Cholesterol and Heart Disease

cugila

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graham64

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Re: What is evidence?

The Great Cholesterol Con

Dr. Kendrick writes:

Have we been conned about cholesterol?

So how can I say saturated fat doesn't matter when everyone knows it is a killer? Could all those millions who have been putting skinless chicken and one per cent fat yoghurts into their trolleys really have been wasting their time? The experts are so busy urging you to consume less fat and more statins that you are never warned about the contradictions and lack of evidence behind the cholesterol con.

In fact, what many major studies show is that as far as protecting your heart goes, cutting back on saturated fats makes no difference and, in fact, is more likely to do harm.So how did fat and cholesterol get such a bad name? It all began about 100 years ago…Major trials since have been no more successful. One involved nearly 30,000 middle-aged men and women in Sweden, followed for six years. The conclusion? "Saturated fat showed no relationship with cardiovascular disease in men. Among the women, cardiovascular mortality showed a downward trend with increasing saturated fat intake." (In other words, the more saturated fat, the less chance of dying from heart disease).

It's a bit of a paradox, isn?t it? That's one of the features of the dietary hypothesis - it involves a lot of paradoxes. The most famous is the French Paradox. They eat more saturated fat than we do in Britain; they smoke more, take less exercise, have the same cholesterol/LDL levels, they also have the same average blood pressure and the same rate of obesity. And you know what? They have one quarter the rate of heart disease we do. The official explanation is that the French are protected from heart disease by drinking red wine, eating lightly cooked vegetables and eating garlic. But there is no evidence that any of these three factors are actually protective. None. By evidence, I mean a randomised, controlled clinical study…

The Framingham study in the US found that people whose cholesterol levels fell were at a 14 per cent increased risk of death from heart disease for every 1mg/dl. Set up in 1948, the study screened the whole population of Framingham near Boston for factors that might be involved in heart disease and then followed them to see what happened to them. It is still going today, making it the longest running and most often quoted study in heart-disease research. A massive long-term study that looked specifically at cholesterol levels and mortality in older people in Honolulu, published in The Lancet, found that having low cholesterol concentration for a long time increases the risk of death.
Low cholesterol levels greatly increase your risk of dying younger. So the cholesterol hypothesis looks something like this:

There is no evidence that saturated fat is bad - and there are lots of 'paradoxes' where countries with a high cholesterol intake don't have a higher death rate from heart disease....

Graham
 

cugila

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Re: What is evidence?

What causes high cholesterol ?
One of the causes of high blood cholesterol levels amount people in the UK is eating too much saturated fat.

The cholesterol which is found in some foods such as eggs, liver, kidneys and some types of seafood eg. prawns, does not usually make a great contribution to the level of cholesterol in your blood. It is much more important that you eat foods that are low in saturated fat.

However, some people have high blood cholesterol even though they eat a healthy diet. For example, they may have inherited a condition called familial hyperlipidaemia (FH).
 

FordPrefect

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A guy plugging a book... Did this in any way take into account genetics, average weight or other factors? I mean Australian aborigines are another race compared to European nations. Not convinced here as it sounds like yet another conspiracy theory I mean does he really expect us to believe that the rest of the medical profession is stupid or somehow involved in some sort of conspiracy? Ultimately figures and fancy charts can be printed in such a way as to be misleading(is this total cholesterol or just bad cholesterol for example) and 90% of people would love him to be right so they can eat as much fatty food as they like.
 

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The most famous is the French Paradox. They eat more saturated fat than we do in Britain; they smoke more, take less exercise, have the same cholesterol/LDL levels, they also have the same average blood pressure and the same rate of obesity. And you know what? They have one quarter the rate of heart disease we do. The official explanation is that the French are protected from heart disease by drinking red wine, eating lightly cooked vegetables and eating garlic. But there is no evidence that any of these three factors are actually protective. None. By evidence, I mean a randomised, controlled clinical study

