Re-source - TRUTH about statins cholesterol and fats

We have been led to believe that all fat is bad for us yet that has never been the case

Crash course in Cholesterol, and Statins

Debunking the Dogma About Fat, how we got here, the beginnings.

For half a century, health agencies and experts have recommended vegetable oils over saturated fats for cooking. They have told the public that vegetable oils are cardiac-protective. However, research suggests that these oils may not be as beneficial as they seem.

When the term "cooking oil" is mentioned, the immediate image that comes to mind for most people is pale and yellow liquid in large transparent bottles labeled "vegetable oil."

Though vegetable oils are a staple cooking oil for many now, they are only a recent invention. For thousands of years until only a few decades ago, common fats used in cooking were animal fats such as lard, tallow, butter, and suet, all of which tend to have a higher saturated fat ratio.

The switch to vegetable oils can be traced back to researcher and physiologist Ancel Keys, who hypothesized in the 1950s that replacing animal fats higher in saturated fats with vegetable oils, which tend to be higher in polyunsaturated fat, would lower blood cholesterol levels and in turn, reduce heart disease.

This idea, and various market changes, led to the widespread adoption of this dietary shift. And based on all the available evidence, it seems that the hypothesis is completely wrong..

While vegetable oils do lower blood cholesterol (which isn’t a good thing), they don’t lower coronary heart disease mortalities at all. In fact, many vegetable oils put consumers at untold risk of other harm.

Nevertheless, Keys' hypothesis has persisted. Starting in the 1960s, the American Heart Association put forward recommendations to switch from animal fat to vegetable oils.

The idea influenced the first edition of Dietary Guidelines for Americans in February 1980. Both the American Heart Association and the Dietary Guidelines for Americans, valid from 2020 to 2025, have disastrously recommended polyunsaturated fatty acid consumption over saturated fat.

In the 1950s, several randomized controlled clinical trials began testing a diet low in animal fat; participants switched from consuming animal fats, such as milk and cheese, to a polyunsaturated vegetable-fat diet. While these studies saw reductions in cholesterol levels, long-term and follow-up studies showed that those who had traded animal fats for vegetable oils and proteins often suffered from higher overall mortality, (more deaths) often with increased cancer deaths.

Starting in the 1980s, several studies also linked low blood cholesterol with cancer, though it hasn't been determined why this link exists. Low blood cholesterol is also linked to dementia, Alzheimer’s and numerous other health issues. The use of Statins (the most profitable drug until 2020) has caused terrible damage to health with no obvious benefit except profit. We will discuss that in a different later in this email.

"The people on the high vegetable oil died at higher rates from cancer, and there were a series of very high-level meetings at the National Institutes of Health throughout the 1980s trying to understand this very concerning outcome," investigative journalist Nina Teicholz said. "Those concerns were not resolved.” The connection between seed oil oxidation and inflammation, and its relation with cancer, was first extensively outlined in Teicholz's book, New York Times bestseller "The Big Fat Surprise." Teicholz is the first to label seed-derived vegetable oils as "seed oils" and spent a decade researching fats and oils to write her book.

Although other health experts have also linked vegetable oil with obesity and diabetes, Teicholz said the evidence is usually from observational studies. In contrast, the cancer link was seen in randomized controlled trials, making it a more robust methodology.

Saturated Fats Are More Suitable for Cooking. Fats high in saturated fat tend to be the most stable when cooked, this is because they are much less reactive with heat and oxygen at the molecular bond level.

Vegetable Oils Continue to Be Recommended Despite Health Risks: 3 Main Reasons

Though research repeatedly shows that vegetable oils, otherwise known as seed oils, are harmful when cooked, dietary guidelines and health organizations continue to promote polyunsaturated vegetable fats over animal fats. Nina Teicholz, an investigative journalist who had spent a decade researching fats and oils, gave three major potential reasons why the recommendation has not changed despite a lack of evidence of vegetable oils' purported benefits and discrepancies in studies that point to possible cancer risks.

1. Bureaucracy Versus Science

The anti-saturated fat nutrition recommendation comes from the American Heart Association (AHA) researcher and physiologist Ancel Keys' Diet-Heart Hypothesis, originally put forward in the 1950s. Keys' original assumption was that fat, which raised blood cholesterol levels, caused coronary heart disease. He later narrowed the fat type to saturated fat.

While the hypothesis has been since debunked, Keys' published a study that compared heart disease and fat consumption in a half dozen countries (Australia, USA, Canada, UK, Japan, and Italy).

The more fat, the more heart disease. The trend line was unmistakeable. Just one little problem, keys left out countries where people eat a lot of fat but have very little heart disease, like Holland and Norway. He also left out countries where people don’t eat much fat, but do have lots of heart disease like Chile.

In fact, Keys had reliable data from 22 countries, but only showed the 6 that fitted his story. The results were all over the place. But you can’t make a big splash in the scientific community with a trend line that is all over the place. So keys did what any dedicated researcher would do that wanted to make a name for himself. He threw out the data that didn’t fit his story and published his results that did.

Unfortunately, this anti-saturated fat recommendation has evolved over the decades from an incorrect diet recommendation to health dogma and national policy. Congressional backing of this diet was the final nail in the coffin.

The 1977 Dietary Goals for the United States, authored by a Senate select committee, followed the AHA's guidance to reduce total and saturated fat intake, and began nationalizing the low-fat, low-cholesterol diet.

