Cholesterol doesn’t cause heart disease

In last week’s article about the ineffectiveness of statin drugs in reducing mortality in most populations I promised I would follow-up with an article on drug-free prevention of heart disease. I will do that this week, but it occurred to me that the first article in this series should have been one that dispels the myth that cholesterol causes heart disease. Understanding that is the key to the prevention strategies that will follow in the next article. So without further ado…

butterYou are all no doubt acquainted with the popular hypothesis on cholesterol and heart disease. It has two parts: first, that eating cholesterol in the diet raises cholesterol levels in the blood; and two, that high cholesterol levels in the blood cause heart disease.

You might be surprised to learn that neither of these statements is true. The first one is relatively easy to dispatch. In the Framingham Heart Study, which is the longest-running and perhaps most significant study on heart disease done to date, it was demonstrated that intake of cholesterol in the diet had absolutely no correlation with heart disease. If you look at the graph below, you’ll see that both men and women with above average intake of cholesterol had nearly identical rates of heart disease as men and women with below average intake of cholesterol.


In fact, the “diet-heart hypothesis”, which is the scientific name for the idea that eating cholesterol causes heart disease, has even been discounted by the researchers who were responsible for its genesis. Ancel Keys, who in many ways can be considered the “father” of the cholesterol-heart disease hypothesis, had this to say in 1997:

“There’s no connection whatsoever between the cholesterol in food and cholesterol in the blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.”

This is a reference to early studies performed on chickens and rabbits where they force-fed these animals high-levels of cholesterol. Since rabbits and chickens are mostly vegetarian, their physiology is not adapted for processing such large amounts of dietary cholesterol, so it’s no surprise they developed atherosclerosis. The mistake was assuming that the results of this experiment could be extrapolated to humans, who are omnivores with significant differences in physiology.

The second tenet of the cholesterol-heart disease hypothesis, the notion that high cholesterol levels in the blood cause heart disease, is referred to as the “lipid hypothesis” in the scientific community. Though it still accepted as gospel truth by the general public and many medical professionals, most researchers now believe the primary causes of heart disease are inflammation and oxidative stress. Unfortunately, the rest of us haven’t gotten the memo, so to speak, that cholesterol isn’t the cause of heart disease.

It would take several articles to explain this in complete detail, but I’d like to give at least a brief summary here.

If cholesterol caused heart disease, it should be a risk factor in 1) all ages, 2) both sexes and 3) all populations around the world (barring any protective factor, of course). Also, if cholesterol caused heart disease we would expect that lowering cholesterol would reduce heart disease. But none of these assumptions turn out to be true.

The rate of heart disease in 65-year old men is ten times that of 45-year old men. Yet a recent study in the Journal of American Medical Association indicated that high LDL cholesterol is not a risk factor for from coronary heart disease (CHD) mortality or total mortality (death from any cause). It is extremely unlikely that a risk factor for a disease would stop being a risk factor at a time when that disease kills the greatest number of people. That is akin to suggesting that smoking causes lung cancer in young men, but somehow stops doing so in older men!

Another consistent thorn in the side of supporters of the “lipid hypothesis” is that women suffer 300% less heart disease than men, in spite of having higher average cholesterol levels. At the recent Conference on Low Blood Cholesterol, which reviewed 11 major studies including 125,000 women, it was determined that there was absolutely no relationship between total cholesterol levels and mortality from cardiovascular or any other causes.

Nor is cholesterol a risk factor in all populations around the world. In fact, some of the populations with the highest levels of blood cholesterol have among the lowest rates of heart disease, and vice versa. Dr. Malcom Kendrick, a well-known skeptic of the lipid-hypothesis, explains this very well in the video below:

Finally, more than 40 trials have been performed to determine whether lowering cholesterol levels can prevent heart disease. In some trials heart disease rates went down, in others they went up. But when the results of all of the trials were taken together, just as many people died in the treatment groups (who had their cholesterol levels lowered by drugs) as in the control groups (who had no treatment).

If you’re still skeptical after reading all of this, perhaps William Castelli, the director of the famed Framingham Heart Study mentioned above can convince you:

“Serum cholesterol is not a strong risk factor for CHD, in the sense that blood pressure is a strong risk factor for stroke or cigarette smoking is a risk factor for lung cancer.”

Or how about Frederick Stare, a long-time American Heart Association member and (former) proponent of the lipid hypothesis:

“The cholesterol factor is of minor importance as a risk factor in CVD. Of far more importance are smoking, hypertension, obesity, diabetes, insufficient physical activity, and stress.”

So there you have it. Contrary to popular belief, cholesterol is not a dangerous poison that causes heart disease. Rather, it is an essential nutrient present in the cell membranes of all tissues of all mammals, and has some very important functions in the body. In fact, in many studies low cholesterol has been associated with an increase in total mortality!

Again, the Framingham Study which followed 15,000 participants over three generations:

“There is a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years.”

In other words, as cholesterol fell death rates went up.

The Honolulu Heart Program study, with 8,000 participants, published in 2001:

“Long-term persistence of low cholesterol concentration actually increases the risk of death. Thus, the earlier the patients start to have lower cholesterol concentrations, the greater the risk of death.”

And finally, the huge Japanese Lipid Intervention Trial with over 47,000 participants:

“The highest death rate observed was among those with lowest cholesterol (under 160mg/dl); lowest death rate observed was with those whose cholesterol was between 200-259mg/dl”

In other words, those with the lowest cholesterol had the highest death rate, and those with cholesterol levels that would today be called “dangerous” had the lowest death rate.

As you can see, not only does high cholesterol not cause heart disease, low cholesterol can actually be dangerous to your health. So toss out your vegetable oil and start eating butter and eggs again! But more on that next week…

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Comments Join the Conversation

  1. Steve C says

    What about the prevention of congestive heart failure. Woldn’t Lipitor be helpful for that? If you keep your cholesterol down, wouldn’t that keep the amount of calcium build up in your artery walls and heart valves down? My father died of cogestive heart failure due to plaque in his heart valve. They tried replacing with a pig valve, but it was a failure, infection. The surgeon spent a lot of 8 hrs removing built up plaque near the heart valve. He was 89.

