Oops, they got it wrong about cholesterol

[claig]

"We've all spent time worrying about our cholesterol levels, but what if it was all... a conspiracy! What if the truth was that eating lots of fat doesn't clog your arteries and kill you, and that there's been a deliberate effort to ignore that evidence in order to secure the financial fortunes of Big Pharma's major anti-cholesterol drugs?"

www.cbsnews.com/news/dawn-of-the-cholesterol-skeptics-big-pharma-conspiracy-theorists-get-a-turn-in-the-spotlight/

"Flawed science triggers U-turn on cholesterol fears"
...
Its Dietary Guidelines Advisory Committee plans to no longer warn people to avoid eggs, shellfish and other cholesterol-laden foods.

The U-turn, based on a report by the committee, will undo almost 40 years of public health warnings about eating food laden with cholesterol. US cardiologist Dr Steven Nissen, of the Cleveland Clinic, said: 'It's the right decision. We got the dietary guidelines wrong. They've been wrong for decades.'

Doctors are now shifting away from warnings about cholesterol and saturated fat and focusing concern on sugar as the biggest dietary threat.

The Daily Mail's GP Martin Scurr predicts that advice will change here in the UK too.
...
He added that the food industry had effectively contributed to heart disease by lowering saturated fat levels in food and replacing it with sugar.

Matt Ridley, a Tory peer and science author, yesterday said there should be an inquiry 'into how the medical and scientific profession made such an epic blunder'.

He described the change of advice in the US as a 'mighty U-turn' and said studies linking high cholesterol and saturated fat in food to heart disease were 'tinged with scandal'."

www.dailymail.co.uk/health/article-3096634/Why-butter-eggs-won-t-kill-Flawed-science-triggers-U-turn-cholesterol-fears.html

I wonder if a similar thing will happen in about 40 years to the "save the planet" climate change warnings.

Oops!

'How is life under the tin foil?'

There is no tin foil, just common sense. Life is remarkably healthy when the helpful advice of the government experts is taken with a large pinch of salt. If they say eggs are bad, then eating eggs is probably a good thing to do.

"Foods high in cholesterol have been branded a danger to human health since the 1970s – a warning that has long divided the medical establishment.

A growing number of experts have been arguing there is no link between high cholesterol in food and dangerous levels of the fatty substance in the blood.
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London-based cardiologist Dr Aseem Malhotra, science director of campaign group Action On Sugar, wrote in the British Medical Journal that it was time to 'bust the myth of the role of saturated fat in heart disease'.

He added that the food industry had effectively contributed to heart disease by lowering saturated fat levels in food and replacing it with sugar.

Matt Ridley, a Tory peer and science author, yesterday said there should be an inquiry 'into how the medical and scientific profession made such an epic blunder'.

He described the change of advice in the US as a 'mighty U-turn' and said studies linking high cholesterol and saturated fat in food to heart disease were 'tinged with scandal'.

www.dailymail.co.uk/health/article-3096634/Why-butter-eggs-won-t-kill-Flawed-science-triggers-U-turn-cholesterol-fears.html

Here is an article by Joanna Blythman. She is good, I have got some of her nutrition books.

"Why almost everything you've been told about unhealthy foods is wrong

Eggs and red meat have both been on the nutritional hit list – but after a major study last week dismissed a link between fats and heart disease, is it time for a complete rethink?

Could eating too much margarine be bad for your critical faculties? The "experts" who so confidently advised us to replace saturated fats, such as butter, with polyunsaturated spreads, people who presumably practise what they preach, have suddenly come over all uncertain and seem to be struggling through a mental fog to reformulate their script.

Last week it fell to a floundering professor, Jeremy Pearson, from the British Heart Foundation to explain why it still adheres to the nutrition establishment's anti-saturated fat doctrine when evidence is stacking up to refute it. After examining 72 academic studies involving more than 600,000 participants, the study, funded by the foundation, found that saturated fat consumption was not associated with coronary disease risk. This assessment echoed a review in 2010 that concluded "there is no convincing evidence that saturated fat causes heart disease".

