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This post is dedicated to Anne who asked me a great question about cholesterol. It made me do what I had been meaning to do ever since I read Dr Malcolm Kendrick\u2019s The Great Cholesterol Con<\/em>…<\/p>\n Dr MK ran some analysis on World Health Organisation (WHO) data. The WHO has extensive data from almost 200 countries on more health measures than you could imagine \u2013 definitely worth a look one rainy, wintry afternoon. This is where Dr MK presented the world with two different Seven Country Studies \u2013 (for those of you who aren’t familiar with the history, it was the Ancel Keys\u2019 Seven Countries Study that started all the fat heart hypothesis stuff). Dr MK took the seven countries with the lowest saturated fat intake and then the seven countries with the highest saturated fat intake. You may need to read this twice \u2013 but he found: \u201cEvery single one of the seven countries with the lowest saturated fat consumption has significantly higher rates of heart disease than every single one of the countries with the highest saturated fat consumption.\u201d<\/p>\n The next chapter in The Great Cholesterol Con <\/em>goes on to look at cholesterol and heart disease (and overall death rates) and quotes many great studies where it is shown that lower <\/em>cholesterol is associated with higher <\/em>mortality. However, it did leave me thinking \u2013 having run the data on saturated fat and heart disease, let\u2019s just run all the data on the cholesterol and heart disease and get to the bottom of this hypothesis from all parts of the allegations.<\/p>\n It actually didn\u2019t take that long \u2013 less than a couple of hours one Saturday afternoon. You go to the WHO statistics area<\/a> of their web site and then pick data for cholesterol from risk factors (how judgemental to start with!) and then look under: Global burden of disease (mortality); All causes; Non communicable diseases and then G Cardiovascular disease (shortened to CVD). CVD deaths include ischemic heart disease and cerebrovascular disease \u2013 that means fatal heart attacks and fatal strokes to us. You find the most recent year where you can get both sets of data to compare like with like. This turns out to be 2002. You download their very user friendly spreadsheet data (CSV) \u2013 cut and paste it into an excel file and then try to remember how the heck to do scatter diagrams in excel!<\/p>\n Before telling you the results, we need to go back for a quick reminder on what we know about cholesterol and then hopefully this can serve as a factsheet for all the cholesterol questions we continually get.<\/p>\n The role of cholesterol<\/strong><\/p>\n It is virtually impossible to explain how vital cholesterol is to the human body. If you had no cholesterol in your body you would be dead. Every single cell of your body is covered by a membrane (think of a membrane as the \u2018skin\u2019 or protective barrier around each cell). This membrane is made largely of cholesterol, fat and protein. Membranes are porous structures, not solid walls, letting nutrients and hormones in while keeping waste and toxins out. If cholesterol were removed from cell membranes they would literally explode from their internal water pressure. Human beings quite simply die without cholesterol.<\/p>\n Cholesterol is vital for hormone production \u2013 the sex hormones and therefore the entire human reproductive system are totally dependent on cholesterol. Hence, not only would humans die without cholesterol, the human race would die out.<\/p>\n Cholesterol is vital for digestion. The human body uses cholesterol to synthesise bile acids. Without cholesterol-rich, bile salts, the human body could not absorb essential fatty acids or the fat soluble vitamins (A, D, E and K) and serious, even life threatening, deficiencies could develop. (It is interesting, therefore, that nature puts cholesterol in virtually every food that contains fat \u2013 providing a digestion mechanism in tandem).<\/p>\n Cholesterol is vital for the brain, central nervous system and memory functions (hence how the side effects of statins include memory loss, mental confusion and people generally just not feeling themselves). Even though the brain is only 2% of the body\u2019s weight, it contains approximately 25% of the body\u2019s cholesterol. The vital connections between nerve endings in the brain, which help to conduct the electrical impulses that make movement, sensation, thinking, learning, and remembering possible, are largely made up of cholesterol.