“Although low-fat high-carbohydrate diets are recommended…in an effort to reduce the risk of coronary artery disease, the results of short-term studies have shown that these diets can lead to…an increased risk of coronary artery disease.” – The American Diabetes Association
As with other popular misconceptions about how our bodies work, confusion runs rampant about lowering cholesterol and cholesterol in general. Ancel Keys played a key role in creating this problem. Along with his other claims, he needed a scientific sounding explanation for how foods containing fat kill us. Looking at his data, Keys noticed that people eating more foods that contain fat generally had higher total cholesterol. While there was—and still is—no proof that high total cholesterol causes cardiovascular issues, Keys called it the cause of their heart problems.
It’s Not About Lower Total Cholesterol Levels
Even while Keys was touting his new findings, the Federal Register (the official log of the federal government of the U.S.) was on record with the true scientific data at that time:
“The role of cholesterol in heart disease has not been established. A causal relationship between blood cholesterol levels and these diseases has not been proved. The advisability of making extensive changes in the nature of the dietary fat intake of the people of this country has not been demonstrated.”
Likewise, to this day, no studies have proven high total cholesterol causes heart disease. In the American Journal of Medicine T. Gordon reported, “Total cholesterol per se is not a risk factor for coronary heart disease at all.” Dr. Uffe Ravnskov analyzed 26 randomized and controlled trials which were designed to lower total cholesterol and, theoretically, the risk of cardiovascular disease and death. Ravnskov’s analysis put people into two groups:
- Treatment Group: People who ate less food that contain fat and/or took cholesterol-lowering drugs.
- Control Group: People who did not eat less food that contain fat and did not take cholesterol-lowering drugs.
Across the studies, the total number of heart attack deaths was equal between the groups, and more people died overall in the group who ate less fat and/or took cholesterol-lowering drugs. Ravnskov concluded: “Lowering serum cholesterol concentrations does not reduce mortality and is unlikely to prevent coronary heart disease.”
Average Outcomes Across the 26 Cholesterol Studies
For foods that contain fat and cholesterol to be killers, three points must be proven:
- Eating natural foods that contain fat leads to risky levels of cholesterol.
- These levels of cholesterol cause cardiovascular disease.
- The diet outlined by government’s guidelines improves these cholesterol levels.
None of these things have been proven.
University of California’s J.B. German summarizes the state of cholesterol research:
“The approach of many mainstream investigators…has been narrowly focused to produce and evaluate evidence in support of the hypothesis that dietary saturated fat elevates LDL cholesterol and thus the risk of coronary artery disease. The evidence is not strong, and, overall, dietary intervention by lowering saturated fat intake does not lower the incidence of nonfatal coronary artery disease; nor does such dietary intervention lower coronary disease or total mortality.”
Eating SANE foods containing fat has never been proven to lead to risky levels of cholesterol. The effect of natural dietary fat on cholesterol has never been proven to cause cardiovascular disease. In fact, studies have shown the opposite. The high-starch, low-fat, and low-protein diet promoted by the government’s guidelines has been proven to worsen the type of cholesterol that decreases the risk of heart disease (HDL cholesterol).
- Anderson KM, Castelli WP, Levy D. Cholesterol and mortality. 30 years of follow-up from the Framingham study. JAMA 1987; 257:2176–80.
- Chyou PH, Eaker ED. Serum cholesterol concentrations and all-cause mortality in older people. Age Ageing 2000; 29:69–74.
- Coulston AM, Hollenbeck CB, Swislocki AL, Reaven GM. Persistence of hypertriglyceridemic effect of low-fat high-carbohydrate diets in NIDDM patients.Diabetes Care. 1989 Feb;12(2):94-101. PubMed PMID: 2539286.
- Ford ES, Liu S. (2001). Glycemic index and serum high-density lipoprotein cholesterol concentration among U.S. adults. Arch. Intern. Med., 161: 572-576.
- Forette B, Tortrat D, Wolmark Y. Cholesterol as risk factor for mortality in elderly women. Lancet 1989; 1:868–70.
- Fried LP, Kronmal RA, Newman AB, Bild DE, Mittelmark MB, Polak JF, Robbins JA, Gardin JM. Risk factors for 5-year mortality in older adults: The Cardiovascular Health Study. JAMA 1998; 279:585–92.
