ACTUALLY PUBLISHED
OUT OF THIS STUDY IS A MUCH,
MUCH BROADER CONCLUSION THAT
REDUCING CHOLESTEROL WILL DO
GOOD THINGS FOR THE AMERICAN POPULATION.
AND NOT ONLY FOR THIS GROUP OF
PEOPLE, BUT FOR ANYBODY REALLY
OVER THE AGE OF TWO.

A cartoon plays and French subtitles are translated.

A voice from a duck saysI'M WORRIED.

A drake says WHY, HONEY?
THOSE HUNTERS HAVEN'T BEEN
AROUND HERE IN MONTHS.

The duck says I'M WORRIED ABOUT YOUR
CHOLESTEROL LEVEL.
I DON'T WANT YOU TO HAVE A HEART ATTACK.

The drake says BUT HONEY, I'M A DUCK.

The duck says HEREDITY IS ONLY PART OF IT.
YOU'VE ALSO GOT TO WATCH WHAT YOU EAT.
LIKE NOT STUFFING YOURSELF WITH
FOOD HIGH IN SATURATED FATS
AND CHOLESTEROL.

An Announcer says WATCH WHAT YOU EAT AS IF
YOUR LIFE DEPENDED ON IT... IT DOES!

An English caption reads "It's your heart, it's your life, it's your move."

Jeremy says THE NATIONAL
CHOLESTEROL EDUCATION PROGRAM.
ON THE ONE HAND, THERE SHOULD
BE MORE SCREENING OF
CHOLESTEROL HAPPENING IN
CLINICS TO FIND PATHOLOGICALLY
HIGH CHOLESTEROL.
ON THE OTHER HAND, THERE SHOULD
BE A BROADER SENSIBILITY THAT
THE EVERYDAY AMERICAN WOULD
KNOW SOMETHING ABOUT CHOLESTEROL.

A female T.V. Announcer, Journalist, Claire Chazal, speaks. She says "People on
the Mediterranean coast are less likely to suffer from heart attacks than others
and that's all due to their diet, which includes olive oil and other fibers...
that's what doctors from Lyca discovered."

Doctor Dominique Dupagne says "It was Dr De Lorgeril’s study in 1999. He had a
very original approach, he thought "what if there’s more to it?." Rather than
making people eat food that lowers their cholesterol, he used a completely
different approach and thought... what do people who don’t get heart attacks eat?
He found that the Mediterranean diet, or those living within the region, very
rarely suffered from heart attacks. People aged under 75 living in the
Mediterranean basin had 8 times fewer heart attacks than Finnish people and 8
times less than Scottish people. That’s not 40 percent, it’s four times less, or 8
times less, so something’s definitely making a difference. He looked into it
and found that it wasn’t anything like the anti-cholesterol diet. It was a
different type of diet that used lots of olive oil, which is normally forbidden
in anti-cholesterol diets, but was widely used in Mediterranean countries.
Goats or ewes milk cheese was normally forbidden because it contains animals
fats, but was used by these populations, as well as cooked meats. The Spanish,
Italians and southern French all love eating cooked meat and yet they’re the
world champions of low heart attack rates. So they had to look at things
differently... rather than make people eat diets aimed at specifically lowering
cholesterol, they told people to eat a normal diet with sunflower oil... And
then the others should eat Mediterranean style. So two groups transpired and
it had an extraordinary result. By which I mean, there were 50 percent less heart
attacks in the Mediterranean diet group compared with the traditional diet
group. So then it became about secondary prevention, for people who’d already
had a heart attack."

In a clip, Doctor Michel de Lorgeril says "What protected our patients was probably this combination of
olive oil, rapeseed oil and natural anti-oxidants provided by fruits, vegetables
and red wine...which probably protected our patients."