<\/p>\n Cholesterol is critical for bones and for all the roles performed by vitamin D. Vitamin D is best known for its role in calcium and phosphorus metabolism, and thus bone health, but we are continually learning more about potential additional health benefits of vitamin D from mental health to immune health. Vitamin D can be ingested (and is, interestingly again, found in foods high in cholesterol) and it can be made from skin cholesterol. Modern \u2018health\u2019 advice to avoid the sun, take cholesterol-lowering drugs, eat a low cholesterol diet (whatever the heck that is supposed to be) \u2013 combined with there not even being a recommended dietary allowance for vitamin D \u2013 is undoubtedly contributing to avoidable modern illness.<\/p>\n One of the key reasons that we need to spend approximately one third of our lives sleeping is to give the body time to produce cholesterol, repair cells and perform other essential maintenance.<\/p>\n This gives you the headlines of the vital functions that cholesterol performs, but hang on to that bottom line \u2013 it is utterly vital and we die instantly without it.<\/p>\n You may be familiar with the term essential fatty acids or essential amino acids (proteins break down into amino acids). The term \u2018essential\u2019 used like this in nutrition means that it is essential that we consume it in our diet because the body can\u2019t make it. The body makes cholesterol. That says to me that cholesterol is even more vital than essential fatty acids or essential amino acids \u2013 even though these too are life critical \u2013 and therefore the design of the human body is such that it was not left to chance that we needed to get cholesterol from food. Of the 500 or so roles that the liver has \u2013 one is to produce cholesterol. It is too vital to be left to chance.<\/p>\n What went wrong?<\/strong><\/p>\n So, how did something so life vital become more vilified than a mass murderer? I think it comes down to three things (and I don\u2019t take credit for this view \u2013 it is there to be worked out by anyone who traces back the history and Kendrick, Uffe Ravnskov and all the thincs.org <\/a>guys have led the way):<\/p>\n 1) Rabbits; 1) In 1913, a Russian chap called Nikolai Anitschkow decided to feed rabbits purified cholesterol and he managed to get their blood cholesterol levels in excess of 1,000 mg\/dl (nearly 26 mmol\/L! Most UK people have levels of 5-7 mmol\/L). He then noticed the formation of \u201cvascular lesions closely resembling those of human atherosclerosis\u201d forming in the arteries of the rabbits. The obvious flaw in the experiment should have been that rabbits are strict herbivores. They do not eat animal products, which is the only source of cholesterol. Hence rabbits are in no way designed to digest cholesterol or animal fat and no one should be surprised if cholesterol or animal fat ended up stuck in any part of the poor rabbit. The only surprise is that no one thought to ask Anitschkow why he was feeding cholesterol and animal fat to herbivores. Interestingly, far less well known is that a parallel test was done on rats and dogs (omnivores) and feeding cholesterol to these species failed to produce lesions.<\/p>\n 2) Ancel Keys. Remember the Minnesota experiment <\/a>that I so often refer to? A brilliant and unbiased piece of research, which has given the world one of the best insights into low calorie dieting ever done \u2013 it was pure genius. This study made Ancel Keys the man of the moment and I guess he wanted to follow it with something equally impactful. There is an anecdote in The Great Cholesterol Con <\/em>and on p113 of The Obesity Epidemic <\/a>where Henry Blackburn, one of Keys\u2019 closest colleagues, tries to explain what may have fuelled Keys drive to find a connection between diet and heart disease.<\/p>\n What is little known is that Keys originally tried to establish a link between cholesterol in food and cholesterol in the blood (our cholesterol levels when we have a blood test) because he thought (probably because of poor Bugs Bunny) that cholesterol in the blood causes heart disease.<\/p>\n Keys did multiples of studies, changing the diets of his human \u2018guinea pigs\u2019, and he presented his conclusions in The Journal of Nutrition, November 1955: \u201cIt is concluded that in adult men the serum cholesterol level is essentially independent of the cholesterol intake over the whole range of natural human diets. It is probable that infants, children and women are similar.