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The International Network of Cholesterol Skeptics (THINCS) is a lobbyist-backed think tank, founded and led from 2003 by Uffe Ravnskov that promotes cholesterol denialism. Its primary objective is to promote
denialism "skepticism" regarding the scientific consensus on the lipid hypothesis, the relationship between cholesterol and heart disease, and the deleterious effects of dietary cholesterol.
THINCS has a particular opposition to statin medication, probably because evidence of its efficacy would undermine their agenda. As such, they cherry-pick studies to suggest that statins promote cancer and heart failure, despite the prevailing science tending to show, if anything, a preventative effect.
The Cholesterol Myths
The formation of THINCS was apparently inspired by Ravnskov's book, published under the English title of The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease in 2000. Although respected as an authoritative guidebook for cholesterol "skeptics", this work engages in fallacies and deceptive rhetoric.
Ravnskov misinterprets the term "cause" in a scientific context (hint: it does not mean "sufficient condition"), and thus, systematically argues against a strawman position that respectable scientists don't even hold — i.e. that the amount and type of dietary fat is the only factor determining blood cholesterol, which in turn is the only determinant of atherosclerosis and heart disease, and no other factor matters. Accordingly, at one point, he interprets a statistic of only 80% and not 100% of heart attack deaths being in people with atherosclerosis as a vindication of his theory (it's not.)
Similarly, in citing the Framingham Heart Study and the declining rate of heart-disease mortality in Japan since 1970, he conflates correlation with causation to support his hypothesis that high cholesterol is actually beneficial, while ignoring confounding factors such as malnourishment or chronic illness that simultaneously lower both blood cholesterol and general health outcomes.
2016 systematic review
In 2016, Uffe Ravnskov, Malcolm Kendrick and other colleagues published a systematic review to examine how low-density lipoprotein cholesterol is associated with mortality in older adults. They concluded that "High LDL-C is inversely associated with mortality in most people over 60 years" and since "elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis." The review was criticized for cherry picking data and confirmation bias. Nine of the authors are members of THINCS. The National Health Service noted that "the review searched only a single literature database, excluded studies only available in non-English language, and excluded studies where the title and abstract did not appear to contain information on the link between LDL and mortality in older adults." Medical experts rejected the review's suggestions. Professor Jeremy Pearson Associate Medical Director of the British Heart Foundation commented that "there is nothing in the current paper to support the authors' suggestions that the studies they reviewed cast doubt on the idea that LDL cholesterol is a major cause of heart disease or that guidelines on LDL reduction in the elderly need re-evaluating."
- THINCS homepage
- Harriet Hall. A review of THINCS, Science-Based Medicine
- Robert T. Carroll. Mythbusting the Cholesterol Myths, The Skeptic's Dictionary
- THINCS Homepage
- Prospective Studies Collaboration, et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths, The Lancet, 2007 Dec 1;370(9602):1829-39.
- Hall, Harriet. Cholesterol Skeptics Strike Again, Science-Based Medicine.
- Meijer, Melchior. Statins - Miracle drug or tragedy?
- Ravnskov, Uffe. Evidence that statin treatment causes cancer
- Statins and Cancer Prevention, National Cancer Institute.
- Affilalo J, et al. Statins for secondary prevention in elderly patients: a hierarchical bayesian meta-analysis, Journal of the American College of Cardiology, 2008 Jan 1;51(1):37-45
- Baigent C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins, The Lancet, 2005 Oct 8;366(9493):1267-78.
- Ford I, et al. Long-term follow-up of the West of Scotland Coronary Prevention Study, New England Journal of Medicine, 2007 Oct 11;357(15):1477-86.
- Kendrick, M. et al. "Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review".
- "Study says there's no link between cholesterol and heart disease"
- "Flawed cholesterol study makes headlines"
- "Expert reaction to systematic review reporting lack of an association between LDL cholesterol and mortality in the elderly".