Have you heard the adage ‘don’t believe what you read’? In the area of health I believe this is generally good advice. Trawling through newspapers has convinced me that much of what is written about how best to manage our health is based more on science fiction rather than fact. I believe this applies as much to anything else to the constant drip-feed of information we get about cholesterol and its supposedly artery-clogging effects. By way of example, take a look at this article which appeared in the on-line version of The Telegraph – a British ‘broadsheet’ newspaper. At first sight, it looks just like any other on-line article. For one thing, it’s written by ‘Telegraph journalist’ ‘Chris Jones’.
Ms Jones tells us how downing cholesterol-reducing Flora pro.activ drinks each day has helped her get her cholesterol levels down to a “much better figure.” Pieces of this nature have long been used by companies to legitimise and add credibility to their products by blurring the lines between editorial and advertising – that’s why they’re called ‘advertorials’.
The risk with advertorials is that they will promote the benefits of the product being pushed, and fail to mention some important failings. So, please allow me to fill in the blanks that Chris Jones appears to have left…
First of all, products like Flora pro.activ are sold to us on the basis of their cholesterol-reducing ability. My attitude to this is ‘so what?’ That’s because the impact that a food or anything else has on cholesterol is irrelevant – it’s the impact it has on health that counts.
So, here’s what you need to know: taking dietary steps to reduce cholesterol simply hasn’t been shown to have broad benefits for health. For example, cholesterol-reducing diets have not been shown to prevent deaths, even in those who are deemed to be at high risk of heart disease. This, quite frankly, is where our faith in cholesterol-reducing foods should come to a shuddering halt. Except, of course, if there exist financially motivated reasons for keeping the faith alive.
Here’s another thing: while Chris Jones tells us her cholesterol levels came down to a better level, there is a distinct absence of detail here. What were her levels before and after? I suppose those interested for more detail and about the test results and perhaps put some counter evidence could contact Chris Jones.
However, there is no facility for comments at the end of the piece. No email address for Chris Jones either. So, I searched the Telegraph site for lists of its journalists and found this [http://www.telegraph.co.uk/journalists/]. Oddly, no one by the name of Chris Jones is listed. How about bloggers [http://www.telegraph.co.uk/comment/blogs/]? No mention of a Chris Jones there either. And neither can I find other pieces written by her on the Telegraph website.
What we have here, it seems, is a biased and detail-free advertorial exalting the benefits of a cholesterol-reducing product with no proven health benefits written by someone who is untraceable. Like the evidence that taking dietary steps to reduce cholesterol benefits health, it looks like Chris Jones does not exist.
One will be far healthier(and saner) if you ignore all medical advice from the mainstream media. The companies assign the bottom of the barrel to the health beat and it is considered a disgrace to be so assigned. This is a major reason the media is always wrong.
What is scarier to me is a recent survey I read that said that a majority of doctors get their prevention advice they give us from the media.
Nice article, Dr. Briffa and imagine similar issues with health articles can be found in the US. Not to open a can of worms that is not worth opening, over what I’ve heard. I do have a story that I can tell from first hand experience though. As you might have picked up, at one time I worked in the health food manufacturing field. My family owned a small to medium sized firm. And while most of our clients were of similar size, from time to time we would work with some of the largest companies in the world. The late 90s were an exciting time to be in the supplement business. The industry was booming. And as a result pharmaceutical companies took notice. One day our company received a call about doing some bottling work. The large supplement company that called was working with a pharmaceutical firm to bring a newer product to market. The problem was they were so busy they were not able to bottle the product. So we agreed to do the work for the drug and supplement firm. One day i received a call from the pharmaceutical company telling me to stock up on everything needed for their product, SAMe tablets, bottles caps, labels, etc. The reason was that the company was going to promote the product. The lady added that their company was able to have newspapers and TV stations run articles on their products as news (which in a way I suppose was). And sure enough it happened a few weeks later. Several major magazines, and TV news station ran articles on the supplement SAMe. It was a blitz. And sales went through the roof on one of the most expensive supplements sold in the health food market at that time. I have to admit, and the family still jokes about from time to time, I was not all that happy about the enormous bottling job I suddenly found myself with. As with many family firms I had more than one responsibility. My two main jobs were purchasing and running the bottling room. I couldn’t just hire new people to help quickly as working with food takes time with training. For about 6 months or so about all I did was eat, sleep, and bottle SAMe tablets.
