This article was originally published January 17, 2010
The universally accepted 'lipid hypothesis' of heart disease claims that saturated fat raises blood cholesterol and that these cholesterol elevations cause heart disease and stroke. For years I have been pointing out that this theory is nonsense. And for years, I have endured ridicule and hostility from the sadly ignorant believers of this untenable theory.
Last year, I received a copy of an article authored by Dr. Helmut Gohlke, a cardiologist from the Bad Krozingen Heart-Center in Germany. Gohlke appears to be greatly agitated by public interest in Der große Cholesterin-Schwindel, the German language version of my book The Great Cholestrol Con. His article appeared in the 2/2009 issue of Herz Heute, a publication produced by the German Heart Foundation (Deutsche Herzstiftung).
Like most of my critics, Gohlke demonstrates a complete inability to counter the specific claims and supporting evidence that I present. He instead relies on misreported data and personal insults. In doing so, Gohlke joins a long line of MDs and PhDs who, despite their abundant "merit badges" and eagerness to belittle my lack of formal qualifications, cannot even begin to refute my arguments in a rational scientific manner.
When I write something contrarian and hence controversial about nutrition and health in my books, you can be sure I've thoroughly done my research first hand. You might not like my findings, but I apologize to no-one for presenting the plain facts uncovered by my research. Getting angry at me for reporting what the research shows is every bit as stupid as getting angry at the weatherman when he presents a forecast of heavy rain. Just as the weatherman does not determine the weather, I likewise do not determine the results of scientific studies. I simply read them with a keen eye and report the results without the biased mindset of those who have significant vested financial or epistemological interests in the outcome of such results.
So to all those sneering doctors and dodgey diet 'gurus' who have tried to discredit me, here's a word of advice: Your insults and misreporting of research do not work (except, of course, with the minority that constitute your die-hard and largely clueless followers). When objective reporting comes up against biased hyperbole, most intelligent people can clearly see through the latter. They know it is the product of a mind stubbornly committed to a theory and incapable of impartially analyzing contradictory evidence for reasons of money, prestige, pride, or plain laziness.
Over the years, the majority of my critics have hailed from the low-carbohydrate and lipid hypothesis camps. Some of these commentators have been especially hostile, but their malevolent quest to discredit and silence me has completely failed. Instead of attempting to shoot the messenger, what these sadly misguided souls really need to do is step back and look at the bigger picture. They need to ask themeselves why their beloved belief systems are continually losing ground. Here's a clue: when a popular theory is based on a mix of distorted research and outright lies, the popularity of that theory inevitably has a limited lifespan.
Low-carb mania, for example, reached a peak in the early 2000s, and has been declining ever since. The lipid hypothesis has shown far more longevity, thanks to the substantially greater financial, governmental and medical resources thrown behind it, but its days too are numbered. Make no mistake, the lipid hypothesis is still deeply entrenched in modern medical practice, but it is attracting ever-increasing amounts of skepticism. Even such mainstream stalwarts as the World Health and Food and Agriculture Organizations have recently published unsupportive reviews; below I present even more studies disputing the lipid hypothesis, one of which appears in the world's most widely read nutrition journal, the American Journal of Clinical Nutrition. Before we discuss these studies though, let's take a look at the English translation of Dr. Helmut Gohlke's critical article and my reply.
The Great Cholesterol Con?
By Prof. Dr. med. Helmut Gohlke
Klinische Kardiology II, Herz-Zentrum Bad Krozingen
(Department of Clinical Cardiology II, Bad Krozingen Heart-Center)
Who would not readily buy or read a book, which appears to make life easier: don't worry any longer about cholesterol, eat pork schnizel, sausages, butter, whipped cream, black forest cherry cake any way you want, and perhaps even throw away the pills which you do not like anyway. Thus, even the advertisement for The Great Cholesterol Con – Why everything you’ve been told about cholesterol, diet and heart disease is wrong has created quite a stir. Many confused patients have written to the German Heart Foundation (Herzstiftung), asking for a comment.
The author, Anthony Colpo, is not a medical professional, but worked as a fitness trainer before he decided to march into battle against today’s medicine. From his experience as a fitness trainer, he gives some good pieces of advice: do sports, avoid overweight, relax. But when he takes on the task to explain – in 544 pages with hundreds of bibliographical references -- why everything you’ve been told about cholesterol and heart diesease is wrong, his incompetence and lack of medical knowledge becomes evident.