Some researcher's doubt that the French people of the age to be dying of heart disease when the idea of the French paradox was coined (1990's) actually had eaten a diet higher in fat. It was not until 1985 that the intake of fat in France increased to equal that in the US.(the original idea concerned France/US) For comparison In 1970 they consumed less than that in the UK .(France 35% of energy, UK 39%)( :Source British Heart foundation statistics)
As for today rather than historical data.
Do they actually smoke more, are they the same weight... and what about alcohol?
United Kingdom /France
Per capita recorded alcohol consumption (litres of pure alcohol) among adults (>=15 years)
11.8 (2003) 11.4 (2003)
Prevalence of adults (>=15 years) who are obese (%) female
23.0 (2002) 11.3%(2003
Prevalence of adults (>=15 years) who are obese (%) male
22.3 (2002) 11.4%(2003)
Prevalence of current tobacco use among adults (>=15 years) (%) both sexes ?
35.7 (2005) 31.7 (2005) (source WHO)
What about consumption of fat today then ?
UK 1995, 38-39% sat fat 15-17% (has declined slightly since but I haven't a French later figure) France 1999 37-40%, Sat fat 15%

There seems to be a lot of myth in Kendrick's statements. particularly about obesity. One thing is evident today is that the French have the lowest obesity rate in Europe, though it is rising.
One reason that this might be is smaller portion: sizes are smaller not only in restaurants but also in recipe books. (ROZIN P, KABNICK K, FISCHLER C & SHIELDS C. The ecology of eating Psychological Science 2003))
From personal observation in the SW, the area ofen equated with the French paradox. They seem to snack far less,(people don't snack), eat a very regular meal pattern, have less access to ( or demand for?) over processed and fast foods. They also appear to eat far more fish and more fruit than in the UK. The staple necessity to accompany every meal is fresh, good quality bread, bakeries are even open on Christmas day. As to alcohol/wine, yes it's drunk but there is no binge drinking and in restaurants one quite often sees half a carafe left on the table at the end of the meal...can you imagine that happening in the UK.
The whole culture of eating and mealtimes is very different.
And they move more. I quite often see very elderly people on their daily walks.
As to cholesterol/BP etc I refer you to the Monica study, particularly the levels for Toulouse as I've written enough!
.http://whqlibdoc.who.int/publications/2003/9241562234_p198-238.pdf
 

hanadr

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Everybody Knows

I've been following the dixcussion on Cholesterol.
I'm one of the people who has researched this and never found that anyone has actually proven that a high fat diet causes high cholesterol and that thereis a further causation of CVD disease risk.
I think this is one of those "Everybody knows " things. What I call the Indigo in the rainbow FACT.
Next time you are fortunate enough to see a rainbow, look carefully. You'll not see any indigo, but if you'd answered your exam questions at school without the indigo in the 7 colours, you'd have lost marks. Another example of this from my a level physics was that I had to quote that a yellow object viewed in yellow light looked yellow, when I saw it as white.
another one I recently came across was someone saying that pork is full of fat. Actually the lean muscle of pork is very low in fat. Mucch lower than beef( which is marbled)
Spinach isn't particularly high in iron, less so than chocolate I think.

Anyone know any other of these everybody knows facts?
Remember Galileo.
 
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catherinecherub

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Re: Everybody Knows

The cholesterol debate will go on and on.
I don't think there is a one size fits all with regard to obtaining good levels and how they are achieved. It is a bit like saying that all diabetics have to eat X,Y and Z to achieve good management. We all know that not to be true as has been shown on this forum.

This article explains all about cholesterol and how some drugs,( including beta blockers, oral contraceptives, diuretics and corticosteroids), genetic factors, other conditions, life style and alcohol intake affect our cholesterol levels.
There are three pages to read and it sheds a lot of light on why levels cannot be universal for everyone following the same dietary habits.

Cholesterol disorders. http://www.merck.com/mmhe/ag/sec12/ch157/ch157a.html
 

cugila

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I've been following the dixcussion on Cholesterol.
I'm one of the people who has researched this and never found that anyone has actually proven that a high fat diet causes high cholesterol and that thereis a further causation of CVD disease risk.