Neither could the foundation's research team find any evidence for the familiar assertion that trips off the tongue of margarine manufacturers and apostles of government health advice, that eating polyunsaturated fat offers heart protection. In fact, lead researcher Dr Rajiv Chowdhury spoke of the need for an urgent health check on the standard healthy eating script.
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With salt, as with sugar, the public health establishment is too cowardly to take on the powerful processed food companies and their lobbyists by drawing a distinction between home-prepared food cooked from scratch and industrial convenience food.

The crucial phrase "avoid processed food" appears nowhere in government nutritional guidelines, yet this is the most concise way to sum up in practical terms what is wholesome and healthy to eat. Until this awareness shapes dietetic advice, all government dietary guidance should come with a tobacco-style caution: Following this advice could seriously damage your health."

www.theguardian.com/lifeandstyle/2014/mar/23/everything-you-know-about-unhealthy-foods-is-wrong

"Aseem Malhotra says saturated fat is not a problem, low-fat products are often full of sugar and statins are over-prescribed

Butter, cheese and even red meat are not as bad for the heart as has been maintained, a cardiologist has said in a leading medical journal, adding that it is time to "bust the myth" of saturated fat.

Aseem Malhotra, interventional cardiology specialist registrar at Croydon University hospital, London, also argues that statins have been over-prescribed because of the government's obsession with lowering cholesterol in an attempt to reduce heart disease – and that the side-effects outweigh the benefits for millions of people who take them every day.

Trans-fats found in many fast foods, bakery goods and margarine are indeed a problem, Malhotra writes in the British Medical Journal. But saturated fats in milk, cheese and meat are another matter.
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Eating processed meat has been linked to higher rates of heart disease and diabetes, but not red meat.

Malhotra says people have wrongly embraced low-fat products thinking they are better for their health or will help them lose weight, when many are full of sugar.
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Rather than take statins, he said, people with cardiovascular risks should eat a Mediterranean diet, rich in olive oil, fruit, vegetables, fish and nuts. He pointed to a recent study that showed that adopting a Mediterranean diet after a heart attack is three times more effective in preventing further illness than statins.

"In the UK eight million people take statins regularly, up from five million 10 years ago," he writes. "With 60 million statin prescriptions a year, it is difficult to demonstrate any additional effect of statins on reduced cardiovascular mortality over the effects of the decline in smoking and primary angioplasty [a technique used by doctors to widen the arteries]."

www.theguardian.com/lifeandstyle/2013/oct/22/butter-cheese-saturated-fat-heart-specialist

I have believed that sugar was the culprit ever since reading, years ago, Dr John Yudkin's Pure White and Deadly.

Of course, Dr Yudkin was vilified for his claims. Good to see him getting the recognition he deserves at last.

When you say "sugar was the culprit", do you know what happens to sugar in the body? Do you know how it is metabolised and what it is converted to?

All guidelines on healthy eating have said that too much sugar is bad for you. If you look at guidance like the food pyramid or the food plate - where is sugar - tied with fat !!

This might need updating - and fat is more complicated than just that word.

Some facts for you:

Saturated fatty acids

SFA are synthesised by the body and are not required in the diet. Therefore, no Population Reference Intake (PRI), Average Requirement (AR), Lower Threshold Intake (LTI), or Adequate Intake (AI) is set.

There is a positive, dose-dependent relationship between the intake of a mixture of saturated fatty acids and blood low density lipoprotein (LDL) cholesterol concentrations, when compared to carbohydrates. So the intake of saturated fats in your diet increases LDL

There is also evidence from dietary intervention studies that decreasing the intakes of products rich in saturated fatty acids by replacement with products rich in n-6 polyunsaturated fatty acids (without changing total fat intake) decreased the number of cardiovascular events.

As the relationship between saturated fatty acids intake and the increase in LDL cholesterol concentrations is continuous, no threshold of saturated fatty acids intake can be defined below which there is no adverse effect. Thus, also no Tolerable Upper Intake Level can be set.

