The "Lipid hypothesis" linking dietary saturated fat to heart disease is wrong
The misguided dietary fat-heart disease hypothesis (a.k.a. the "lipid hypothesis") was developed in the 1950s by Ancel Keys in an attempt to prove a causal link between dietary saturated fats and ischaemic cardiovascular disease (CVD), such as coronary heart disease (CHD) and heart attacks. Keys cherry-picked data for his published analysis from only 6 countries, out of the 22 countries for which data was available at the time. This extremely flawed analysis began the push for the "margarine era" and the "low fat" diet by government health agencies, resulting in the obesity and diabetic epidemic of today, not-to-mention making tidy profits for the polyunsaturated vegetable seed oil industry.
Even in today's enlightened era, people are still encouraged to adjust their diet to include less saturated fat and cholesterol (a task that pharmaceutical companies know that we humans are doomed to fail and will thus turn to their drugs to solve the problem).
The lipid hypothesis relies on two parts (both UNPROVEN):
PART (1): Consuming dietary saturated fats increases levels of cholesterol in the blood
PART (2): Having elevated cholesterol levels in the blood causes heart disease
Unproven "Lipid Hypothesis" PART (1):
"Consuming dietary saturated fats increases levels of cholesterol in the blood"
The truth: Dietary saturated fat /cholesterol has little effect on blood cholesterol levels
Blood cholesterol levels are not much affected by diet. A survey of South Carolina adults found no correlation of blood cholesterol levels with consuming foods high in saturated fat and/or containing cholesterol, such as steak, sausages, bacon and other fatty meats, lard, eggs, cheese, whole milk and butter (Lackland et al, 1990). Most people can give up these foods and their cholesterol may not budge a single point. This is because the body can make as much as 1500 grams of cholesterol a day, which may be more than 6 times the amount in the diet.
Even Ancel Keys, the originator of the erroneous dietary fat / heart disease hypothesis (which was based on studies feeding oxidized cholesterol to rabbits, causing their cholesterol levels to skyrocket), admits there is no connection between dietary cholesterol and blood cholesterol:
"There's no connection whatsoever between the cholesterol in food and cholesterol in the blood. And we've known that all along. Cholesterol in the diet doesn't matter at all unless you happen to be a chicken or a rabbit."
- Ancel Keys
Rabbits are herbivores . . . they are not supposed to eat cholesterol, but in contrast, we've been eating it for thousands of years.
Low-cholesterol (non-enjoyable) diet lowered the serum cholesterol by a mere 0 to 4%. So concluded Ramsay and Jackson after reviewing 16 trials using diet in an attempt to lower cholesterol levels. (Ramsey et al, 1991)
No connection was found between the composition of the food and the cholesterol level of the blood in the 1950's Framington study. Almost 1000 individuals were questioned in detail about their eating habits. Drs. William Kannel and Tavia Gordon, authors of the report, wrote: ”These findings suggest a cautionary note with respect to hypotheses relating diet to serum cholesterol levels. There is a considerable range of serum cholesterol levels within the Framingham Study Group. Something explains this inter-individual variation, but it is not diet.” Their results were never published.
High, middle or low blood-cholesterol groups ate the same kind of foods. U. of Michegan meticulously analysed diets over a 24 hour period of >2000 individuals in Tecumseh, Michegan. No differences in dietary fats was found in the participants, when they were divided into 3 groups (low, middle, high), according to their cholesterol levels. Also of interest,those with a low blood cholesterol ate just as much saturated fat as did those with a high cholesterol. (Nichols et al, 1976)
99 middle-aged London bankers accurately weighed and recorded diets over 2 weeks, revealing no connection between food and blood cholesterol levels (Morris et al, 1963)
After 60 years of trying, the proponents of the diet-heart hypothesis have still not been able to prove that dietary saturated fat or cholesterol has anything to do with heart disease.
Unproven "Lipid hypothesis" PART (2): "Having elevated cholesterol levels in the blood causes heart disease"
The truth: "Elevated blood cholesterol levels "are weakly correlated with" instead of "causes" heart disease" (which has quite a different meaning)
Grossly unscientific logic is confusing a weak correlation with cause. Elevated blood cholesterol being weakly correlated with heart attacks does not mean cholesterol causes heart attacks. By way of illustration --- gray hair is correlated with getting older, but it doesn't mean gray hair is the cause of getting old.
There have been literally hundreds of studies done on the association between blood cholesterol and heart disease. Some found a weak correlation, others a weak non-correlation
Half of all heart-attack victims have normal or low cholesterol. Autopsies performed on heart-attack victims routinely reveal plaque-filled arteries in people whose cholesterol level was low.
LDL cholesterol (which is oxidized in the process of healing any damage to a weaked arterial wall) and saturated fat typically constitute less than 25% of arterial plaque.
Large Framington Heart Study debunked the "Blood cholesterol causes heart disease" myth
A Massachusetts, U.S. study ongoing since 1948, directed by the National Heart Institute; originally enrolled 5209 men and women, who had no signs of CVD; participants tested every 2 years. In 1971, 5124 of the original participants' adult children and their spouses were also enrolled in the study.
