Friday, 25 July 2008

High Cholesterol : Fact or Fiction Pt 1

Cary G Dean.

Over the past couple of decades there has been a growing concern about fats and cholesterol. Dieticians, nutritionists and doctors have been telling us that fat is a killer.

Governments have introduced national policies based around its reduction.

Eat less cholesterol, saturated fat and salt, eat more fibre-rich foods we are all told.

The evidence is incontrovertible that if we do not, we are doomed to the West's greatest killer - heart disease.

But is the evidence so clear?

Despite the certainty implied by the propaganda, the debate continues in the medical journals, behind the scenes.

Is diet a killer?

Apart from those with a very rare disease, has cholesterol got anything to do with heart disease - or any other disease? And even if it has, will a change of diet be beneficial?

Like all debates, this one about cholesterol has two sides.

High Cholesterol Fact or fiction explores the evidence on which present healthy eating dietary recommendations are based.

Much of the evidence used in the cholesterol debate is complex.

Nevertheless, with so much of only one side of the debate having been published and your having been subjected to so much that is misleading, I will try to explain the other side in as much detail as possible.


On the basis of research in the 1920s and 1930s by Sir John Boyd Orr and others, that was the advice given to the British people in 1938.

The Government introduced free school milk - full cream, that is.

Drinking too much Pasturized milk can be deadly, Raw milk isn't the big Ogre it's made out to be, so get it if you can.- later we went to work on an egg.

As a consequence, child deaths from diphtheria, measles, scarlet fever and whooping cough fell dramatically well before the introduction of antibiotics and widespread immunisation.

Rickets, called the English Disease because it was so wide-spread, and other deficiency diseases were relegated to the past.

Other factors helped, but most important of all was the better nutrition that gave children a higher resistance.

The recommendations above shaped our diet for nearly fifty years and helped to give us a mean life expectancy that is now among the highest in the world.

Sixty years in 1930, our mean life expectancy had climbed to seventy years by 1960 and to seventy-five years by 1990. Now we are told they are shortening our lives - killing us with coronary heart disease.

Why the sudden change? To discover that, we need to know something of the history of coronary heart disease and how the strategy to combat it evolved.

Coronary heart disease

There are many diseases that affect the heart but the one that the healthy eating strategies seek to prevent is Coronary Heart Disease (CHD), more correctly called ischaemic heart disease (IHD).

CHD is a condition where the coronary arteries that supply blood to nourish the heart muscle are narrowed by a build-up of material on their walls (an atheroma) to such an extent that they become blocked.

This cuts off the blood supply to part of the heart muscle, and we have a heart attack. The narrowing also encourages the clotting of blood and, in consequence, it is possible for a clot to cause a heart attack long before the atheroma is large enough to do so.

The material generally blamed for the build-up is cholesterol and the healthy eating advice given to the public to reduce the incidence of CHD is aimed simply at reducing the levels of cholesterol in the blood.


Because of the propaganda, you can be forgiven for thinking that cholesterol is a harmful alien substance that should be avoided at all costs.

In fact, nothing could be further from the truth.

Cholesterol is an essential component in the body.

It is found in all the cells of the body, particularly in the brain and nerve cells.

Body cells are continually dying and new ones being made.

Cholesterol is a major building block from which cell walls are made.

Cholesterol is also used to make a number of other important substances:

Hormones (including the sex hormones), bile acids and, in conjunction with sunlight on the skin, vitamin D 3 . The body uses large quantities of cholesterol every day and the substance is so important that, with the exception of brain cells, every body cell has the ability to make it.

Cholesterol may be ingested in animal products, but less than twenty percent of your body's cholesterol needs will be supplied in this way.

Your body then makes up the difference.

If you eat less cholesterol, your body merely compensates by making more.

Although the media and food companies still warn against cholesterol in diet, it has been repeatedly demonstrated that the level of cholesterol in your blood is affected very little by the amount of cholesterol you eat.


J W Gofman, et al. The role of lipids and lipoproteins in atherosclerosis . Science. 1950; 111: 166. J P Strong, H C McGill jr. The natural history of coronary atherosclerosis. Am J Pathol. 1962; 40: 37. W F Enos, R H Holmes, J Beyer. Coronary disease among United States soldiers killed in action in Korea. Preliminary report. JAMA 1953; 152: 1090.

Friday, July 25, 2008 9:21 AM

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