The Panel concludes that saturated fatty acids intake should be as low as is possible within the context of a nutritionally adequate diet. Limiting the intake of saturated fatty acids should be considered when establishing nutrient goals and recommendations

Cis-polyunsaturated fatty acids

(cis-PUFA) In view of the different metabolic effects of the various dietary cis- polyunsaturated fatty acids, the Panel proposes not to formulate a Dietary Reference Value for the intake of total cis- polyunsaturated fatty acids.

Also, the Panel proposes not to set specific values for the n-3/n-6 ratio as there are insufficient data on clinical and biochemical endpoints in humans to recommend a ratio independent of absolute levels of intake (*this is the omega 3 / omega 6 issue)

n-6 polyunsaturated fatty acids

(n-6 PUFA) Linoleic acid (LA) cannot be synthesised by the body, is required to maintain “metabolic integrity”, and is therefore an EFA. (essential fatty acid )

However, there are not sufficient scientific data to derive an Average Requirement, a Lower Threshold Intake or a Population Reference Intake.

There is a negative (beneficial), dose-dependent relationship between the intake of linoleic acid and blood LDL cholesterol concentrations, while this relationship is positive for HDL cholesterol concentrations (* so omega 6 decrease LDL and raises HDL)

In addition, linoleic acid (LA) lowers fasting blood triacylglycerol concentrations when compared to carbohydrates.

There is also evidence that replacement of saturated fatty acids by n-6 polyunsaturated fatty acids (without changing total fat intake) decreases the number of cardiovascular events in the population

.As the relationship between linoleic acid intake and the blood lipid profile is continuous, no threshold value of linoleic acid intake can be identified below which the risk for cardiovascular events increases.

The Panel proposes to set an Adequate Intake for linoleic acid of 4 E%, based on the lowest estimated mean intakes of the various population groups from a number of European countries, where overt LA deficiency symptoms are not present.

n-3 polyunsaturated fatty acids

(n-3 PUFA) Alpha-linolenic acid (ALA) cannot be synthesised by the body, is required to maintain “metabolic integrity”, and is therefore considered to be an EFA.

However, there are not sufficient scientific data to derive an Average Requirement, a Lower Threshold Intake or a Population Reference Intake.. The Panel proposes to set an Adequate Intake for alpha-linolenic acid of 0.5 E%, based on the lowest estimated mean intakes of the various population groups from a number of European countries, where overt alpha-linolenic acid deficiency symptoms are not present.

There is no convincing evidence that the intake of alpha-linolenic acid has detrimental effects on health (e.g. in promoting diet-related diseases). The Panel, therefore, proposes not to set a Tolerable Upper Intake Level for alpha-linolenic acid.

The human body can synthesise eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) from alpha-linolenic acid.

The fish oil question

Intervention studies have demonstrated beneficial effects of preformed n-3 long-chain polyunsaturated fatty acids on recognised cardiovascular risk factors, such as a reduction of plasma triacylglycerol concentrations, platelet aggregation, and blood pressure

Trans fatty acids

(TFA) Trans fatty acids are not synthesised by the human body and are not required in the diet. Therefore, no Population Reference Intake, Average Requirement, or Adequate Intake is set.

Consumption of diets containing trans-monounsaturated fatty acids, like diets containing mixtures of saturated fatty acids, increases blood total and LDL cholesterol concentrations in a dose-dependent manner, compared with consumption of diets containing cis-monounsaturated fatty acids or cis-polyunsaturated fatty acids.

Consumption of diets containing trans-monounsaturated fatty acids also results in reduced blood HDL cholesterol concentrations and increases the total cholesterol to HDL cholesterol ratio. The available evidence indicates that trans fatty acids from ruminant sources have adverse effects on blood lipids and lipoproteins similar to those from industrial sources when consumed in equal amounts.

Prospective cohort studies show a consistent relationship between higher intakes of trans fatty acids and increased risk of coronary heart disease. The available evidence is insufficient to establish whether there is a difference between ruminant and industrial trans fatty acids consumed in equivalent amounts on the risk of coronary heart disease.

Dietary trans fatty acids are provided by several fats and oils that are also important sources of essential fatty acids and other nutrients. Thus, there is a limit to which the intake of trans fatty acids can be lowered without compromising adequacy of intake of essential nutrients. Therefore, the Panel concludes that trans fatty acids intake should be as low as is possible within the context of a nutritionally adequate diet.