    • Shari says

      Actually the solution to the problem of excess calcium buildup in the arteries causing hardening of the arteries is intake of Vitamin K-2. In simplest terms; K-2 is necessary to activate Matrix Gla Protein which regulates calcium in/out of artery tissue. Once activated by K-2 it allows Calcium to bind to it, then K-2 dependent Osteocalcin enables calcium to bind to connective tissue, bone, teeth and cartilage where it should go properly. Note: I am referring to Vitamin K-2 not K-1,. Vitamin K-2 is also referred to as Methaquinione, MK-4 and MK-7 being the two formed best used by the body. K-2 can be obtained with proper careful diet or via supplements.

  2. Rafiq T. Khan says

    I am 55 years old. My doctors put me on statins about 20 years ago after they said my cholesterol level (221) was high. I have always exercised and ate healthy. A few days ago my doctor took me off statins (Crestor 5 mg 3 times per week ) after my CPK test went through the roof and I was having muscle pains in my shoulders. It appears that this cholesterol thing is pure hocum based on flawed studies and bogus science . Every cell in the human body produces cholesterol the function of which it to repair damage. The true culprit in heart disease is inflammation not cholesterol. I saw a report on the news the other night a report of a new study which showed that eating foods high in cholesterol did not affect the level of cholesterol in the blood. I can only now hope that there has not been any permanent damage to my muscles caused by the use of ststins.

  3. Pamela says

    Are low cholesterol levels dangerous if the levels are low naturally and not due to medication? I am very thin and have a total cholesterol of 144, TRI 47, HDL 48, LDL 87, AND vldl 9.
    Thank you

  4. Jessie says

    I’m interested in what you think about studies showing that vegetarians have much lower rates of heart disease. It would seem that they eat far more grains, which should cause more inflammation. Thoughts?

    • Yosako says

      One caveat is…pomegranate juice can’t be used along with Crestor, it’s a potentially lethal interaction with a documented case of rhabdomyolisis.

  5. Paul Yeso says

    Just finished reading “Grain Brain” by Dr. David Perlmutter. He strongly supports the hypothesis that CHD is caused by inflammation brought on primarily by what we eat. He cites several studies both old and new. He also claims that LDL is not a BAD cholesterol but rather a protien whose primary function is to deliver cholesterol to the brain which requires cholesterol to function as it is intended. Are we on the right track here? Can you shed some light on my comments?

  6. Nancy says

    My cholesterol measured 8 and at the time I was on the celebrityslim diet which is low carbs high protein diet. I have been given 3 months to change diet and exercise before giving me tablets. My blood pressure is perfect and yet I can cycle 20 miles and do cardio excersise. I am worried about pushing myself in case I have a heart attack but the above comments have slightly helped. Past 3 weeks I’ve been taking benecol and high fibre diet so let hopping my next text is lower and don’t need medication. Celebrity diets are not good at all!

    • Nick Pollard says

      Like some other comments, it doesn’t look as if you have read the article! I suggest you buy one of the “cholesterol myth” books, don’t be persuaded to take statins and eat a normal, healthy diet with healthy animal fats.

    • Yosako says

      Nancy, you might want to check on Bergamot extracts, some studies show cholesterol reductions similar of some statin drugs, with the added benefit of increases in HDL and potential reductions in blood sugar.

      As for brands, so far I’ve found Bergamonte (HP Ingredients, 30% polyphenols) and Bergamet (38% polyphenols).
      Jarrow’s Citrus Bergamot product is rebranded Bergamonte, although with a recommended dose of 500 mg/day instead of 1000 mg/day.

  7. Ann Shaughnessy says

    According to my research, there are some missing pieces to the cholesterol argument. The ratio of LDL to HDL, which should be <5, and a better indicator of overall risk is the triglycerides to HDL ratio. A ratio of 4 is considered high and under 2 is excellent. My LDL is high, but my HDL is 2x normal: at 80. My ratio is 3.4. My triglyceride ratio is 1.2. But my total cholesterol is 226, which is considered high risk. So, is total cholesterol the deciding factor. Also, 330 total is still considered by some experts as acceptable, and LDL at 130. This is a very confusing issue.

  8. says

    14 years ago at a young age, I had a quintuple bypass surgery, despite watching the traditional risk factors. Promptly after my surgery I was put on half a dozen medications including strong doses of name-brand statins to reduce my cholesterol. Some of the medication’s side effects had damaging effects on my body. At one point I could hardly walk up and down the stairs. Despite taking the medication I had the bypass grafts close up and repeated stents! I then realized, there was a missing piece i.e. the psychosocial factors including job stress.

  9. Case Diz says

    As was noted in someone else’s comment- No one in Framingham Heart Study with total cholesterol under 150 had a cardiovascular event.

    • Lucy says

      They didn’t have heart attacks but the low cholesterol people were more likely to die. (media didn’t report that) Look up low cholesterol, cancer and parkinsons disease.

      I asked a doctor about the cancer being associated with low LDL and she made a head spinning change of subject and told me that’s not proven. Well by the same criterion high cholesterol is not proven to cause heart disease.

  10. Case Diz says

    The specific portion of the Honolulu Heart Study you reference is of elderly people. If you read the whole study, it says in the discussion section-

    “The reasons for these results are not clear. Perhaps they indicate a selective mortality; those individuals who are susceptible to biological effects of high serum cholesterol die before they reach age 75 years. The individuals who are left would be a select group with lower cholesterol and whose genetic makeup or other factors protect them from the effects of higher cholesterol concentrations. To some degree Honolulu Heart Program data support this hypothesis—there are few individuals with truly high concentrations of cholesterol remaining in this population. Previous data on concentration of cholesterol from this population show that the distribution of cholesterol has shifted towards the left as the cohort ages”

    • Canucker says

      Can we please separate out the data for older (65+) people from younger ones? Most elderly people are going to die from just living a long time & their systems eventually fail (nature only cares for species – not individuals). In particular, the heart/lung system has been “beating” like an athlete for well over a billion cycles – if we could build cars that did so well, Detroit would have closed years ago.
      So, it’s not a surprise to discover most people die of heart disease; tell us, how many of the “unexpected” (early, younger than 65) die of these various problems.
      There’s too much money tied up with all this pseudo research.

