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ilinda

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(from www.mercola.com website)

        New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol

        February 25, 2015
       
By Dr. Mercola

    For the past half century, cholesterol has been touted as a grave health hazard, and dietary fat and cholesterol have been portrayed as being among the “deadliest” foods you could possibly eat.

    This may finally change, as limitations for cholesterol will likely be removed from the 2015 edition of Dietary Guidelines for Americans. It’s about time really, as 60 years’ worth of research has utterly failed to demonstrate a correlation between high cholesterol and heart disease.

    Not only does undamaged natural cholesterol not cause heart disease, it is actually one of the most important molecules in your body; indispensable for the building of cells and for producing stress and sex hormones, as well as vitamin D.

    Cholesterol is also important for brain health, and helps with the formation of your memories. Low levels of HDL cholesterol have been linked to memory loss and Alzheimer's disease, and may also increase your risk of depression, stroke, violent behavior, and even suicide.

New American Dietary Guidelines May Remove Limits on Cholesterol


    A draft1 of the 2015 edition of Dietary Guidelines for Americans,2 created by the Dietary Guidelines Advisory Committee, now states that “cholesterol is not considered a nutrient of concern for overconsumption.”

    And, according to a recent report in the Washington Post,3 an insider claims the new stance on cholesterol will remain in the final report. As noted by medical journalist Larry Husten:4

        “The proposed change reflects a major shift in the scientific view of cholesterol that has taken place in recent years.

        Although serum cholesterol is still considered an important risk factor, cholesterol consumed in food is now thought to play a relatively insignificant role in determining blood levels of cholesterol.”

    However, if you process saturated fat or cholesterol and heat it by frying, then  you create very dangerous products that will clearly increase your risk of cardiovascular disease. So this new information does not give you free license to eat any type of cholesterol. Remember, trans fats are worse than sugar for your health.

Guidelines on Fat and Cholesterol Should Never Have Been Made


    Steve Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, told USA Today:5 “It’s the right decision. We got the dietary guidelines wrong. They’ve been wrong for decades.” This message was echoed in Time Magazine, which recently reported that:

        “n the latest review6 of studies that investigated the link between dietary fat and causes of death, researchers say the guidelines got it all wrong. In fact, recommendations to reduce the amount of fat we eat every day should never have been made.”

    Low-fat diets saw a real upswing in 1977, but according to research published in the Open Heart journal,7 led by Zoe Harcombe, PhD, there was no scientific basis for the recommendations to cut fat from our diet in the first place.

    What’s worse, the processed food industry replaced fat with large amounts of sugar, While Dr. Harcombe shies away from making any recommendation about how much dietary fat might be ideal, she suggests that the take-home message here is to simply “eat real food.”

    I have to say, it’s refreshing to finally see that message being repeated in the mainstream media. As reported by Time Magazine:8

        “The less adulterated and processed your diet is, the more nutrients and healthy fats, proteins and carbohydrates your body will get, and the less you’ll have to worry about meeting specific guidelines or advice that may or may not be based on a solid body of evidence.”

Processed Fructose Affects Your Body Like Alcohol


    The low-fat craze led to an avalanche of new processed food products, promising to benefit both your waistline and your heart. Alas, nothing could have been further from the truth.

    When fat was removed, sugar was added in, and this has led to a massive increase in obesity, diabetes, heart disease, and non-alcoholic fatty liver disease. As it turns out, your body metabolizes fructose in the same way it metabolizes ethanol, creating the same toxic effects.

    Unlike glucose, which can be used by virtually every cell in your body, fructose can only be metabolized by your liver, because your liver is the only organ that has the transporter for it.

    Since nearly all fructose gets shuttled to your liver, and, if you eat a typical Western-style diet, you consume high amounts of it, fructose ends up taxing and damaging your liver in the same way alcohol and other toxins do.

    In fact, when you compare the health outcomes of fructose versus alcohol consumption, you see the diseases they cause are virtually identical:
    Chronic Ethanol Consumption    Chronic Fructose Consumption
    Hypertension    Hypertension
    Cardiomyopathy    Myocardial infarction
    Dyslipidemia    Dyslipidemia
    Pancreatitis    Pancreatitis
    Obesity    Obesity
    Hepatic dysfunction (ASH)    Hepatic dysfunction (NASH)
    Fetal alcohol syndrome    Fetal insulin resistance
    Addiction    Habituation, if not addiction

Non-Alcoholic Liver Disease Has Become a Serious Public Health Concern


    Dr. Robert Lustig, Professor of Pediatrics in the Division of Endocrinology at the University of California, has been a pioneer in decoding sugar metabolism and sounding the alarm on processed fructose in particular.