Crazy, isn’t it?! This stuff really bothers me since I have hereditary high cholesterol and there is so much misinformation out there!
Unbielivable!
Yes, it is scandalous.
Actually, such massaging of the knowledge economy is not uncommon, but it is not uncommon for massaging of the knowledge economy to pass unnoticed. Well spotted Dr B, many of us are only aware of this instance because you’ve brought it to our attention.
It is helpful to know if this article or something similar appeared in the print edition of The Daily Telegraph, or if the print edition has carried advertising or Flora margarines after, or in proximity, to this advertorial whose online history traces to 30 June 2011. If anybody has a bit of free-time and fancies doing a bit of research to check back editions .. .. report back, please.
And if anybody wants to read some alternate thoughts on the German centred outbreak of E.coli that focus upon some of the mis-information and mis-perceptions surrounding the outbreak click here.
Hello. I’m getting in touch on behalf of Flora pro.activ. We very much respect Dr Briffa and his comments, but would like to address a few issues raised in the above post.
Firstly, using advertorials to talk about Flora pro.activ. Advertorials are traditionally used to communicate complex messages in an editorial style, in a way that print advertising tends to preclude – usually because there is more text than is appropriate for advertising. Using an editorial style makes it an easily recognisable format for readers to understand, but no attempt is made to hide the fact that this is a paid-for piece of writing. Flora pro.activ has run a series of advertorials with the Daily Telegraph using real-life stories to show how Flora pro.activ, when eaten everyday in conjunction with a healthy diet and lifestyle, can reduce cholesterol levels.
All the advertorials, and indeed all communications from Flora pro.activ, go through a rigorous approval process to ensure that all content is factually correct.
In terms of the importance of reducing cholesterol, let us first look at cardiovascular disease (CVD), which affects the heart and circulation of the blood. Mainly comprising coronary heart disease (CHD) and stroke, CVD is the number one cause of death worldwide, accounting for the deaths of nearly 17.5 million people every year. In 2007, CVD caused approximately a third of deaths in the UK. Every year, coronary heart disease is also responsible for 88,000 UK deaths: approximately one in four deaths in men and one in five deaths in women aged before 75. The major risk factors globally for CVD are from tobacco use, high cholesterol, raised blood pressure, alcohol use, high body mass index, high blood glucose, low fruit and vegetable consumption and physical inactivity. These major risk factors together account for around 61% of cardiovascular deaths. The World Health Organisation (2009) estimate that one third of heart disease is attributed to high cholesterol. Further information can be found here: http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf
Whilst Flora pro.activ does not claim to be able to address all of the risk factors, its active ingredient of plant sterols has been scientifically proven to help in the reduction of cholesterol when eaten everyday in conjunction with a healthy diet and lifestyle. Over 190 studies have proven plant sterols significantly lower cholesterol and it’s the weight of this evidence that allowed the EU authorisation of this health claim under art. 14 of the EU Regulation on Nutrition and Health Claims in October 2009, following the European Food Safety Authority (EFSA) scientific opinion in July 2008. . This claim was one of the first Disease Risk Reduction (DRR) claims to pass the European Commission’s authorisation process , which requires food companies to submit extensive scientific dossiers to support health claims linked to reduced risk of disease . We absolutely agree that simply lowering cholesterol without making wider positive changes to one’s diet and lifestyle will not make a significant positive health impact. As you will have seen in the article published, Chris Jones makes a concerted effort to improve her overall health and fitness levels as we aim to do in all our communications.