Limiting the intake of trans fatty acids should be considered when establishing nutrient goals and recommendations.

Cholesterol

Cholesterol is synthesised by the body and is not required in the diet. Therefore, no Population Reference Intake, Average Requirement, or Adequate Intake is set.

Although there is a positive dose-dependent relationship between the intake of dietary cholesterol with blood LDL cholesterol concentrations, the main dietary determinant of blood LDL cholesterol concentrations is saturated fat intake. ( *in other words, saturated fat increases LDL cholesterol)

Furthermore, most dietary cholesterol is obtained from foods which are also significant sources of dietary saturated fatty acids, e.g. dairy and meat products.

Therefore the Panel decided not to propose a reference on cholesterol intake beside its conclusion on the intake of saturated fatty acids

www.efsa.europa.eu/en/search/doc/1461.pdf

It's the European Food Safety on fats in the diet.

(Have you guessed what excess sugar makes yet?)

To summarise:

Your body makes saturated fat. Therefore you don't need any in your diet as there is a link between dietary saturated fat and LDL cholesterol.

Your body needs unsaturated fat. It's also shown that dietary unsaturated fat (especially omega 3 and omega 6 which we can't make) increases HDL and lowers LDl.

Trans fats are bad.

Some foods contain essential nutrients and saturated fat. So be careful how much you consume.

Some foods high in cholesterol also contain a lot of saturated fat. So be careful with that.

Sugar - too much is bad for you.Excess calories get converted to all sorts of fat for storage as fat is an efficient energy store.

I'm not syre whether you've misunderstood or whether it's Mercola and Malhotra doing god knows what.

The advice to reduce saturated fat intake and replace with polyunsaturated fats is not wrong. It's well supported by the evidence, even the newer studies. The Chowdry meta analysis, which was widely hailed by all sorts of nutritionists last year actually showed that reducing saturated fats and replacing them with polyunsaturates results in a 20% decrease in cardiovascular events. This is in line with previous results.

It makes no sense at all to argue that red meats and saturated fats aren't the issue andbthen argue in support of the MEditerranean diet. The whole diet is based on rhe premise of limiting red meat and saturated fat intake and basing your protein and fat intakes on lean white meat, fish, nuts and olive oils. If switching to the med diet is working its likely because reducing your saturated fat and red meat intake is reducing your risk of dying from CVD or cancer.

When I say that 'sugar was the culprit' I read Dr Yudkin's and it seemed pretty convincing to me. He meant too much refined white sugar.

He meant too much refined white sugar

And do you know what too much white sugar does? Do you know what happens to it?

White sugar has been known to be an issue for ages. Like I said, it's always been something to have as "a treat" and is not essential.

Fat is an issue. It affects HDL and LDL cholesterol levels and ratios. Fat is a massive word though - it encompasses so many forms in one word.

Sugar and fatty liver disease

www.britishlivertrust.org.uk/liver-information/liver-conditions/non-alcoholic-fatty-liver-disease/

And sugar and triglycerides

www.healthcentral.com/cholesterol/c/42538/107006/triglycerides/

Sugar is converted to triglycerides. Stored in fat cells for later use as energy.

We need more words for it. Referring to each fatty acid by name might be overkill for everyday usage though

I think this article is quite balanced

www.theguardian.com/lifeandstyle/2013/mar/11/how-bad-is-steak-for-you

Have some saturated fat. But not too much. Unsaturated good for you. Omega 3 and Omega 6 are great and essential.

Sugar - refined sugar. Don't have as a substitute

Carbs - unprocessed, not refined, simple carbs.

Vegetables - great

Watch your calories. Excess calories don't go away. They get stored.

Yes - we do need more words for fat. But the message has to be simple.

(And look. No mention of cholesterol. But all of the above affects cholesterol, types of cholesterol and triglycerides. Which is linked to disease)

Oh - and red wine. That's probably ok.