In a recent interview, Doctor de Lorgeril says "We managed to reduce the risk
by 50 to 70 percent. So there were two reactions in the medical and scientific
community... one section of people said, great, that’s fantastic, we thought the
same thing, you’ve demonstrated it and we’ll see a range of studies being
carried out in various countries to confirm our results. And then there was a
group of people who didn’t accept these results, certainly not the idea. If we
think back to it now, people must have been mentally blocked to have thought
that way and say that it can’t be true because the cholesterol levels were the
same in both groups. I remember some of my American colleagues telling me,
Michel, we believe you but we can’t get our heads around your results, "how
can you lower the risk of heart disease without lowering cholesterol levels?"

In a clip spoken in French, an actor waves his hands gesturing. the Astra-Zeneca
logo appears. He draws a blue line graph with a sudden peaking action, using
his index finger. He applauds.

In an Astra-Zeneca spot, a voice says "Hi, my name’s Paul, I'm a representative
for Astra Zeneca, and since you’re here with me, let me present ‘Crestor’! 0.5
milligrams and the turning point for prescriptions.
Our success, in 2006, reached... 150 million Crestor pills swallowed, that’s 300
pills every minute, treating over 890,000 patients since its launch.
Look at that... that’s the figure we reached by October, but where do you think
we are? Here? Here? Here? No, we’ve got to here!
So well done, I think we deserve a pat on the back!
[applause]

The Narrator says IN 1980, A
JAPANESE RESEARCHER DISCOVERED
A SUBSTANCE THAT LOWERED LEVELS
OF L.D.L.... THE SO-CALLED BAD CHOLESTEROL.
THAT MARKED THE BIRTH OF A NEW
CLASS OF DRUG... STATINS,
WHICH INHIBIT THE BODY'S
ABILITY TO PRODUCE CHOLESTEROL.
STATINS BECAME THE MOST
PRESCRIBED DRUG AFTER THE TURN
OF THE CENTURY.
220 MILLION PEOPLE AROUND THE
WORLD TAKE PRESCRIPTIONS OF THEM.

Doctor Mikael Rabaeus, Cardiologist, says When statins were introduced, it was absolutely extraordinary.
It was crazy. Suddenly, there was a pill for people who’d already had a heart
attack, and it reduced mortality and the risk of a second attack, it was
fabulous. People ‘bought’ into them straight away.

Doctor Dupagne says The WOSCOP study was carried out among high-risk Scottish
people... people with high blood pressure, overweight people, smokers... People
with high heart attack rates, and they were made to take a drug called
pravastatin and split into two groups. The first group took pravastatin, and
the second group took the placebo to compare the number of deaths from heart
disease. There was a 30 percent reduction in deaths from heart disease, and that was
the first time that had been achieved, with a clear and significant result. At
the same time, the other study, called the 4S study was being done with savastatin,
whose brand name was zocor, which was given to people who’d already had a heart
attack. Again, half of them were given the drug, the other half received a
placebo: There were 30 percent less recurring heart attacks in the group who took
savastatin compared with the group taking the placebo. So the cholesterol
sceptics, including myself, were completely taken aback by this. We were
speechless, it was checkmate.

Doctor de Lorgeril says "As a doctor, I prescribed them, including to my family
members. I couldn’t intellectually question the clinical trials published in
international medical journals. It seems inconceivable to me that investigators
could cheat or lie in order to deceive the whole medical community. That’s what
peer reviews are for, in principle, if something is published in a medical
journal, it will be checked by competent people and therefore, as I saw it,
people had to believe it was true."

Doctor John Abramson says SO WITH
85 PERCENT OF ALL OUR CLINICAL
TRIALS COMMERCIALLY FUNDED, AND
NOW 97 PERCENT OF THE MOST
INFLUENTIAL CLINICAL TRIALS
COMMERCIALLY FUNDED, WHAT WE
FIND IS THE ODDS ARE MORE THAN
FIVE TIMES GREATER THAT
COMMERCIALLY FUNDED TRIALS WILL
CONCLUDE THAT THE SPONSOR'S
DRUG IS THE TREATMENT OF CHOICE
COMPARED TO NON-COMMERCIALLY
FUNDED TRIALS OF EXACTLY THE SAME DRUGS.
THOSE ARE PRETTY GOOD ODDS.
WE TEND TO THINK OF SCIENTIFIC
STUDIES AS BEING OBJECTIVE AND
NOT BEING SUBJECT TO BIAS.
BUT WHAT WE FIND WHEN WE LOOK
AT THE WAY THE SYSTEM IS
STRUCTURED, THE COMPANIES
SPONSOR THE TRIALS TO HELP TO
SELL THEIR DRUGS.
THE COMPANIES OWN THE DATA THE
SAME WAY THAT THE COCA COLA
COMPANY OWNS THE RECIPE FOR COKE.