Soon after, in 1980, the National Institutes of Health published its first edition of Dietary Guidelines for Americans. A whole section was dedicated to reducing cholesterol and fats. With this, the hypothesis and dietary recommendation was taken out of the realm of science and into the world of politics and government. From there, the bureaucracy took over and the machine of government turned dogma into policy and programs.

Bureaucratic powers, however, are antithetical to scientific reasoning. Good science requires skepticism to survive and involves challenging preconceived hypotheses and conclusions to get closer to the truth. Bureaucracies, however, are designed to execute on rules and guidelines, not challenge them.

Such is the case with the AHA, the main mouthpiece in this area, heavily funded by those companies who profit heavily from this advice.

The AHA has recommended against animal fat consumption for nearly half a century. Retracting such a cornerstone recommendation would pose a problem for the AHA, hence why many leading researchers dedicate their lives and careers to finding evidence to support their dogma, and steer popular opinion.

2. Financial Incentives

A sizeable financial empire spanning the food and pharmaceutical industries has been built on the Diet-Heart Hypothesis. This is a significant reason why many researchers, health organizations, and the industry resist considering that animal fats may not be that harmful. Vegetable oils have been with the AHA since the association's rise to prominence. Founded in 1924 at the outset of the coronary heart disease epidemic, the AHA remained a fringe and underfunded research organization for decades.

Then in 1948, things changed. Procter & Gamble (P&G) designated the AHA to receive all the funds from its 'Truth or Consequences' contest on the radio. The funds totalled over $1.4 million, equivalent to $20 million today.

According to the AHA's official history book, titled "Fighting for Life" by William W. Moore, AHA's director from 1972 to 1980, P&G executives presented the cheque at a luncheon, and "suddenly the coffers were filled, and there were funds available for research, public health progress, and development of local groups—all the stuff that dreams are made of!" It was this funding that launched the organisation. I’m confident the AHA were “grateful”.

P&G was the first company to sell hydrogenated seed oil as food. Its product Crisco was initially made from hydrogenated cottonseed oil. I’m sure you can join the dots. P&G are the first company to try to sell an industrial product as food, they award a massive amount of money to the AHA, and then the AHA says that this new product is the healthy choice, and not the natural fats (nutrient dense tallow and butter) which have been used for centuries.

Today, the AHA has awarded over 120 AHA "heart-check" marks to vegetable oil products. These logos are displayed on product labels certifying the AHA has approved them as heart-healthy. While many of these oils are olive oil, they also include canola, soy, and vegetable. Only four dairy heart-checks were given, unfortunately these are to soy milk (estrogenic) or a brand of nonfat milk with above-average sugar content

It’s an nice little ‘earner’. The AHA charges food makers fees to use their logo but the association's financial returns don't appear to detail the exact revenue from the heart check program.

Over the decades, the pharmaceutical industry has also made billions of dollars selling drugs that lower LDL cholesterol, deemed "bad cholesterol" and the primary cause of coronary heart disease. Animal fat increases all cholesterol levels, including LDL, while vegetable oils decrease cholesterol levels. This is an even bigger ‘earner’.

3. Egos and Established Notions Are Hard to Challenge

Over half a century, the belief that saturated fat is bad for the heart has become a dogma among doctors and nutritionists. Therefore, arguments that contradict the Keys' Diet-Heart Hypothesis are met with extreme resistance. Researchers and journalists who publicly challenge this dogma have been subject to attacks and backlash.

This response is not new. As far back as the hypothesis' inception, some researchers whose work challenged Keys' lost their academic careers. For example, the late Dr. George Mann from Vanderbilt University, a professor and biochemist who challenged the Diet-Heart Hypothesis, This research path cost him his NIH funding and entrance to reputable journals for publication.

Keys himself openly dismissed and criticized those who put forth other causes for heart disease. While one may interpret Keys' actions as one of a guilty researcher trying to hide his deceit.

The late Professor John Yudkin, a physiologist and nutritionist at the Queen Elizabeth College in the United Kingdom, asserted that sugar could lead to heart disease. His hypothesis was ridiculed and marginalized. Keys called Yudkin's hypothesis "a mountain of nonsense", even though, decades later, research indicated that Yudkin's idea is very much on the right track.

Mann was also the associate director of the Framingham Heart Study from 1948 to 1955. Initiated in 1948, the large ongoing study investigates epidemiology and risk factors for cardiovascular disease.

During Mann's time as the associate director of the observational study, researchers found that rather than decreasing coronary heart disease risk, low cholesterol levels were unexpectedly associated with an increase in coronary and total mortality. The study also observed "no relationship" between coronary heart disease and the diet of the participants interviewed.

In 1972, Mann co-authored a study on the African Maasai people who consumed a diet high in meat, milk, and animal blood but had low blood cholesterol and little to no heart disease. However, Mann speculated that exercise could be what protected these people from heart disease.

In his 1977 commentary "Diet-Heart: End of an Era," Mann lamented the fastidious establishment of Keys' hypothesis as dogma despite the lack of evidence.

Keys dismissed Mann's paper in a letter published in 1978, accusing Mann of "deliberately" distorting data. (Pot-Kettle-Black)

For half a century, health agencies and experts have recommended vegetable oils over saturated fats for cooking. They have told the public that vegetable oils are cardioprotective. However, much research suggests these oils are devastating for health.

