By Marika Sboros
The Guardian newspaper in the UK has been haemorrhaging readers for years.
The newspaper’s recent uncritical support for medical orthodoxy and dogma around diet, nutrition, drugs and cardiovascular disease hasn’t helped. Its treatment of ongoing controversy around cholesterol-lowering drugs known as statins is raising red ethical flags.
British cardiologist Dr Aseem Malhotra, is demanding that The Guardian retract its online article by health editor Sarah Boseley. The headline: Butter nonsense: rise of the cholesterol deniers.
Malhotra has lodged a written complaint with The Guardian’s editor in chief, Katharine Viner. He has included the UK’s Independent Press Standards Organisation’s Board and Complaints Committee.
‘Hatchet jobs’
He says that Boseley’s article is misleading, inaccurate, distorted and defamatory. He calls it a “hatchet job”. If The Guardian does not retract the article, it will “continue to cause significant damage to public health with a negative effect on millions of people”.
The Guardian has a “duty to monitor independence”, Malhotra writes. “Never more so than when reporting on issues when lives are at stake”.
Top medical doctors agree with him. Malhotra’s letter of complaint includes comment by BMJ (British Medical Journal) editor in chief Dr Fiona Godlee.
Godlee says Boseley’s article “seemed to be a blatant attempt to suppress that debate by attempting to discredit those who question the merits of statins in people at low risk of heart disease”.
It was “misleading and fell well short of the standards for accuracy or impartiality expected of a credible and trusted publication”, Godlee says. It warrants “at least very substantial correction”.
Sir Richard Thompson, past president of the Royal College of Physicians and former personal physician to Britain’s Queen Elizabeth, agrees. He says that there is currently scientific debate on whether cardiovascular disease is closely related to blood cholesterol levels. There is also debate on the frequency of statins side-effects. And whether benefits are large enough to justify widespread prescription.
Big Pharma’s ‘criminal acts’
“Attacking doctors who genuinely hold opposite views, such as labelling them ‘cholesterol or statin deniers’, should be no part of this healthy debate,” Thompson writes. “Rather, we must all try to move towards a scientific consensus for the benefit of patients.”
Last year, Malhotra spoke alongside Sir Richard in the European Parliament on over prescription of medications, including statins. Sir Richard has criticised the drug industry for “criminal acts” and called for an independent inquiry into how drugs are approved. He has also called statins “a total fraud”.
BMA (British Medical Association) Board of Science Dr JS Bamrah has also tweeted support for Malhotra. He said: “@sarahboseley is changing the face of medical journalism by such biased, crude, one sided reporting. I just wonder what her incentive is to attack you (referencing myself) in this way. Might she be too cosy with the other side? Can’t think of any other motive.”
Even Boseley’s colleagues have been critical of her article. Unusually, two well-known, respected female Guardian columnists on food and health sent Malhotra unsolicited messages of support.
‘Character assassination
One called the article “shockingly bad”. Another said she had “never seen a character assassination that long minus a quote from the subject under attack”. She added: “I certainly would never get away with that.”
Of course, The Guardian is not alone in what many critics see as “gutter journalism”. The Mail On Sunday did something similar in an article by health editor Barney Calman. Calman targeted Malhotra as well as Scottish GP Dr Malcolm Kendrick and public health researcher Dr Zoë Harcombe.
Statin ‘deniers’?
He called them statin “deniers”, despite their well-documented, evidence-based views on statins. Calman’s reporting has also dragged Britain’s Health Secretary, Matt Hancock, into the statins debate.
However, Malhotra, Kendrick and Harcombe don’t deny that statins have benefits. And as Malhotra told iNews recently, the key point is whether benefits outweigh side effects of the drugs for the patient?
“In many cases, they don’t,” he said.
Thus, the most important issue is ensuring that patients are fully aware of absolute benefits and risks. That, therefore, allows them to make an informed decision on whether to take or stop the drug.
“This is the ethical practice of true evidence-based medicine,” Malhotra said.
(Click here to read a full version of Malhotra’s letter. You can also find it on Facebook.)
Malhotra says that his letter of complaint comes from a background as a once “proud Guardian contributor”. Since 2008, he has written 19 opinion editorials for the newspaper group.
His contributions include three front-commentaries in The Observer on the topics of hospitals selling junk food. Topics covered include dangers of “too much medicine“ and the threat posed to population health of excess sugar consumption.