    In one of his papers,9 published in the Journal of the Academy of Nutrition and Dietetics in 2010, Dr. Lustig describes three similarities between fructose and its fermentation byproduct, ethanol (alcohol):

        Your liver's metabolism of fructose is similar to alcohol as they both serve as substrates for converting dietary carbohydrate into fat, which promotes insulin resistance, dyslipidemia (abnormal fat levels in the bloodstream), and fatty liver
        Fructose undergoes the Maillard reaction with proteins, leading to the formation of superoxide free radicals that can result in liver inflammation similar to acetaldehyde, an intermediary metabolite of ethanol
        By "stimulating the 'hedonic pathway' of the brain both directly and indirectly," Dr. Lustig noted, "fructose creates habituation, and possibly dependence; also paralleling ethanol"

    As recently reported in Scientific American,10 non-alcoholic fatty liver disease11 (NAFLD) now affects an estimated 25 percent of Americans, including an estimated 20 percent of children, who have never had a drop of alcohol. Cases of NAFLD have even been reported in children as young as three years old. This may sound like an impossibility. But did you know that most infant formulas contain the sugar equivalent of a can of Coca-Cola?

    Ditto for many baby foods, which can contain as much sugar and harmful trans fats as chocolate cookies or cheeseburgers. Babies are methodically “poisoned” with exorbitant amounts of refined sugar and processed fructose from day one, so it’s really no wonder that so many of our youngsters struggle with weight issues and associated diseases.  As explained in Scientific American:12

        “NAFLD describes the accumulation of fat in hepatocytes, or liver cells, in excessive amounts. These fats are typically triglycerides, which the body naturally stores and creates from calories that it doesn’t need right away. Normally these fats are burned off for energy, but if the body is overwhelmed with calories and a lack of exercise, then the triglycerides are simply never released. They instead accumulate in the liver and cause NAFLD, which can lead to inflammation, scarring, liver dysfunction and even liver cancer.”

Wrong Dietary Guidelines Has Led to Flawed Medical Interventions, Too


    Since the cholesterol hypothesis is false, this also means that the recommended therapies—low-fat, low-cholesterol diet, and cholesterol lowering medications—are doing more harm than good. Statin treatment, for example, is largely harmful, costly, and has transformed millions of people into patients whose health is being adversely impacted by the drug. As noted in the featured video, we now know a whole lot more about HDL and LDL, commonly referred to as “good” and “bad” cholesterol respectively, although that is also a bit of a fallacy.

    Depending on the size of the particles, LDL may be either harmful or harmless, so LDL is not necessarily “bad” across the board. The issue of particle sizes is discussed in greater detail in my 2013 interview with Chris Kresser, L.Ac. If you’ve had your cholesterol levels checked, your doctor most likely tested your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. But we now know those are not accurate predictors for cardiovascular disease risk.

    A far more accurate predictor is your LDL particle number, the test for which is called an NMR Lipoprofile. It’s easy to get and all major labs offer it, including LabCorp and Quest. Most insurance policies cover the test as well. Best of all, even if your doctor were to refuse to order it, you can order it yourself via third-party intermediaries like Direct Labs, or you can order the test online, and get blood drawn locally. Also:

        Check your HDL to total cholesterol ratio. HDL percentage is a potent heart disease risk factor. Just divide your HDL level by your cholesterol. This ratio should ideally be above 24 percent.
        Boost your HDL cholesterol and lower your triglyceride levels. High triglycerides are a very potent risk factor for heart disease. In combination, high triglycerides and low HDL levels are an even bigger risk; this ratio is far more important to your heart health than the standard good vs. bad cholesterol ratio. In fact, one study found that people with the highest ratio of triglycerides to HDL had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL.

        You calculate your triglyceride/HDL cholesterol ratio by dividing your triglyceride level by your HDL level. This ratio should ideally be below 2. So while you strive to keep your HDL cholesterol levels up, you'll want to decrease your triglycerides. You’ll find strategies for increasing your HDL level below. Triglycerides are easily decreased by exercising and avoiding grains and sugars in your diet.

Statins Are Based on a Flawed Premise


    Part of the reason why cholesterol-lowering drugs like statins are ineffective for heart disease prevention (besides the fact that the drug causes heart disease as a side effect) is that drugs cannot address the real cause of heart disease, which is insulin and leptin resistance, which in turn increase your LDL particle number via a number of different mechanisms. While some genetic predisposition can play a role, insulin and leptin resistance is primarily caused by a combination of factors that are epidemic in our modern lifestyle:

        A diet high in processed and refined carbohydrates, sugars/fructose, refined flours, and industrial seed oils
        Insufficient everyday physical activity. Chronic sitting is also an independent risk factor that causes biochemical changes that predispose you to insulin and leptin resistance, even if you’re very fit and exercise regularly
        Chronic sleep deprivation. Studies have shown that even one night of disturbed sleep can decrease your insulin sensitivity the next day and cause cravings and overeating
        Environmental toxins. Exposure to BPA, for example, can disrupt weight regulation
        Poor gut health. Studies indicate that imbalances in your gut flora (the bacteria that live in our gut) can predispose you to obesity and insulin and leptin resistance, and processed foods high in sugar effectively feed harmful bacteria, allowing them to take over

For Heart Health, Focus on Boosting Your HDL


    A healthy diet is foundational for optimal health, and step number one is to ignore the advice to eat a low-fat, low-cholesterol diet. Other strategies that will help reduce your risk of heart disease include the following:13
    Replace processed foods (which are loaded with refined sugar and carbs, processed fructose, and trans fat—all of which promote heart disease) with whole, unprocessed or minimally processed foods, ideally organic and/or locally grown.
    Avoid meats and other animal products such as dairy and eggs sourced from animals raised in confined animal feeding operations (CAFOs). Instead, opt for grass-fed, pastured varieties, raised according to organic standards.
    Eliminate no-fat and low-fat foods, and increase consumption of healthy fats. Half of the population suffers with insulin resistance and would benefit from consuming 50-85 percent of their daily calories from healthy saturated fats, such as avocados, butter made from raw grass-fed organic milk, raw dairy, organic pastured egg yolks, coconuts and coconut oil, unheated organic nut oils, raw nuts, and grass-fed meats. No- or low-fat foods are usually processed foods that are high in sugar, which raises your small, dense LDL particles.

