Putrajaya’s demand for an article published in the WHO Bulletin on Jan 8 to be retracted is long overdue but necessary in countering the external anti-palm oil campaign.
But it is miserably short in what our scientists and palm oil researchers should do.
Making ministerial statements, deferral of the Asean-EU partnership and writing to the head of states of EU countries are necessary.
But we have to also fight science with science. Our own experts and researchers in palm oil seem to have lost their ability to speak and write.
The little-known WHO Bulletin article in question, “The palm oil industry and non-communicable diseases”, authored by Kadandale, Marten and Smith, was sensational at best and served only to pander to the current Western anti-palm oil campaign.
The article regarding the palm oil industry was misleading, confusing, and not to the point concerning palm oil and non-communicable diseases. The authors made a poor attempt at linking palm oil to heart disease.
The following are more specific criticisms of the article:
1. The title of the article was misleading. Very little attempt was made to argue on how palm oil was linked to heart disease, other than mere citation of published works.
2. The full text of the article had 10 pages. Nine out of 10 of them consisted of a general discussion on commerce, trade, marketing, supply chain, lobbying by the palm oil industry, and the environment.
Only one page focused on health in general, although at the beginning, the article hinted and made references to heart disease.
3. The authors seem to harbour the notion that saturated fats and low-density lipoprotein (LDL) cholesterol were bad and responsible for ischemic heart disease. Such thinking is not current but stagnated in the era of the 1980s.
4. The authors made reference to the study of Chen et al (2011) that compared the mortality rate from palm oil consumption in developing countries and the developed countries.
Using data from WHO, they pointed out that palm oil consumption in developing countries had a negative impact on heart disease but not stroke. For developed countries, palm oil consumption did not have an impact on both heart disease and stroke.
Chen et al did not consider confounding factors such as other medications taken and diet. The study was poorly designed. Furthermore, it was an observational study and there should be no inference drawn from the study.
5. Kadandale et al blinkered themselves to the latest scientific arguments on the lipid-cholesterol hypothesis of heart disease. There are volumes of scientific reports on the subject based on alternative and parallel hypotheses, and with good refutation of the prevailing lipid-cholesterol theory of heart disease.
Ignoring these current studies and counter-arguments means Kadandale et al have been biased, selective in their citations, and academically dishonest.
6. The authors based their study on outdated WHO and FAO 2003 reports linking palm oil consumption with increased risk of cardiovascular disease. The mid-1990s was the culmination period where saturated fat and LDL cholesterol were believed to be the main causal factor for heart disease. Such thinking was debunked in the first decade of the 21st century.
7. The paper by Demasi et al (2017), “The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance”, published in The Pharmaceutical Journal of the British Royal Pharmaceutical Society, made compelling arguments and pointed to the many flaws in previous studies on lipid/cholesterol hypothesis of heart disease.
8. In 1992, Rath and Pauling put forward their unified theory of cardiovascular disease and showed that cholesterol was not the cause of heart disease, but rather a result of weakened arteries.
Their unified theory emphasised the body’s enzymatic degradation of the connective tissue or collagen matrix by the protease, plasmin.
Rath and Pauling also proposed that the sticky apoprotein transported by the LDL cholesterol, and lysine, were respectively endogenous and exogenous inhibitors of plasmin-induced proteolysis.
Rath and Pauling’s theory was corroborated by Yoshinori Ohsumi, who in 2016 won the Nobel Prize for his discovery of mechanisms for autophagy, the process for degrading and recycling of cellular components. Why did Kadandale et al ignore all these studies?
9. Wong (yours truly), Mohamed, and Niedzweicki, (2016), “Atherosclerosis and the cholesterol theory: A reappraisal”, built on the work of Rath and Pauling.
Another study of ours in 2015, “The effect of multiple micronutrients supplementation on quality of life in patients with symptomatic heart failure secondary to ischemic heart disease: A prospective case series clinical study”, showed positive results even though patients were told to consume coconut oil and palm oil daily. Why were our studies ignored?
The WHO is correct in its decision not to retract the article by Kadandale et al. Only fraud and falsification of data would necessitate such a retraction.