Finally some news that is worth reading. The LA Times just ran a story on Oct 22nd 2013 "Time to end the war against saturated fat?" It was refreshing to know that I was not the only one talking about the benefits of a low-carb/high-fat diet. "British Medical Journal has issued a clarion call to all who want to ward off heart disease: Forget the statins and bring back the bacon (or at least the full-fat yogurt). Saturated fat is not the widow-maker it's been made out to be, writes British cardiologist Aseem Malhotra" The story's lead paragraph read. Ahhh, bacon! Though the LA Times is for readers who don't generally want too much science, it was rooted in a solid peer reviewed BMJ article with some provoking questions entitled "Saturated fat is not the major issue" by Dr. Aseem Malhotra, interventional cardiology specialist registrar, Croydon University Hospital, London, brought up the fact that shortly after the US stated that saturated fat was deadly, studies were already disproving the heralded "seven countries" study. Which concluded "that a correlation existed between the incidence of coronary heart disease and total cholesterol concentrations, which then correlated with the proportion of energy provided by saturated fat. But correlation is not causation. Nevertheless, we were advised to cut fat intake to 30% of total energy and saturated fat to 10%.” (1) "The aspect of dietary saturated fat that is believed to have the greatest influence on cardiovascular risk is elevated concentrations of low density lipoprotein (LDL) cholesterol. Yet the reduction in LDL cholesterol from reducing saturated fat intake seems to be specific to large, buoyant (type A) LDL particles, when in fact it is the small, dense (type B) particles (responsive to carbohydrate intake) that are implicated in cardiovascular disease" (2) To summarize, carbs create small dense LDL particles which are bad news, but saturated fats are large and very large LDL particles which are harmless.
What about cholesterol?
The first response I get when I tell people that a high-fat diet is great for weight loss and energy, they say something about cholesterol. "I have high cholesterol, I can't do a high-fat diet" or something along that line. Well, good news! (not really new news) but the correlation of cholesterol and heart disease has not been proven. "Despite the common belief that high cholesterol is a significant risk factor for coronary artery disease, several independent population studies in healthy adults have shown that low total cholesterol is associated with cardiovascular and non-cardiac mortality, indicating that high total cholesterol is not a risk factor in a healthy population." (3), (4), (5)
Notice the dates, 1994, 2002, some of these studies have been out there for a long time, peer reviewed and published, how come they have not hit the mainstream medical community? Is it that "the science is settled" argument and we move on with our blinders on? I hope not!
Aseem Malhotra states "A recent “real world” study of 150 000 patients who were taking statins showed “unacceptable” side effects—including myalgia, gastrointestinal upset, sleep and memory disturbance, and erectile dysfunction—in 20% of participants, resulting in discontinuation of the drug.(6) This is massively at odds with the major statin trials that report significant side effects of myopathy or muscle pain in only one in 10 000."
Statin drugs are a huge business. Pfizer’s Lipitor was the world’s top-selling medicine in 2010, according to IMS, raking in sales of $13.3billion. AstraZeneca’s Crestor, which garnered $5.38billion in sales during 2009, is one of the company’s best selling medicines.
Total sales last year of cholesterol-treating medicines - including statins - were $35billion, according to IMS. So if you follow the money, it's a tough decision to state publicly that it's not really necessary to take statin drugs to lower cholesterol when you can reduce your carb intake and get the same results.
From a UK Telegraph article "Despite the commercial success of statins, Dr Mali, (a pharmaceuticals analyst at Matrix Partners), out that the persistence of heart disease does raise questions about the drugs’ value for money.
“Statins have been the fairy tale story in the industry. But heart disease is still the number one killer in the western world, so one could argue how much value for money have we really got out of their use,” he said."
Aseem Malhotra stated a stinging truth "Adopting a Mediterranean diet after a heart attack is almost three times as powerful in reducing mortality as taking a statin. The recently published PREDIMED randomised controlled trial was stopped early after it showed that in high risk people the Mediterranean diet achieved a 30% improvement over a “low fat” diet in terms of cardiovascular events.(7) Dr, Malhotra states finally "It is time to bust the myth of the role of saturated fat in heart disease and wind back the harms of dietary advice that has contributed to obesity." So if I were reading this correctly, saturated fat, in his professional opinion, is not the culprit, but the dietary advice that has been given since Ancel Keys somehow won over the hearts and minds of the world in the 1970's; that is the problem. A low fat diet makes you fat & sick, while a low carb/high fat diet makes you skinny. Pass the bacon! (Organic of course)
1. Committee on Medical Aspects of Food Policy. Diet and cardiovascular disease: report of the panel on diet in relation to cardiovascular disease. 1984
2. Musunuru K. Atherogenic dyslipidaemia: cardiovascular risk and dietary intervention. Lipids2010;45:907-14.CrossRef, MedLine 3. Nago N, Ishikawa S, Goto T, Kayaba K. Low cholesterol is associated with mortality from stroke, heart disease, and cancer: the Jichi Medical School Cohort Study. J Epidemiol2011;21:67-74.CrossRef Medline
4. Bae J-M, Yang Y-J, Li Z-M, Ahn Y-O. Low cholesterol is associated with mortality from cardiovascular diseases: a dynamic cohort study in Korean adults. J Korean Med Sci2002;27;58-63.
5. Simes RJ. Low cholesterol and risk of non-coronary mortality. Aust N Z J Med1994;24:113-9.Medline
6. Zhang H, Plutzky J, Skentzos S, Morrison F, Mar P, Shubina M, et al. Discontinuation of statins in routine care settings. Ann Intern Med2013;158:526-34. MedLine
7. Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med2013;368:1279-90. CrossRef MedLine
Tim & Lynette Jenné are learners first and foremost. We love to ask "why?" We question the status quo. We also love to research and find answers for ourselves. As parents of four adult children, we've learned a few things along the way that may be helpful to others. We love to live & eat clean, simple lives.