Another interesting article - Claig might approve

www.theguardian.com/lifeandstyle/2013/oct/22/butter-cheese-saturated-fat-heart-specialist

Part of it:

He adds that it may depend on what sort of foods the saturated fat comes from. Dairy products contain vitamin D, a lack of which has been linked to increased heart disease, and calcium and phosphorus, which may have blood pressure lowering effects. Eating processed meat has been linked to higher rates of heart disease and diabetes, but not red meat.

Vitamin D and E are fat soluble and are found in fatty foods

But saturated fat does raise LDL - so it's a case of not too much,..

And

Malhotra says people have wrongly embraced low-fat products thinking they are better for their health or will help them lose weight, when many are full of sugar. "Last week I saw one patient in her 40s who had had a heart attack," he told the Guardian. "She said she had gained about 20kg in the last six months. She had been drinking five low-fat drinks a day."

He calculated that each 450ml flavoured milk drink contained about 15 teaspoons of sugar, which meant she had consumed 75 teaspoons of sugar each day.

That is an issue. It's wrong that a low fat product can have so much sugar in. Very very wrong

He tells his patients that butter and cheese – though not processed cheese – are better for them than low-fat spreads and that the odd steak will not hurt. Rather than take statins, he said, people with cardiovascular risks should eat a Mediterranean diet, rich in olive oil, fruit, vegetables, fish and nuts. He pointed to a recent study that showed that adopting a Mediterranean diet after a heart attack is three times more effective in preventing further illness than statins.

Butter - high in saturated fats
Very spreadable margarine - high in poly unsaturates and low in trans fats
Harder margarine - high in trans fats

But....the fat in such sources is not a high percentage of dietary fat.

I am shocked by the low fat stuff with all the sugar in. That is wrong.

I think that's the guardian reporting of the Malhotra BMJ article that Claig gave a DM link to earlier. I'm trying to get to the full article but it seems to be paywalled.

The low fat stuff with added sugar in is a huge issue. This is where I think groups like sugar action do have a point to make. Replacing the fat you cut out with sugar is likely to negate any benefits you would have got.

The dairy thing is interesting. It would fit with a couple of things I've read in the last few weeks about odd chain fatty acids reducing cholesterol.

I've spent the past few hours researching fish types, different oils, linseed oil, looking at Tesco etc etc.

Fish is good - but we've gone and polluted the sea so they contain mercury.

But... I do like my meat though. I do use olive oil and have always cut the fat off. I tend to use spreads that have no trans fats in and I am very good about sugar. But...sugar is everywhere.

I am very bad at fruit and veg though. I really should do something about my diet. I am in a healthy BMI and my HDL / Cholesterol ratio is....ok. My cholesterol is fine and I don't smoke.

I have the advantage of knowing all this stuff. It must be very complicated for people who get conflicting information.

Ha ha I could have written most of that post myself.

I do think they are doing a reasonable job of simplifying the message and getting it across. But I can see how it must seem confusing with the huge quantity of poorly written science and health articles in the media. It's like being faced with a huge wall of conflicting and sometimes inaccurate information and no way of sifting through it to find out what it all means.

Throws in milk sugar and fruit sugars into the thread.

Walks away and wonders what effect that will have.....

It has made me think a bit more about my diet though. So thanks claig.

I won't eat much saturated fat though. But I might look at my breakfast....

(Off to start a thread on Chat about breakfast now)

I have got this guy's book. I haven't read it, just flipped through it. But even with my flipping, I know more about a common sense diet than the metropolitan elite. This guy used to be a vegetarian and had put weight on and had IBS. One day in desperation, he decided to ignore everything he had been told by the metropolitan elite. The book is about what happened next.

"Damn your low fat diet: How a reformed vegan gorges on all the foods his granny enjoyed... and has never felt better
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for the previous 26 years I’d been a vegan, eschewing not just meat but all animal products.

My diet was an extreme version of the NHS Eat Well regime, which recommends lots of starchy foods and smaller quantities of saturated fats, cholesterol, sugar and red meat.
...
Worst of all, I had irritable bowel syndrome (IBS), which left me feeling as if I had lead weights in my gut. My belly was bloated and distended after every meal. I was, to use a technical term, knackered.

But that was about to change. In 2010, I decided to give up my supposedly healthy lifestyle and embrace good old-fashioned meat.