  11. Ann Shaughnessy says

    Chris, I am 71 and two weeks ago stopped all cholesterol medication, sinus meds, and also all vitamins except that which comes from proper eating. I was so fatigued I didn’t care any more. Two days later my energy returned. I go to a yoga class every day for an hour, cycle, walk my dog 1.5 miles, and have sharper perception all around. Am I going to have a heart attack because I stopped my meds? I use salt water for sinus, witch hazel for allergy itch, and chew cardamom seeds for any pain relief, which I rarely have anymore.

    • John Scully says

      Hello Ann. I have had pains in my legs for so long and I do not know if it is the statins or whatever. My question will the cardamon seeds take away the pain?

      • Yosako says

        Read my other comment on CoQ10 / Ubiquinol.

        Prescribing statins without CoQ10 supplementation is basically assisted suicide, specially for elderly people.
        That’s because they inhibit production of LDL cholesterol and CoQ10, a substance needed by the cells’ mitochondria.
        Since the body’s production of CoQ10 declines with age, starting after 30 and specially after 65-70, reducing the levels of something that is already low is just plain nuts.

        100 mg of Ubiquinol per day are usually enough to send the body’s CoQ10 levels high enough to counter any statin-induced depletion; higher doses can be used for blood pressure reduction and heart stuff.

    • Yosako says

      It’s almost certain that statins caused you fatigue…because they require CoQ10 (or better, its antioxidant form Ubiquinol) supplementation!

  12. Greg says

    Surely all the talk about how cholesterol may or may not cause heart disease can easily be answered. From what I have seen, many studies show raised cholesterol is a risk for heart disease and it seems many studies don’t. So there is no proof is there?

    Has anybody actually proven how high cholesterol actually causes heart disease? Sure, we have a theory of how that might happen but has there been research to prove it? Seems to me we are pinning a lot of medical treatment on a correlation rather than a causation? Or am I reading it all wrong?

  13. Bo Jangles says

    There were some rabbit studies where feeding the rabbits iodine or dessicated thyroid eliminated almost all of the arteriosclerosis. Iodine and the thyroid hormones are lipophilic I suspect much more strongly so than other hormones. Heart disease is largely hypothyroidism ..Broda Barnes demonstrated this 40 years ago. The other component is high estrogen, which usually only happens to men in old age..which is why women tend to outlive men.

  14. Fook yong says

    I am a strong believer of following the nature , that is to say the nature who make us as human being and it decided what human needed to eat in order to survive and stay healthy , just like the nature designs the cow to eat glass , feeding meat daily to the cow is certain to cause problem to the cow !
    Likewise we human are designed to be meat , grain and vege eater as evidence in our set of the teeth , the canine teeth we have are for tearing the meat , the molar teeth for grain and vege etc…, so if we are to eat only a vegan diet or a meat only diet , in either way , we will end up being unhealthy .This is because it is Unnatural !!
    Any formal study of longitivity of vegetarian ? Any formal study of eating food rich in cholesterol will increase the body cholesterol level ? and finally any conclusive study that the high level of low density cholesterol in the body correlated to high incidence of artery blockage ? I can’t find any convincing study on this ! Again go back to nature , watching the animals in the wild , was there any study to prove that the lions have a higher incidence of heart disease than the vegetarian eating buffalo ? Please noted in the wild , the lions or any carnivores creature will instinctively go to eat the internal organs of the kill first ! Nature tell them that the high cholesterol are best for them and the high cholesterol offals will not cause heart disease to shorten their life span ! Nature is our best teacher to teach us to live healthily , going against nature is courting the bad health to yourself !

    • J Arce says

      What’s bad about eating meat is the hormones and the antibiotics that they feed the animals – that is not natural. Nature’s food is organic.

    • Frank Filtrante says

      Many many years ago (1984) I mentioned a new butter replacement I had heard of to a woman in the neighborhood. Her reply was ” No thanks, I prefer to keep eating real stuff.” That was 30 years ago.(The internet was just becoming the WEB) It woke up my brain. I have been researching this kind of thing ever since. Turns out to be TRUE! Natural is better. All things in moderation of course.

    • Gemgrrrl says

      The lion goes for the internal organs first because they are the first to putrify. If your and your family are going to gnaw on an antelope for a few hours in the hot sun, you don’t want all that nasty bacteria in their digestive tract ruining your meal.

      The human anatomy and physiology actually follows that of a committed herbivore, vs a carnivore or omnivore. To narrow that down even further, we are designed primarily as “starch eaters”. We have a long digestive tract, but little area for bacterial fermentation of cellulose (plant fiber). A carnivores digestive tract is smooth, vs ours which has lots of nooks and crannies. This slows down digestion and allows for a great absorption of nutrients and water. But also provides lots of places for fats and proteins to get trapped and putrefy.

      We start breaking starch down at the beginning of our digestive tracts, via salivary amylase. We also have large brains compared to our body size – and brains gobble up lots of glucose. In humans, glucose is most easily liberated from starchy foods. In the wild, for big brained modern humans, roots and tubers would necessarily be our primary food source because we need all of that glucose to power our big brains. This would be supplemented with insects for protein, berries, seeds and nuts, and maybe small amounts of meat from small vertebrates.

      A carnivores stomach pH can get down to around 1 when there is food present. This is highly, highly acidic. Herbivores, on the other hand, typically have a stomach pH of 4-5. Why is this important? In the wild, most animals are full of bacteria and parasites. Eaten raw, this would present a serious health risk. But the stomach pH of carnivores is so highly acidic that nothing can survive. Many can survive a pH of 4-5, which makes meat a poor food choice for “wild” humans.

      Another important factor is uric acid. This is a highly toxic substance that is responsible for the breakdown of complex proteins. When your body produces it in response to protein in the GI tract, the body must eliminate it quickly to avoid negative impact. It is cleared by the liver, and our liver can only remove 1/10th that of a carnivores liver in the same time frame. This means bad mojo (ie: inflammation) for our bodies when we eat a protein heavy diet.

      Good carbohydrates… the unprocessed ones, like potatoes, bananas, squash, corn, etc… are actually the thing your (human) body wants the most of, and is designed to use most efficiently. That is what we should be focused on eating. We should limit our intake of fats and dietary proteins, which our digestive tracts are not equipped to handle in large doses.