While saturated fat has historically faced criticism due to its association with blood cholesterol levels and coronary heart disease, emerging studies have provided a more nuanced understanding of this topic, including this fat's potential advantages in high-temperature cooking.

Big Pharma's Take

The biggest blockbuster drug of all time are LDL cholesterol-lowering medications: statins. Saturated fat has to remain the bogeyman because saturated fats tend to raise your LDL cholesterol, so that was always part of the assumption of why saturated fats are bad.

This is a classic Hegelian Dialectic.

The funding from pharmaceutical companies, including Pfizer, Merck, and AstraZeneca, made up 3.8 percent of the American Heart Association's total revenue in 2021–22, a total of nearly $34 million.

Pfizer, Merck, and AstraZeneca are all major players in the statin industry.

Funding from non-pharmaceutical corporations made up almost 18 percent of the AHA's funding that same year, totalling over $157 million. While the AHA provides the names of all its pharmaceutical benefactors, the organization declined to give names of the other corporations and donation values.

Statins are one of the most widely prescribed drugs on the planet. Whether they have been of great benefit to humankind is a difficult question.

Until 2021 they were the most profitable drug sold in history. To give you an idea of how profitable, there are approximately 67 million people in the UK, and Statins are one of the most commonly prescribed drugs in the UK: around 8 million adults in the UK take them, and by reducing the parameters for prescribing of Statins for Cholesterol reduction, big Pharma and the NHS hope to get at least 10 million people on this drug..

NHS Business Services Authority published the official statistics in June 2022.

The key findings showed that:

* The cost of prescription items dispensed in the community in England was £9.69 billion, an increase from £9.61billion in 2020/21.

* The number of prescription items dispensed in the community in England was 1.14 billion.

* Atorvastatin (a statin medication) was the single most dispensed drug in England in 2021/22 with 53.4 million items.

However when you add up all the different available statins, this number is significantly higher.

NHS spending on statins is currently about £500 million per annum and rising at an annual rate of 30%. This is all paid for by our taxes, not just income tax, but the tax on fuel, wine, food etc etc.

The Global Statin market size reached USD 15.38 billion in 2022. Looking forward, it is predicted to rise to USD 22.21 billion by 2030

So do you think Big Pharma is being benevolent?, or does self interest and profit play a major part?

A few interesting facts

Highest life expectancy in Europe. The Swiss

Highest cholesterol in Europe. The Swiss

The highest fat rich diets in Europe. The Swiss and French

The lowest cardiovascular disease in Europe. The Swiss and French

Statin drugs came out in 1987. To facilitate the sale of them, we were made afraid of Heart disease, and more specifically; Cholesterol.

Additionally In the 1980’s a new but separate fear was promoted, Alzheimer's disease is a neurodegenerative disease that usually starts slowly and progressively worsens and is the cause of 60–70% of cases of dementia disease. It didn’t exist in any measurable number prior, not even by a different name. It has several potential causes, one of which is a fat and cholesterol deficiency.

Your brain is mainly made of cholesterol. And statins disrupt your liver making cholesterol.

Is Cholesterol the bogeyman, and doesn’t it cause Heart attacks and Strokes?

Cholesterol is essential for all animal life, with each cell capable of synthesizing it by way of a complex 37-step process. All animal cells (exceptions exist within the invertebrates) manufacture cholesterol, for both membrane structure and other uses, with relative production rates varying by cell type and organ function. About 80% of total daily cholesterol production occurs in the liver and the intestines.

We hear about HDL and LDL and HDL is ‘Good’, LDL is ‘Bad’. However, nothing the body makes is bad. HDL is the carrier and returns any excess Cholesterol back to the liver to be recycled. LDL is the repairer and the deliverer. It also delivers Cholesterol to the brain.

40 years ago a total cholesterol level of 8-9mmol/L was considered normal. Now you are pushed to take prescribed statins if it is under 5mmol/L. Human physiology hasn’t changed in 40 years, but the rate of Cardio Vascular Disease has increased. Statins haven’t made anything better. Our body produces cholesterol in the liver, Your liver makes cholesterol for a purpose. It isn’t a mistake.

Your body is made of trillions and trillions of cells walls are a minimum of 30% cholesterol. Some are 60% cholesterol. Without cholesterol the cells don’t work properly. Your brain is 75% cholesterol by weight. The white matter, ‘myelin’ is cholesterol. You can’t make sex hormones without cholesterol. Testosterone, estrogen, progesterone, cortisol and adrenal hormones are all steroid hormones which are 95% by weight, cholesterol.

We also ended up with Low testosterone, which in men, causes erectile disfunction, and women causes difficulties relating to menopause (low libido pre menopause and muscle wasting, joint pain and incontinence post menopause).

If you don’t have enough cholesterol you get erectile disjunction, you get menopause, you get adrenal exhaustion, you get cognition diseases. Statins have been prescribed since 1987, which coincides with the rise in Alzheimer’s cases.

Vitamin D3 is created by 7 DHC (dehydrocholesterol) cholesterol plus UVB radiation. And Vitamin D is about as good as it gets for overall health. (Put simply, sunshine hitting your skin which contains cholesterol)

Which food source has the highest amount of cholesterol. A clue, its purpose is to enable the brain to develop.

Breast milk.