The book is riddled with terrible mistakes. The trusting reader will be misinformed and led astray.
Some examples: Colpo argues that any correlation between cholesterol and heart attack has never been proven. Yet, as early as 1984, the Lipid Research Clinics Coronary Primary Prevention Trial – this was long before statin drugs were discovered – showed that a high LDL-cholesterol was indeed correlated to a higher number of heart attacks; the more the cholesterol level was lowered – at the time still called colestyramin – the lower the number of heart attacks.
In addition, Colpo repeatedly argues that today’s medicine considers cholesterol the only cause of coronary heart disease. Even a brief glimpse into the current guidelines of Deutsche Gesellschaft für Kardiologie (Pocket-Leitlinie Prävention 2007) (German Cardiological Society, pocket guideline on prevention 2007) shows that lipid metabolic disorder only ranks fifth, after smoking, lack of activity, unhealthy food, and overweight – followed by high blood pressure and diabetes.
Another example: He argues that statins do not work in women – at least not in relation to life expectancy. This is wrong, too. The results of the Heart Protection Study, conducted with 20,000 male and female patients, showed that – even among those over 75 years of age – statins do lower mortality by 12.9%, death from heart disease is even lowered by 18%, complications caused by cardiovasculary diseases are lowered by 25%.
Or: Colpo advocates taking high-dosage vitamin pills. Obviously, he slept through vitamin research completely. Many studies have proven that vitamin drugs are not effective against heart diseases or cancer. They even may cause dangerous consequences. The number of serious wrong evidence presented, for instance, concerning homocystein, nutrition, bypass surgery or stents, is unacceptedly high. Anybody who trusts Colpo’s evidence is taking a high risk, for example by not taking the prescribed statins, or by following his advice to eat lots of animal fats.
However, many readers will take note of Colpo’s arrogant manner. The author, who had neither medical training nor medical experience, considers himself the greatest expert in heart medicine and pretends to know more than all Nobel prize laureats and international professional associations combined. This high-handedness appears ridiculous. Indeed, The Great Cholesterol Con should not be taken seriously.
My Reply to Dr. Helmut Gohlke
In its 2/2009 issue, Hertz Heute published a scathing criticism of my book The Great Cholesterol Con by Dr. Helmut Gohlke of the Bad Krozingen Heart-Center. Gohlke’s letter contains numerous errors and several blatant mistruths that I will counter in my reply below. I am also disappointed by the unusually large degree of unprovoked personal hostility Gohlke displays towards me, something I consider most unbecoming for a medical professional.
I will now address Gohlke’s claims point-by-point:
Gohlke claims: “When books entitled, The Lie About Cholesterol (Die Cholesterinlüge) or, recently, The Great Cholesterol Con (Der große Cholesterinschwindel) appear on the market, a lot of money is made with them.”
Dr Gohlke’s strategy here is readily transparent. He is attempting to cast aspersions on my motives and integrity by insinuating that The Great Cholesterol Con is primarily a money making endeavour.
I’ve got news for Dr Gohlke. Considering the far more lucrative activities I spurned in favour of writing The Great Cholesterol Con, the book actually constitutes a personal financial liability. After spending over four years researching and writing the book, I had to self-publish and finance the original English language version myself. In a culture obsessed with instant gratification, where the best-seller lists are filled with books promising to quickly make one rich/slim/irresistible to the opposite sex, a contrarian book on heart disease was evidently the last thing most American and Australian publishers wanted to consider. As I do not have the marketing clout and distribution capabilities of a big publishing house, sales of my book were handicapped right from the outset. If my goal in writing the book was to make “a lot of money”, I could not have picked a worse possible strategy.
My book continues to be ignored by English-language publishers, despite it receiving glowing reviews from a wide spectrum of commentators and sporting a 5-star rating on the American website Amazon.com. However, German publisher Kopp-Verlag has finally brought my book under the auspices of a commercial publishing house by releasing a German language version. I am eternally grateful to them for doing so, and sincerely hope they are rewarded handsomely
for their courageous decision. Initial feedback from the publisher indicates that the book is indeed selling well in Germany, Switzerland and Austria, despite being completely ignored by the mainstream media. The popular press and big American/Australian publishers may not be aroused by the life-saving information in The Great Cholesterol Con, but the German, Swiss and Austrian publics evidently are.