So that's it then ! All the many official bodies around the World such as our own British Heart Foundation are all wrong then ? There is no connection between Cholesterol and CVD. I must be mistaken and misguided....... :?
 

fergus

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All the many official bodies around the World such as our own British Heart Foundation are all wrong then ? There is no connection between Cholesterol and CVD.

Agreed! :D

In my view, I'm afraid the idea that saturated fat raises cholesterol which then leads to heart disease seems perfectly plausible at first. The only problem is that the evidence doesn't support it. The hypothesis, because an idea without available evidence in support of it can only be hypothetical, made sense when it first emerged. It seemed so obvious, so straightforward and so simple that it just had to be true. The science that has invested a great deal of time and money in trying to confirm the hypothesis has drawn a complete blank however.
Now it wouldn't exactly be the first time the medical community had put it's considerable weight behind a hypothesis, only for it to be proved wrong. HRT, thalidomide, aspirin, high carb low fat diets, there is a great deal of evidence to support the argument that the medical profession is a long, long way short of infallible.

All the best,

fergus
 

cugila

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In my view, I'm afraid the idea that saturated fat raises cholesterol which then leads to heart disease seems perfectly plausible

Agreed. :D

Ferg, I think this is one yet again we will have to agree to disagree. :D

I accept your views, I don't agree with them, there is no proof of what you say. You can quote as many research studies, links, papers as you like. I can come up with as many to the contrary.

I have had a triple by pass and if you think it will change my mind because people who low carb believe something different, that 'aint gonna' happen Ferg. Never in a month of Sunday's. I believe what I know is working for me, not information from some Diabetic's who think they know better than the majority of Cardiologists in the World. When you and they are as well qualified in that field then I might just listen....till then, it's all just hearsay, a hypothesis.

All the best
Ken.
 

graham64

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There seems to be a lot of myth in Kendrick's statements.

I wouldn't have thought the following was based on myth, perhaps Phoenix your confusing your myths with facts after all these can hardly be called small studies.

Keys’ studies didn’t prove a relationship between intake of saturated fat and heart disease, but aren’t there other, more convincing, studies which indicate such a causal relationship? Kendrick has recently surveyed the available evidence, and the following paragraphs show what he found.

1.A review in the British Medical Journal in 2001 concluded that "Despite decades of effort and many thousands of people randomised, there is still only limited and inconclusive evidence of the effects of modification of total, saturated, monounsaturated, or polyunsaturated fats on cardiovascular morbidity and mortality."

2.A Swedish paper published in the Journal of Internal Medicine in 2005 reported on a study covering 30,000 people over six years. The conclusion was that "Saturated fat showed no relationship with cardiovascular disease in men. In women, cardiovascular mortality showed a downward trend with increased saturated fat intake."

3.A study involving 48,835 women and lasting more than 8 years was reported in the Journal of the American Medical Association in 2006. Reducing consumption of saturated fat had no effect on coronary heart disease, stroke, total mortality or cancer.
4.A report published in The Lancet in 2004 gave the results of an international search (262 centers in 52 countries) for risk factors for heart disease. Nine risk factors were identified. Consumption of saturated fat was not among them.

5.This last conclusion was hardly surprising. A study reported in the Journal of the American Medical Association in 1982 had shown that a series of changes which included decreasing the saturated fat consumption of 361,662 men by 28% produced no beneficial effect on incidence of coronary heart disease or total mortality

http://www.lewrockwell.com/orig10/deutsch1.html

Graham
 
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catherinecherub

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Each to his own on the management of cholesterol.
As a heart attack survivor, I am going to follow a cardiologist's advice and no amount of research papers for and against high fat/low fat diets will make me change my mind. A member of a diabetic forum is not medically qualified to tell me what to do or even make suggestions on the matter and as said in my previous post, some of us have cholesterol disorders of genetic/other origins.
 

sugarless sue

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Although there is no discernible relationship between reported diet intake and serum cholesterol levels in the Framingham Diet Study group, “it is incorrect to interpret this finding to mean that diet has no connection with blood cholesterol,” Dr. William B. Kannel, director of the Framingham Heart Study has stated.

