* This is the second part of the review of the North Karelia study, which claimed that reducing (saturated) fat reduces deaths from heart disease.
* This note summarises the counters, which were made in the first note, to the fat-heart-deaths claim.
* This note adds four further points – all based on original research that I have done:
1) The two Finland cohorts in the Seven Countries Study (SCS) were west Finland and North Karelia. The diets were similar; the cholesterol levels were similar and yet the deaths from coronary heart disease were substantially different. As shared last week, war and displacement provide an explanation; fat and cholesterol don’t.
2) The North Karelia study involved substantial replacement of butter with rapeseed oil. Rapeseed oil contains plant sterols, which will lower cholesterol but worsen heart disease.
3) My PhD reviewed the evidence from all randomised controlled trials that reduced dietary fat and/or reduced saturated fat in favour of unsaturated fat. The trials did lower cholesterol (through the plant sterol mechanism), but they failed to make any significant difference to mortality – heart deaths or all deaths.
4) Both cohorts of Finland had the highest recorded average cholesterol levels of all 16 cohorts in the SCS. This was because they are furthest away from the equator. I explain why in this note.
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