However, if Gohlke finds the idea of earning money from heart disease-related projects so repugnant, perhaps he would like to confirm that he carries out his work at the Bad Krozingen Heart-Center entirely free of charge. And perhaps he would like to make publicly available the strong letters of protest he has no doubt sent to the manufacturers of statin drugs, which earn the pharmaceutical giants tens of billions of dollars each year. And I’m sure he has had much to say to the senior staff at “non-profit” organisations such as the American Heart Association, whose lavish salaries would make the CEOs of many large companies green with
If the very modest revenue I make from The Great Cholesterol Con is somehow objectionable, then the far more lucrative earnings made by practicing cardiologists, drug companies, and “non-profit” health authorities would surely be utterly repulsive to people like Gohlke.
Gohlke may find it hard to believe that others may be motivated by factors aside from money, but the truth - whether Dr. Gohlke wishes to acknowledge it or not - is that I feel very strongly about the staggering amount of misinformation propagated about cholesterol. I also find it disturbing to think of all the lives that could have been saved had the medical establishment turned its attention to the real causes of heart disease, rather than battling to keep the untenable cholesterol myth alive. The Great Cholesterol Con is the end result of this strong personal conviction.
I note that Dr. Gohlke himself has co-authored a book, a text titled Cardiovascular Prevention and Rehabilitation:
This book retails at Amazon.com for $249.00, over ten times the price Amazon.com is asking for the English-language version of my book.
Gohlke, his co-authors, and his publisher are of course free to charge whatever they wish for their book. They are also free to publish a book containing their views on coronary medicine; but I have every right to do the same. Gohlke should confine his criticisms of my book to factual scientific matters, not malicious and wholly unwarranted insinuations about my financial motives.
[Gohlke]: “Who would not readily buy or read a book, which appears to make life easier: don't worry any longer about cholesterol, eat pork schnizel, sausages, butter, whipped cream, black forest cherry cake any way you want, and perhaps even throw away the pills which you do not like anyway.”
This is the first of numerous blatant lies propagated by Dr Gohlke in order to discredit my book. At no point do I encourage people to “eat pork schnizel, sausages, butter, whipped cream, black forest cherry cake any way you want“. In fact, I explicitly warn against gleefully binging on fats in the book (I suggest Dr. Gohlke carefully re-read Chapter 26). The diet recommended in The Great Cholesterol Con is one based on the kind of diet that humans evolved on; namely, a diet revolving around fresh meats, eggs, vegetables, fruits and nuts.
This eating pattern is often referred to as “Paleolithic“ nutrition; in all my readings, I have yet to find evidence of schnizel or cherry cake consumption among Paleothic humans.
I also do not at any point in the book recommend for people to recklessly “throw away” their medications. Quite the opposite: I recommend that people who wish to discontinue medication avoid doing so abruptly, and to first seek the assistance of a medical practitioner.
[Gohlke]: “Thus, even the advertisement for The Great Cholesterol Con – Why everything you’ve been told about cholesterol, diet and heart disease is wrong has created quite a stir. Many confused patients have written to the German Heart Foundation (Herzstiftung), asking for a comment.”
If this is true, then I find it most uplifting and encouraging. Evidently I am succeeding in inspiring people to question the pseudo-scientific absurdity that constitutes the cholesterol hypothesis of heart disease.
[Gohlke]: “The author, Anthony Colpo, is not a medical professional, but worked as a fitness trainer before he decided to march into battle against today’s medicine.”
For Gohlke’s edification, I never took up arms “to march into battle against today’s
medicine“. I will be the first to acknowledge that when it comes to emergency medical care, the achievements of modern medicine are often nothing short of astounding. The ability to routinely snatch trauma and accident victims from the jaws of death, and nurse them back to full recovery is a truly stupendous achievement.
None of this, however, changes the fact that the cholesterol theory of heart disease is completely false. Medical success in one area does not excuse the propagation of dangerous fallacies in another. I cite a massive volume of research in my book explaining just why the cholesterol paradigm is a counterproductive sham. Apart from very brief reference to a mere two studies – which he disingenuously misquotes - Gohlke does not discuss any of this research.
[Gohlke]: “From his experience as a fitness trainer, he gives some good pieces of advice: do sports, avoid overweight, relax. But when he takes on the task to explain – in 544 pages with hundreds of bibliographical references -- why everything you’ve been told about cholesterol and heart disease is wrong, his incompetence and lack of medical knowledge becomes evident.”