    Balancing your omega-3 to omega-6 ratio is also key for heart health, as these fatty acids help build the cells in your arteries that make the prostacyclin that keeps your blood flowing smoothly. Omega-3 deficiency can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year. For more information about omega-3s and the best sources of this fat, please review this previous article.
    You also need the appropriate ratios of calcium, magnesium, sodium, and potassium, and all of these are generally abundant in a whole food diet. To get more fresh vegetables into your diet, consider juicing.
    Optimize your vitamin D level. Some researchers, like Dr. Stephanie Seneff, believe optimizing your vitamin D level through regular sun exposure, opposed to taking an oral supplement, may be key to optimizing your heart health. If you do opt for a supplement, you also increase your need for vitamin K2.  Meanwhile, Dr. Robert Heaney recently highlighted research showing that carnivorous animals actually get some of the vitamin D they need from the meat they eat. For the longest time, meat was not considered a good source of vitamin D, primarily because it was so difficult to measure that we didn’t think it contained useful amounts. He recommends getting approximately 5,000 to 6,000 IUs of vitamin D per day from all sources – sun, supplements, and food – in order to reach and maintain a healthy blood level of 40-60 ng/ml.
    Optimize your gut health. Regularly eating fermented foods, such as fermented vegetables, will help reseed your gut with beneficial bacteria that may play an important role in preventing heart disease and countless other health problems.
    Quit smoking and reduce your alcohol consumption.
    Exercise regularly. Exercise is actually one of the safest, most effective ways to prevent and treat heart disease. In 2013, researchers at Harvard and Stanford reviewed 305 randomized controlled trials, concluding there were "no statistically detectable differences" between physical activity and medications for heart disease. High-intensity interval training, which requires but a fraction of the time compared to conventional cardio, has been shown to be especially effective.
    Pay attention to your oral health. There's convincing evidence linking the state of your teeth and gums to a variety of health issues, including heart disease. In one 2010 study,14 those with the worst oral hygiene increased their risk of developing heart disease by 70 percent, compared to those who brush their teeth twice a day.
    Avoid statins, as the side effects of these drugs are numerous, while the benefits are debatable. In my view, the only group of people who may benefit from a cholesterol-lowering medication are those with genetic familial hypercholesterolemia. This is a condition characterized by abnormally high cholesterol, which tends to be resistant to lowering with lifestyle strategies like diet and exercise.

Carefree

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Re: New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol
« Reply #1 on: February 25, 2015, 12:58:30 PM »
The Diet Dictocrates, as coined by Sally Fallon of the Weston A Price Foundation, have been selling the low fat low cholesterol myth for decades.  This was part of my awakening almost 10 years ago.  If you want to know more go to www.westonaprice.org

In 2011, I had the honor of sharing the stage with Dr. Mercola as we were both recipients of the "Activist of the Year" award from the Weston A Price Foundation.  Considering the massive amount of work he has done, I felt a little ridiculous, but we each contribute to our communities in different ways.

I was a vegetarian for 7 years until I finally could not resist my cravings for meat, during my pregnancy with my first daughter.  A few years later, while trying to find answers for my health issues as well as my youngest daughter who had a reaction to her vaccines, I found the WAPF and for last 10 years I have been teaching my community about the importance of naturally raised fats in our diets.  We eat mostly organic, drink raw milk and cream as well as raw cheeses, fermented foods, properly prepared grains and nuts, and free range pastured animal products.  Ruminant animals like cows, goats and sheets (deer, elk, buffalo etc.) were designed to eat grass; not grain which is employed by the massive US meat industry (and it's 85% GMO grain to boot).  To a ruminant, this is like eating sugar all day.  It wreaks havoc on their immune systems, so the industry then pumps them with constant doses of antibiotics, which people will eventually consume.  Their poor diet completely changes the fatty acid profile of the finished meat product and when we consume this meat that is not only higher in total fat compared to grass fed, but all the wrong kinds of fat, we set ourselves up for a shift in our own fatty acid profile.

Cholesterol is so essential for humans that our bodies actually make it.  Our brain and central nervous system is mostly cholesterol.  Here is a great article: http://www.westonaprice.org/health-topics/cholesterol-friend-or-foe/

When I finally woke up to the industrial food complex and its bed partner the pharmaceutical industry, I was in a constant fog and often depressed.  When I changed my diet and starting eating more naturally raised animal products the fog lifted, I was energized and creative.  If you read the article above you will see how important cholesterol is to your brain and memory.  More over, the more I work on my diet and healing my body, the more synchronicities and signs I receive. 