  15. confused says

    If you research ‘composition of aterial plaque’ you can easily see many, many studies looking at what exactly plaque is. It is not a blob of saturated fat as you may thing, or a blob of cholesterol, but it is a ‘scab’ if you will, of a mix of cholesterol and fatty acids, including mono and poly PUFA’s. So replacing natural fats with seed oils isn’t doing anyone any favours, as this weakens the ‘scabs’ and makes them more likely to break off. Common sense serves well in conflict and common sense tells me that eating seed oils is not natural. We must put ourselves again with nature – plants and animals as our foods. If seed oils have to go through ten different processes to come out the other side edible, then they were obviously not meant to be eaten that way. Esselstyne by the way has been shown to have a VERY small study population. He has never added any new patients or used any new slides to my knowledge apart from that one ‘proving’ his diet works. There are dangers with a very low fat diet, as fat plays an important part in our diets and has been a natural part of our diets. Nuts, fatty fish, meat fat, avacado’s etc. Fat is not the enemy. Perhaps just eating a natural good diet would have benefits, rather than going low fat, or high protein or whatever and skip the Heart Foundation tick foods like cereals etc. I don’t know…too much conflicting information out there i just eat natural and what i want, it seems to keep me healthy. I have no idea what my blood pressure or cholesterol is and don’t care. But for anyone who is wondering what the? just look at what heart disease plaque is made of.

    • Richard says

      I do not know exactly what you mean by seed oils but people that add some nuts and seeds to their diet on a weekly basis have fewer heart problems.

    • says

      @confused brings up a very good point.
      My understanding too is that the plaque is like a “scab” (made up of cholesterol etc), so the “scab” may be protecting the arterial wall.
      If that is the case, I not sure why the focus of research is not on the makeup/composition of the “scab” but on what has caused the damage to the arterial wall, that the “scab” is trying to protect. If that is addressed, then that would eliminate the reason for the “scab” being there in the first place.

  16. Victor says

    Just got my results back after eating a cholesterol low diet for a year. My blood cholesterol levels went up significantly form 234 to 247. This is proof enough for me that there is no correlation between what we consume and our cholesterol levels. I did loose weight, 10 lbs. however and lowered my blood pressure significantly from 125/82 to 116/70.

    I certainly don’t want to take statins. What should I do going forward? Becoming a vegetarian is not an option. How do I assess my heart risk?

    • Richard says

      Your comment lacks details of your diet so how can anyone assist you to get your cholesterol level down?

  17. Lorenzo B. says

    I have pushed back on my doc that wants me to take statins but today the bloodwork came back and I have 300 cholesterol despite living an active life, being 37 and eating a healthy diet (including eggs for breakfast). Is there no normal range for cholesterol as there is for other markers? Also since my understanding is that oxidation is the problem wouldn’t higher levels mean a bigger chance to have some of it oxidize?

    • Mike Mejia says

      Lorenzo B.,
      300 is very high for cholesterol. Don’t believe everything you read here. 99% of the doctors in this country will tell you that you absolutely need to bring that number down.

      The good news is that you can bring it down with diet. I switched to a low fat vegan diet and brought my cholesterol down 30 points in a very short period of time. And I have lost over 15 lbs, have more energy than ever, and eat as much as I want (rice, potatoes, corn, beans, vegetables, etc.)

      However, with a cholesterol that high, you may still need medication at some point. But I would try to see how much you can lower it by eliminating animal products, oils and refined carbs.

      • norman wheeler says

        250 total cholesterol not long ago was considered normal. Then it was lowered to 200….I wouldn’t take a statin drug
        period. We’ve become a far over medicated society largely because of people…..doctors/ drug companies and the advertising media make money from DRUGS and getting people to take them for the rest of their lives. Take a pill for heartburn daily, to feel good , to prevent dry mouth etc. And then men find themselves impotent… some cases due to the pills they take….but of course we have pills for that. Eat right, exercise, and get sufficient sleep. Don’t drink like a fish or smoke tobacco. Forget the pills

    • Gemgrrrl says

      Ditch the soft drink AND the steak, and eat a big ‘ole bowl of veggies. Less inflammation, better digestion, lower blood sugar (fats decrease absorption of glucose from the blood – bad), and way, way more energy.

      Not saying that you can’t or shouldn’t ever enjoy some protein… but it should be the tip of your food pyramid vs the base.

  18. Ron says

    Yes, I mean Seneff, the Phd who works for and writes scientific research papers at the Massachusetts Institute of Technology. What are your credentials? And how do you know without a doubt that massive doses of toxic vaccines given to infants don’t do brain damage? Do you know that a court has awarded a huge compensation to parents whose son died soon after his MMR vaccine? Did you know that the court, after listening to the scientific evidence from both sides, ruled that the MMR vaccine was the cause of death? Did you know that the United States Congress passed a law specifically to handle these cases named the National Vaccine Injury Compensation Program?

    “The Vaccine Injury Compensation Trust Fund provides funding for the National Vaccine Injury Compensation Program to compensate vaccine-related injury or death claims for covered vaccines administered on or after October 1, 1988.”

    Look, the fact is I don’t want to argue with you. You think statin drugs are a Godsend for anyone whose cholesterol is over 150, and that mega-doses of vaccines given to infants are somehow totally harmless. That’s fine. I don’t. I believe that the big winners in both cases are quite obviously the pharmaceutical companies, the same ones that killed thousands with their “thoroughly tested” Vioxx. You’re not going to change my mind and I’m not going to change yours. So leave it at that. Either way I’m not responding to anything else you may have to say.

    • Brian says

      Yes, the Seneff with a PhD who works at MIT. In the computer science department. She has no clinical experience, and displays a stunning lack of biological knowledge in much of her writing. Much of her research involves doing word-frequency analysis of the VAERS database, without considering that VAERS was never meant to be a research database; that wasn’t it’s purpose, and as such, it’s actually really bad at it.

      The Vaccine Injury court is not an arbiter of science; it’s a judge who listens to testimony and makes a decision. The burden of proof is actually a VERY small hurdle to jump. To wit, parents don’t have to prove that a vaccine DID cause the injury; merely that it COULD have caused the injury, or is otherwise in some way POTENTIALLY related to the injury. A ruling in this court, however, isn’t any sort of proof, is it? Or are we now using court cases as science, with laypersons essentially replacing people with years of study and experience under their belts?

  19. MMercer says

    You mention that the Framingham Heart Study shows no correlation between Cholesterol levels and Heart disease. However, the risk calculator on the Framingham Web Site clearly increases the risk for those with higher cholesterol levels.