As we shall soon see, it is Gohlke whose knowledge on matters pertaining to cholesterol is pitifully lacking.
[Gohlke]: “The book is riddled with terrible mistakes. The trusting reader will be misinformed and led astray. Some examples: Colpo argues that any correlation between cholesterol and heart attack has never been proven. Yet, as early as 1984, the Lipid Research Clinics Coronary Primary Prevention Trial – this was long before statin drugs were discovered – showed that a high LDL-cholesterol was indeed correlated to a higher number of heart attacks; the more the cholesterol level was lowered – at the time still called colestyramin – the lower the number of heart attacks.”
To cite the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT ) as proof of the lipid hypothesis is a true act of desperation.
This study examined the effect of cholestyramine (a drug belonging to the fibrate family, the predecessors to statins) in middle-aged men with extremely high cholesterol levels. Like many promoters of the cholesterol hypothesis, Gohlke selectively cites research in order to bolster his case. There are some critical facts about the LRC-CPPT that Dr. Gohlke has chosen not to share in his letter, so I will mention them here.
Firstly, when the final results for the LRC-CPPT were tabulated, thirty patients (1.6 percent) in the treatment group suffered a fatal heart attack compared to thirty-eight (2.0 percent) in the control group, a miniscule absolute difference of only 0.4 percent. The researchers did not include these unimpressive figures in the study's summary. Instead they quoted the more striking, but misleading, 'relative risk' reduction figure of 24 percent. Relative risk is the percentage that 0.4 percent comprises of 2 percent (the death rate in the control group), and means little in the absence of absolute figures, which show the exact number of CHD deaths.
Quoting relative risk in the absence of absolute figures is a favorite tool of researchers looking to amplify the impact of otherwise uninspiring results. The mortality difference of eight deaths between the cholestyramine group and the control group occurred amongst 3,806 men over a period of 7.4 years.
Such a difference could easily have been due to pure chance. And indeed, using the level of statistical significance (.01) nominated in the original LRC-CPPT protocol report, the results could not be reliably regarded as being due to anything but chance. In the 1979 protocol report, the designers of the LRC-CPPT themselves stated that "… since the time, magnitudeand cost of the study make it unlikely that it could ever be repeated, it was essential to be sure that any observed beneficial effect of cholesterol-lowering was a real one. Therefore, [significance] was set at .01 rather than the usual .05." The 0.01 level "was chosen as the standard for showing a convincing difference between treatment groups."
However, when the final results were published in 1984, the LRC-CPPT researchers appeared to have suffered a severe bout of memory loss. They had used, not the 0.01 level, but the 0.05 level in their statistical tests! This bald-faced abandonment of the earlier and more exacting published protocol was also accompanied by the use of what is known as a 'one-sided', or 'one-tailed', test. Those familiar with statistical tests know that opting for the one-tailed test
instead of the more stringent 'two-tailed' test lowers the significance level even further.
Even after adopting greatly loosened statistical tests, the LRC-CPPT researchers still had to combine fatal and non-fatal coronary events before they could barely obtain statistically significant supportive results. Neither the differences in fatal nor non-fatal coronary events reached significance when considered separately.
This is the kind of sloppy, manipulated evidence that Dr. Gohlke holds up as definitive proof of the cholesterol theory!
The discrepancies with the LRC-CPPT were not limited to dubious statistical maneuvers. When total mortality was calculated, death rates from non-coronary causes were higher amongst cholestyramine recipients compared to controls. In fact, overall death rates between the two groups were almost identical - sixty-eight (3.6 percent) died in the treatment group, compared to seventy-one (3.7 percent) in the control group.
Dr. Gohlke may not concur, but most intelligent people would seriously question the wisdom of taking toxic drugs that offer no longevity benefit whatsoever.