Carrie

ilinda

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Re: New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol
« Reply #2 on: February 27, 2015, 05:01:17 AM »
The Diet Dictocrates, as coined by Sally Fallon of the Weston A Price Foundation, have been selling the low fat low cholesterol myth for decades.  This was part of my awakening almost 10 years ago.  If you want to know more go to www.westonaprice.org

In 2011, I had the honor of sharing the stage with Dr. Mercola as we were both recipients of the "Activist of the Year" award from the Weston A Price Foundation.  Considering the massive amount of work he has done, I felt a little ridiculous, but we each contribute to our communities in different ways.

I was a vegetarian for 7 years until I finally could not resist my cravings for meat, during my pregnancy with my first daughter.  A few years later, while trying to find answers for my health issues as well as my youngest daughter who had a reaction to her vaccines, I found the WAPF and for last 10 years I have been teaching my community about the importance of naturally raised fats in our diets.  We eat mostly organic, drink raw milk and cream as well as raw cheeses, fermented foods, properly prepared grains and nuts, and free range pastured animal products.  Ruminant animals like cows, goats and sheets (deer, elk, buffalo etc.) were designed to eat grass; not grain which is employed by the massive US meat industry (and it's 85% GMO grain to boot).  To a ruminant, this is like eating sugar all day.  It wreaks havoc on their immune systems, so the industry then pumps them with constant doses of antibiotics, which people will eventually consume.  Their poor diet completely changes the fatty acid profile of the finished meat product and when we consume this meat that is not only higher in total fat compared to grass fed, but all the wrong kinds of fat, we set ourselves up for a shift in our own fatty acid profile.

Cholesterol is so essential for humans that our bodies actually make it.  Our brain and central nervous system is mostly cholesterol.  Here is a great article: http://www.westonaprice.org/health-topics/cholesterol-friend-or-foe/

When I finally woke up to the industrial food complex and its bed partner the pharmaceutical industry, I was in a constant fog and often depressed.  When I changed my diet and starting eating more naturally raised animal products the fog lifted, I was energized and creative.  If you read the article above you will see how important cholesterol is to your brain and memory.  More over, the more I work on my diet and healing my body, the more synchronicities and signs I receive. 

Carrie
Wow, Carrie, thanks for posting your "story", which probably reads like a lot of others who are waking up. 

There is an interesting parallel between some of your story and mine.  I had been a vegetarian most of my adult life, but in later years I began to dream of eating eggs.  It got so that I would dream I was biting into an egg while awakening, and my mouth would be wide open as I awoke.  I knew it was time to start eating eggs, so I found a source of organic eggs and all was well for a while.

Then I began to dream I was eating chicken, and often I would awaken with mouth wide open, while dreaming of biting into a piece of chicken!  So I did begin eating organic chicken.  I do feel better, and interestingly I never dreamed of eating beef or pork.

As we awaken from our forced slumber, people are regaining control over their lives and the internet is the main thing that makes our research so much easier!

Thanks also for the Weston A. Price Foundation mention and link.

Yowbarb

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Re: New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol
« Reply #3 on: February 27, 2015, 04:41:16 PM »
Great info, ilinda and Carefree!
Some of what Dr. Mercola says overlaps with Dr. Sandra Cabot.

Posted this... I recommed also,
Doctor Sandra Cabot - 1 hour Love your Liver presentation

http://youtu.be/dD05neSu2wo

ilinda

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Re: New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol
« Reply #4 on: April 14, 2015, 07:07:22 AM »

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ISIS Report 13/04/15
Low Fat and Low Saturated Fat Diet Bad for Health

Government guidelines on restricting dietary fat and saturated fat to reduce cholesterol and heart disease are bad for health according to evidence from independent studies Dr Mae-Wan Ho
New guidelines on statins for millions of healthy people seriously flawed

The mantra that saturated fat is bad for you and must be removed to reduce the risk of heart disease has been drummed into public consciousness for almost four decades. But independent scientific evidence shows that this advice has paradoxically increased our cardiovascular risk. And the obsession with total cholesterol levels has led to the over- medication of millions with statins with yet more harm than benefit.
The British Medical Journal (BMJ) re-opened the debate on dietary fat and cholesterol lowering drugs with major articles published in October 2013, especially one by cardiologist Aseem Malhotra at Croydon University Hospital, London on why saturated fat is not the major issue [1], and another by John Abramson at Harvard Medical School and three colleagues in US and Canada universities asking if people at low risk of cardiovascular disease should take a statin [2]. The articles were in anticipation of UK’s pharmaceutical regulatory agency NICE’ new guideline issued in July 2014, which recommends statins for healthy people with a 10 % or greater ten-year risk of cardiovascular disease (CVD) [3], a dramatic change over its previous 2006 guideline, which recommended statin only for people who already had clinical CVD and whose ten-year risk of developing CVD was 20 % or greater, or whose risk was increased because of diabetes, or by being in high-risk ethnic groups. The new guidelines increased the number of people eligible for statins by 4.5 million [4]. The move followed a revision in US guideline calling for treatment of people with a 7.5 % or greater ten-year risk, which expanded the number of healthy people for whom statins were prescribed by ~13 million.
Flimsy ‘evidence’ linking heart disease, cholesterol and dietary fat