Doctor Dupagne says So at the time, despite our doubts regarding certain studies
which could not reproduce the initial results that showed the drug was as effective
among people who only had high cholesterol, nobody or almost nobody dared
contradict them or question the results. We were faced with a statins market
worth dozens of thousands of dollars, so anybody who cast doubt over statins
at a medical conference, even cardiologists, were unlikely to be invited back.
You’d have to be suicidal to criticise statins and there wasn’t much science to
back it up because after the successful results achieved a few years previous,
there was a worldwide surge of them... so statins were given to everyone: young
girls on the pill whose cholesterol levels were rising, little old ladies with
slightly higher cholesterol levels, almost everyone could be prescribed statins.
To the delight of scholarly associations who were in partnerships, doctors now
believed it was their duty to prescribe a drug that could protect their patients,
and the patients themselves were asking for them because they’d been told to
worry about their cholesterol, everyone would say: "Doctor, can I have a
cholesterol check?" because they wanted to know their cholesterol level.
At the time, it wasn’t easy to cast doubt on the drug’s appeal.

A clip shows a pharmacist's drawer full of drugs.

The Narrator says IN 2004, A SCANDAL
BROKE OUT OVER THE
ANTI-INFLAMMATORY VIOXX WHICH
CAUSED THE DEATH OF 30,000
PEOPLE IN THE UNITED STATES.
THE LEGAL SYSTEM UNCOVERED THAT
THE LABORATORY WAS AWARE OF THE
POTENTIALLY FATAL EFFECTS OF
ITS DRUGS AND HAD DELIBERATELY HIDDEN THEM.

Doctor de Lorgeril says "It was the nineties when people started realising that
the pharmaceutical industry and the researchers working for it were able to
tell lies. It was a horrendous surprise... yes, they could exaggerate the beneficial
effects of a drug and hide the toxic effects. We’d had our doubts, but at that
moment, we thought it would be worth having a look at previous studies. And then
the 2nd phenomenon happened, which was very important, where the health authorities
imposed new regulations for clinical trials. It involved all the studies carried
out and published about statins after the Vioxx scandal, so from 2005-6 onwards
until now, and that’s when we realised that there’d been a problem with the
trials carried out before the 2005-6 scandal. So there was a dual movement, on
the one hand, we realised that we may have been deceived, and on the other hand,
from that point onwards, all clinical trials on statins were proved to be
negative, which meant that they were shown to have no beneficial effects."

The Narrator says NEITHER THE DOUBTS
REGARDING THE INITIAL STUDIES
ON STATINS, NOR THE
IMPOSSIBILITY OF REPRODUCING
POSITIVE RESULTS COULD IMPEDE
THE ANTI-CHOLESTEROL OBSESS ON.
THE DOGMA REMAINED... THE LOWER
THE LEVELS THE BETTER.

Doctor Rabaeus says When I began my career in 1985 as a cardiologist, the normal
level was around three grams per litre, and since I’ve been working, this level
has gradually decreased and now sits below two. So naturally, more and more
people have a so-called ‘high’ cholesterol level. And then a second element
came into play, which was to treat high-risk patients.

An ad in a clip shows a man coming down a spiral staircase.

The man says NOW MEDICAL INFORMATION
COMES ALONG THAT SAYS YOU MAY
NEED TO GET THAT BAD
CHOLESTEROL EVEN LOWER.
NOW WHAT DO YOU DO?
WELL, IF YOUR DOCTOR SAYS AIM
LOWER, ASK ABOUT CRESTOR.
CRESTOR ALONG WITH DIET CAN
LOWER BAD CHOLESTEROL BY UP TO
52 PERCENT.