Let’s for one moment humour Dr. Gohlke and assume that the woefully small reduction in coronary mortality was real and not purely a chance occurrence. This is still in no way an endorsement of the cholesterol theory, for there is no evidence that the reduction was actually caused by lipid-lowering itself. In later studies with statin drugs, where statistically significant reductions in coronary mortality were observed in middle-aged men with pre-existing heart disease, there was often no correlation between the degree of cholesterol reduction and the reduced risk of heart attack. This is not surprising when one considers the abundant volume of
research showing statins exert a wide range of potentially beneficial anti-atherosclerotic and anti-clotting effects that are completely unrelated to cholesterol reduction. If Gohlke has read my book, he should know full well about this research, as I discuss it at length. Interested readers may also wish to refer to a 2005 paper on this very subject that I authored for The Journal of American Physicians and Surgeons. It can be accessed freely here:
Gohlke repeatedly sneers at my claim that cholesterol does not cause heart disease, but is silent on the massive volume of evidence I present in my book supporting this contention. He offers no intelligent rebuttal whatsoever of the following documented contradictions to the cholesterol hypothesis:
• Why have scores of studies found a complete lack of correlation between serum LDL (the so-called "bad" cholesterol) and total cholesterol levels and extent of
• Why have numerous tightly controlled clinical dietary cholesterol-lowering trials
failed to produce any reduction in CHD, despite the fact that cholesterol levels were
indeed lowered in the treatment groups?
• Why have controlled clinical studies observed more atherosclerotic regression, less decrease in minimal luminal diameter, fewer cardiovascular events, and significantdeclines in mortality among patients taking fish oil, despite the fact that it often raised serum LDL cholesterol levels?
• Where is his discussion of the fact that statins exert anti-inflammatory, antiatherogenic effects even when their cholesterol-lowering capabilities are disabled?
• Why have numerous statin trials found no correlation between the degree of
cholesterol reduction and the extent of reduced heart attack risk?
To claim that elevated LDL or total cholesterol promotes heart disease in the face of such observations completely defies logic.
Instead of addressing these uncomfortable contradictions, Gohlke uses the 'appeal to authority' strategy by repeatedly highlighting my lack of formal medical qualifications. This is of little import; lack of formal qualifications does not necessarily equate to lack of knowledge on medical matters. I submit to Dr. Gohlke that there are numerous talented health journalists and writers that have no formal medical qualifications. Furthermore, whether I am a Nobel laureate, a fitness trainer/health writer, or even a sanitation worker is utterly irrelevant. What is relevant is that I have presented a compelling, damning, and scientifically backed argument against the cholesterol theory. Despite what he clearly believes to be his superior status as a practising cardiologist, Gohlke displays a complete inability to refute this argument in a scientific manner. Gohlke apparently does not understand that snobbery, decorated credentials, and personal derision make very poor substitutes for reasoned scientific discussion.
[Gohlke]: “In addition, Colpo repeatedly argues that today’s medicine considers
cholesterol the only cause of coronary heart disease. Even a brief glimpse into the current guidelines of Deutsche Gesellschaft für Kardiologie (Pocket-Leitlinie Prävention 2007) (German Cardiological Society, pocket guideline on prevention 2007) shows that lipid metabolic disorder only ranks fifth, after smoking, lack of activity, unhealthy food, and overweight – followed by high blood pressure and diabetes.”
Another blatant lie. I do not state that modern medicine considers cholesterol the only cause of heart disease; I state that cholesterol constitutes medicine’s central pillar of heart disease prevention, and has done so for the past four decades, a fact in no way altered by cholesterol’s ranking in a pocket handbook issued in 2007 by the German Cardiological Society.
[Gohlke]: “Another example: He argues that statins do not work in women – at least not in relation to life expectancy. This is wrong, too. The results of the Heart Protection Study, conducted with 20,000 male and female patients, showed that – even among those over 75 years of age – statins do lower mortality by 12.9%, death from heart disease is even lowered by 18%, complications caused by cardiovascular diseases are lowered by 25%.”
Yet another shamelessly deceptive statement that highlights Gohlke’s unwillingness to accurately relay the findings of scientific research. The results he cites for the Heart Protection Study were for men and women combined, with men making up the major demographic of the study (75% of all participants were male). To transpose the overall results from a trial in which most subjects were male onto females specifically is a most dubious tactic.
Gohlke could have – but did not - mention a far more relevant study; namely a 2004 pooled analysis that examined all the existing female data from statin trials whose participants included women. This pooled analysis showed that statin drugs do not lower overall mortality in women, regardless of whether they are used for primary or secondary prevention. In women free of coronary disease, statins fail to lower both coronary and overall mortality, while in women with coronary disease, statins lower coronary mortality but increase the risk of death from other causes, leaving overall mortality unchanged. Gohlke cannot claim to be unaware of this paper – after all, it is discussed in my book and appeared in one of the world’s most widely read medical journals - the Journal of the American Medical Association.
Readers can access this paper for themselves right here:
[Gohlke]: "Or: Colpo advocates taking high-dosage vitamin pills. Obviously, he slept through vitamin research completely. Many studies have proven that vitamin drugs are not effective against heart diseases or cancer. They even may cause dangerous consequences."