    How do you explain this?

    • Dan says

      Because there is in fact a clear correlation between the two. This guy (whoever he is) doesn’t even make a distinction between HDL / LDL cholesterols – and ignores the very extensive / borderline irrefutable evidence showing that statins reduce both mortality and morbidity in nearly every category of patient.

      All this conspiracy **£& pedelled by people with very little else to do with their time – I wouldn’t mind if they were hypothesising about JFK assassinations / Area 51, but this is real life stuff taking countless lives every year. The same pharma companies have invested millions in countless other drugs for this problem which have been rejected by the medical body owing to a lack of efficacy, but statins have repeatedly stood up to scrutiny on this count. Too many people (overweight and with very high cholesterol) come through the doors of our surgery every year with a whole array of cardio issues – many don’t come out again. These people are aware and many are desperately trying to change their lifestyle before it is too late, despite the many obstacles lying in their path – generally, they are form the lower socio-econimic categories and do not have the support or the fiscal resources to follow through on this. They do NOT need irresponsible s**t like this being pedalled about to discourage them further from saving their own lives. Wake up Mr. Kresser -for every person you discourage from altering their lifestyle habits, I see blood on your hands mate.

      • Ron says

        So Dan, why then was the incidence of heart attacks much, much lower 100 years ago? You know, back when people ate high fat diets, much less sugar, almost no refined food, and absolutely no fast food? You are aware, of course, that back then statin drugs weren’t even a twinkle in any pharmaceutical company’s eye, aren’t you? So Dan, if people rarely suffered heart attacks back then, at least as compared to now, without a single person ever taking a statin drug, why on earth would you think they are essential to CV health?

        Here you go Dan, time to bone up on the scientific literature:

          • Lucy says

            I don’t know about the validity of the argument, but life expectancy is an average. That number does not mean that people all died at 46. There was a huge infant mortality rate, and people died of infections a lot at young ages, but some people did make it to old age.

        • Richard says

          Are you sure they ate more fat 100 years ago?

          Of course, they ate much less sugar, no fast food and likely no processed food other than maybe lunch meat and sausage.

          As far as the comment about how long they lived, I think that should be ignored. Other factors impact the average age at death that are not related to diet. The big one in the last one hundred years is the fewer dying at birth.

          • Bhupinder says

            They surely ate more of fats than today and suffered less heart problems….
            Talking about today,people out there eat more of junk foods, work less, go obese, have hypertension, are stressed… less greens…body goes out of order…tries to compensate on its own…and ends up being messed up

      • Z.M. says

        Dan: “Because there is in fact a clear correlation between the two. This guy (whoever he is) doesn’t even make a distinction between HDL / LDL cholesterols – and ignores the very extensive / borderline irrefutable evidence showing that statins reduce both mortality and morbidity in nearly every category of patient.”

        Not true. After looking through most of the evidence, I’ve come to the conclusion that lowering cholesterol is a waste of time –

        • Lucy says

          I agree. Nobody checked the data. IT was group think. ONe person said it and then this whole cholesterol thing became the be all and end all of heart disease. Statins are not magic pills that stop heart disease by lowering cholesterol. Manage stress, at a normal diet (not low fat), keep blood sugars down. I think all this cholesterol in the blood is nonsense. 75 percent of people with heart disease have normal to low cholesterol.

  20. Mark says

    So if cholesterol has no correlation with CVD, what causes high blood cholesterol and how and why? And please don’t answer with, “Sugar, processed foods, lack of exercise, and stress.”

    Because I assume that cholesterol gets into the blood stream in excessive levels via what you eat. How else does it get there? Yes, I know the body needs it…that’s why it creates it, but it doesn’t deliver it via the bloodstream.

    I went to that Framingham Study and is said “high blood cholesterol” is one of the major risk factors….

    “Over the years, careful monitoring of the Framingham Study population has led to the identification of the major CVD risk factors – high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity – as well as a great deal of valuable information on the effects of related factors such as blood triglyceride and HDL cholesterol levels, age, gender, and psychosocial issues. Although the Framingham cohort is primarily Caucasian, the importance of the major CVD risk factors identified in this group have been shown in other studies to apply almost universally among racial and ethnic groups, even though the patterns of distribution may vary from group to group.”

    • Ron says

      I’m no doctor, but I think most doctors agree that something like 80% of your cholesterol is made by your body. Makes one wonder why your body would purposely manufacture a substance that would ultimately kill you, doesn’t it?

      There is no question that the vast majority of doctors consider cholesterol a risk factor for cardiovascular disease, and there probably is some truth to it when the HDL/LDL ratio is all out of whack. But with everything I’ve read on the subject I find it impossible to believe that taking drugs (statins) to push your cholesterol levels lower and lower can’t possible be the right thing to do, especially when every cell in your body needs cholesterol.

      Also, I have to wonder if anyone has done studies where cholesterol was the ONLY so called “risk factor” involved. In other words, I’d like to see studies where blood pressure, blood sugar, diabetes, smoking, and heredity, among other factors, weren’t also present.

      • Marie Ann Ferencz says

        There in fact has been studies at the Cleveland Clinic …and indeed proved some points you have stated in your post.

    • Bhupinder says

      If one doesn’t eat enough of cholesterol through diet…body will make cholesterol on its own….bcoz it is an essential part of working body….as a consequence liver gets stressed up too….blood levels of cholesterol shoot up even when u r on low cholesterol diet

  21. Antti says

    Chris: Do you have the source for Ancel Keys’ quote about no connection between cholesterol in food and cholesterol in blood.

    I really need to find it to prove my point. :)

  22. Kat says

    It’s about time the human population WOKE up. These studies are funded either by the meat and dairy industry or the pharmaceutical industry to go in the favour of that meat and dairy is ok. If everyone was to go vegan this multi billion industry that we call the pharmaceutical industry would basically go out of business because we would need the medication. The meat industry would fail because we would not need the meat. The pharmaceutical industry controls so much of what is put out that it has to put a dark shadow on veganism when though veganism can cure all these diseases. Take a look around you take a look at the sick people ask them what does their diet consist of? Im pretty sure they won’t be vegan, far too many sick people in the hospitals due to poor diet lack of nutrition. Veganism isn’t made up, it’s not based on fake claims it questions these studies out there does there own PROPER research and comes up with the best answers. Some people just don’t want to make the connection and it’s sad that in 2014 people still can’t see eating meat and dairy is killing you

    • Ron says

      Kat, sorry, but you are wrong. People like Gary Taubes, Dr. Kresser, Dr. Perlmutter, and many other highly respected people were not paid off by pharmaceutical companies. They did the science, read through hundreds of studies, and came to the only sensible conclusions possible. High fat/low carb diets are the most natural and healthiest human diets. I’m not going to argue the point other than to ask you if, in our 2 million history, there was ever a time that humans were purely vegans? The answer is clearly no. We evolved as omnivores, not herbivores. No scientists would deny that.