We invite you and your readers to visit our websites, http://www.floraproactiv.co.uk or http://www.flora-professional.co.uk to learn more about the extensive scientific proof on the reduction of LDL-cholesterol when eating plant sterols everyday, in conjunction with a healthy diet and lifestyle.
In terms of Chris Jones from the Daily Telegraph, Chris is actually the Content Editor of the Telegraph. She was referred to as a journalist so that it was easier for readers to understand that she worked and wrote for the Telegraph. We would be happy to put you in touch if you would like to speak with her directly.
Regarding the fact that her final cholesterol levels were not included in the piece, whilst we appreciate that may seem odd, it’s actually because the results were so dramatic. Scientific proof shows that plant sterols in Flora pro.activ can reduce bad (LDL) cholesterol by up to 15%, when eaten everyday as part of a healthy diet and lifestyle. In some cases people will see a much more dramatic drop in cholesterol levels. This was the case for Chris Jones – her cholesterol levels reduced by significantly more than 15%. However, we are very careful not to communicate any results that show more than a 15% reduction as we do not want to implicitly claim that plant sterols can reduce bad (LDL) cholesterol by more than 15% as there isn’t scientific proof to support such a claim.
Finally, we notice that one of your readers has queried whether this article appeared in print. It did, and was published in Stella magazine on 26 June.
We hope that the above addresses all of your questions, but welcome any further correspondence and would be happy to answer any questions.
Kind regards,
Clare Smith
Thanks for your response, Clare. Would you mind clarifying your role regarding any company that makes or markets Flora pro.activ?
“All the advertorials, and indeed all communications from Flora pro.activ, go through a rigorous approval process to ensure that all content is factually correct.”
Who performs this approval process? Is it independent of Flora pro.activ employees and the publication that is being paid to run the advertorial?
More than once you refer to Flora.pro.activ’s ability to reduce cholesterol levels in conjunction with a healthy diet and lifestyle. Pharmaceutical companies, in contrast, do not qualify the cholesterol-reducing properties of their drugs by tacking on ‘when taken in conjunction with a healthy diet and lifestyle’. Has there been any attempt to assess the cholesterol-reducing properties of Flora pro.activ (and no other intervention) compared with placebo?
More importantly, though, what evidence do you have that taking Flora pro.activ is beneficial to health (say, in terms of reduced risk of heart disease, heart attacks or risk of death)? You might be aware of research linking sterols with adverse health effects. Perhaps we come onto that once we’ve clarified the position regarding the purported health benefits of these compounds.
“We absolutely agree that simply lowering cholesterol without making wider positive changes to one’s diet and lifestyle will not make a significant positive health impact.”
Flora pro.activ is sold on the basis that it can reduce cholesterol levels. If cholesterol-lowering is of limited value, then this is true, surely, of any product that reduces cholesterol? Would you care to comment?
I’m relieved that Chris Jones is a real person and would like to take you up on your offer of having direct contact with her. Could you email her phone number and email to john@drbriffa.com. Can you confirm that the photograph that appeared in the Telegraph is of Chris Jones? Thank you.
I note what you say about some people’s cholesterol levels dropping more than the average when using Flora pro.activ (I assume, ‘in conjunction with a healthy diet and lifestyle’). Of course, this throws up the distinct possibility that while cholesterol levels will drop significantly more than the average, others will find that their cholesterol levels will drop by much less. Would you agree?
Hello Clare,
The advertorial suggests the ‘journalist’ who, forgive me for so clarifying, is not a journalist at all but a ‘Content Editor’ ate chicken breast, ‘without the skin’. What would constitute the basis of the wisdom, or perceived wisdom, in this choice and action? Does Ms Jones have experience, formal training, or knowledge or access to advice that could render such a decision, informed and objective? Did Ms Jones have much involvement in assembling the copy? Ms Jones is referred to in the third person, dod someone else assemble the copy and was that someone else in any a journalist? Is the copy the result of the travails of a person whose work is more inclined to marketing?