I propose that it is Gohlke who needs to wake from a deep slumber. I’m not sure what Gohlke means by “vitamin drugs” – in any case, I do not recommend such a substance in The Great Cholesterol Con. While I don’t endorse any type of drug in my book, I do indeed recommend vitamin, mineral, amino acid, and fish oil nutritional supplements. The research showing reduced cardiovascular morbidity and mortality for the supplements in my book is cited and discussed in detail.
Again, Gohlke ignores this evidence. As for his insinuation that vitamins “may cause dangerous consequences”, I challenge him to present tightly controlled evidence showing harmful effects from the nutritional supplement regimen outlined in my book.
[Gohlke]: "The number of serious wrong evidence presented, for instance, concerning homocysteine, nutrition, bypass surgery or stents, is unacceptedly high."
I’d offer a rebuttal of Gohlke’s claim that numerous of my statements concerning “homocysteine, nutrition, bypass surgery or stents“ are “erroneous“...but Gohlke does not cite even a single example. I can only assume that, despite his displeasure with these statements, he did not feel confident enough to cite even a single specific example.
[Gohlke]: "Anybody who trusts Colpo’s evidence is taking a high risk, for example by not taking the prescribed statins, or by following his advice to eat lots of animal fats."
Here we go again. Nowhere in the book do I encourage people “to eat lots of animal fats”. I simply point out that the war on animal fats is based on deeply flawed science, and discuss the vast body of scientific literature showing this to be the case. Gohlke offers no commentary whatsoever of this abundant evidence.
The consumption of all macronutrients (be it fat, protein, or carbohydrate) should be based on a number of factors including an individual’s caloric needs, type and amount of physical activity, glycemic control, and digestive abilities. I do not encourage people to simply go ahead and partake indiscriminately of any macronutrient, including fats from animal sources. Regardless of what Gohlke chooses to believe, gluttony is not part of my nutritional arsenal.
Gohlke claims those who do not take statins are at “high risk”. Actually, it is those who do take statins that are at high risk; muscle and tendon damage, sexual dysfunction, cognitive disturbances, liver toxicity, rhabdomyolysis, and increased risk of birth defects are among the many documented side effects of statin use. I discuss these side effects at length in my book; again, Gohlke offers no discussion whatsoever of these untoward effects.
[Gohlke]: "However, many readers will take note of Colpo’s arrogant manner."
How ironic. Gohlke, in a most pompous manner, deliberately misquotes studies, attributes statements to me that I never made, continually resorts to ad hominem attacks, then has the temerity to claim that it is me who is arrogant. The mind boggles...
[Gohlke]: "The author, who had neither medical training nor medical experience, considers himself the greatest expert in heart medicine and pretends to know more than all Nobel prize laureates and international professional associations combined. This highhandedness appears ridiculous."
The only thing ridiculous here is Gohlke’s extremely wild imagination. Evidently, Gohlke feels threatened by the self-assuredness and conviction evident in my writings, and has to resort to juvenile antagonism of a most hyperbolic nature. While I don’t claim to be “the greatest expert in heart medicine”, nor pretend “to know more than all Nobel prize laureates and international professional associations combined”, I am quite capable of backing my arguments with an abundance of valid scientific evidence, without the need to continually attack my opponents personally despite the absence of any prior provocation. Unfortunately, the same cannot be said of Dr Gohlke.
I might not have formal medical qualifications, but I can – and have – easily destroyed any claim to scientific validity for the cholesterol theory of heart disease. Gohlke may be a practising medical practitioner, but he fails miserably to defend his beloved lipid hypothesis.
[Gohlke]: "Indeed, The Great Cholesterol Con should not be taken seriously."
Given his complete inability to refute the content of my book in a rational, scientific and honest manner, and his need to incessantly resort to personal denigration, I suggest it is Gohlke who should not be taken seriously. Instead of trusting Gohlke’s biased and misleading review of my book, I encourage people to read the book for themselves, and to examine first hand the research I have cited. If this is done, the spurious nature of Gohlke’s criticisms will become fully apparent.
July 17, 2009.
Folks like Dr. Gohlke will no doubt become angry, but I would be remiss if I didn't share with readers some recent research that further highlights the dubious nature of the lipid hypothesis.