      You might also find it interesting that the country of Sweden, which is one of those Scandinavian countries that always seems to be ahead of the curve, has officially switched from the commonly held belief that a low fat diet is healthy, to recommending a high fat/low carb diet for its citizens. Someday our backward thinking country will also see the light.

      • Rick says

        Isn’t it possible, and even likely, that there is not ONE best diet for all homo sapiens? Isn’t it possible that there are a variety of diets that best suit individuals based on their DNA, metabolism, stress levels, etc. etc. If this is the case, it also helps explain why much current research is contradictory or non-conclusive – the populations included in the study are too diverse.

    • Marie Ann Ferencz says

      Sorry to say, VEGANS look deathly ill in their emaciated appearance, at least the ones I have seen and know. A very thin person is said to be at greater risk of many ills…and being vegan ? TO me is simply not the total answer. Many people believe being one is the be all and end all to total heart health as well as general health…when in fact a good 6 ounces of meat once a week would do them some good.

  23. says

    Great article Chris. I saw a link at the bottom that was supposed to be a link to handouts from one of your presentations. I was very excited to see those handouts but unfortunately the link only went to your products page. I really would enjoy seeing the handouts. Is there any way that you can direct me to them via another link?

  24. JS says

    “Contrary to popular belief, cholesterol is not a dangerous poison that causes heart disease. Rather, it is an essential nutrient present in the cell membranes of all tissues of all mammals, and has some very important functions in the body.”

    Glucose is an essential nutrient and has some very important functions in the body. I think we know that if we have too much of it in our bloodstream its not good for us. Too much of anything is the blood stream is a poison, that why our bodies regulate what’s in our blood. I agree with this article to an extent. However, lets not get carried away, too much cholesterol in the bloodstream probably is not a good thing

    • Lucy says

      I agree. Nobody checked the data. IT was group think. ONe person said it and then this whole cholesterol thing became the be all and end all of heart disease. Statins are not magic pills that stop heart disease by lowering cholesterol. Manage stress, at a normal diet (not low fat), keep blood sugars down. I think all this cholesterol in the blood is nonsense. 75 percent of people with heart disease have normal to low cholesterol.

  25. Robert Sargent says

    Hi I can definitily tell you what causes Heart Problems and with no bull about it,first I had open Heart back in 1989 on the 29/1 and I believed what the medics told me and I followed it for 4yearsand sat in a chair for all that time .That decided me to look for the truth and I have been searching since and have found it .
    I wont bore you with all the tecs,it is two Items which you have to forget,they are flour and all that can be made from it and SUGAR the most important because it is the most dangerous.I am now clear of heart problems and intend to stay that way,it has not been easy but believe me it has been worth it and I wont ever believe another doctor for as long as I live as they listen to the DRUG FACTORIES who only give you that which will keep you living and suffering for the mighty dollar .I forgot I gave away the pills and I took fish oil ,about 12-15 tablets a day for 3-4 years and gave away all flour products until I heard about the sugar then I gave that away and it was amazing ,within 3 weeks I felt the difference ,the rest is history,So go cure your selves Robert

    • Steve says

      Robert – I’d agree with you.

      I recall reading one doctors book about the cholesterol myths and his comment was that stress is one key cause of heart disease and quoted a study of heart disease amongst Finnish people when part of their land was given to Russia after WWII. The “meditarean diet” isnt that significant – the key is that people around the Med are usually more relaxed, hence this may also contribute to the idea that lack of stress makes for way less heart attacks.

      To me that makes a lot of sense as stress changes body chemistry, so if you are under constant stress ( instead of only short bursts ) , it makes sense that the potent “fight of flight” chemicals designed for short bursts are constantly flowing ariound the body and “supercharging” it. Any mechanic will tell you if you over rev an engine for long enough, she go bang! We are machines, it makes sense to me.

      My personal take is the key to a long liffe is a calm heart.

      I also have a sweet tooth and it would be intersting to see correlation between sugar intake and heart attack incidence.

      My grandfather died from a heart attack , he also had a bad temper and a sweet tooth, so maybe it has some basis.

      Further research is always welcome.

      • Marie Ann Ferencz says

        Sorry to say, VEGANS look deathly ill in their emaciated appearance, at least the ones I have seen and know. A very thin person is said to be at greater risk of many ills…and being vegan ? TO me is simply not the total answer. Many people believe being one is the be all and end all to total heart health as well as general health…when in fact a good 6 ounces of meat once a week would do them some good.

        • MRod says

          Let’s not add any more myth’s to the pile, OK? A vegan diet can be excellent if properly managed. For example, Dave Scott, winner of an astonishing six Ironman Triathlons was is a vegan! In case you are unfamiliar, the Ironman is a race involving over two miles of open ocean swimming, over 100 miles of bicycling through mountainous terrain, followed by a marathon run. Would you call Dave Scott ‘sickly?’ Would you advise him to eat meat?

      • Marie Ann Ferencz says

        I stated above my husbands heart surgeon at the Cleveland Clinic stated INDEED, YES…..’STRESS’ is the number one factor in heart disease. SO calm it down…exercise, do all in moderation….PRAY…soothes the soul and BODY..including HEART.

  26. ory says

    It all depends on your state of mind and overall vibration , its got nothing to do with your diet , vegetarians get heart attacks and cancers but fat burger eaters and alcoholics sometimes live till there 90s . its the way you think and feel not your cholesterol intake .

  27. John Smith says

    “Another consistent thorn in the side of supporters of the “lipid hypothesis” is that women suffer 300% less heart disease than men”

    Please decode this sentence for me. To me, if women suffered 100% less heart disease than men they would suffer no heart disease at all. And “300% less” makes no sense to me whatsoever.