The demonization of saturated fat began with Ancel Keys’ seven countries study [5] which found a correlation between heart disease and total cholesterol concentration that in turn correlated with the proportion of energy provided by saturated fat. However, Keys excluded data from 16 countries; and when data from all the countries were included, the association between fat calories as a percentage of total calories and death from degenerative heart disease was greatly diminished, and there was no association between dietary fat and mortality from all causes [6].
Nevertheless, people were advised to cut fat intake to 30 % of total energy and saturated fat to 10 %. Dietary fat is believed to have the greatest influence on cardiovascular risk through elevated concentrations of low density lipoprotein (LDL) cholesterol [1]. But the reduction in LDL cholesterol from reducing saturated fat intake appears to be specific to large, buoyant type A LDL particles, when it is the small dense type B particles – responsive to carbohydrate intake – that are implicated in cardiovascular disease.
Low fat diet bad for health
Recent prospective cohort studies have not supported any significant association between saturated fat intake and cardiovascular risk. If anything, saturated fat has been found to be protective in many studies.
A randomized control trial published in 2008 showed that a low carbohydrate diet gives greater improvements to health than a low fat diet with the same number of calories [7]. Several other randomized trials published between 2003 and 2007 also showed that a low carbohydrate diet reduces weight and improves lipids more than a low fat diet. Cardiovascular research scientist James DiNicolantoio commented in his review [8], that the data suggest the current global epidemic of atherosclerosis, heart disease, diabetes, obesity and the metabolic syndrome is being driven by a diet high in carbohydrate/sugar as opposed to fat.
A study published in 2012 similarly showed that a low fat diet results in the greatest decrease in energy expenditure, an unhealthy lipid pattern, and increased insulin resistance in comparison with a low carbohydrate and low glycaemic index diet [9].
As Malhotra pointed out [1], food with most of the fat removed generally does not taste as good. To compensate, the food industry puts in more sugar. Scientific evidence is mounting that sugar is a possible independent risk factor for the metabolic syndrome (the cluster of hypertension, dysglycaemia, increased triglycerides, low HDL (high density lipid) cholesterol, and increased waist circumference). In previous generations, cardiovascular disease existed largely in isolation. Today, two-thirds of people admitted to hospital with diagnosed acute myocardial infarction have metabolic syndrome, and 75 % have completely normal total cholesterol concentrations.
Low cholesterol a risk factor of cardiovascular and non-cardiac mortality, high cholesterol not a risk factor

Malhotra drew attention to several independent population studies in healthy adults, which have shown that low total cholesterol is associated with cardiovascular and non-cardiac mortality, indicating that high total cholesterol is not a risk factor in healthy populations [1].
Among the most recent is a community-based prospective cohort study in 12 rural areas in Japan involving 12 334 healthy adults aged 40 to 69 years, who were screened for serum total cholesterol. The outcome measured was total mortality by sex and cause of death, with average follow-up period of 11.9 years [10].
The results showed that compared with a moderate cholesterol level of 4.14 – 5.17 mmol/L, the age-adjusted hazard ratio (HR) of low cholesterol (< 4.14 mmol/L) was 1.49 (95 % confidence interval (CI) 1.23-1.79) in men and 1.50 (95 % CI 1.10-2.04) in women. High cholesterol (≥6.21 mmol/L) was not a risk factor. The association remained almost the same in analyses that excluded deaths due to liver disease. The multivariate-adjusted HRs and CIs of the lowest cholesterol group for haemorrhagic stroke, heart failure (excluding myocardial infarction) and cancer mortality are significantly higher than those of moderate cholesterol group for each cause of death. The current UK and US recommended normal level of cholesterol is <5 mmol/L.
Dietary fat meta-analysis of randomized control trials
National dietary guidelines were first introduced in 1977 and 1983 by US and UK government respectively, to reduce coronary heart disease (CHD) by reducing fat intake. But no analysis of the evidence base for the recommendations has ever been undertaken. A new study examines the evidence from randomized controlled trials (RCTs) available to the US and UK regulatory committees at their respective points of implementation. A team led by Zoë Harcombe at the University of the West of Scotland, Hamilton carried out a systematic review and meta-analysis on RCTs published prior to 1983 on the relationship between dietary fat, serum cholesterol and the development of CHD [11]. A total of 2 467 males participated in 6 dietary trials consisting of 5 secondary prevention studies and one that included healthy participants.
There were 370 deaths from all causes in both the intervention and control groups. The risk ratio (RR) from meta-analysis was 0.996 (CI 0.865 to 1.147). There were 207 and 216 deaths from CHD in the intervention and control groups respectively, the RR was 0.989 (95 % CI 0.784 to 1.247). There were no significant differences in death from all causes or from CHD between intervention and control groups.
The mean serum cholesterol levels fell in all groups, control and intervention. The standardized mean different for the six trials combined was -12.6 % + 6.7 % for the intervention groups and -6.5 % + 5.1 % for the control groups. Though significantly higher in the intervention groups, this did not result in significant difference in death from CHD or from all causes.
The authors concluded [11, p.6]: “It is a widely held view that reductions in cholesterol are healthful per se. The original RCTs did not find any relationship between dietary fat intake and deaths from CHD or all-causes, despite significant reduction in cholesterol levels in the intervention and control groups. This undermines the role of serum cholesterol levels as an intermediary to the development of CHD and contravenes the theory that reducing dietary fat generally and saturated fat particularly potentiates a reduction in CHD.” Finally, they stated: “The present review concludes that dietary advice not merely needs review; it should not have been introduced.”
Replacing saturated fat with polyunsaturated fat?
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ilinda

