In part 1 of this series, The Cholesterol Lie – And The Truth, we learned from Cholesterol Clarity that saturated fat and cholesterol have been designated as the primary dietary cause of heart disease. In particular, the pervasive scientific and cultural narrative is that cholesterol and saturated fat are very bad for you. They clog your arteries. And that you should avoid foods such as beef, butter, eggs, whole milk and full fat cheese.
The problem with this hypothesis is that it doesn’t match reality. Data demonstrates that 75% of people who have a heart event have cholesterol levels in the “healthy” range and that 50% have a cholesterol level in the “optimal” range. It has also been shown through epidemiological studies that perhaps the opposite is true. Populations with higher dietary saturated fat consumption and higher blood cholesterol levels tend to have lower levels of heart disease.
So as it very often happens in life, it looks like the truth is actually the very opposite of the commonly held belief. The truth, for whatever reason, has been twisted by the establishment. And very powerful vested interests continue to promote The Cholesterol Lie, knowingly or otherwise, to the detriment of those they purport to care for and represent.
Even the professionals whose knowledge and decisions should be based purely on empirical information, such as scientists, nutritionists and your doctor, will succumb to the status quo. They will take the easy path, remain ignorant and continue to promote a false belief.
How can this be? Why would your doctor willfully promote false information? Is it possible he or she just doesn’t know the truth? Or has the truth been muddied and your doctor is just taking the path of least resistance?
How the Lie Started
According to Cholesterol Clarity, there are three main studies that are the genesis for the Cholesterol Lie as we know it today.
First was a study from 1951, called The Lipid Hypothesis published in the American Journal of Medicine, which is the namesake for the theory behind The Cholesterol Lie. It purported to link the consumption of dietary fat (lipids) and cholesterol with heart disease.
But the “father” of The Lipid Hypothesis is considered to be a scientist called Ancel Keys. Keys was a physiologist and researcher who published what is known as The Seven Countries Study. Of particular interest is that he is also the researcher responsible for the development of “K-rations” for the U.S. military and the highly popular Mediterranean Diet. The man was a prolific scientist and researcher who had a tremendous impact in the areas of diet and nutrition over his lifetime.
The government funded Seven Countries Study began in the 1950’s and was endorsed by The American Heart Association. Mr. Keys was apparently concerned about the high rate of heart disease in American businessmen at the time and believed the primary cause for this malady was dietary. Specifically of course, he believed that it was the consumption of excess dietary fats that were the problem. And to prove this hypothesis he began and eventually published The Seven Countries Study.
The primary flaw in this highly influential study lies in its title. Keys used the data from seven countries to provide the proof that high levels of dietary saturated fat and cholesterol were the cause of heart disease. Apparently though, he decided to leave out the data from 15 other countries which would have disproved his theory.
– “Although Keys could have included a total of twenty-two countries in his research data—including countries where people ate more fat with very little heart disease and countries where people ate less fat with more heart disease—he chose to leave those statistics out of his conclusions. They simply didn’t fit his theory about saturated fat: that it raises cholesterol levels, which leads to heart disease.”
– “Based on the work of Ancel Keys, the American Heart Association, in 1956, officially announced that real foods previously deemed healthy, like butter, lard, eggs, and beef, were now suddenly bad for you; that’s when the birth of the low-fat diet movement began in earnest, and it’s still the pervading school of thought regarding heart health today.”
The work of Keys was further propelled along by the U.S. government, initially through what was known as the McGovern Report. Federal politician George McGovern, who was already a believer in a low fat diet, headed a United States Senate Select Committee which was “responsible for getting the government involved in making standardized national dietary recommendations.” The eventual recommendation of the report was that Americans consume less fat, less cholesterol, less refined sugar and more complex carbohydrates.
The United States federal government then became further involved through the National Institutes of Health’s Coronary Primary Prevention Trial (CPPT) study which ran from 1973 to 1984. And again, the study’s results ended up recommending a low-fat, low-cholesterol diet for a healthy heart. Along with the dietary advice came a new recommendation—cholesterol-lowering medications when necessary.
Once again, however, the science behind the government funded CPPT study was highly suspect.
– “But, again, the study was flawed; the behind-the-scenes shenanigans involved were utterly unscrupulous. However, the brainwashing had already begun; Americans were advised to cut their fat intake significantly—by doctors, government agencies, manufacturers of food, and the media.”
– “Based on the CPPTs faulty data, the NIH boldly stated that no more trials were necessary: We have proved that it is worthwhile to lower blood cholesterol … Now is the time for treatment.”
– “Calling this the single biggest blunder in the history of medicine is not overstating the case. And we’re still reaping what we have sown three decades later.”
Another main impetus behind The Cholesterol Lie was “the National Heart, Lung, and Blood Institute through its National Cholesterol Education Program in 1985” according to Dr. William Davis from the book Wheat Belly. The underlying advice from the program was “to cut fat and cholesterol intake and replace the calories with whole grains.” In other words, replace natural sources of dietary fat with carbohydrates. According to Dr. Davis “1985 coincides precisely with the start of a sharp upward climb in body weight for men and women.”
And then finally we have the United States Department of Agriculture’s Food Pyramid issued in 1992. This was a graphical representation of the optimal number of servings to be eaten each day from the basic food groups: carbohydrates (bread, cereal, rice, pasta), vegetables, fruit, dairy, proteins (meat, poultry, fish, eggs, dry beans, nuts), and finally fats, oils and sweets. The Food Pyramid’s foundation and broadest source of calories was a recommendation for 6-11 servings of carbohydrates per day. The Food Pyramid would also help drive the pervasive low-fat high-carb dietary recommendations of government, doctors and nutritionists.
