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The Cholesterol Debate, part 1: What if eating saturated fat doesn’t lead to heart attacks?

Cholesterol is a subject I hear a lot about.  People are tested for it, eat low fat foods to avoid it, and many are prescribed statins. The current way of thinking is, if we keep our cholesterol numbers within a certain range, it will lower our risk of heart disease.  I’ve questioned this idea for many years and I worry about people I know who are avoiding whole foods with saturated fats and taking statins. On the other hand, my friends worry about me because I’ve been eating bacon and eggs for breakfast for years.

Catalyst, an Australian TV program, recently aired a two-part series called The Heart of the Matter. Part one was entitled Dietary Villains and part two was about the Cholesterol Drug War.

In Dietary Villains, they explain how the theory that the consumption of saturated fat would increase the risk of heart disease was developed and then accepted by medical professionals and the public. In the 1950’s, Ancel Keys, an American nutritionist, compared the rates of heart disease and saturated fat consumption in several countries and concluded that the higher the rate of saturated fat consumption, the higher the rate of heart disease. However, there are questions about his conclusions, and numerous studies failed to show that reducing the saturated fat in your diet would reduce your risk of dying from a heart attack. The Framingham study, that began in 1948 and is still in effect today, showed that cholesterol can relate to heart disease, but only until the age of about 47. It also showed that people over the age of 50 with high cholesterol lived longer, and those who ate the most fat weighed less and were more active. Despite hundreds of articles published in medical journals discussing the lack of scientific evidence that high fat diets can lead to heart disease, government health policies, doctor advice and public opinion is still influenced by Keys’ hypothesis. The Lyon Diet Heart study examined the Mediterranean diet and found that there were 76% less deaths as a result of heart attack even though there was no change in cholesterol levels.

Cholesterol functions include supporting cell membrane structure, brain health, and the production of hormones – it’s essential to life. The body produces 80-90% of it’s cholesterol so very little comes from our diet, and when we reduce the cholesterol in our diet, the body can produce more.

Despite frequent comparisons to plumbing where fat clogging the pipes is compared to our arteries, fat and cholesterol do not deposit on artery walls. Although cholesterol is found in plaque, it is not the cause – rather, it’s part of the repair process when inflammation occurs in an artery. Cholesterol travels through the blood attached to proteins: LDL transports it to the tissues (bad), HDL removes it from the plaque (good). However, LDL is only “bad” if its oxidized because it can lead to inflammation.

The theory that plaque forms as a result of inflammation is becoming more accepted. We’ve focused on saturated fat and cholesterol as being the problem but sugar, because it causes an insulin response and insulin induces inflammation in blood vessels, is a major problem, as is stress. Because of the fear that saturated fat was unhealthy, people substituted carbohydrates and vegetable oils in their diets. The carbohydrates increase insulin levels and the Omega-6 fatty acids in vegetable oils are easily oxidized so both of these substitutions are major contributors to increased inflammation. We need a balance of Omega-3 and Omega-6 fatty acids so it’s possible that the reason there were such good results with the Mediterranean diet in the Lyon Diet Heart Study is because people ate more foods with Omega-3 fatty acids, like fish, and less carbohydrates, like sugar.

Patients are people, too!
Are you eating a low fat, high carb diet to keep your cholesterol levels within the range recommended by doctors? Do your own research, but you may find you would be healthier if you ate good quality saturated fats like meat and dairy from grass-fed animals, and coconut oil. I’ve found a lot of good information, backed by studies, on Mark’s Daily Apple, including this blog post Top 7 Most Common Reactions to Your High-Fat Diet (and How to Respond)

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