Cholesterol: the big bluff is a documentary co-produced by Arte and broadcast on the French-German public channel in 2016. It develops an unqualified thesis: the link between cardiovascular diseases and cholesterol would be a vast lie, shaped both by a series of scientific approximations and by powerful economic interests [1]. The audience success will be there with 1.4 million spectators on the day of the broadcast. France Inter praises the work of one of the best French documentarians on issues related to health and its institutions and evokes a universal myth that collapses et a whole section of the pharmaceutical industry and the food industry which is collapsing [2]. Same story in Telerama which talks about the invention of statins by industry, the most prescribed drug of the 2000s as a response to dogma of culprit cholesterol. The magazine claims that this dogma of culpable cholesterol is today so entrenched that its detractors have all the difficulty in the world to convince of its innocence, even with supporting evidence. [3].
In this documentary which claims to give voice to around fifteen specialists – medical researchers, cardiologists, medical journalists, nutritionists, there will never be any question of the strong existing scientific consensus. As soon as it is released, the French Society of Cardiology publishes a long update [4] which traces the history of cardiovascular diseases. It recalls the identification in the 1950s of the major risk factor of high cholesterol levels (alongside tobacco, diabetes and high blood pressure). To be more precise, it is not cholesterol (an essential protein for the functioning of our body) that is involved, but a category of particular proteins (called LDL and sometimes referred to as bad cholesterol) responsible for transporting cholesterol into the blood. cholesterol to the cells that need it.
The French Society of Cardiology then evokes the “statin revolution” 1990s, these drugs “which dramatically reduce LDL cholesterol”. For her, “denying the benefit of statins and their impact on life expectancy is both dishonest (by denying scientific facts) and dangerous (for patients who in good faith will stop their treatment)”. Same protest from the National Academy of Medicine which fears “that the title and content of this documentary, as well as the debate which followed, put the health of many patients at risk by influencing their behavior in a deleterious manner” [5]
Pretty HeartDante Gabriel Rossetti (1828-1882)
Despite the clarifications from health authorities and professional associations of doctors, media campaigns denouncing the use of statins lead many patients to stop their treatment, with dramatic consequences. This is what happened with the publication in 2012 and 2013 of two successful books: The Guide to 4000 useful, useless or dangerous medications Professors Philippe Even and Bernard Debré and The truth about cholesterolby Professor Even, prefaced by Professor Debré. A study concluded [6] that the controversy generated by the publication of these works resulted in an increase in the cessation of their treatment by patients at risk. One of the signatories, questioned by the Why Doctor websitebelieves that these treatment interruptions would have resulted in “between 9,000 and 10,000 more deaths [à l’échelle nationale] in 2013 than in 2011 and 2012 » [7].
In 2016, a major meta-analysis (i.e. an analysis of the available scientific literature) published in The Lancet confirms the numerous benefits of using statins and their limited side effects [8]. But it also made it possible to assess the consequences of disinformation in two countries victims of similar campaigns. In the United Kingdom, 200,000 people are estimated to have stopped their treatment, resulting in between 2,000 and 6,000 additional cardiovascular events. In Australia, 60,000 people have stopped taking statins, leading to between 1,500 and 3,000 preventable heart attacks and strokes.
The French Society of Cardiology recalls that if, until 1994, there may have been a scientific controversy on the benefit of reducing cholesterol (LDL-cholesterol), this ended with the publication of the results of large trials therapeutics and solid meta-analyses [9]. She then gave way to a controversy without rational basisa controversy that Arte chose to rekindle 22 years later. Since then, the benefit/risk ratio of statins to reduce cholesterol levels has been regularly confirmed for patients to whom they are prescribed. A report from the National Academy of Medicine took stock of the subject in 2018 and concluded that this therapeutic class is particularly favorable for the prevention of cardiovascular accidents, particularly in patients at very high risk or with documented cardiovascular disease. [10].
The documentary Cholesterol: the big bluff therefore spreads disinformation with proven harmful consequences. It is still available without any warning on the Arte store. Its director, Anne Georget, subsequently directed Vaccines and men (2022), a documentary that argues that the side effects of vaccines outweigh their benefits. It was also co-produced by Arte and is online on the channel’s store.
References
1| Georget A, Cholesterol: the big bluff (2016). On boutique.arte.tv
2| Devillers S, “Cholesterol, the big bluff”, on Arte: an investigation into the medical history of cholesterol, France InterOctober 18, 2016.
3| Belpois M, Watch the documentary Cholesterol: the big bluffTélérama, October 18, 2016.
4| French Society of Cardiology, Cholesterol and cardiovascular diseases: the scientific point of view of the SFC, MedscapeOctober 21, 2016.
5| Academy of Medicine, « Cholesterol and statinsweb page, December 21, 2016. On academie-medecine.fr
6| Bezin J et al., “Impact of a public media event on the use of statins in the French population”, Archives of Cardiovascular Diseases2017, 110:91-8.
7| Lebrun AL, “Controversy over statins: 10,000 more deaths in 2013, Why DoctorSeptember 12, 2016.
8| Collins R et al., “Interpretation of the evidence for the efficacy and safety of statin therapy”The Lancet, 2016.
9| Heart and Metabolism Circle of the French Society of Cardiology, “Statins and cardiovascular diseases: from the end of the scientific controversy to the end of the controversy?! »2021.
10| Academy of Medicine, “Efficacy and adverse effects of statins: evidence and controversy”rapport, 2018.