Cholesterol is essential, and doesn’t cause Heart disease. In fact, cholesterol tries to fix inflammation in our arteries in a similar way that firemen turn up at a house fire to put out the fire, you see a burning building, you will probably see firemen and fire engines. The firemen didn’t cause the fire, they are there to help put it out. (apologies to Lady Firemen)

Cholesterol has been the bogey man for several generations, it was supposedly going to kill you either by Heart disease or a stroke, and this has been proven to absolutely and positively untrue.

Cholesterol isn’t the problem, as such, Statins cannot be the answer.

We need to have a refresher on statins at this stage. What actually do statins do, and how.

Statins have been prescribed since 1987, and achieve what they set out to do. They stop the liver from doing its job properly. The liver makes cholesterol according to what the body requires.

They will actively block the enzyme that creates cholesterol, known as hydroxy-methylglutaryl-coenzyme A reductase (HMG-CoA). However, strange symptoms have always been present with statins that we haven't been able to explain fully.

We already know that by blocking HMG-CoA, we block the production of CoQ10 (same pathway), which is an amazing molecule that helps us make energy, and is extremely important for heart health (where we find most CoQ10). This is why people supplement it.

There's more to the story though than CoQ10 and statins though. Patients who are on Statins also suffer from myopathy myalgia, increased calcification of the soft tissues (gall bladder, joints, arteries etc) and osteopenia. This is likely due to the reduction in Vitamin K2, and the effect this has.

What exactly is going on here? Well recent research has revealed some interesting insights. What we know now is that these symptoms collectively stem from something else, including the blocking of CoQ10.

Statins block a compound known as Geranylgeraniol (GG). GG is a substance that is made in the human body via a biochemical pathway called the mevalonate pathway. This is the same biochemical pathway that makes cholesterol. Guess what else GG does?

GG allows us to actually make CoQ10 (we need this) and Vitamin K2-MK4 (we need this also, it’s the only biochemical synthesised form of Vitamin K2 in the human body). Vitamin K2 in partnership with Vitamin D3 regulates our calcium by putting it into the bone where it needs to be, and pulls it out of the soft tissues. GG is literally making K2 in over 25 organs and tissues in the body, and Statins block the creation of GG.

If we don’t have enough Vit K2, we suffer from calcium deposits in soft tissues, and not in the bones. This isn’t a good thing.

This is a big breakthrough in understanding of the effects of statins and it helps explain why patients suffer from symptoms like increased calcification, arteriosclerosis, and muscle myopathy. GG is also required for the making of skeletal proteins. Without it, we can't deliver new muscle proteins properly.

Vitamin D3 can come from supplements or sunshine, but only if you have a ready supply of cholesterol in your skin, and per a normal functioning body. When the cholesterol in your skin reacts with UVB light it creates the required Vit D3. Statins are robbing your body of more than just cholesterol, and Vitamin K2, you are now low on Vitamin D3, the free sunshine drug.

The argument in favour of limiting saturated fat intake is based on evidence that shows that replacing saturated fat with unsaturated fat decreases the risk of cardiovascular events. But usually, overall mortality rates don't significantly improve. The core studies showing this link were carried out in the 1960s and ’70s, forming the foundations against saturated fat intake.

These studies include the Los Angeles Veterans Administration diet study conducted in the 1960s. More than 800 men aged 55 or older participated in the trial.

Half the participants replaced two-thirds of the animal fat in their diets with vegetable oil, while the other half continued to consume animal fat. After six years, the first group saw a 13 percent drop in cholesterol levels, and only 48 men died from heart disease during the study compared with 70 in the group that consumed animal fat. The caveat to this finding is that the overall mortality between the two groups was about the same, but more cancer cases were reported in the group that consumed vegetable oils.

Another highly cited study is the Anti-Coronary Club study conducted in the 1950s. The researchers didn't intervene in the control group members' diets, but the experimental group was told to reduce their animal fat intake, consume as much fish and poultry as they liked, consume one ounce of corn oil per day, and cook with polyunsaturated fat. As a result of the intervention, participants' cholesterol levels dropped and hypertension improved. However, more deaths were reported among this experimental group.

"The intervention studies were done in the ’60s and ’70s ... and certainly the intervention studies suggested that there was a small benefit, but it wasn't statistically very strong," nutrition researcher Peter Clifton, who is a professor at the University of South Australia said. Mr. Clifton, who recommends replacing polyunsaturated fats with saturated fats, said more robust evidence supporting the diet-heart hypothesis comes from cohort studies that follow large populations.

One such cohort study published in 2015 examined more than 120,000 men and women. The researchers found that those who replaced 5 percent of their saturated fat intake with polyunsaturated fat and whole grains had fewer cardiovascular events. Another 2014 cohort study published in Circulation followed more than 2,700 people and found that high levels of linoleic acid, an omega-6 fatty acid, in the blood were associated with fewer cardiovascular events. A problem with cohort studies is that, unlike randomized controlled trials, they can't prove causality.

Since researchers can't control factors in participants' lives, including dietary choices, any relationship is linked only by association. Cohort studies also take a long time, so participants may be lost during follow-up, which can introduce bias into the findings.

The Evidence Against the Saturated Fat and Heart Disease Link

Scientists who challenge the current dietary recommendations to reduce saturated fat intake emphasize the limited evidence supporting such interventions. They often cite the large randomized controlled trials that show that lowering saturated fat or replacing it with polyunsaturated fat had no effect or even caused harm.