From that day on, I ate red meat four or five days a week. I gobbled the fat on chops, chicken skin and pork crackling. I feasted on everything we’re told to avoid. The effects were instant.

Twenty-four hours after eating meat again, all my IBS symptoms had gone. As the weeks and months passed, every aspect of my health improved dramatically. I became leaner, shedding body fat and becoming stronger and fitter. My headaches went away, never to return. Even my libido increased.

It felt like being young again, like coming back to life. But though I felt energised, I was also furious.

Furious with myself for sticking to the ‘healthy’ eating advice, which was actually far from a sensible diet. But also furious with the so-called experts who have been peddling this low-fat, high-carbohydrate claptrap for so long that no one thinks to question it.

She was right to be sceptical, it turns out. For years the authorities told us cholesterol-rich foods would kill us — but we’ve since learned that is utter drivel.

While Ancel Keys, the scientist whose research in the Fifties first raised concerns about cholesterol levels, suggested that heart disease was linked to large amounts of cholesterol in the blood, he never claimed those levels were linked to the amount of cholesterol we eat.

‘There’s no connection whatsoever between cholesterol in food and cholesterol in blood,’ he said in a magazine article in 1997. ‘And we’ve known that all along.’

Since then, the NHS’s paranoia about cholesterol in food has been replaced by concerns about saturated fat — found in everything from butter, cheese and cream to pies, cakes and biscuits.

They suggest saturated fat increases the risk of heart disease. But this is open to debate.

France has the lowest rate of death from coronary heart disease in Europe, yet the country has the highest consumption of saturated fats.
...
His diet in his later years was not one that would have appealed to Gran. She was vehemently against margarine.

‘I’m not eating anything made in a factory,’ she’d say. ‘You don’t know what they put in it.’

It was a fear shared by many of her era. Had I heeded such warnings, I would have avoided my battle with processed food, in the form of soya, the bean whose industrially produced extracts are marketed as a low-fat and exceptionally healthy source of protein.

Today, soya is everywhere. About two-thirds of all processed food in the U.S. contains some form of it.That percentage will not be much different here — you’d be amazed at how often you eat ‘hidden’ soya.
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This new healthy eating advice had much in common with the vegetarian diet. We felt we were following a golden path, especially when we discovered the apparent wonders of soya.

Only later did we discover that research by the Weston A. Price Foundation had suggested that processed soya foods are rich in chemicals called trypsin inhibitors, which disrupt protein digestion. I believe it was these that created all my problems with IBS.

Soya has also been associated with hypothyroidism, or an under-active thyroid, a condition whose symptoms include unexplained weight gain, lack of energy and depression

www.dailymail.co.uk/femail/article-2105132/Damn-low-fat-diet-How-reformed-vegan-John-Nicholson-gorges-foods-granny-enjoyed--felt-better.html

'I decided to give up my supposedly healthy lifestyle and embrace good old-fashioned meat'

Remember what they say - meat is bad for us and also bad for their other con , "savng the planet".

What is their game? It's worth findingout.

Come on claig

That's just more quotes. What do you think of the guidelines?

They suggest saturated fat increases the risk of heart disease. But this is open to debate

Saturated fat increases LDL. You make it yourself. But foods with saturated fat also contain needed vitamins and minerals.

So...some but not too much.

Soya...- I think you are confusing soya with soybean oil.

What is wrong with soybean oil ? It's high in polyunsaturates and not hydrogenated. I thought I explained why soybean oil is ok. Can you name some foods with soya in?

meat is bad for us

No...but too much meat is not good for you. There's a difference.

'France has the lowest rate of death from coronary heart disease in Europe, yet the country has the highest consumption of saturated fats.'

Do the French know about food? It is part of their culture. It is amazing how knowledgeable and how much care they take about food. They are educated an socialised to it from a young age.

I am sure you are Googling DM articles right now.

Can you explain why you think the soya bean is bad for you?
What do you think it does to your body's systems?

yet the country has the highest consumption of saturated fats

Yes - but they eat other things as well. It's not just consumption. It's percentages plus the other food as well.

Looking forward to your explanation about soya.