Doctor John Abramson says AND IN
THE CHOLESTEROL GUIDELINES,
THE LAST MAJOR REVISION WAS IN 2001.
IN THE AMERICAN CHOLESTEROL
GUIDELINES, 9OUT OF 14 OF THE EXPERTS
WHO WERE ON THE PANEL THAT SET
THE STANDARDS HAD FINANCIAL
TIES TO THE DRUG COMPANIES.
NOW, THIS IS VERY IMPORTANT
BECAUSE THE 2001 GUIDELINES
ALMOST TRIPLED THE NUMBER OF
AMERICANS FOR WHOM STATIN
THERAPY WAS RECOMMENDED.
THE NUMBER WENT FROM 13 MILLION
TO 36 MILLION.
AND MOST OF THE 23 MILLION
PEOPLE FOR WHOM STATINS BECAME
RECOMMENDED BASED ON THOSE
GUIDELINES DID NOT YET HAVE HEART DISEASE.

Doctor Greene of the Cholesterol Skeptic Network says IT'S AN ODD PARADOX.
I'D LIKE TO TAKE A MOMENT TO
THINK ABOUT THESE TERMS WE USE
WHEN WE TALK ABOUT NORMAL AND PATHOLOGICAL.
WHEN SOMETHING IS PATHOLOGICAL,
THERE'S CLEARLY A DISEASE THERE.
AND THIS IS EASY WHEN YOU'RE
DEALING WITH SOMETHING LIKE
CHOLERA OR TUBERCULOSIS.
ITS CHARACTERISTIC LESIONS OR
COMPLEXES OR GERMS THAT CAN BE GROWN.
IT'S HARDER WHEN YOU'RE DEALING
WITH THIS CONTINUUM OF SOME
DEGREE OF FATTY PLAQUES BEING
ON PRETTY MUCH EVERY ADULT'S
INSIDE OF THE BLOOD VESSELS BY
THE TIME THEY'RE OVER THE AGE OF 40.

Doctor de Lorgeril says "The important thing to understand about atherosclerosis,
which is the lesions that form in the arteries, they are basically plaques.
Imagine your artery is a tube, a plaque will develop in a localised manner
within a normal artery. In a given location, a stenosis forms and is generally
asymmetrical, so it makes it difficult for the blood to pass through the
narrowed section, caused by an atherosclerosis plaque. If we take a cross-section
like this... this is the opening of the artery. The blood gets through because of
the high pressure it’s under, but if it's stenosed, it's because of this
atherosclerosis plaque here, which is formed of very hard tissue, like wood.
In some patients you’ll find calcium deposits all along the artery opening,
which is another calcification process, which are like prickles that can lead
to a burst and cause what’s called a thrombus, and this thrombus can eventually
lead to the total obstruction of the artery opening, and that’s what causes a
heart attack. Over time, some old atherosclerosis plaques, especially the ones
you see in old people during autopsy, they’ll have cholesterol crystals here.
Paradoxically, these cholesterol deposits are the consequence of the deterioration
of the atherosclerosis plaque, but some believed they were the cause."

As he speaks, he draws a diagram.

Doctor Dupagne says "There’s something we must never forget... cholesterol isn’t
poison like arsenic running through your arteries. Cholesterol is an essential
fat for producing our cells... we can’t live without cholesterol, without
cholesterol we’d die. The aim isn’t to lower cholesterol levels in the blood
like you would for arsenic or cyanide. They’re a family of products that play
very intricate metabolic roles, so if you interfere with these balances or
change something to protect the heart, you can very quickly alter other
fundamental metabolic chains, whether you’re working in the field of cancer,
auto-immune diseases, and many other fields, so there’s always a huge risk of
robbing Peter to pay Paul and ending up with a lower level of cholesterol,
where you may have prevented heart disease but you’ve increased the risk of
other diseases.

