When I finished medical school, I had a solid foundation in physiology, pathology, pharmacology, and more. However, I didn’t fully grasp the importance of reviewing evidence and understanding what evidence-based medicine truly meant.
The Influence of Ideologies
Early in my career, I could be swayed by ideologies or potential mechanisms rather than real evidence. Ideologies and mechanisms can sound persuasive and convincing, and I even fell for some bogus conditions like adrenal fatigue or the supposed benefits of juice “cleanses.”
The Reality of Scientific Evidence
In reality, the only way to know if something is true is to conduct studies in actual humans and look at hard outcomes. A mechanism or ideology is just a hypothesis, and most hypotheses in science end up being wrong. Randomized controlled trials (RCTs) are the gold standard, but they aren’t always possible. For example, no one is going to conduct a lifelong nutrition RCT, so sometimes observational studies are still very important.
Cholesterol and Heart Disease
One ideology I often hear is that we need cholesterol for our cells, including our brains, to function. Therefore, some argue that we shouldn’t worry about high cholesterol causing heart disease or lowering high cholesterol with statin medications. This statement is based on ideology, not evidence. Lower LDL cholesterol has a clear association with lower heart disease risk. Furthermore, statins in the right population have been shown to decrease heart disease risk significantly. For example, in people with diabetes, statins decrease overall mortality and cardiovascular risk by 50% in a study of 5000 people.
The Importance of Expert Advice
Heart disease remains the number one killer of Australians, and the tragic death of Shane Warne demonstrates that it can occur in younger people who appear fit and healthy. This is not to say that everyone should go on a statin, but it’s crucial to get your health information from experts based on evidence rather than social media and ideologies that push an anti-medicine agenda.
For reliable information, the Heart Foundation Australia has great resources, and my favourite Instagram heart doctor is @daniellebelardomd ❤️