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Great Cholesterol Lie?

The Shrike

Philosopher
The Shrike
Joined
Nov 2, 2009
Messages
5,147
Location
Oklahoma, USA
Saw this story featured prominently on a Facebook friend's wall. A heart surgeon claims that it's not cholesterol from fatty diets that leads to heart disease, it's inflammation of arteries from a lifetime of low-fat, processed foods. In other words, medical science has been wrong on this issue for decades. Your thoughts?
 
I find it unlikely that an excess of fats is the culprit in heart disease. I think a deficiency of some yet unknown is. (eta or allergy response)

And I just had a related thought today. If the best diet can lower cholesterol is about 5%, how did they ever find the highs and lows in the Framingham study? Yes, our lipids vary by 100%. but they can't be caused by diet. Big variations must be an effect, not a cause.

Now I'll go read the link.

eta: My won history is of three angioplasties at 18 month intervals. (w/ seven stents,) Then I went low carb, and in three days people were asking what i was doing to make me look so much better. I isolated it to gluten sensitivity. Now it's been 8 years, a 530% improvement. I told my cardiac surgeon to use his Statins as suppositories, with their supposed 30%. And I have added vitamin K2-7. Menaquinone. Time will tell, but my arteries seem stable.
 
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The Shrike said:
Saw this story featured prominently on a Facebook friend's wall. A heart surgeon claims that it's not cholesterol from fatty diets that leads to heart disease, it's inflammation of arteries from a lifetime of low-fat, processed foods. In other words, medical science has been wrong on this issue for decades. Your thoughts?
Click to expand...
My immediate thought is that it's both, ie neither of these diets are good for the heart.
 
The Shrike said:
Saw this story featured prominently on a Facebook friend's wall. A heart surgeon claims that it's not cholesterol from fatty diets that leads to heart disease, it's inflammation of arteries from a lifetime of low-fat, processed foods. In other words, medical science has been wrong on this issue for decades. Your thoughts?
Click to expand...

Almost as good a source as the Daily Mail!:D;)
 
Cholesterol is fairly complex with HDL, LDL, and then multiple subtypes of LDL. The pattern of blood cholesterol associated with a risk for heart disease is caused by a high carbohydrate diet, not by too much fat.

Recent studies (the most comprehensive to date) have failed to link dietary saturated fat with cardiovascular disease risk, much to the chagrin of those scientists who have staked their careers on the current guidelines.

http://www.ncbi.nlm.nih.gov/pubmed/20071648
http://www.ncbi.nlm.nih.gov/pubmed/24723079
 
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When I first got into an HMO at about age 45, my first checkup found that my total cholesterol was over 300 with very high LDL. At the time, I was riding my bike about 100 miles a week and eating if not a spectacular but at least decent diet.
My doc felt that this was genetic... And put me on statins (Lipitor). Numbers promptly went into the "optimal" range.
I have been on various statins ever since. I had a single angina episode about 7 years ago now, and got stents. Likely due to the 40+ years of undiagnosed high levels.....
At any rate, my numbers remain in the optimal area at 68.

Right after the angina episode and the stents, I went on a low-fat diet and lost bunch of weight, but I found that my diet did not affect my numbers. When I started eating more of what I liked, my numbers stayed the same...
And that's still the case.
Over the last few years, I've been taking "Welchol" in addition to the statin... This is a drug that binds cholesterol in the gut. This combo seems to be very effective at maintaining my numbers in the optimal range.
 
When relying on claims of a self-professed "expert" it is worth digging a little deeper into their background:

http://www.quackwatch.org/11Ind/lundell.html

http://www.ncahf.org/digest11/11-31.html

De-licensed surgeon peddling questionable theories. Dwight C. Lundell, M.D., who lost his Arizona medical license in 2008, has been promoting books that clash with scientific knowledge of health disease and prevention. His central premise is coronary heart disease is caused by inflammation and that lowering cholesterol levels will not lower the risk of heart attacks or strokes. Instead, he advocates a high-protein, low-carbohydrate diet, low-dose aspirin, and fish oil and conjugated linoleic acid supplements for everyone. Lundell's offerings are promoted with the statement that he has performed more than 5,000 operations during 25 years of cardiothoracic surgical practice. But they fail to mention that between 2000 and 2008, he was subjected to five regulatory actions by the Arizona Medical Board and in 2004 he was also convicted of wilful failure to file federal income tax returns for the years 1992 though 1996.