Doctor Rabaeus says "Somebody please explain this. After two million years of
evolution among human beings, why would there be a ‘bad’ cholesterol and a
‘good’ cholesterol? What does that mean? It doesn’t really mean anything. If
both cholesterols have been secreted by the liver for two million years, it’s
because we need them both.
The second thing is, what makes the two cholesterol levels increase or decrease?
H.D.L., also known as ‘good’ cholesterol, increases in direct correlation with
physical activity. Obviously, for the first 10,000 years, men did a lot of
physical activity and therefore had a high level of H.D.L., but increased H.D.L.
levels don’t protect your health, it’s the physical activity that keeps you
from falling ill. The L.D.L. is exactly the same, but the other way round, we use
up less L.D.L. when we are sedentary, so the levels rise. But, yet again, it’s a
sedentary lifestyle that’s the killer.

A British clip plays showing a full refrigerator in a middle-class home. A
woman takes a jug full of a greasy substance out.

An Announcer says CERTAIN FOODS ARE HIGH
IN SATURATED FAT. THIS IS THE AVERAGE
AMOUNT OF SATURATED FAT
A PERSON CONSUMES IN A MONTH.
IF YOU EAT TOO MUCH OF THIS,
THEN, OVER TIME, FATTY DEPOSITS
COULD BUILD UP IN YOUR ARTERIES
AND THIS INCREASES YOUR RISK
OF HEART DISEASE.

A clogged kitchen sink appears.

The Announcer continues IF SATURATED FAT CAN
CLOG THIS PIPE, IMAGINE WHAT IT'S DOING TO YOURS.

Doctor De Lorgeril says "Now we have extremely sophisticated imaging techniques
that enable us to measure the quantity of calcium in the arteries, we even take
calcium scores which some researchers say are a better predictor of strokes than
cholesterol levels. Here are some of the factors associated with a higher
calcium score... First of all, diabetes, then kidney failure or susceptibility
to kidney failure, thirdly having a spontaneously low cholesterol level and
fourth of all, taking statins. So right under your noses there’s a terrible
knock to the defence of statins... how can you say that statins reduce the risk
of heart disease... which I don’t agree with... and at the same time acknowledge
the fact that statins increase the calcium score which is considered by many to
be the best predictor of heart disease. They’re just incompatible."

A clip for a product called "Crestor" runs in Spanish.

The Spanish ad says "If your cholesterol level is high and your doctor
prescribed you Crestor, you may be experiencing side-effects such as type-2
diabetes. If you are in this situation, contact us and book an appointment
with our lawyer, Mr Nick Pacheco."

The Narrator says AFTER TEN YEARS
OF THE MASS PRESCRIPTION OF
STATINS, THOUSANDS OF PATIENTS
COMPLAINED OF SERIOUS
SIDE-EFFECTS, TO THE POINT
WHERE, IN THE UNITED STATES,
LAW FIRMS STARTED OFFERING
THEIR SERVICES ON TELEVISION TO
DEFEND THESE PATIENTS.

An ad in Spanish offers legal advice.

Doctor Uffe Ravnskov says "The side-effects appear over time, not straight away.
The body tends to fight against the reduced cholesterol level by producing more
cholesterol and it can take months, sometimes 6 months before undesirable
effects take form. At that point, most people don’t realise that the statins
are to blame. All the symptoms are similar to those that usually affect elderly
people. So if a man goes to his doctor and says
"There’s something wrong with my muscles, they’re painful, I’ve become so weak,"

"How old are you?" asks the doctor.

"I'm 78 years old."

"Well, you see, that’s what happens to everyone when you get old, your
eyesight goes, your muscles weaken and you lose your memory."
And you forget that it could be caused by your drugs."