Sterols and their effects interest me, for public health interests me greatly, could you report with the answer to the question; ‘from where do the plant sterols, the active ingredient in Flora pro.activ, come from? What ‘plants’, what geographical location, and what process explains how they come to be in Flora pro.activ?
VBR
Chris
.. in any way a journalist .. ?
I couldn’t resist commenting on this especially after the reaction from the Flora Pro-active employee. I bet she herself is not aware that the ingredient they love about this product is nothing more or less than “wood pulp effluent”. Yes, really! “wood pulp effluent”. Read here and keep well away from this stuff.
http://www.westonaprice.org/modern-foods/576-toxins-on-your-toast
Glenice
Oh, but you’ve got to have your Flora..
How did people managed to lower cholesterol previously? it’s always been around!.
The thing that annoys me is why replace one bad habit ( using spreads ) with another? ( a ‘healthy’ spread’.
Arghhh. people so so easy to brainwash it’s unreal!
You only have to watch ‘Embarrassing Bodies’ to realise that some Doctors are still relying on the BMI, and low fat recommendations to overweight people.
IO am afraid it’s a fact of life that will never be reversed, because the mantra has been drummed into Medical Sudents’ brains for too long. It is like trying to convince people that their particular God doesn’t exist. They will never see any other alternative. My Cholesterol was recorded at just 5.2 My Doctor said it was below average. That is more or less what it has always been. I eat meat and fish of all kinds. I don’t remove the skin from meats. I eat butter, eggs and cheese. I am losing weight! For the first time in 20 years I am really losing weight! Thanks Dr. Briffa.
JW
Good and important article, credit to you a g a i n
Dr John! Many years ago here in Australia when Flora Proactiv margarine hit the shelves with the claims of cholesterol reduction I was ignorant at the time of the extent of corruption and pharma propaganda but were skeptical of the hype and asked for evidence. I asked if I take the stuff as instructed will my blood test show the reduction? I just became aware of the cholesterol con and the statin lies and dangers. I newer got a reply. It does not matter now, as we know cholesterol is not the problem, in fact suppressing it with drugs we suppress CoQ10 production as well AND IT IS DETRIMENTAL BIG TIME! The problem is chronic sub-clinical (or silent) inflammation provoked by environmental assaults of chemical toxins, bacterial and viral infections, nutritional inadequacies, pollution, metabolic unbalances, drug side effects and mental stress that sets in motion of the cascade of events ending in atherosclerosis.
Be well!
joseph
I’ve gone for the healthy diet and lifestyle route for my well being.
That definitely means no Flora products of any kind!
Surely; If this ‘spread’ really did have any effect at all – It’d have to come with a warning for pregnant women not to take it…..
This omission alone tells me that it is pure rubbish.
Anyone who still thinks that we should all be cutting our cholesterol should read this:
http://www.zoeharcombe.com/2010/11/cholesterol-heart-disease-%E2%80%93-there-is-a-relationship-but-it%E2%80%99s-not-what-you-think/
Would be interested to hear what Claire Smith from Flora thinks of this….
If anyone actually wants to plot Cholesterol vs CHD and total mortality (The data is all on the WHO site) will find a relationship.. An inverse one! Particularly in women
WOMEN DO NOT NEED STATINS – Nor does anyone really though!
Which ‘Telegraph’? There are many regional papers called the something-Telegraph.
I would steer clear of sterols as they may be more harmful than helpful. http://www.trackyourplaque.com/blog/2009/09/do-heart-healthy-sterols-cause-heart-disease.html
Thanks for exposing the use of advertorials. It doesn’t really matter which product it is. This fake reporting is just advertising and should be recognized as such.
Clare Smith
As you can see, your response has caused more questions to be posed. You say you welcome further correspondence, and are happy to answer any questions. Can I hold you to these statements, please?
Delores
The Daily Telegraph (linked to in blog post)
What Dr Briffa has exposed is yet another example of the media industry doing anything to sell something, – presumably Flora provided some finance to ‘help’ this advertorial along?
