The letter stated that FULL TEXT OF THE LETTER (Cape Times, September 14, 2012) In his book Challenging Beliefs, Professor Tim Noakes takes issue with and contradicts many aspects of conventional wisdom and accepted medical practice. Some of what he says may well be true and his views on the contribution of refined carbohydrates to the obesity epidemic are almost certainly correct. However we believe he goes too far in suggesting that a switch to a high-fat, high-protein diet is advisable for all persons. Such a diet may have allowed him to lose weight and run faster but its widespread implementation is contrary to the recommendations of all major cardiovascular societies worldwide, is of unproven benefit and may be dangerous for patients with coronary heart disease or persons at risk of coronary heart disease. Further his questioning of the value of cholesterol lowering agents (statins) is at best unwise and may be harmful to many patients on appropriate treatment. The very strong evidence is that statins in patients with coronary artery disease improve mortality (they make you live longer). Multiple placebo-controlled studies have confirmed this. Generic statins are now cheap and should be widely used. The side-effect profile of these agents is benign and there is general agreement that their benefits far outweigh any minor risks associated with their use. Noakes is welcome to his views. As an academic it would be appropriate for him to air these and to debate them in an academic forum and the medical literature where they could be critically evaluated and challenged by his peers. To present these controversial opinions as fact to a lay public, in his un-refereed book, is dangerous and potentially very harmful to good patient care. We understand some patients are placing their health at risk by discontinuing statin therapy and their prudent diets on the basis of this “expert opinion”. Having survived “Aids Denialism” we do not need to be exposed to “Cholesterol Denialism”. Scientists and clinicians have an ethical obligation to ensure that the information they impart to their patients and the public at large is correct, in line with best available evidence, and will not cause harm. Patrick Commerford MB ChB FCP(SA) FACC (Professor of Cardiology and Head Cardiac Clinic UCT and Groote Schuur Hospital) Dr Miko Ntsekhe MD PhD FCP(SA) FACC (Cardiac Clinic UCT and Groote Schuur Hospital) Dr Dirk Blom FCP(SA) PhD Lipid Clinic Department of Medicine UCT and Groote Schuur Hospital Professor A D Marais FCP(SA) Chemical Pathology, Clinical Laboratory Services, UCT Health Science Faculty Dr Elwyn Lloyd MD FCP(SA) FACC Cardiologist Dr Adrian Horak FCP(SA) Cardiologist