\u201d i.e. I only tested adult men and there is no relationship between cholesterol eaten and cholesterol in the blood and it is probable that there will similarly be no relationship for women or children.<\/p>\n In 1997 Keys put this even more assertively: “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.”<\/p>\n Did you know \u2013 even the UK Food Standards Agency (FSA) and UK National Health Service (NHS) admit this?<\/p>\n – \u201cHowever, dietary cholesterol has little effect on blood cholesterol. More important is the amount of saturated fat in your diet\u201d. (National Health Service<\/a>). (Notice the second sentence? They just couldn’t let the theory go).<\/p>\n – \u201cBut the cholesterol we get from our food has much less effect on the level of cholesterol in our blood than the amount of saturated fat we eat\u201d. (Food Standards Agency<\/a>). (This link may disappear, as the FSA is bowing out of giving nutritional advice).<\/p>\n What the government advice should say is: The body makes cholesterol. The cholesterol you eat has no impact on the level of cholesterol in your blood \u2013 not \u201clittle\u201d, but \u201cno\u201d \u2013 (and we\u2019ve known that all along). And they should also explain how saturated fat can <\/em>determine blood cholesterol levels and then provide irrefutable evidence that it does. But it must be hard for public health bodies to even go this far. As we saw in a recent thread \u2013 the FSA also now accept that there is no limit on the number of eggs we can eat: If only Keys had stopped here, but he wanted to find an explanation for heart disease and he was not about to be deterred. For some reason, which I find inexplicable, he then turned to fat (the entire literature on this topic is very vague about \u201cfat\u201d vs. \u201csaturated fat\u201d so his early writings are also very vague on the topic). Here\u2019s a bit of Mensa logic for those who like this kind of thing:<\/p>\n i) Only animal foods contain cholesterol (meat, fish, eggs, dairy). NO non animal foods contain cholesterol.<\/p>\n ii) All animal foods contain fat \u2013 saturated and unsaturated. Some may be very low in fat (e.g. white fish), but they all contain some fat.<\/p>\n iii) If there is no link whatsoever between increased consumption of foods containing cholesterol and blood cholesterol levels, there can be no link whatsoever between increased consumption of animal foods and blood cholesterol levels since only animal foods can be increased in consumption to increase consumption of cholesterol!<\/p>\n So, Keys first did the graph that was presented at the Mount Sinai hospital (which is the one shown in the Tom Naughton video<\/a> and in Dr Robert Lustig\u2019s \u201cSugar: The Bitter Truth<\/a>\u201d ) and then went on to do the Seven Countries study \u2013 which I have read all twenty volumes of and take apart piece by piece in Chapter Eight of The Obesity Epidemic: What caused it? How can we stop it (on this page).<\/p>\n As Kendrick\u2019s two unbiased seven country studies showed \u2013 there is not even an association <\/em>between saturated fat and heart disease \u2013 let alone a causation. However, Keys published his seven countries study and the rest, as they say, is history.<\/p>\n 3) The Robert Redford film All the Presidents\u2019 Men <\/em>that had the memorable quote \u201cfollow the money\u201d. This is absolutely at the heart of everything in the diet industry from national dietary organisations to the food, drink and drug industries and individuals in between.<\/p>\n The Ancel Keys work interestingly claimed that saturated fat consumption (A) caused heart disease (C) not directly, but by raising cholesterol (B). Hence A was supposed to cause C through B. For this to even get off the starting blocks, A and C have to be related (plot one against the other and there has to be a clear relationship); A and B have to be related and B and C have to be related. None of these in fact holds. The Kendrick study shows that A and C are not related. There is no logic that A and B could be related \u2013 because of the problem of fat and cholesterol being found in the same foods and Kendrick presented many studies that showed B and C were not related. I aim in this article to put the nail in the coffin for any idea that high cholesterol is even associated <\/em>with high heart disease. We will, in fact, show that the evidence confirms the opposite.<\/p>\n
\n2) Ancel Keys;
\n3) Money!<\/p>\n![\"\"](\"http:\/\/www.theobesityepidemic.org\/wp-content\/uploads\/2010\/11\/14fsaeggs.png\" "\\"14fsaeggs\\"")
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