Opposition to the link between saturated fat and heart disease includes the Sydney Diet Heart Study, the Minnesota Coronary Survey, and the Women's Health Initiative Dietary Modification Trial.

In the 1990s, the Women's Health Initiative Dietary Modification Trial involved nearly 49,000 postmenopausal women who had to reduce either their saturated fat intake to less than 10 percent or make no change in their diet. The study found that reducing fat didn't affect the women's heart disease or weight loss.

The Sydney Diet Heart Study was conducted between 1966 and 1973. It put 458 men who had had a heart attack on a diet that replaced their saturated fat with soy oil. While the men's LDL cholesterol dropped, their risk of death increased by more than 60 percent, and their risk of heart disease increased by 70 percent.

The Minnesota Coronary Survey, conducted at about the same time, followed 9,000 people and reported similar findings: LDL cholesterol levels fell while risks of death and cardiac events increased.

In 2020, 12 researchers came together to publish a state-of-the-art review in the Journal of the American College of Cardiology (JACC).

"Whole-fat dairy, unprocessed meat, and dark chocolate are SFA-rich [saturated fatty acid-rich] foods with a complex matrix that are not associated with increased risk of CVD [cardiovascular disease]. The totality of available evidence does not support further limiting the intake of such foods," the authors wrote.

Regarding cohort studies, the perceived benefits of replacing saturated fats with polyunsaturated fats "could be attributed to a possible beneficial effect of polyunsaturated fatty acids and not necessarily to an adverse effect of SFAs," according to the authors.

"The effect of saturated fat and raising LDL cholesterol is pretty small. So it's not a really powerful fat," Mr. Clifton said. There are also large meta-analyses with findings that support both sides of the argument, such as the 2020 Cochrane Review.

Cochrane Reviews are recognized as the gold standard in research. The authors examined 15 randomized, controlled trial findings on replacing saturated fat with polyunsaturated and monounsaturated fat. The study concluded that this replacement reduced the risk of a cardiovascular event by 17 percent but didn't affect overall mortality.

The authors of this commentary emphasized findings that show that reducing saturated fats didn't reduce total mortality, cardiovascular mortality, coronary heart disease mortality, fatal and nonfatal heart attacks, and coronary heart disease events.

Another argument put forward by the authors of the JACC report is that not all saturated fatty acids are equal, so health professionals should look at the sources rather than the overall consumption of saturated fat.

Lauric acid, a type of medium-length saturated fat commonly found in coconuts, strongly raises LDL cholesterol; therefore, some studies suggest that it elevates cardiovascular risk. However, studies on unrefined coconut oil suggest that it has an overall cardioprotective effect.

Butter is high in palmitic acid, another saturated fat with a potent LDL cholesterol-raising effect. However, a meta-analysis on butter has shown it to have a cardioprotective effect. About 70 percent of dairy is saturated fat, yet studies have shownthat high dairy consumption is heart-protective. Milk has short-chain saturated fat, which is linked to cardioprotective effects.

Beef has also been shown to have a relatively neutral effect on heart disease. Although beef is often associated with having high saturated fat, monounsaturated and polyunsaturated fats make up about 50 to 60 percent of beef fat.

Contrary to popular belief, the primary source of saturated fat may not be animal-based food but processed food, as argued by obesity researcher Zoe Harcombe, who holds a doctorate in public health nutrition.

The 2020–2025 Dietary Guidelines for Americans shows that processed food accounts for 42 percent of saturated fat consumed by Americans aged 1 year and older. On the other hand, animal-based food, including milk, meat, and poultry, makes up 27 percent (pdf).

Saturated fats are often added to processed food to prolong their shelf life and improve their texture.

Processed foods are also high in sugar, and professor Benjamin Bikman (a hero of mine), a cell biology expert at Brigham Young University with a doctorate in bioenergetics, explained that the combination of saturated fat and refined carbohydrates is the most toxic.

Sugar in the blood oxidizes LDL cholesterol. This forms small, dense LDL cholesterol more prone to atherosclerosis. Sugar also increases triglyceride levels in the blood vessels. Oxidized LDL cholesterol and raised blood triglyceride levels are risk factors for heart disease. To make things more complicated, research has shown that LDL cholesterol may not be the best predictor for cardiovascular risk.

So, 'Bad' Cholesterol May Not Be So?

For decades, low-density lipoprotein (LDL) cholesterol was one of the most critical indicators that doctors measured for heart disease. Now, doctors and researchers are challenging whether LDL cholesterol, also known as "bad cholesterol," is really as bad as we once feared. Research shows that measuring LDL cholesterol doesn't always effectively assess a person's cardiovascular risk and that other tests may be more useful.

Low-Density Lipoproteins Versus LDL Cholesterol. Many people with normal LDL cholesterol levels may experience heart attacks, cardiovascular research scientist James Di Nicholantonio explains.

The number and size of LDL particles, rather than LDL cholesterol, may be a more relevant risk factor.

Studies have shown that LDL cholesterol levels predict higher cardiovascular risk 40 percent of the time, while apolipoprotein B (apoB) concentration, the summation of all LDL particles and their precursors, is associated with elevated risk 70 percent of the time.