  28. Skeptical says

    I’m with Alf I’d love to know which key article/articles from Framingham study/ies showed no correlation between cholesterol and heart disease as well, it’s now June and it seems you have conveniently avoided or forgotten the question?

    • Richard says

      The study showed a very strong correlation, nobody with a total under 150 had heart disease.

      What so many doctors call a “normal” level is in fact the average level. So what should be clear is that it is not healthy to be average in this case. Scientist can test people with levels of 180 to 250 till they are blue in the face and will likely not learn much. The risk does not increase much in that range.
      Test total levels of 130 to 300 and LDL of 75 to 150 and see what happens…

  29. Robert Sargent says

    Sorry for taking so long to answer,I had forgotten about your Post until I found a reminder.My wife is 4ft 10 inch and weighs in at 90Kg and regardless of what she does,even to the point of starving,she cannot lose weight.I afraid I don’t know the answer.I can tell you that she has made it down to 78 kgs but not for long and we lived in the NT at that time.I don’t know if it is possible for people to loose weight when they have been heavy all their lives.Nor do I agree with the science on weight,I believe that it all has to do with where your ancestors came from.Such as a cold or hot climate ,then also the mixing of the genes through inter racial marrying and the like ,which would put the control of weight outside the understanding of man at his present level of Intelligence.After all we cant even live together without argument,nor wipe out poverty,even though we waste more food then we eat,and still cant give it to the starving population???????? Then you look at the Trillions of Dollars which are wasted on war.
    Not to mention the over Government of all the countries in the world!!!! how much do they take??? Then the waste is 100 times worse then it could be.No ,we have a long way to go yet.Until money is a bygone era …and a new system is declared that rewards all work,and the people that perform them..
    regardless of their sex nor religion,until we give up this hate we have for our fellow man just because he is different to us, then we shall always be a backward Planet.Sorry I got a bit off the track there but
    I don’t know the answers …..Sorry …. Robert

    • Sabina says

      Did you or your doctors consider that your wife might have hypothyroidism, which slows a person’s metabolism and hence they can’t lose weight. Most people have that problem and it is easily detectable by a blood test.

  30. David says

    You seem to have some good points. However, one thing keeps coming into my mind as I read this and that it for me high fat and even moderate fat and even low fat by American standards causes me to gain weight out of a healthy level. As an athlete and longeviety seeker I try to stay lean and for me at 50 years of age the only thing that works is a low fat diet. Some say: “The fat you eat is the fat you wear” My results have proven this. I have been monitoring my diet and exercise for 17 years and have found that when I stray from low fat, I become fat. I am not opposed to eating tasty animals (morally speaking) but the only ones I can eat and manage to stay healthy are shellfish and bivalves. I am allergic to fish so I am at a great disadvantage there. If I stray from a 10% of calories from fat then I become fat and I am not willing to do that anymore. Been there, done that, didn’t work.

  31. Robert Sargent says

    Hello I am not sure about this Dr. Caldwell Esselstyn’s Theory.I watched his presentation on You Tube and even though I am no Doctor and don’t have any credentials to my name I am not an Idiot as I left school with an IQ of 148 and still have an IQ of 132 after suffering Open heart surgery 23 years ago and 2 strokes and several heart attacks also so I think I have a fair idea of what works and what doesn’t.I gave you all the name of a Doctor on Dr Chris Kesser column who doesn’t go for the bamboozling tech. stuff but spells it out in plain language. plus he also was the first Doctor to hold a beating Heart in his hands.He also has done over 5000 Heart Operations.From there he opened his own research centre hence the book.Again the site you can read all about him.Enter “The Great Cholesterol Lie ” into Google search and you will find every thing you need to know . Robert

  32. KC Grapes says

    If you really want to prevent or reverse your heart disease you should get Dr. Caldwell Esselstyn’s book, Prevent and Reverse Heart Disease. He has proven that it can be done. Dr. Esselstyn has worked with numerous heart disease patients, each of whom had had more than one by-pass operation and other procedures but with no long lasting success. His book shows photos of the arteries in these patients both before and after they adopt his program. It is just incredible how the plaque in the arteries is all but gone in the after photos. Esselstyn never once mentions worrying about cholesterol in his book. But what he does tell his patients to eliminate out of their diets is fat and oil of all kinds. If you’re really worried about heart disease you’ll be fascinated by his book. Esselstyn has proven, with real patients, that heart disease can not only be prevented, it can be reversed.

    • Ron says

      I’d love to see the answer to this. Esselstyn is a respected doctor at the Cleveland Clinic and does have considerable proof that his low fat diet works. That said, as someone who has type 2 diabetes, I tried his diet as presented by his son in his Engine 2 diet book and found it to be disastrous. It raised my fasting blood sugar level to well over 300.

      Since then, over 3 years ago, I switched to a Paleo diet, which not only keeps my blood sugar levels under control, but has also lowered my overall cholesterol to 200 (for whatever that’s worth). I also lost over 30 pounds on the Paleo diet, even though that wasn’t a main priority, or something that I consciously tried to do.

      So anyway, my question still stands. Why is it that Esselstyn can guarantee that you will not have a heart attack if you follow his low fat diet to the letter? And why does he have such compelling proof showing considerable improvement in atherosclerosis if his diet isn’t helpful? Could it be that eliminating processed food, junk food, and hfcs are the main reasons these mostly opposite diets are both successful?

      • Richard says

        I have read all of Dr Esselstyn’s non-cook books along with the same for Drs Fuhrman, Ornish and McDougal. At no time have any of them said only a low-fat diet was the answer….

        They all have exact information in the books which continues to be mis-quoted in blog after blog.

        Surely, the Paleo diet is not a healthy answer for most people. It does not matter how much weight you lose on a particular diet, that fact does not make it a healthy diet.




    • Mrs. H. says

      Mr. Sargent, Thank you for sharing your experiences here. Are you taking H202? What has been your experience with that?

    • MRod says

      You ‘sound’ like a bully the way you type in capital letters, call people names, and have such a harsh tone while at the same time making inaccurate statements like this: “THE REASON FOR THIS BILE….TO BREAK DOWN FAT AND EXTRACT VITAMINS FROM IT.” In fact bile does not break down fat, it emulsifies it. That means bile reduces large fat globules into small ones.