Doctor de Lorgeril says "Statins, and anti-cholesterol drugs in general, cross
over the blood-brain barrier, which means they enter the brain and disturb the
production of cholesterol within the brain. This has an awful secondary effect
because no one was aware of it until recently, and due to pressure from certain
doctors and toxicologists, the health authorities finally admitted that statins
could cause memory problems, sleep disorders and therefore neuro-toxicity.
Unfortunately, despite being a major toxic factor, its effects are still
underestimated. We must not forget that Alzheimer’s disease starts with memory
problems, sleep disorders and therefore you can say that statins - although
additional studies would obviously be required... almost push us towards
Alzheimer’s disease, especially since statins are diabetogenics and diabetes
is a major risk factor for developing Alzheimer’s, some people even say that
Alzheimer’s is a type-3 diabetes."

A woman in her forties with long brown hair speaks. A caption reads "Doctor
Beatrice Golomb, Professor of Medicine."

Doctor Golomb says WE
PUBLISHED A CASE SERIES OF 171
PEOPLE WITH COGNITIVE ADVERSE
EFFECTS ON STATINS.
AND SOME OF THESE ARE QUITE
COMPELLING AND TROUBLING CASES.
THERE WAS ONE INDIVIDUAL WHO
WAS A RETIRED PROFESSOR IN
MULTIPLE DIFFERENT DEPARTMENTS
WITH A REPORTED IQ OF OVER 180
WHO HAD ACTUALLY BEEN
IDENTIFIED BY TWO ACADEMIC
INSTITUTIONS AS HAVING THE
RAPIDLY PROGRESSIVE FORM OF
ALZHEIMER'S DISEASE.
AND HE ACTUALLY WENT TO A
50-YEAR SCHOOL REUNION WITH A
SIGN AROUND HIS NECK SAYING,
"MY NAME IS... I HAVE ALZHEIMER'S,"
SO THAT PEOPLE WOULD UNDERSTAND
WHY HE WOULD REPEAT THE SAME
SENTENCE AGAIN AND AGAIN AND
WOULDN'T RECOGNIZE PEOPLE HE'D
KNOWN CLOSELY FOR DECADES.
HE ALSO COULDN'T READ MORE THAN
A PAGE OF TEXT BECAUSE HE
COULDN'T REMEMBER WHAT HE'D READ.
AND THEN HIS WIFE DECIDED TO
STOP HIS SIMVASTATIN AND HE
APPEARED TO SCREEN FOR AN
EXPERIMENTAL DRUG TRIAL FOR
ALZHEIMER'S AT ANOTHER UNIVERSITY.
AND THEY REASSESSED HIM.
AND THEY SAID, NOT ONLY DO YOU
NOT HAVE ALZHEIMER'S... YOU DON'T
HAVE DEMENTIA.
AND BY HIS RECKONING IT WAS
ABOUT TWO YEARS BEFORE HE WAS
ALL THE WAY BACK TO NORMAL.
BUT BY THEN HE WAS BACK TO
READING THREE NEWSPAPERS A DAY.
THE NEW YORK TIMES, THE WALL
STREET JOURNAL AND WASHINGTON
POST ONLINE.

Doctor Rabaeus says "The main experts, particularly an English group who’ve
carried out studies on cholesterol, have been saying for many, many years that
‘no, there aren’t any side effects’. But now, one of them has admitted that yes,
there was probably an increased rate of diabetes. We’re gradually seeing more
and more side effects being identified. Why? One, because we didn’t take it
into account before and two, because people have been taking them for over 10-15
years and the effects are now plain to see.

A clip shows an elderly woman with a pair of shapely legs emerging from a limo.
Captions read "Height, five foot nine, weight 130, dress size 6, total cholesterol
273." She drops, evidently having a seizure.
[cheers, applause]

Doctor de Lorgeril holds up a document and says "On this graph, which is taken from an article published
in 2004 in the British Medical Journal, a very credible journal, we have the
years here and the incidence, or the number of hospitalisations for heart
attacks in the United Kingdom in red. You can see that the curve for heart
attack remains fairly flat, whereas there’s literally an explosion of statin
prescriptions. Obviously, if statins were effective in preventing heart attacks,
there would have been a reduced number of hospitalisations for heart attacks,
in other words, the red line should have crossed the statin prescription line.
But that’s clearly not the case at all."