Other studies comparing LDL cholesterol levels against cholesterol levels in LDL and its precursors, apoB number, and LDL particle number, also found that the latter two tend to be stronger predictors of risk, while LDL cholesterol is the weakest.

So what's the difference between LDL particles and LDL cholesterol?

An LDL particle is a type of lipoprotein made by the liver. Its primary function is to deliver triglycerides from the liver to other cells in the body. Transporting cholesterol is more akin to an LDL's side hustle. The cholesterol that an LDL transports is called LDL cholesterol.

High-density lipoprotein (HDL) and LDL cholesterols contain the same cholesterol; their carriers are what differ. LDL cholesterol can also leak into blood vessels, causing atherosclerosis, thereby earning its "bad" reputation.

On the other hand, HDL particles can venture into atherosclerotic plaques to absorb the cholesterol trapped inside, preventing further plaque formation and helping to prevent heart disease. Hence, HDL cholesterol is considered "good.” Therefore, nutritionist Jonny Bowden says labeling HDL and LDL cholesterols as good and bad cholesterol is wrong.

Mr. Bowden, who co-authored the bestselling book "The Great Cholesterol Myth," compared measuring the number of LDL particles to counting the number of passengers traveling in cars on a road. We know that more cars mean more congestion and traffic accidents, but more passengers doesn't necessarily indicate this. Conversely, traffic could still be congested even if passenger numbers are low or average.

"My LDL [cholesterol] was like 100 (2.6mmol/L), maybe 110 mg/dL(2.8mmol/L)" (very, very close to to the perceived ideal of lower is better), Mr. Bowden said. "Then I got the particle tests, and they showed an entirely different picture."

The test showed that he carried many small, dense LDL particles in his blood and was at high risk for cardiovascular events.

There are two types of LDL particles: large and buoyant, and small and dense. The small and dense LDLs are much more atherogenic (contributive to atherosclerosis), whereas the large, buoyant LDLs are less so. These two types of LDLs can be measured through advanced lipid testing.

About 80 percent of total LDL cholesterol level comprises the more harmless large, buoyant LDLs, with atherogenic small, dense LDL making up the rest. Interestingly, fats increase large, buoyant LDLs and decrease small, dense LDLs, whereas refined carbohydrates increase small, dense LDLs. Professor Erik Froyen from California State Polytechnic University, who has a doctorate in nutritional biology and whose research investigates mechanisms by which fatty acids impact cancer and cardiovascular disease risk factors, has also demonstrated this in his work.

Research suggests that intake of refined carbohydrates is more relevant than saturated fat in causing coronary heart disease.

Mr. Bowden compares large, buoyant LDLs with large volleyballs that float along in the water, moving with the tide, while small, dense LDLs are like small golf balls that get stuck between rocks, where they start oxidizing and accumulating to form atherosclerotic plaques. Individuals with more large, buoyant LDLs are said to exhibit a pattern A type of cholesterol profile, and these people are at low risk of atherosclerosis. On the other hand, those with more small, dense LDLs exhibit a pattern B cholesterol profile and are at risk of atherosclerosis. Their markers for metabolic disease risks may also be elevated.

Small, dense LDLs carry less cholesterol than large, buoyant LDLs, so a person can have a normal LDL cholesterol level but a pattern B cholesterol profile. However, lipidologist professor Carol Kirkpatrick, head of the Wellness Center at Idaho State University, highlighted that for most people, overall LDL particle number is more relevant than LDL size. What we know now is that, yes, [small dense LDLs] may be important, but it really ends up being a red flag for people who have metabolic dysfunction.

Some studies have found that large LDLs have a neutral effect on atherosclerosis, though other scientists disagree. "We know that statins, for instance, lower cardiovascular risk, and statins preferentially reduce larger LDL particles," said professor Kevin Maki of Indiana University, whose interest is in preventing and managing cardiometabolic disease. However, the statin and LDL link has also been challenged.

"It's really unclear if the benefit of statins is because it lowers LDL," cardiologist Dr. Robert Dubroff states. "There are other drugs that can lower LDL, and many of them have been tested in well-conducted randomized trials and shown no benefit.” Dr. Dubroff indicated that there are interventions that lower cardiovascular risk without lowering LDL.

History

People didn’t think critically about the fat that our ancestors had used for thousands of years, we have eaten saturated fat, cooked with tallow, cooked with lard, all these solid and saturated fats had been a staple of the human diet for 100’s of generations, and they hadn’t caused heart attacks until now. Seems obvious to us now, but it wasn’t then.

Cholesterol has been the bogey man for several generations, it was supposedly going to kill you either by Heart disease or a stroke, and this has been proven to absolutely and positively untrue.

To tell the origin of our story, I’ll end to go right back to the beginning. How it came to be that cholesterol was originally thought of as the baddie.

I’ll begin over 120 years ago in 1901 when a German chemist was commissioned by the German Navy to create a synthetic lubricant for diesel engines in submarines. Hydrogenation was perfected in 1901 and patented in 1903 by Wilhelm Normann. He introduced the hydrogenation of fats, creating what later became known as trans-fats.

His product only had a very small market, as Germany only had about 100 submarines, so he sold his patent in 1908, the patent was bought by Joseph Crosfield & Sons Ltd. . A company that had begun in 1814 as Joseph Crosfield's soapery was established on the north bank of a loop of the river Mersey in an area known as Bank Quay, near to urban Warrington. From the autumn of 1909 hardened fat was being successfully produced in what in a large scale plant in Warrington.