From 2007 through May 2010, Lundell was listed as an advisor to NourishLife, a company that markets vitamins, fish oil supplements, and conjugated linoleic acid supplements as "pharmaceutical grade" products claimed to help children with speech problems. The Truth About Heart Disease Web site, which promotes his book, The Great Cholesterol Lie, invites people to become "members" by paying $47, $77, or $245 per month for access to additional information. The highest membership category is said to include access to private consultations with Lundell, but the site is not currently taking new members. Quackwatch has additional information about Lundell's background and activities.
Click to expand...
 
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At this point, there is not enough evidence for anyone to say with any certainty exactly how diet, cholesterol and heart health are related. Statins, which lower cholesterol, don't seem to be changing life expectancy.

The only thing that seems certain is that the type of cholesterol you ingest is not perfectly correlated with the type of cholesterol that ends up in your blood.
 
Loss Leader said:
At this point, there is not enough evidence for anyone to say with any certainty exactly how diet, cholesterol and heart health are related. Statins, which lower cholesterol, don't seem to be changing life expectancy.

The only thing that seems certain is that the type of cholesterol you ingest is not perfectly correlated with the type of cholesterol that ends up in your blood.
Click to expand...

The inflammation thing might have some merit as far as I can tell (and I say that as a rank layman)

The issue that has captured my attention most recently - and probably most because it confirms my pre-existing biases, but with that fully acknowledged I'm prepared to run with this hypothesis - is the link between the microbiome and inflammation.

There seems to be a lot of credible information surfacing recently that suggests that there is a credible link between inflammation and a host of modern disease and that inflammation is largely a result of depleted microbial health. In the modern age our dependence on antibiotics and diets that promote unbalanced microbial ecosystems means that we are systematically causing mass extinctions of bacteria that would otherwise have a positive impact on health. The hypothesis suggests that certain bacteria irritate the digestive system and trigger immune responses that condition the body to respond. When the microbiome is wiped out with antibiotics, or is unbalanced by diets that promote the wrong sort of microbiota, the body doesn't gain the immune responses that prevent inflammation within the system and causes a cascading effect that leaves us vulnerable to a host of disease. The stuff I've been reading/watching suggests that one of the biggest benefits you can have for your health is to consume a great deal more fibre in the form of fruit, vegetables, grains and pulses. When you stick to such diets there is a pronounced difference in the types of bacteria you find in your stools. Some research s even finding very positive effects with certain conditions (e.g. irritable bowel syndrome) by conducting poo transplants, wehreby a sick person has the poo of a healthy person transplanted into their lower bowel through a colonoscopy-type procedure whereby the healthy bacteria colonise the lower bowel and inflammation is reduced.

As i said, I'm a rank layman and am sceptical of the latest dietary fads, but it seems to me that this field of inquiry could be quite revolutionary in the sense that it treats the symbiotic human/bacteria relationship as being of great importance.

This two part TV series was what got me interested - it's annoying having to watch 30 minutes of material to confirm a person's claims but even if it just serves as a jumping off point for finding written evidence (there are external links to more info on the page for people who don't want to commit that much time)

The qualifier I would give is this program - the flagship science program for the ABC in Australia - also played a special on the cholesterol issue cited in the OP and was universally condemned for an uncritical and unbalanced report that relied on crank "experts" offering dangerous advice at odds with mainstream scientific thinking.

That being said, this doesn't conflict with any understanding of human health that I am aware of:

http://www.abc.net.au/catalyst/gut_reaction_part_1/

http://www.abc.net.au/catalyst/stories/4070977.htm
 
There is also the datum that gemfibrozil has been shown to lower the cholesterol numbers, but does not improve heart attack/stroke event rate.

I'm not sure I've ever seen any study of clinical practice that shows the benefits of Statin therapy. Only the studies done by the pharma manufacturers.