On a clip, a News Anchor says GOOD MORNING.
THIS IS BIG NEWS FOR PEOPLE
WITH HIGH CHOLESTEROL, WHO ARE
ON STATINS BUT WHO HAVE STILL
NOT BEEN ABLE TO LOWER THEIR
BAD CHOLESTEROL ENOUGH.
THIS NEW CLASS OF DRUGS, IT
WORKS IN AN ENTIRELY DIFFERENT
WAY AND THE NEW STUDIES SHOW IT
CAN LOWER BAD CHOLESTEROL IN
THESE PEOPLE AN ADDITIONAL 60 PERCENT.
THAT'S HUGE! BUT THE DRUG ISN'T FOR
EVERYONE... IT NEEDS TO BE GIVEN
BY INJECTION EVERY TWO TO FOUR
WEEKS AND ALMOST 30 PERCENT OF
THE PEOPLE IN THE STUDY HAD TO DROP OUT.
BIGGER STUDIES ARE BEING DONE
NOW TO DETERMINE WHETHER THESE
DRUGS TRULY REDUCE THE RISK OF
HEART ATTACK AND STROKE, WHICH
IS REALLY WHAT WE'RE AFTER AND
WHETHER THEY'RE SAFE.
HOWEVER WE'VE BEEN TALKING TO
CARDIOLOGISTS ALL WEEKEND, AND
THEY'RE VERY EXCITED ABOUT
THESE DRUGS AND THE F.D.A. IS
EXPECTED TO RULE ON AN
APPLICATION FOR APPROVAL LATER THIS YEAR.

Doctor De Lorgeril says "Some people want to sell new drugs that lower cholesterol
levels even further and they are the ones with the power. They have both the
financial resources to impose and sustain this theory, they also have their
political and administrative connections, etc. and then there’s a small group
of people who can be considered alternative, who say no! The jokes are over,
we have enough scientific data to say that it's not true. This group of people
is winning because it’s the fight between the old and the new and the new always
wins. We’ll just have to see whether the new generations carry it on.
But the battle will be hard."

A full-screen caption reads "Consult your doctor before stopping
any medical treatment."

On a small screen, an Interviewer says DO YOU KNOW
YOUR NUMBER?

Nina Teicholz says WHAT NUMBER?

The Interviewer says YOUR
CHOLESTEROL NUMBER.

Nina Teicholz says I DO.
I HAD THEM TESTED FOR NIGHTLINE.
THEY'RE ON MY WEBSITE.

Harvey Levenstein says NO.
DON'T HAVE A CLUE.

Uffe Ravnskov says I'M A MEMBER
OF A FAMILY WITH FAMILIAL WITH
HYPERCHOLESTEROLEMIA, SO IT'S
BETWEEN 7 AND 8.

Doctor De Lorgeril says "Yes I do, because my patients ask me."

Henry Blackburn says I DON'T
KNOW WHAT IT IS NOW.

Sally Fallon says MY TOTAL
CHOLESTEROL WAS 189.
I WISH IT WERE A BIT HIGHER.

Doctor Jeremy Greene says NO, I
ACTUALLY DO NOT KNOW MY
CHOLESTEROL NUMBER.
ONE OF THESE DAYS.

Gary Taubes says I SHOULD,
BUT I DON'T.

Beatrice Golomb says NO.
WHY SHOULD I?
I DON'T THINK THAT THEY HAVE
ANY IMPLICATIONS ON MY...
[laughs]

A German doctor says "I don't know my cholesterol level, or let's say I forgot
it. for various reasons I've suppressed that memory."

(theme music plays)

The end credits roll against clips on a small screen.

"to my father"

Directed by Anne Georget.

Head of Production, Dan Weingrod.

Quark Productions, Juliette Guigon and Patrick Winocour.

ARTE G.E.I.E. Head of Programming, Philippe Muller.

ARTE G.E.I.E.... Quark Productions 2016.

Watch: Cholesterol: The Great Bluff