Ruffling feathers …
In so doing, Malhotra has clearly ruffled many feathers among medical doctors and professors. It’s probably no coincidence that many are heavily conflicted with close links with food and drug industries.
In making the case for retraction, Malhotra says that Boseley’s intention in writing her article was not just to undermine his credibility. She sought to “undermine other respected doctors, scientists and courageous medical journal editors whose primary purpose is”to advance legitimate scientific debate and improve population health”.
He says that the Guardian would benefit from an internal investigation into Boseley’s article. This would prevent a recurrence and maintain its credibility as one of the most trusted newspapers in the UK.
In her article, Boseley calls Malhotra a “young telegenic cardiologist working in private practice”.
Yet, as he points out, the vast majority (>95%) of his clinical work is seeing patients in the NHS. He sees only a small number of private patients in Harley Street on an ad hoc basis.
Boseley also made inquiries, several days before publication of her article, to the head of communications of the respected independent health think-tank, The King’s Fund. She asked whether Malhotra was still a Fund trustee and why he was appointed ahead of other candidates.
The head of communications emailed an extensive reply explaining that Malhotra is a practising clinician and a public health campaigner, and both roles are relevant to his appointment.
Malhotra’s profile is on the King’s Fund website. It includes a reference to his Honorary Consultant Cardiologist role in the NHS. Boseley omits any mention in her article.
Pioppi Diet
Boseley also focuses on Malhotra’s book, The Pioppi Diet, citing comment from the heavily conflicted British Dietetic Association (BDA). The BDA called it one of their “ five worst celeb diet books in Britain”.
Malhotra points out that this is the same BDA that openly declares itself “delighted to work with the sugar bureau”. The BDA also has corporate sponsors from the ultra-processed food and drink industries.
Boseley fails to mention the many independent, respected doctors, scientists and dietitians who endorsed Malhotra’s book. They include the Chair of the Academy of Medical Royal Colleges, Professor Dame Sue Bailey. Bailey called The Pioppi Diet a “must have for every household and a must read for every medical student and doctor”.
The former chair of the Royal College of General Practitioners Dr Clare Gerada also reviewed it favourably in the British Journal of General Practice. Gerada said that the book is “not just a guide for individuals to rapidly improve their health from making simple lifestyle changes”.
It also “explains why policy changes to improve the food environment and our dependence on medicines also needs to happen. In addition, a revision of dietary guidelines is required to reverse the UK’s obesity epidemic and sustain the NHS.”
Malhotra also finds it “odd” that Boseley finds space and time to mention Andy Burnham and Keith Vaz MP as “trying the (Pioppi) diet”. She fails to mention the most high-profile politician who endorsed the diet: deputy Labour Party leader Tom Watson. Watson lost almost 100lbs in less than a year following the plan. He also sparked media headlines for using the diet.
Statins debate
And Boseley omits to mention that Malhotra has declared that he is giving all personal royalties for book sales to charity.
She also quotes one of the UK’s major statin supporters, Professor Sir Rory Collins, of Oxford University. She repeats Collins’ concerns that media scaremongering on statin side effects is endangering lives.
Unlike Collins, an academic who does not see patients, Malhotra has prescribed and managed thousands of patients taking statins for close to two decades.
“It is doctors on the front line that have gained the greatest insight into the side effects that interfere with the quality of life for many patients,” Malhotra writes.
Boseley implies that those questioning the conventional cholesterol hypothesis and the value of mass prescribing of statin drugs are a small vocal minority. And that this small minority lacks credibility, in comparison to the “unbiased” experts she has chosen, Malhotra writes.
That is clearly not the case.
It is also clear, as Malhotra describes it, that the controversy around statins has become “a complete mess”.
Statins are the world’s most prescribed drug and the pharmaceutical industry’s most lucrative billion-dollar, blockbuster drug ever. For example, in the UK alone, more than 6-million people take statins. The drugs do have a well-documented role in secondary prevention of heart attack and stroke. However, robust evidence suggests that in some cases, risks outweigh benefits.
‘Legitimate questions’
Malhotra stresses that there are now “legitimate questions” over whether statins offer any benefits in high risk/secondary prevention”. French cardiologist Dr Michel De-Lorgeril goes further and is “convinced there are none at all!”
De-Loregil is author of Cholesterol and Statins: Sham Science and Bad Medicine.
The Guardian does appear to be in need of extensive reputation rehabilitation, say its critics. Recent revelations that an animal activist group paid the newspaper a whopping US$886,600 to publish a series of articles have not helped its image.
- To read Malhotra’s complaints letter in full, click here.