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Re: New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol
« Reply #5 on: June 24, 2015, 02:07:57 PM »
ISIS Report 24/06/15  www.i-sis.org.uk
The ‘Deadly Dangers of Saturated Fat’ & the ‘Superlative Safety of Statins’

Part 1

Although these myths were thoroughly discredited recently, it is important to know how they originated and why they have persisted despite lack of proof and abundant evidence to the contrary Dr Paul J Rosch

A fully referenced version of this article is posted on ISIS members website and is otherwise available for download here

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The twin myths of the deadly dangers of saturated fat and the superlative safety of statins were thoroughly discredited recently (see [1, 2] Low Fat and Low Saturated Fat Diet Bad for Health and Statins for the Healthy are Harmful, SiS 66). Nevertheless, it is important to know how they originated and why they have persisted despite abundant evidence to the contrary.
Irrelevant animal experiments and false conclusions

It began with some irrelevant animal experiments and false conclusions. The presence of cholesterol in blood as well as atherosclerotic plaque had been known since 1850. In 1910, Adolf Windaus, a German physician and chemist, who later received a Nobel Prize for Chemistry, reported that atheroma in human aortas contained 6 times more free cholesterol than healthy arteries, and over 20 times more cholesterol ester [3].  A few years later Nikolai Anitschkow showed that feeding rabbits purified cholesterol obtained from egg yolks for two or three months produced lipid laden lesions in the aorta and other arteries [4].  However, there was little clinical interest in these observations as coronary heart disease was uncommon at the time.

That changed in 1950 when John Gofman, who had been impressed with Anitschkow’s experiments repeated them and replicated his results.  He was convinced that serum cholesterol and/or its dietary sources contributed to coronary atherosclerosis but knew this was not a direct effect as the cholesterol molecule was too large to pass through the arterial wall.  Little was known about how cholesterol was transported to different body sites to make vitamin D, testosterone, estrogen and other steroid hormones and Gofman was uniquely qualified to investigate this. Prior to receiving his medical degree in 1946, he obtained a Ph.D. in physics at Berkeley, where he studied under Nobel Laureates Ernest O. Lawrence and Glenn T. Seaborg.  Lawrence was awarded the 1939 Physics Nobel Prize for inventing the cyclotron, a device that accelerates charged particles.  Seaborg received the 1951 Chemistry Nobel Prize for using the cyclotron to discover uranium, plutonium, neptunium and other new elements and their isotopes, especially as uranium-235 was required to make the atomic bombs that ended the war with Japan.

Gofman learned of a new analytic ultracentrifugation device that had been developed in Sweden, and because of his superb background in physics and chemistry, immediately saw how it could be used to study cholesterol transport. He obtained one for his laboratory and found that the hypercholesteremic serum samples of his cholesterol-fed rabbits could be separated into two distinct compartments based on their density. The layer at the top of the serum sample was designated low-density lipoprotein cholesterol (LDL) and the deposit at the bottom of the test tube was called high-density lipoprotein cholesterol (HDL) [5].  As LDL appeared to be particularly proatherogenic, he proposed that it promoted the rapid progression of coronary disease in humans and later developed an atherogenic index based on lipoprotein values and ratios [6].   This stimulated myriad investigations, including the research of Michael S. Brown and Joseph L. Goldstein [7], who received the 1985 Nobel Prize in Physiology or Medicine “for their discoveries concerning the regulation of cholesterol metabolism" that led to the development of statins [8].  Gofman believed that avoiding animal fats and cholesterol would help prevent coronary disease, as indicated in his Introduction to The Low Fat, Low Cholesterol Diet: What To Eat And How To Prepare It, a 1951 book co-authored by his pediatrician wife, Dr Helen Gofman and others at Berkeley [9].
False association between animal fats, cholesterol and heart disease

Anitschkow also got a big boost from Ancel Keys, who chaired the 1951 conference of the UN’s Foodand Agriculture Organization in Rome. He asked the audience aboutdiet as it related to the heart attack epidemic in middle-aged men that was sweeping across the US.  Prior to 1920, less than 10 percent of all US deaths were due to heart disease,but by 1950, this had escalated toover 30 %. A University of Naples professor told him there was no such problem in his or nearby cities, which Keys personally verified.  The only exception he found was asmall class of wealthy people who dined on meat daily. The general public had meat once or twice a week and mostly ate pasta, fruits and vegetables. He also found that except for the meat eaters, the average cholesterol levels were low, and concluded that there was an association between a high fat diet, elevated serum cholesterol and coronary heart disease rates, just as Anitschkow proposed. Within a few years, Keys identified six countries where there were similar findings [10], and subsequently embarked on his extensive Seven Countries study in healthy middle-aged men that appeared to confirm these cause-effect relationships [11].