- Frost G, Leeds AA, Dore’ CJ, Madeiros S, Brading S, Dornhorst A. (1999). Glycaemic index as a determinant of serum HDL-cholesterol concentration. Lancet, 353: 1045-1048.
- German JB, Dillard CJ. Saturated fats: what dietary intake? Am J Clin Nutr. 2004 Sep;80(3):550-9. Review. PubMed PMID: 15321792.
- Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR. High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med 1977;62:707-714.
- Hays JH, DiSabatino A, Gorman RT, Vincent S, Stillabower ME. Effect of a high saturated fat and no-starch diet on serum lipid subfractions in patients with documented atherosclerotic cardiovascular disease. Mayo Clin Proc 2003;78:1331–6.
- Jonsson A, Sigvaldason H, Sigfusson N. Total cholesterol and mortality after age 80 years. Lancet 1997; 350:1778–9.
- Krumholz HM, Seeman TE, Merrill SS, Mendes de Leon CF, Vaccarino V, Silverman DI, Tsukahara R, Ostfeld AM, Berkman LF. Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years. JAMA 1994; 272:1335–40.
- Meckling KA, O’Sullivan C, Saari D. Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. J Clin Endocrinol Metab 2004;89:2717–23.
- Menotti A, Mulder I, Nissinen A, Feskens E, Giampaoli S, Tervahauta M, Kromhout D. Cardiovascular risk factors and 10-year all-cause mortality in elderly European male populations; the FINE study. Eur Heart J 2001; 22:573–9.
- Räihä I, Marniemi J, Puukka P, Toikka T, Ehnholm C, Sourander L. Effect of serum lipids, lipoproteins, and apolipoproteins on vascular and nonvascular mortality in the elderly. Arterioscler Thromb Vasc Biol 1997; 17:1224–32.
- Ravnskov U. Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome. BMJ. 1992 Jul 4;305(6844):15-9. Erratum in: BMJ 1992 Aug 29;305(6852):505. PubMed PMID: 1638188; PubMed Central PMCID: PMC1882525.
- Ravnskov U. High cholesterol may protect against infections and atherosclerosis. QJM. 2003 Dec;96(12):927-34. Review. PubMed PMID: 14631060.
- Ravnskov U. Saturated fat doesn’t affect blood cholesterol. Am J Clin Nutr. 2006 Dec;84(6):1550-1; author reply 1551-2. PubMed PMID: 17158443.
- Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study. Lancet 2001; 358:351–5.
- Scientific steering committee on behalf of the Simon Broome Register group. Risk of fatal coronary heart disease in familial hypercholesterolaemia. Br Med J 1991; 303:893–6.
- Sharman MJ, Gomez AL, Kraemer WJ, Volek JS. Very low-carbohydrate and low-fat diets affect fasting lipids and postprandial lipemia differently in overweight men. J Nutr 2004;134:880–5.
- Siegel D, Kuller L, Lazarus NB, Black D, Feigal D, Hughes G, Schoenberger JA, Hulley SB. Predictors of cardiovascular events and mortality in the Systolic Hypertension in the Elderly Program pilot project. Am J Epidemiol 1987; 126:385–9.
- Sondike SB, Copperman N, Jacobson MS. Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. J Pediatr 2003;142:253–8.
- Status of Articles offered to the General Public for the Control or Reduction of Blood Cholesterol Levels and for the Prevention and Treatment of Heart and Artery Disease Under the Federal Food, Drug, and Cosmetic Act. Federal Register. 1959, December 12.
- Weverling-Rijnsburger AW, Blauw GJ, Lagaay AM, Knook DL, Meinders AE, Westendorp RG. Total cholesterol and risk of mortality in the oldest old. Lancet 1997; 350:1119–23.
- Yudkin J. Diet and coronary thrombosis hypothesis and fact. Lancet. 1957 Jul 27;273(6987):155-62. PubMed PMID: 13450357.
- Zimetbaum P, Frishman WH, Ooi WL, Derman MP, Aronson M, Gidez LI, Eder HA. Plasma lipids and lipoproteins and the incidence of cardiovascular disease in the very elderly. The Bronx aging study. Arterioscl Thromb 1992; 12:416–23.