- Attempts to reach Viner and Boseley for comment via phone and email yesterday were unsuccessful. The company’s spokespeople said both were unavailable. An automated email from Boseley said she was on leave and would not be accessing emails.
- EDITOR’S UPDATE: The Guardian has responded via email today to say: ‘A complaint has been passed to our independent readers’ editor.’
- Follow me on Twitter @MarikaSboros
- Like my Facebook page
I’m one of the many people who have been prescribed statins (this was after having a stent fitted) and suffered accordingly.
I knew NOTHING about statins so assumed (as one would), that the doctor had prescribed something that was going to be helpful.
Soon after I’d started taking them, I was out shopping in a huge undercover precinct, having travelled there by underground – the entrance of which happened to be the full length of the precinct away when I was stabbed in the thigh with a dagger, or so it felt.
I managed, barely, to stay on my feet but I came very close to fainting from the pain – it was like nothing I had ever experienced before; it made severe cramp seem like a flea-bite.
It took me around 15-20m to be able to move off ((I’d been leaning one-legged against a wall), hobbling very gingerly in the direction of the underground station.
I live or die by my computers (I fix them for a living), so started searching for what could have caused the problem when I did eventually get back home (had to take a taxi from the station – I simply couldn’t have walked).
Statins seemed a likely cause. More research; stations seemed a highly likely cause. Visited my local doctor whose solution was to try a different statin, saying something along the lines of, “We’ll find something that works for you”. In the months and years that followed, I’ve been harassed (to lesser and greater degrees) by a whole range of doctors, including a vascular consultant, for being unwilling to take statins – and not one of them was able to point me to any good research showing any valid reason for taking them.
What was their motivation; or was it simply ignorance and following whatever they has been taught, rather than thinking for themselves?
Hi Bob, thank you for sharing your personal experience.
Just read the article on CNN https://edition.cnn.com/2019/03/27/health/statins-eligible-adults-study/index.html.
Where one Dr. Amit Khera commented on risks and benefit of statin talking very ‘clinically’ as it doesn’t affect him.
Quote:
Weighing the risks and benefits of a lifelong medication like statins is important, says Dr. Amit Khera, director of the UT Southwestern Medical Center’s Preventive Cardiology Program, who was not involved in the study.
When Khera counsels his own patients about statins, the three side effects they most commonly ask about are muscle aches, changes in cognitive function and liver function.
“Statins can cause muscle aches, but even if it’s as high as one in 10 who get muscle aches, that means 9 in 10 will not. For the vast majority, that won’t happen, and it generally goes away when we stop the statin,” Khera said.
As for concerns about cognitive decline, “it is not something seen in large studies, so if it does occur, it is infrequent and hard to separate from the usual cognitive decline of aging,” he said.
Additionally, “we realized over time that minor increases in liver function tests are not clinically significant, as statins very rarely cause serious liver damage for patients,” he said. Unquote
Those statements almost made my blood boil. Clearly he is trying to explain and diminish those adverse effects of statins. For responsible doctors I would expect more. To prescribe a drug which has only a miserable one per cent absolute risk reduction of benefit for future heart attack and this is done by the statin manufacturer using hired guns and after screening out those who cannot tolerate statins before starting the trials is a total failure.
Let us analyse the statements in detail – it is known that statins causes muscle aches – the heart is a big piece of muscle which cannot stop working unlike our legs or hands. The damage done is irreparable and when on statin and trying to say that it will go away when the statin was stopped is highly irresponsible. Patients shall be told to stop statins when they feel muscle aching and lethargic.
It is also a known fact that statins causes new onset diabetes to many patients whio are not diabetic before starting on statins. The thousands of litigation’s faced by the statins manufacturers is something for any responsible doctors to ponder. The statin manufacturers have now included the statement that Statins could cause Type 2 diabetes in patients in their safety instruction for prescribing statins. Diabetes is not easily reversible. Any responsible physician should counsel their patients and check the blood glucose for every 30 min interval (for three hours) the next morning after taking a statin pill the previous night. Glucose toxicity will cause diabetes. And to cover the patients with metformin and give instructions to stop the statin when blood glucose rose. It is of no use to review the blood work of the patient at the next doctor’s visit, which could be another month away. The poor patient having elevated blood glucose at diabetic level will become diabetic at the next visit. This is then misinterpreted as patient developing diabetes unrelated to statins. These so called physicians have basically forgotten the fundamental duties of responsible doctors.