This most famed study and the one most quoted to support the hypothesis simply concluded that having high blood cholesterol levels was the best indicator for heart disease risk. (And BTW, the correlation factor between blood cholesterol and heart disease was 0.36, an insignificant amount in a study this size, and no other study has found a higher correlation). Considering the results, what they should have concluded, is that none of the factors they looked at predicted heart disease and blood cholesterol was not a significant predictor of heart disease. Note that they did not conclude that cholesterol was the CAUSE of heart disease, which is what has been erroneously quoted. (Maybe, someone needed to justify the mega-cost of the study?)
The study actually found that over a third of coronary heart disease occurs in people who do NOT have particularly high total cholesterol levels
"An analysis of cholesterol values . . . in 1,700 patients with atherosclerotic disease revealed no definite correlation between serum cholesterol levels and the nature and extent of atherosclerotic disease."
- Michael DeBakey, MD, Famous heart surgeon
The truth: Dietary saturated fat is not associated with cardiovascular/heart disease
(including such as: coronary heart disease, heart attacks, strokes, HBP)
Analyses of 60 years of studies pronounced a verdict of "Not Guilty" in the case implicating "Saturated fat" with Heart Disease
- 23 nutritional factors were found to be moderately/strongly associated with heart disease, but . . . Saturated fat was not one of them! So found researchers from McMaster University in 2009, who undertook "a systematic review of evidence linking a wide variety of nutritional factors and heart disease", publishing their results in the Archives of Internal Medicine. They analyzed146 research studies involving millions of people over a span> 60 years.
- The combined results of several epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of cardiovascular disease (ischaemic CVD) . A study published in the Jan. 2010 Journal of Clinical Nutrition, which analyzed the association of dietary saturated fat with risk of coronary heart disease, stroke or any other cardiovascular disease in 21 epidemiological studies (these look for associations between things):
5-23 years of follow-up of 347,747 subjects determined that only 11,006 developed CHD or stroke. Consideration of age, sex, and study quality did not change the results.
- A Medical Research Council survey showed that men eating butter ran half the risk of developing heart disease as those using margarine (Nutrition Week, 1991)
- As heart-disease rates skyrocketed in the mid-1900s, animal fat consumption was actually going down. While vegetable oil (with its inherent excessive omega-6 content) was being consumed in dramatically increasing amounts.
Introducing HDL and LDL Cholesterol
With the obvious flaws in the theory, some amendments were necessary. Enter center stage - HDL and LDL cholesterol. LDL (the supposed "bad" guy) carries cholesterol to tissues, and if it hangs around it ends up getting oxidized. HDL (called the "good"guy), carries excess cholesterol back to the liver from the tissues to be recycled. The amended theory is that the oxidation of LDL in the blood begins the atherosclerosis process, leading to heart disease - it makes sense. Keep your LDL low and your HDL high and you're good to go! The theory vindicates most cholesterol, but vilifies LDL cholesterol (and its buddy saturated fat).
HDL, LDL and total cholesterol values do provide some secondary indicators of a problem
Total blood cholesterol is calculated as: HDL value + LDL value + Trigycerides/5
However, the total cholesterol value on its own doesn't tell you a whole lot, unless its >300, which does indicate a high risk of CHD. (People with a total cholesterol of 250 can be at low risk for heart disease due to their HDL levels. Conversely, people with a cholesterol level < 200 can be at a very high risk of heart disease).
TWO RATIOS that DO PROVIDE GOOD INDICATORS of a problem:
HDL value/ Total cholesterol (percentage should be >24%)
Triglyceride / HDL (percentage should be <2%)
Unfounded dietary guidelines
The medical profession and articles all over the internet continue to espouse the largely unfounded dietary guidelines. For example:
MISGUIDED ADVICE AT Heart and Stroke Foundation website
(Must be they don't subscribe to Archives of Internal Medicineor American Journal of Clinical Nutrition).
"Limit foods high in saturated fat, trans fat and/or cholesterol, such as whole-milk dairy products, fatty meats, tropical oils, partially hydrogenated vegetable oils and egg yolks. Instead choose foods low in saturated fat, trans fat and cholesterol. Here are somehelpful tips:
- Include: fat-free and low-fat milk products, legumes (beans), skinless poultry and lean meats.
- Choose fats and oils: such as liquid and tub margarines, canola, corn, safflower, soy bean and olive oils."
DO NOT FOLLOW THE ABOVE MISGUIDED ADVICE IN THIS BOX
Except: You should minimize intake of trans fats / partially hydrogenated vegetable oils, found in high-heat-processed polyunsaturated vegetable oils (most all grocery-store offerings E.g. Canola, soybean, corn, safflower oils) and processed foods containing these oils (including margarine), including restaurant foods fried in them
The body has numerous essential uses for cholesterol
When you consume cholesterol, the body doesn't need to make as much.
Lackland, D T, et al, (Nov 1990) J Nutr, 120:11S:1433-1436
Morris JN et al, (1963) Diet and plasma cholesterol in 99 bank men. British Medical Journal ;1:571-576
Nichols AB, et al (1976) Daily nutritional intake and serum lipid levels. The Tecumseh study. American Journal of Clinical Nutrition;29:1384-1392.
Nutrition Week, Mar 22, 1991, 21:12:2-3
Ramsay LE, Yeo WW, Jackson PR. (1991) Dietary reduction of serum cholesterol concentration: time to think again. British Medical Journal;303:953-957.
Attend to Diet, Lifestyle and Emotional State
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