Murdock and his misuse of media power is simply the tip of the iceberg, and Rupert Murdock’s protestations of innocence (I believed it to be honest) are like Clare Smith’s in only underpinning many peoples’ recognition that such articles are a big scam.
And to think that Guinness are prohibiited from saying “Guiness is good for you”, when insiduous, misleading articles like the Flora advertisement (for that’s what it is!) are freely permitted.
In 1975 I caused a row by refusing to eat so called ‘healthy’ Flora instead of butter, on the premise that butter was natural and Flora was ‘bu****ed about with.
I have never regretted my decision, and since then many have followed my example.
Thanks for your response, Clare. Would you mind clarifying your role regarding any company that makes or markets Flora pro.activ?
Certainly. To clarify, I work for Lexis PR, and we handle public relations for Flora pro.activ.
Approval process
The approval process for the advertorials is overseen by Unilever, who takes its marketing responsibilities very seriously. In all cases Unilever obeys the laws of the countries in which they operate and, more broadly, they behave with honesty, integrity and openness. Unilever’s internal control procedures require sign off by both the in-house legal team and nutrition team who are both aware of and adhere to all relevant legislation.
The relevant legislation is the Nutrition and Health Claims (England) Regulations 2007. These bring into force Regulation (EC) No. 1924/2006 of the European Parliament and of the Council on nutrition and health claims made on foods.
This Regulation ensures that any nutrition or health claim made on foods’ labelling, presentation or marketing is clear, accurate and based on evidence accepted by the scientific community.
There is a Register of permitted health claims http://ec.europa.eu/food/food/labellingnutrition/claims/community_register/authorised_health_claims_en.htm where you can see that the claim “Plant sterols have been shown to lower/reduce blood cholesterol. High cholesterol is a risk factor in the development of coronary heart disease.” is permitted.
Assessing the cholesterol-reducing properties of plant sterols compared with placebo
There have been over 40 clinical studies, most of which were placebo-controlled. We invite you to visit http://flora-professional.co.uk/plant_sterols.asp for further information on the scientific reviews that have been undertaken
Flora pro.activ is sold on the basis that it can reduce cholesterol levels. If cholesterol-lowering is of limited value, then this is true, surely, of any product that reduces cholesterol? Would you care to comment?
Lower cholesterol is not of limited value and has been recognised as a major risk factor in developing cardiovascular disease, which is well documented by the WHO and, as already mentioned, supported by the EFSA. Therefore Flora pro.activ products are not of limited value and have been clinically proven to lower cholesterol. Also these products are of even greater value when taken in conjunction with other steps to support a healthy lifestyle, such as eating a healthy diet and taking exercise.
Chris Jones
I can confirm the photograph is of Chris Jones. I will email you with her line manager’s contact details.
When cholesterol levels will drop significantly more than the average, others will find that their cholesterol levels will drop by much less. Would you agree?
You’re right, as previously mentioned Flora pro.activ is proven to help lower cholesterol by up to 10% and an additional 5% when moving to a healthier diet and lifestyle in the general population.
Sterols and their effects interest me, for public health interests me greatly, could you report with the answer to the question; ‘from where do the plant sterols, the active ingredient in Flora pro.activ, come from? What ‘plants’, what geographical location, and what process explains how they come to be in Flora pro.activ?
Plant sterols come from vegetable oils such as sunflower or soy, as well as tall oils. Depending on the time of the year, they are sourced from different geographical locations. Plant sterols are added as part of the spreads-making process
1. Daily fluctuations in cholesterol levels, the margin of error in lab results and confounding variables such as dietary modification would make the claim of a 10% reduction in cholesterol impossible to verify.
2. The claim does not mention a time period for the 10% reduction. How many buckets of Flora do I need to ingest to get a 10% reduction in cholesterol?
3. Reducing cholesterol might not be a good thing if it brings down HDL levels.
4. Overall harm from ingesting polyunsatured fatty acids might be considered greater than the benefit of a 10% reduction in cholesterol.
Briffa has identified a fraudulent misrepresentation.