After several years of muscle pains and aches my wife no longer takes any statins and feels a thousand times better. Readings are also well within standard levels, whatever they are nowadays!
The Guardian has become a (vegan) agenda-driven rag. At least the Daily Mail is equal opportunity stupid – Calman’s similar article will be both preceded and followed with the exact opposite POV. The other big difference is that the Mail readers saw through the bias whereas the Guardian did not allow replies from the little people..
Conventional Wisdom is currently losing out in the Real World. Articles like these are The Anointed fighting back. All power to Aseem and the small but increasing number of medical professionals, even including some dieticians, who are moving forward.
Statin is a poison to many people. Just ask those who had a stent or two inserted to open the blocked coronary artery and were prescribed statins to lower cholesterol, many having muscle ache with no strength to do anything. Put on a CGM and start taking a statin, those glucose intolerant and with metabolic syndrome will see clearly that their blood glucose spike into the diabetic range.
The Statin con job would not have succeeded if the present cheap CGM eg the Freestyle Flash glucose meter are available four to five decades back. The majority of present doctors trained under the autocratic medical training system were brained washed by the pharmaceutical sponsored training and most of these MDs have a closed mindset that Statins save lives, which is a blatant lie.
It is an undeniable fact that most people with heart attack are with low or normal cholesterol level. The cardiologists admitted that they dont know the actual cause – only listing high cholesterol as a risk factor! (Where the goalpost for desirable cholesterol level keep changing.)
Many people taking statins have come to realise this and stopped taking this poison. The gravy train is slowing down and stopping, hence the need to do what the tobacco people had been doing resorting to all underhand tactics to boost the bottom line.
Tan, I agree. The increasing availability of glucose monitors is a major blow for dimwitted high-carbohydrate advice to diabetics.
The cholesterol nonsense just provides too much money to give up easily. If there wasn’t so much money involved, it would disappear tomorrow.
When my doctor friends talk about cholesterol I give them a few statistics and ask them to explain why their theory produces the opposite results to those they’ve been taught to expect. Here’s one: in America of 137,000 people, in 541 hospitals, who’d had a heart attack, 78% had below average cholesterol (American Heart Journal, 2009).
The Guardian has behaved like pharma’s useful idiot. The bias is clearly apparent in every mistake in the article, small and large, because they are all intended to be negative.
Those who seek to close down legitimate scientific debate are entrenching harmful practice and delaying improvement.
Jimmy Wales was on the board of the Guardian, I don’t know if he still is. It would explain why Wikipedia and the Guardian both are anti-science and pro-dogma.
Seriously!? That would explain a lot … My interaction with Mr Wales on Twitter shows that he is only about the money. Not much personal or business integrity there.
“In January 2016, Wales, along with Baroness Rebuck, became a non-executive director of the Guardian Media Group”
taken from Wikipedia
I suspect as he wants to turn Wikipedia into mainstream media he is learning from the Guardian how to do this, but I could be wrong
Wow is this going to become Noakes II or Fettke II
It sure sounds like it.
Marika — The Guardian writer is a highly respected journalist — as is The Guardian itself. You demean yourself with your attack on both. This was done without going to her for comment after snagging her off throughout the piece. She may well have erred on this piece but you owe her the ethical nicety of asking her to respond to the attacks. Pat Sidley
You clearly have not bothered to read my article. Therefore, you demean yourself with your presumption and bias against me. I most certainly did go to Sarah Bosely and The Guardian for comment, via email and phone, as is my ethical responsibility as a journalist. Initially, The Guardian said neither Katharine Viner nor Boseley was available for comment. After publication of my article online, The Guardian has just replied to say the complaint has been forward to the relevant editor. I will update my article with that. I suggest you do the ethical thing and read my entire article before commenting further.
Why do you waste your time and everybody else’s by commenting on an article you clearly haven’t read?
“Attempts to reach Viner and Boseley for comment via phone and email yesterday were unsuccessful. The company’s spokespeople said both were unavailable. An automated email from Boseley said she was on leave and would not be accessing emails. If that situation changes, Foodmed.net will report.”
Thank you Marika for doing due diligence!!
Pat, Marika clearly states that she has sought a response from the journalist. Like the Guardian journalist, maybe you should do some basic fact checking.
Statin sales needing a boost, perhaps… ?
Janet agreed and now that Statins are off patent Big Pharma are trying to get their new, very expensive cholesterol lowering drugs onto the market so that they can continue to make money. Why won’t anyone listen to those who are trying to tell the truth?