Strong support for Anitschkow also came from the Framingham study, which had been initiated by the National Heart Institute in 1948 to identify factors thatcontributed to heart disease [12]. Residents of this small manufacturing town near Boston were periodically investigated for anything that might conceivably influence the development of coronary heart disease, including blood levels of sugar, cholesterol and other chemicals, fat consumption, smoking, degree of obesity, physical activity and exercise habits. Their 6-year follow-up analysis of over 4 000 healthy men and women aged 31-65 found that serum cholesterol measured at the start was significantly higher among those who experienced coronary events during this period. The Framingham study went on to identify other modifiable risk factors such as smoking, hypertension, obesity, diabetes and lack of exercise, which had additive effects.  Nevertheless, the major culprit was elevated cholesterol from dietary fat. This was reinforced by the 1977 McGovern Senate Committee on Nutrition report that advised avoiding saturated fats to lower cholesterol levels and prevent heart disease [13].
Official government policy established on cholesterol as the culprit


This became official government policy with the establishment of the National Cholesterol Education Program in 1985, and is ongoing.  September has been designated National Cholesterol Education Month, during which everyone is urged to have their cholesterol and lipoprotein levels measured.  That’s not surprising as the role of cholesterol and LDL now seemed to be indisputable. In a 1958 editorial, Dr. William Dock, a renowned cardiologist and Chairman of the Department of Pathology at Stanford University Medical School, wrote [14]: “Thus the early work of Anitschkow bears comparison with that of Harvey on the circulation and of Lavoisier on the respiratory exchange of oxygen and carbon dioxide.” Dock also compared the significance of Anitschkow’s research to Koch’s discovery of the tubercle bacillus. And a more recent ranking of “Cardiology's Ten Greatest 20th Century Discoveries” [15] listed the top three as 1) The Electrocardiogram, 2) Preventive Cardiology and the Framingham Study, and 3) The “Lipid Hypotheses” and Atherosclerosis.
How could we have been so wrong for so long?

Note that the last author used the term “Lipid Hypotheses” to include both the saturated fat diet-heart disease theory as well as the belief that elevated cholesterol was the cause of coronary atherosclerosis. But neither of these hypotheses has ever been proven. With respect to Antischkow's monumental discovery, rabbits are herbivorous and cholesterol is a foreign substance they cannot utilize or metabolize.  In addition, although serum cholesterols were often over 1 ooo mg/L (26mmol/L), the lipid deposits in arteries consisted mainly of macrophage derived foam cells rather than the fibrous and atheromatous plaques found in patients with symptomatic coronary atherosclerosis [16]. More importantly these findings could not be reproduced when the experiments were repeated in rats, dogs and other meat eaters, so they should not be extrapolated to people.

As noted in [1], although Keys had data on 22 countries, he cherry picked the seven that best supported his theory. When all the countries were included, there was no fatty diet-heart disease link [17], and had he selected Israel, Sweden, Germany and France, he would have concluded that the more saturated fat and cholesterol consumed, the lower the incidence of coronary heart disease. Despite that, Keys was featured on the cover of Time magazine, and his claim that saturated fats in the diet clogged arteries and caused heart disease was now supported by so many prestigious organizations and authorities that it was viewed as gospel. It was severely criticized by others, such as Russell Smith, a psychologist with a strong background in mathematics and physiology. He meticulously reviewed over 2 000 studies on the links between dietary fat, cholesterol and heart disease and came to this conclusion [18]:

“The word “landmark” has often been used to describe Ancel Keys Seven Countries Study, commonly cited as proof that the American diet is atherogenic. The dietary assessment methodology was highly inconsistent across cohorts and thoroughly suspect. In addition, careful examination of the death rates and associations between diet and death rates reveal a massive set of inconsistencies and contradictions. . . . It is almost inconceivable that the Seven Countries study was performed with such scientific abandon. It is also dumbfounding how the NHLBI/AHA alliance ignored such sloppiness in their many “rave reviews” of the study. . . . . In summary, the diet-CHD relationship reported for the Seven Countries study cannot be taken seriously by the objective and critical scientist.”

George Mann, the highly respected Professor of Medicine and Chemistry at Vanderbilt and a co-director of the Framingham study at the time, was even more vitriolic [19]:

“Saturated fat and cholesterol in the diet are not the cause of coronary heart disease. That myth is the greatest scientific deception of this century, perhaps of any century. The diet-heart hypothesis has been repeatedly shown to be wrong, and yet, for complicated reasons of pride, profit and prejudice, the hypothesis continues to be exploited by scientists, fund-raising enterprises, food companies and even governmental agencies. The public is being deceived by the greatest health scam of the century.”
“The greatest health scam of the century”

Observational studies can show a statistical correlation but not causation. Keys repeatedly tried several times to demonstrate significant changes in serum cholesterol by altering dietary fat intake with no success [20]. Decades later, he wrote [21]: “Dietary cholesterol has an important effect on the cholesterol level in the blood of chickens and rabbits, but many controlled experiments have shown that dietary cholesterol has a limited effect in humans.”

He was even more emphatic in a subsequent Internet magazine interview [22]: “There’s no connection whatsoever between cholesterol in food and cholesterol in 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.”  However, by this time, most of the country was on a low fat or Prudent Diet that not only restricted saturated fat, but also increased polyunsaturated liquid vegetable fats such as corn oil.