Seems the medical world gets int a groove of treating by guidelines that are established by the industry, and there after doing another study re: comparison to non-treatment would be considered un-ethical. Hypertension is one area, did you know that 80% of stroke victims are on medications at the time? So does all that treatment do anydamnthing?
 
Yeah Bit pattern, I think the biome is the key, and how the diet effects it might by the defining act.

I'm thinking one dietary habit we are NOT evolved for is a daily balanced diet. Gorge on buffalo one week, eat grubs and seeds until the tribe finds a dead mastadon. Each extreme breeds the optimum biome to build up it's end products, other end products are re-plenished on the next extreme.

Moderation in all things, but not every day. (and never bonelessskinless chicken breast)
 
casebro said:
Yeah Bit pattern, I think the biome is the key, and how the diet effects it might by the defining act.

I'm thinking one dietary habit we are NOT evolved for is a daily balanced diet. Gorge on buffalo one week, eat grubs and seeds until the tribe finds a dead mastadon. Each extreme breeds the optimum biome to build up it's end products, other end products are re-plenished on the next extreme.

Moderation in all things, but not every day. (and never bonelessskinless chicken breast)
Click to expand...

Bonelessskinlesstasteless chicken breast. I eat that crap four times a week.
 
casebro said:
Hypertension is one area, did you know that 80% of stroke victims are on medications at the time? So does all that treatment do anydamnthing?
Click to expand...

Do you know that a majority of dead people die in the hospital? So hospitals are obviously risks, not benefits, to sick people! Most people in the USA who die of cancer have been treated with chemotherapy and/o radiation! So these probably do nothing!

Obviously most people on a drug are first diagnosed as having symptoms of the disease that the drug is used to treat, That alone tells you nothing about the effectiveness of the drug (except that in these cited cases, the drugs must not be a 100% cure).

In truth, the link between diet and heart disease is still very complex, and I think that medical doctors are beginning to recognize that it is far more complicated than a simple link to dietary fat intake. I think at least part of that was known for a low time.

There are clearly citations by non-pharmaceutical company scientists who have found that drugs that lower serum cholesterol also lower chances of heart attacks and stroke

e.g.http://www.bmj.com/content/326/7404/1423?
linkType=FULL&journalCode=bmj&resid=326/7404/1423

And yes, citations that show lowering LDL cholesterol and raising HDL cholesterol are not the only solution, either; carbohydrates clearly also play a role (though how is still largely uncertain).

I agree: the best solution is to not eat too much of any one thing, avoid fad diets, and recognize that you will die of something someday no matter what you eat.
 
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Something occurs to me - why do we even believe that there *is* a 'perfect' diet that the human body has evolved for? There's only very weak selection pressures for keeping any organism alive well past its reproductive phase - at some stage the benefits of being around to help look after the grandkids will drop off as one becomes a net burden to the local genetically-related group. I don't think it's wrong to just admit that after a while one's system will wear out and break down no matter what we put into it as fuel - and enjoying what one eats while one is alive is, to me, worth more than fruitlessly chasing some 'optimum' but unappealing diet and taking daily pills to modify blood chemistry in the hope that the numbers that are changing are the right ones, in the right direction.

There's a management saying about how if you chase particular metrics for a complex system then you eventually end up optimising for those metrics, not for the underlying business success that you wanted. I've seen it happen in the web industry all over the place - increasing e.g. page views at the expense of ease of use. Cholesterol numbers seem to be quite analogous - sure, you can decrease it, but does it actually help you live your life longer and more pleasantly?

Ultimately I think it boils down to the desire to feel in control of one's inevitable progression towards death, and to feel or be seen to be doing 'something' to arrest it. This doesn't mean I smoke, drink heavily, eat anything and everything, and refuse to exercise - I actually eat relatively healthily (I think) and do moderate exercise of various kinds, but having seen my father die of a combination of long-running heart problems and prostate cancer, I'm pretty philosophical about the concept that something's gonna get me before too long, so I might as well strike a balance between taking sensible steps to limit the damage but making sure I can still eat the things I enjoy.

I remember seeing a clip from a documentary about a middle-aged couple in the 70s (I think?) that had developed a 'perfect' nutritional formula and thus consumed measured amounts of various nutrients from labelled jars every day. I guess they're dead now too.
 
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