The Cholesterol/Heart Disease Myth
Just as fat has gotten a bad rap, so has cholesterol. For years it was believed that saturated fat, those fats found in butter, animal fat and dairy products elevated blood cholesterol levels. The elevated cholesterol levels then led to arteriosclerosis, which increased the risk of heart attacks. In spite of millions of dollars spend on research to verify this hypothesis, the connection has never been thoroughly proven. Nor has the reduction in saturated fat consumption proven to extend a healthy individual’s life span.
The authors of the Framingham study, Herber and others, after 40 years of studying 6000 people, found that the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower one’s serum cholesterol. The Framingham Study began in 1948 with 5,209 participants. It has been followed by the Offspring Study (with spouses), and the Third Generation Study.
Other research suggests the following: People with higher blood cholesterol have been found to be capable of faster mental processing than those with low cholesterol, and that those whose levels of blood cholesterol are unusually low, or have been artificially reduced seem to be more prone to suicide and aggressive behavior. Additional studies indicate:
• Half the people who have heart attacks and strokes do not have high blood
• People whose blood cholesterol is low develop just as many plaques in their
blood vessels as people whose cholesterol is high.
• Older women with high cholesterol live longer than older women with low
• Cholesterol levels do not predict the risk of a heart attack in men over age
In the 34-year follow-up of the Framingham studies, high cholesterol was not predictive of heart disease after the age of 47. In fact, the studies showed that those over 50 whose cholesterol went down had the highest risk of having a heart attack. However, high total cholesterol has been shown to be a risk factor for coronary heart disease in young and middle-aged men. One explanation is that men of this age are in the midst of advancing their professional careers and are therefore more acutely stressed than other age groups. Mental stress is a well-known cause of cardiovascular disease.
LDL and HDL, the magic numbers Cholesterol is made up of fats and oils called lipids that cannot dissolve in the bloodstream. Carriers in the blood called lipoproteins transport the lipids throughout the body. Two of the lipoproteins are LDL, low-density lipoproteins, (small, dense particle of cholesterol), and HDL, high-density lipoproteins, (larger particles of cholesterol). Higher numbers of LDL is associated with increased risk of coronary heart disease. When there is inflammation or injury, because of their size, the LDL particles lodge themselves more easily than larger HDL particles into arterial walls causing plaque buildup and cell wall damage. Oxidation of the LDL molecules in the blood vessel walls is thought to cause hardening of the arteries. HDL is associated with a decreased risk of coronary hearty disease because they are less likely to lodge themselves into arterial walls.
In a Swedish study that followed 175,000 patients with heart disease, researchers found that they were 3 times more likely to have larger numbers of LDL than HDL. Low-fat, high carbohydrate diets have consistently been shown to create the smaller, denser more dangerous particles (LDL). Low-carbohydrate, higher-fat diets – especially saturated fats – create larger cholesterol particles (HDL) and are less likely to contribute to heart disease. Although lowering LDL appears to be a factor in decreasing the risk of heart disease, recent research indicates that raising the HDL does not reduce the risk of heart disease.
The issue of cholesterol is very complex and more information about HDL and LDL is appearing in the literature. Dr. Mark Houston, author of What Your Doctor May Not Tell You About Heart Disease states “Cholesterol is not inherently bad, and an elevated level is not a sure sign of coronary heart disease-any more that low levels are a promise of good health” (page 62). He explains that HDL cholesterol comes in at least five different forms, and they change shape and size depending on the role they are called upon to play. Some forms are more protective than others. The kind and amount of HDL you have is more important and predictive than your overall number. The same is true of LDL cholesterol. There are three different forms of LDL. Each is more or less dense depending on their composition. It is the smallest that is the most dangerous because it can slip through the walls of the endothelium and burrow into the arterial walls, beginning the inflammatory cascade that can lead to a stroke or heart attack.
The Framingham study linked low cholesterol with greater risk of cancer. Women aged 56-70 had the lowest mortality rates when their total cholesterol was between 240 and 280. milligrams/deciliter (mg/dL). Women over 70 with cholesterol levels under 240 mg/dL predicted greater mortality.
Another study provides a cautionary note. The Northern Manhattan Study was composed of a diverse of participants. The mean age was 69. It included 63% women, 21% white, 24% black, and 52% Hispanic. The results suggest that increased daily total fat intake for this diverse group, above 65 grams, significantly increases risk of ischemic stroke.
Cholesterol serves vital functions Cholesterol is a steroid alcohol manufactured in the liver and in most cells. The major part of circulating serum cholesterol has been produced by the liver, rather than absorbed from food. Cholesterol plays a vital role in keeping our cells healthy and does the following:
• Provides the precursors to make phospholipids, a fatty compound that
makes up much of the brain.
• Gives cell membranes their necessary structure.
• Acts as an antioxidant protecting our cells from free radicals.
• Is the natural healing substance that repairs the damage when free radicals
or viruses damage blood vessels, or if there is an excess of polyunsaturated
fats in our cell membranes.
• Functions as a component of bile, needed for the digestion of fat.
• Is necessary for all hormone production.
• Facilitates many biochemical processes, including mineral metabolism,
blood sugar regulation and the synthesis of hormones.
• Is needed by the receptors in the brain to properly utilize the “feel good”
chemical serotonin to maintain a healthy nervous system.
What Shall We Do?
In an essay published in the New York Times, 1/2/2007, Drs. Gilbert Welch, Lisa Schwartz, and Steven Woloshin say, “ the criterion for normal cholesterol keeps dropping, so that the disease of high cholesterol can be diagnosed in more than half the population.” The case against cholesterol has recently gotten even more dramatic. New guidelines (2012) introduced by experts from the American Heart Association and the American College of Cardiology would greatly increase the number of Americans taking statins. Rather that wait until a certain level of cholesterol is reached, patients will be advised to take a statin drug if they already have a heart disease, if their LDL cholesterol is 190 or more, if they’re middle-aged with type-2 diabetes, if they are at risk for a stroke, and if they’re between the ages of 40 and 75 years of age with an estimated 10-year risk of heart disease.
Fat has been a villain long enough. Fat, particularly saturated fat, has had a bad rap for decades. Time magazine (June 23, 2014) had a picture of a swirl of butter on its cover with the headline, “Eat Butter.” The byline was “Scientists labeled fat the enemy. Why they were wrong.” The article goes on to discuss studies that concluded “that there was no significant evidence that saturated fat is associated with an increased risk of cardiovascular risk.” Further it says, “current evidence does not support low consumption of saturated fats or high consumption of polyunsaturated fats.”
Although it is very difficult to go against the recommendations of the USDA and the powerful medical establishment, there is a growing body of evidence that indicates it is our Western diet causing many of our health problems. It is not the saturated fats. It is the polyunsaturated fats, the trans fats and the processed foods that are the guilty parties – along with our sedentary life style. Good fats are important for our overall health and critical for our brain health. To make the best food choices, and the best fat choices, we must look at the major studies and decide for ourselves, in collaboration with our medical providers, what is best for our long term health.