One of the first ideas that the researchers had was to look at how diet related to cholesterol levels and how diet related to the development of heart disease. I’ll give you the surprise ending right up front: there wasn’t any correlation. What’s interesting about this part of the study, however, is that the researchers didn’t publish it at the conclusion of the study, so it never really saw the light of day. You’ve probably heard the old saying that doctors bury their mistakes. Well, researchers often bury outcomes they don’t expect and don’t welcome.
 

cugila

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This is where I could just post more contrary studies, links, opinions and letters etc backing my view of things.....to be perfectly honest, I don't see the point of repeating what has been said many times before, not just here. Two opposing views and we are never going to agree.

So, I won't bore you. Yawn....sorry ! Do your own research with an open mind and draw your conclusions, like I did. :|
 

phoenix

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I wouldn't have thought the following was based on myth, perhaps Phoenix your confusing your myths with facts after all these can hardly be called small studies
You are now switching your argument to other studies and i'm not going to play your game and follow them up. Your original quote contained several errors, I was kind and called them myths.

The original post said that the French had the same rate of obesity as ithe UK: actually they have half the obesity rate:
that they eat more sat fat: they eat about the the same as in the UK (though I suspect it comes from different sources);
they smoked more. they smoke slightly less
that they havel the same average blood pressure and cholesterol. Had you followed this up you would have found this holds true comparing the North of France to much of the UK but not for the SW of France where the BP and cholesterol levels are slighly lower but CVD is very much lower )

Now I do think there is a great difference between the SW French lifestyle and that in the UK .There are several aspects that may prove to be part of the explanation of the differing levels of CVD. Incidently, a comparison of conventional risk factors(ie BP, lipids, weight) and CVD instances between Northern France and Oxford reveals similar levels of risk factors and similar CVD instances.
I certainly don't think that you will pinpoint any French (or should it be South European) paradox down to one dietary component. There are immense differences in lifesyle and diet between places with high levels of CVD like Glasgow and places with low levels like the Gers
However, your thread started with the arguments of Kendrick, why should anyone accept his arguments about cholesterol if he has not got a few basic and easily verifiable facts correct?

Like Ken, I'll stick to what my cardiologist says,. As he's from SW France, I think I've got good odds that he's doing the right thing.
 

fergus

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Hmmm, looks like this discussion is becoming split along familiar lines.....

Ken, I don't think I presented an argument about the alternative theories re the genesis of heart disease? I simply suggested that, since even vastly expensive studies and very well resourced agencies had consistently failed to present convincing evidence, a healthy scepticism regarding the current orthodoxy was perhaps appropriate.

I certainly don't think that you will pinpoint any French (or should it be South European) paradox down to one dietary component. There are immense differences in lifesyle and diet between places with high levels of CVD like Glasgow and places with low levels like the Gers

Pheonix, I think these are relevant arguments. The current official line that saturated fat consumption is a heart disease risk factor isn't borne out by the available evidence. Diet and lifestyle factors are so many that pinning the blame on sat. fat is foolish and prejudicial. Malcolm Kendrick's suggestion that non-dietary factors are more significant (cortisol and its catabolic effect on the vascular system) is very interesting and does appear to fit the evidence better than the orthodox theories.

My concern is that the anti-sat. fat argument is the corollary of the high carb., low fat diet. I don't think anyone would deny such a diet is totally inappropriate for diabetics. Indeed, the HCLF diet only became the standard approach once sat. fat had been wrongly associated with heart disease. The fact that a HCLF diet appears to worsen all the risk factors of heart disease, not improve them, tends to be ignored and attributed to non-compliant patients rather than couner productive advice. I think if we accept that high carb diets are irrational for diabetics, the logical conclusion is to question the dogma re. saturated fat.

Anyway, I always thought the Gers were from Glasgow? :wink:

fergus
 

phoenix

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Anyway, I always thought the Gers were from Glasgow?
:lol:
Obviously something to do with the Auld Alliance.
How about a clinical trial: swapping chips for cassoulet on match days