(In 1911 the company was purchased by Brunner, Mond & Company and 1919 it was absorbed into Lever Brothers, and 10 years later became a subsidiary of Unilever.)

Joseph Crosfield and Sons acquired Normann's patent ostensibly for use in the production of soap. Their chief chemist, Edwin C. Kayser, was hired by Procter & Gamble's business manager, John Burchenal, and they patented two processes to hydrogenate cottonseed oil. Although their initial intent was to completely harden oils for use as raw material for making soap, these processes ensured that the fat would remain solid at normal storage temperatures and could find use in the food industry.

Procter & Gamble called the product Crisco, a modification of the phrase "crystallized cottonseed oil". They used advertising techniques that encouraged consumers not to be concerned about ingredients but to trust in a reliable brand. Further success came from the marketing technique of giving away free cookbooks in which every recipe called for Crisco. Crisco vegetable oil was introduced in 1960. In 1976, Procter & Gamble introduced sunflower oil under the trade name Puritan Oil, which was marketed as a lower-cholesterol alternative.

Proctor and Gamble who owned then owned the patent, and named the product ‘Crisco’. They commissioned the American Heart Association to say that these trans fats were healthy, and natural fat contained a bogeyman called cholesterol.

Proctor and Gamble began to run adverts which said that butter and cream and lard was an unhealthy way of cooking food, it contained something called cholesterol. The used extensive ad campaigns and sold it as a healthier way to cook, and also portrayed the use of animal fats which had been used for centuries as ‘common’. This next bit is a little sexist, they targeted housewives and made them feel less than ideal if they cooked with historic animal fat and not Crisco.

1950’s

Heart disease was beginning to kill people in large numbers.. the President of America had a heart attack in 1955 and was out of action for 10 days, this was a cause of Great concern to everyone, men were dying and from something that hadn’t affected their parents. And no one understood why this was happening. People dying in their prime..!

Could it be caused by your personality type, Driven people didn’t really relax and the stress was killing them?, could it be a vitamin deficiency?, perhaps it was the fumes from car engines. Maybe cigarette smoke?

These could be viable hypothesis..

But one other hypothesis was suggested by a pathologist from The University of Minnesota Mr Ancel Keys. (Boo-Hiss)

Ancel Keys was considered a very aggressive man, an arrogant bully, even by his friends, he was a forceful man, he would happily argue his opinion. He came up with what became known as his Heart Diet Hypotheses.

And his idea what that you would eat saturated fat and cholesterol your diet, eggs cheese dairy meat etc, and this would lead to you having elevated cholesterol in your blood, and this would somehow clog up your arteries. And you would have a heart attack. This is still how some people see fat even now.

1960

The American Heart Association. At the time, this was the only public health group that was dealing with Heart disease, and everyone was following their advice, it was a simpler time and people still believed public bodies acted in the best interest of the public.

The American heart association would like to tell people what to do, but there was no data. So Ancel wangled himself onto the nutrition committee of the newly formed American Heart Association

1961

With not much more data available, He was able to get his recommendation published called Dietary Fat and its Relation to Heart Attacks and strokes. His idea was that you needed to restrict your dietary fat and Cholesterol in order to prevent heart disease. This was the first advice anywhere in the world. No other advice was available, and despite this being complete wrong; the idea stuck.

The advice became institutionalised, repeat something often enough, and becomes considered fact.

It was a very simple idea, it was easy to understand, and easy to visualise. Cut out animal foods, replace butter, replace it with margarine, replace the saturated fat with unsaturated fat and you won’t die.

The world breathed a sigh of relief, we had an answer to the problem, it was fairly simple to grasp, it sounds logical, and it isn’t really an inconvenience.

In parallel to the above, Here’s a little history on rapeseed oil:

During WWII, rapeseed oil was grown widely in Canada to be used on naval ships as a lubricant. When the war ended, there was so much farmland in Canada already dedicated to growing rapeseed that they wanted to find other uses for it so they could continue selling it for a profit.

The problem with rapeseed oil: It’s such a terribly foul-tasting and rancid-smelling oil that it isn’t fit for human consumption.

So they spent the next few decades until the 1970’s working out a way to make it edible. That process requires heavy refining, bleaching and deodorising using harsh chemicals (as far from “natural” as it gets) to finally yield the neutral-tasting, odourless oil that now sits on supermarket shelves and has the masses believing it is good for the heart. Rapeseed oil is sold in the US and Canada as Canola oil. (Canadian Oil Low Acid)

Fast forward to today: Almost all processed and pre-packaged foods – everything from crisps and breakfast cereal to canned soups and salad dressings – are made with ‘seed oils’; sunflower, rapeseed, canola, cottonseed, soybean/vegetable or corn oil.

Why? Because they’re cheap to produce. And because many people are still in this mindset that cooking oils are somehow better for you than natural saturated fats like tallow or butter.

With the enormous variety of cooking oils available on the grocery store shelves it can be very frustrating and confusing to decide which ones are the most healthy and how to properly use them. There are many differing opinions out there about which oils are good or bad, but many of the opinions are just that – opinion. And often they’re completely misinformed.

Scientific research has been clouded and falls into two camps; research that has been bought and paid for by the companies that sell seed oils, and the research with little or no vested interest.