The first report on the Prudent Diet was from the Joliffe Anti-Coronary Club in Manhattan, which had as controls a group of healthy middle-aged men who followed their usual diet of lots of eggs, butter, cheese and red meat. The Prudent Diet cohort strictly avoided these and substituted a special margarine rich in polyunsaturated fats for butter. After four years, although serum cholesterol was reduced in those following the Prudent Diet, eight had died from a myocardial infarction, compared to none in the control group [23].

Numerous other attempts to reduce coronary disease by limiting saturated fat intake also failed and several observational studies similarly found that saturated fat restriction was associated with increased risk of coronary heart disease deaths [24-28]. As Sylvan L Weinberg, a past president of the American College of Cardiology, warned in a subsequent editorial [29]:

“The low-fat–high-carbohydrate diet, promulgated vigorously by the National Cholesterol Education Program, National Institutes of Health, and American Heart Association since the Lipid Research Clinics-Primary Prevention Program in 1984, and earlier by the U.S. Department of Agriculture food pyramid, may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type II diabetes, and metabolic syndromes. This diet can no longer be defended by appeal to the authority of prestigious medical organizations or by rejecting clinical experience and a growing medical literature suggesting that the much-maligned low-carbohydrate–high-protein diet may have a salutary effect on the epidemics in question.”

The Framingham study, which established cholesterol as the most important risk factor for coronary heart disease, was never able to prove this or to show that saturated fat increased serum cholesterol or coronary disease. During the early 1950s, detailed information on dietary habits had been obtained on a thousand participants.  A follow-up analysis in 1971 found no connection between diet andserum cholesterol and the authors concluded [30]: “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.” The senior author William Kannel was then Director of the Framingham study, and this report was never published for obvious reasons.  However, over two decades later, William Castelli, who succeeded Kannel as Director, wrote [31]:

“In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people’s serum cholesterol...we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories weighed the least and were the most physically active.”  And a 30-year follow-up revealed that [32] "For each 1 mg/dl drop of cholesterol there was an 11 % increase in coronary and total mortality.”

Saturated fat-heart disease hypothesis thoroughly discredited


The Tecumseh Community Health Study, which utilized data on the composition of over
2 700 foods, found that cholesterol and triglyceride levels were unrelated to quality, quantity, or proportions of fat, carbohydrate, or protein consumed [33]. Participants who ate the least cholesterol also had the highest blood cholesterol levels.

The World Health Organization’s Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) epidemiologic project was undoubtedly the largest study ever designed to explore the relationship between risk factors and cardiovascular disease.  It began in 1971 as a collaborative effort involving 32 centers in 21 countries that monitored approximately 10 million men and women aged 25-64 for ten years. It thoroughly discredited the saturated fat–heart disease hypothesis. All the countries in the top eight for saturated fat consumption had lower death rates for heart disease than all of the eight countries that consumed the least fat. The French consumed three times as much saturated fat as the Azerbaijani but had one-eighth the rate of heart disease deaths. Heart disease mortality in Finland was four times greater than in Switzerland, even though saturated fat consumption was similar [34].

Although such epidemiologic studies cannot prove or disprove causal relationships, no large scale interventional trial has ever demonstrated that restricting saturated fat reduces the risk of coronary disease [35, 36]. This was true even when combined with reducing other risk factors like hypertension and cigarettes as evidenced by the $115 million Multiple Risk Factor Intervention Trial (MRFIT). This involved 28 medical centers and 250 researchers who screened 361 662 men and deliberately chose those who were at the highest risk in order to increase the power of the test.

Compared to matched controls, cholesterol intake was cut by 42 %, saturated fat consumption by 28 %, total calories by 21 %, and there was a significant reduction in hypertension and cigarette smoking after 8 years. Although there was a modest fall in serum cholesterol, there was no effect on coronary heart disease and the disappointing conclusion was [37]: “The overall results do not show a beneficial effect on Coronary Heart Disease or total mortality from this multifactor intervention.”

The Women's Health Initiative (WHI) study was established by NIH in 1991 to address the most common causes of death, disability and impaired quality of life in postmenopausal women. This 15-year $625 million project involved 161 808 healthy postmenopausal women followed at 40 clinical centers that included three interventional clinical trials; Hormone Therapy, Calcium/Vitamin D supplementation and Dietary Modification. The Dietary Modification component evaluated the effect of a low-fat and high fruit, vegetable and grain diet on the prevention of CHD, breast and colorectal cancers. Study participants followed either their usual eating habits or the dietary regimen noted above. The results indicated that despite some reduction in cardiovascular risk factors such as blood lipids and diastolic blood pressure, there was no significant reduction in the risk of coronary heart disease or stroke in the cohort that restricted fat and increased fruit, vegetables and grain [38, 39].

As William James, the father of modern psychology noted, “There is nothing so absurd that it cannot be believed as truth if repeated often enough.” Although many more articles could be cited, most people still believe that saturated fatcauses heart attacks. Other reasons for this will be explored in Part 2, whichwill haveafocus on statin safety and efficacy, why figures don’t lie but liars can figure, why measuring cholesterol is a waste of time and money, and what really causes heart disease; so stay tuned!
(For further information visit www. stress.org)

 

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