Saturated Fat Is Not Associated With Cardiovascular Disease
A couple of weeks back I shared with readers a WHO and FAO-sanctioned review showing that saturated fat and total fat intake were not associated with cardiovascular disease. Hot on the heels of that report comes a similar paper, appearing in the American Journal of Clinical Nutrition, also concluding that saturated fat shows no association with heart disease or stroke.
Researchers from Harvard Univerity and the Children’s Hospital Oakland Research Institute pooled the data from twenty-one prospective epidemiologic studies examining the association of dietary saturated fat with coronary heart disease (CHD), stroke, and cardiovascular disease (CVD; CHD inclusive of stroke) risk.
During 5–23 years' follow-up of 347,747 subjects, 11,006 developed CHD or stroke. Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD. The pooled relative risk estimates that compared extreme quantiles of saturated fat intake were 1.07 for CHD, 0.81 for stroke, and 1.00 for CVD. In other words, those who ate the highest amounts of saturated fat had no greater risk of CVD than those who ate the lowest. Consideration of age, sex, and study quality did not change the results.
Those of you tempted to dismiss these findings as the work of pro-meat/dairy/egg industry shills or fringe-dwelling skeptics should note that one of the authors, Dr. Ronald Krauss, has worked at the National Heart, Lung, and Blood Institute (NHLBI), has been a Senior Advisor to the National Cholesterol Education Program (NCEP), and is actively involved with the American Heart Association (AHA), having served as Chairman of the Nutrition Committee. He is founder and Chair of the AHA Council on Nutrition, Physical Activity, and Metabolism. The NHLBI, NCEP and AHA have all been key players in gaining global acceptance for the pseudo-scientific absurdity that constitutes the lipid hypothesis of heart disease.
Swedish Farmers Live Longer on Dairy Fat and Veggies
Last year, a study published in the International Journal of Environmental Research and Public Health reported on CHD mortality and morbidity among 1,752 Swedish rural males. During 12-years' follow-up, 88 died during follow-up, 335 were hospitalized or died due to CVD and 138 were hospitalized or died due to CHD.
When the dietary records of the men were analyzed, the crude unadjusted data showed that consumption of cream and full-fat milk and daily consumption of fruit and vegetables were associated with a lower risk of CHD. When the data was adjusted for confounding factors the only statistically significant dietary factor associated with reduced CHD was the combination of daily fruit and vegetable intake and high dairy fat consumption (relative risk = 0.39). Choosing wholemeal bread or eating fish at least twice a week showed no association with CHD. Farmers developed less coronary heart disease than non-farmers.
Japanese with High Cholesterol Live Longer
The Japanese have long been cited in support of the lipid hypothesis, but there is an abundance of research involving Japanese participants showing this hypothesis is in fact complete nonsense. The latest of such studies appeared in the Journal of Lipid Nutrition.
Japanese citizens over the age of 40 qualify for free annual health check-ups. The Fukui Study was based on data collected by the Public Health Center of Fukui from such check ups between 1986 and 1990 of residents of Fukui City in Japan. Researchers stratified 22,971 participants into groups according to their cholesterol levels.
Compared with those in the 240-259 mg/dl category, those in the 160-169 mg/dl (both sexes) and the 140-159 mg/dl (women) groups suffered significantly higher all-cause mortality.
Next, the researchers conducted a meta-analysis of five large Japanese studies (including the Fukui Study) with a combined total of over 170,000 subjects to examine cholesterol levels and all-cause mortality.
Participants with cholesterol levels between 160-199 mg/dL were chosen as the reference group. The meta-analysis revealed that the relative risk in the <160 mg/dL group was significantly higher than in the reference group [RR = 1.71], and that the relative risks in the 200-239 mg/dL and >240 mg/dL groups were significantly lower than in the reference group [RRs of 0.83 and 0.78, respectively].
The authors suggest that "Japanese subjects with cholesterol levels >240 mg/dL (>6.22 mmol/L) should not be regarded as hypercholesterolemic or dyslipidemic except when having some genetic disorders like familial hypercholesterolemia because they are in the safest ranges in terms of all-cause mortality".
NOTE TO JAPAN: Along with muffin tops, Snoop Dogg clothing and Big Brother, cholesterol lowering is one trend from the West you should definitely ignore. It's a wank.
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2. No listed author. The Lipid Research Clinics Program. The Coronary Primary Prevention Trial: Design and implementation. Journal of Chronic Diseases, 1979; 32: 609-631.
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