So there you have it. A basic summary of how we ended up with The Cholesterol Lie. But the question remains, why does it persist? And specifically, why does it still persist with most primary care physicians?
Doctors and the Standard of Care
All of the high profile government funded research and programs listed above placed a significant part of the blame for heart disease on cholesterol in the arteries. And this is when “the drug companies very quickly swooped in to influence the science in this field … they got their people on FDA panels, and they were part of creating the National Cholesterol Education Program.” The standard of care for “high cholesterol” then became the treatment of cholesterol levels with medication and a low-fat diet.
The National Cholesterol Education Program also led to the simplified and arbitrary numerical standards for measuring healthy cholesterol levels. These were recommendations for a Total Cholesterol of below 200 and LDL Cholesterol below 100. It also recommended a low-fat diet and prescription based statin drugs for treatment. Doctors were then bound by this standard of care.
Regardless of its merits, it became standard medical practice to treat “high cholesterol” with statin drugs and to recommend a low-fat high-carb diet. “So physicians today basically have no choice but to recommend treatment with statin medications for anyone with elevated cholesterol.” Otherwise treatment would be considered below the standard of care; not a good position to be in when considering medical malpractice insurance.
In the present day, within the confines of the medical insurance industry, doctors are paid based on the number of patients they treat rather than the quality of that treatment. As in any business or organization, the bottom line will necessarily have a significant effect on operations. And most doctors therefore, simply cannot afford to spend the quality time necessary with their patients to dig deeply into lifestyle and dietary issues to treat health concerns. It then becomes the path of least resistance to simply treat patients’ cholesterol levels by the recognized standard of care and issue a prescription.
Even in the face of decades of significant evidence to the contrary, for the most part the same standard of care remains today. So it seems that very powerful cultural and vested interests can have a significant effect even in the medical community where science and empirical data should prevail.
– “I am troubled by how little most traditionally trained medical doctors are taught about the nutritional component of health. Sadly, much of what they learn is based on the theories pushed by Ancel Keys … and George McGovern.”
– “the mainstream medical community seems determined to stick with outdated and potentially dangerous ideas.”
– “We’ve been giving people the wrong advice for the past fifty to sixty years. And instead of admitting that we have gotten it all wrong on obesity and chronic disease, we now think we should push the message even harder.”
It is within the context of faulty science, the prevailing standard of care, poor nutritional education and powerful vested interests that the primary means of treating “high cholesterol” became a class of drugs called statins.
Prior to statins it was very difficult to lower cholesterol levels with medication. But with the development of this new class of drugs in the early 1990’s it became possible to lower cholesterol levels by 30-40% in short order. In other words, take a pill and empirically lower a “bad” number. This makes for very easy treatment and verifiable numerical results.
Statins have also become enormously profitable for all who promote their use as a means to lower cholesterol:
– “So if you can argue that an elevated cholesterol level causes coronary disease, you’ve got a big reason why there is now a multi-billion dollar industry.”
– “In the mid-1990s, Pfizer Pharmaceuticals introduced the cholesterol-lowering statin drug Lipitor (atorvastatin). It hit the marketplace with a bang, quickly becoming the most profitable and best-selling drug in the history of the world.”
– “Based on the billions of dollars in annual revenue generated by what so many people describe as magic pills for heart health, other drug companies quickly jumped on the statin bandwagon … Everybody in the pharmaceutical industry wanted a proverbial piece of the pie.”
– “It’s enormously profitable and it’s paid for many glorious vacations in Orlando and a lot of nice dinners. It’s paid for many things for those who promote statins. We’re talking about a $29 billion annual industry, so this has fueled a very successful campaign to treat cholesterol.”
Although statins will indeed perform as advertised in lowering cholesterol levels, this is not the same thing as treating and reducing the risk of heart disease. And we know this, of course, because there is no causal relationship between cholesterol levels and heart disease.
– “Here’s a reality check for people who are taking a statin drug: These drugs will artificially lower your cholesterol levels, but they will not prevent a heart attack, stroke, or cardiovascular disease.”
– “statins have become a doctor’s first line of defense … despite the fact that these drugs, while being touted as a grand cure-all, have done nothing to stop the rise of heart disease”
– “The bottom line? If you have high cholesterol but have no heart disease and have never experienced a heart attack, there is no compelling evidence that you should be taking a statin drug.”
In addition, statins are considered by many health professionals to be extremely dangerous and have many side effects such as fatigue, muscle soreness, joint soreness, memory loss as well as a weakening of mental focus. There have also been studies that demonstrate a relationship between statin usage and an increased likelihood of diabetes and Alzheimer’s.
– “Based on the side effects we have seen and the fundamental metabolic pathways that are interrupted by these statin drugs, probably 100 percent of people taking them experience side effects, they just might not be aware of them yet. We know that statins are disrupting their metabolism and negative things are going on. It’s just that these things could take years to manifest.”
– “The effects of cholesterol on memory are fully documented. Cholesterol is vital for both the formation and function of each memory synapse in our brains. As thousands of people can testify, when you have no cholesterol, you have no memory.”
The Life Lesson
This is more than an esoteric issue regarding health. It is a screaming red hot flag for how our society will sometimes bury the truth. How the establishment, vested interests and the supposed smartest among us will blindly, or otherwise, ignore the truth to maintain the status quo—even the scientific and medical communities who are supposed to be unaffected by bias and purely empirical in their reasoning.
It is a lesson that every man of character should make note of and use as a reference for the rest of his life.
All the best,