We shall only look at the ‘no vested interest’ information.

Of primary importance is which oils are stable when heated and thus don’t oxidise (ie, carcinogenic) or go rancid easily.

Oxidation and/or rancidity can take an otherwise healthy oil and turn it into a free radical laced toxic swill that you really do not want to ingest.

Of equal importance is the oil’s fatty acid profile, which has a huge impact on its health benefits, or lack thereof.

I have the majority list of most edible oils that are commonly available for purchase, which ones to use, what to use them for and which ones to avoid altogether. I could discuss the basic biochemistry of the different groups of fatty acids they contain. This is important to understanding why certain oils should be used and others avoided.

Of particular importance is the degree of saturation of each fatty acid. The more saturated a fat is the less prone it is to becoming oxidised from light and heat exposure, the less likely it is to go rancid, and therefore the more suitable it is for cooking involving heat.

The less saturated they are the more prone they are to breakdown with light and In these cases extra precaution needs to be taken – and certain types of oils are best avoided altogether.

But to save you half an hour..

Organic grass-fed Tallow, Organic grass-fed Butter, and if you are a vegetarian, Coconut Oil.

If you fancy olive oil, make sure it isn't mass produced from a supermarket, but single estate, date of harvest given etc. don’t cook with it.

The reason is simple, it’s a high value item and most olive oil that are sold in the supermarkets have been adulterated with seed oils. There is more olive oil sold globally than could possibly be created from the amount of Olive trees on the planet.

Boring bit about statins.

In 1971, Akira Endo, a Japanese biochemist working for the pharmaceutical company Sankyo, began to investigate cholesterol. Research had already shown cholesterol is mostly manufactured by the body in the liver with the enzyme HMG-CoA reductase. The first agent Endo and his team identified was mevastatin (ML-236B), a molecule produced by the fungus Penicillium citrinum.

A British group isolated the same compound from Penicillium brevicompactum, named it compactin, and published their report in 1976. The British group mentions antifungal properties, with no mention of HMG-CoA reductase inhibition. Mevastatin was never marketed, because of its adverse effects of tumors, muscle deterioration, and sometimes death in laboratory dogs.

Cholesterol researcher Daniel Steinberg writes that while the Coronary Primary Prevention Trial of 1984 demonstrated cholesterol lowering could significantly reduce the risk of heart attacks and angina, physicians, including cardiologists, remained largely unconvinced.

Never one to ignore a new profitable drug, P. Roy Vagelos, chief scientist and later CEO of Merck & Co, was interested, and made several trips to Japan starting in 1975. By 1978, Merck had isolated lovastatin (mevinolin, MK803) from the fungus Aspergillus terreus, first marketed in 1987 as Mevacor.[11]

In the 1990s, as a result of public campaigns, people in the United States became familiar with their cholesterol numbers and the difference between HDL and LDL cholesterol, and various pharmaceutical companies began producing their own statins, such as pravastatin (Pravachol), manufactured by Sankyo and Bristol-Myers Squibb. I

n April 1994, the results of a Merck-sponsored study, the Scandinavian Simvastatin Survival Study, were announced. Researchers tested simvastatin, later sold by Merck as Zocor, on 4,444 patients with high cholesterol and heart disease. After five years, the study concluded the patients saw a 35% reduction in their cholesterol, and their chances of dying of a heart attack were reduced by 42%.[11][180] In 1995, Zocor and Mevacor both made Merck over US$1 billion.[11]

This is where statistics are used to convince non mathematicians that black is orange.

Link to lancet study. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S) - The Lancet

All trial candidates actually had coronary heart disease (CHD). This is the actual paper, and I’ll translate at the end of each paragraph

4444 patients with angina pectoris or previous myocardial infarction and serum cholesterol 5·5-8·0 mmol/L on a lipid-lowering diet were randomised to double-blind treatment with simvastatin or placebo. 4444 people who had heart disease with what used to be a normal, level of cholesterol.

Over the 5·4 years median follow-up period, simvastatin produced mean changes in total cholesterol, low-density-lipoprotein cholesterol, and high-density-lipoprotein cholesterol of -25%, -35%, and +8%, respectively, with few adverse effects. 256 patients (12%) in the placebo group died, compared with 182 (8%) in the simvastatin group.

The relative risk of death in the simvastatin group was 0·70 (95% Cl 0·58-0·85, p=0·0003). The 6-year· probabilities of survival in the placebo and simvastatin groups were 87·6% and 91·3%, respectively. There were 189 coronary deaths in the placebo group and 111 in the simvastatin group (relative risk 0·58, 95% Cl 0·46-0·73), while noncardiovascular causes accounted for 49 and 46 deaths, respectively. 622 patients (28%) in the placebo group and 431 (19%) in the simvastatin group had one or more major coronary events. The relative risk was 0·66

4444 people with heart disease/Angina/or had already had a heart attack.

189 untreated people died of heart attack

49 untreated people just died

622 untreated people had a heart attack and didn’t die

860 untreated people died in total

111 treated people died of heart attack

46 treated people just died

431 treated people had a heart attack and didn’t die

588 treated people died in total

The hidden information is that less than 5000 people were studied in this single trial. 20 such trials may have been conducted on behalf of the same company. 19 studies with vastly different results may have remained unpublished. After all, these studies are paid for by the drug manufacturer. In this case Merck.

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