      Many of us are just confused by all the complicated and conflicting information out there. Why should anyone take JUST your advise and ignore all the rest?

    • Richard says

      Are you sure he gave it up for the reasons you give? It could not be because in 2008 he lost his license to practice surgery?

      Because you consume animal fat all the time and are still breathing I am suppose to ignore the science out there that talks about the risks in consuming excessive amounts of animal protein?

  34. ALF says

    Chris, if it’s not too much trouble, could you tell me which key article/articles from Framingham study/ies showed no correlation between cholesterol and heart disease, and support the idea that saturated fat is beneficial? (There are close to 2000, and reading through the list, I’m a little overwhelmed) If you’re aware of specific articles from the Nurses study that address this point, the references would also be greatly appreciated.



  36. Cindy Schoonmaker says

    Like Ken…I would like to know then….why are so many people in the West dying of Heart Disease and Cancer?

    If it’s not the animal protein and dairy….what is it?

      • Marie Ann Ferencz says

        Stress as told by my husbands Cleveland Clinic Surgeon stated was number ONE….followed by GENETICS…

        • says

          I agree stress and the inflammation cause by stress is a major factor. At least for me it was, I had a quintuple bypass at a young age, despite being on statins and being told by my PCP that I had a “clean bill of health” as my cholesterol was “under control”.

          I also agree that Genetics plays a role. However there are recent exciting finding that re-ignites the age old debate of “Nature vs Nurture”. Research indicates that there is an epigenetic layer that acts like a switch, that control if a gene gets expressed. These “epigenetic switches” are influenced by the cellular environment which are in turn impacted by the stress hormones and diet

      • Reggie says

        I don’t see doctor in front of your name, not one of your have put forth the effort to do in depth studies on the causes heart disease or cvd. Go to the American Heart Disease web site as they are a trusted source unlike the individual on this web site who fails to provide any kind of credentials. I am not pro pharmaceutical companies but without them the mortality rate would not be as low as it is today. The data proves that lifestyle modifications and medication if needed reduces your chance for a cardiovascular events. If doctors hands were not tied by the managed care system and were able to treat heart disease more aggressively we could lower the incidence of heart disease. Lets remember that Heart Disease remains the number cause of death world wide and is higher than the next 7 diseases combined. Cholesterol is a risk factor for heat disease. This article is a joke and written like a competing pharmaceutical company trying to discredit their competition by twisting the data from various studies. Try to find a different way to rip people off.

        • Canucker says

          Oh, c’mon. Having an MD only means that you have regurgitated in written exams what you were told by the previous set of medical experts. Medical training was hijacked by the Rockefeller/chemical gang in the 1920s – it has yet to recover.
          Common sense does not require a degree; just use some of it sometimes to think for yourself.

  37. says

    I am an Optometrist. I read with interest your post. I seems to go against everything I have been lead to believe, but the research you quoted is compelling. Is there no risk for high collesterol? Is there risk for high Triglycerides?

    I am diabetic, it seems that high fat in my diet really messes with my blood sugars. Thanks for the good information. By the way, I quoted you in my blog. Here is the link if you are interested

    It seems the goverment is using bad science to justify bad government

    • Geiri says

      Inflammation and stress. One of the problems is a high consumption of omega-6 oils compared to omega-3. For most of human history the ratio was about 1:4-4:1. Today we have about 15-20x more omega-6 than omega-3 and that causes inflammation. It’s ironic that people moved away from saturated fat (harmless) to “heart healthy” vegetable oils.

    • Robert M Sargent says

      Yes it is curable,go to this site and buy his book.It is Dr Dwight Lundell a heart surgeon with 25 years experience in heart surgery.If you are serious about curing your disease you will buy like I did and I would give a hell of a lot more for his book than what he asks for it Robert

        • Reggie says

          If he had the cure for heart disease he wouldn’t have to right a book. he would have the clinical data to support it through his own clinical work and would be well known in the medical community through out the world. Heart disease is still the number one cause of death and the number on way people try to make money off those that don’t understand. Maybe he should right a diet book as well.

      • Richard says

        I am certainly never going to buy his book. If you can not summarize it’s contents I will never know what he has to say.

    • Marie Ann Ferencz says

      Seeing as my husband who has ALWAYS had low LDL and a good HDL and normal TRGS….had a sudden heart attack, YES, you read this right…He suffered from Bursitis and went to the ER…after all the standard testing he was said to have one blocked artery that a stent would be needed. After the CATH,it was said ‘he should be dead’. ALL three major arteries feeding the heart were totally blocked, 2 of the smaller vessels totally blocked. DOC was amazed…as ALL his blood Chol levels NORMAL….YET, when at the Cleveland Clinic, the operating surgeon stated that 1. STRESS was the number 1 cause….2. GENETICS was next, he has 2 uncles maternally who had severe heart issues. 3. THE BIG ‘CHOLESTEROL’…SO he had 5 bypass open heart. Survived and did so heart muscle damage. Thanks to God and excellent care…Any and all people I have known to have severe heart disease ? Have had LOW BLOOD CHOLESTROLS….so please all you Statin lovers explain this one…BTW ? He was instructed to EAT BUTTER, not margarines at all….Use Olive Oil…eat moderate red meats and dairys…Please no one explain he was an annomaly. sp…
      I am sick of docs being in bed w/big pharma and getting kick backs w/prescribing these Statin drugs…as well as many other drugs..IT is a racket. So much more is involved in heart disease.

  38. Donal says

    Hey Chris ,
    Good article I enjoyed reading it. Certainly some interesting points made and some I found very informative while others left me confused to say the least.
    Just wondering could you clarify your comment in the comment section regarding Transfats and especially PUFA & MUFA

    “However, in practice I’m not sure how important the distinction is since all trans-fats used in this country (to my knowledge) contain high amounts of PUFA and MUFA. They should be avoided completely.”

    Just wondering are you advocating the avoidance of just foods high in trans fats or actually foods that contain PUFA & MUFA also. Or is your point that foods high in PUFA & MUFA tend to be high Trans also and thus should be avoided.
    I guess my question is could you clarify your stance on PUFA, MUFA and to a lesser extinct Trans.
    I have recently read Food standards Agency Manuel of Nutrition 11th Ed. from UK which it includes information on a host of nutritional topics. Current recommendations are to increase consumption of omega 3 poly unsaturates, eg mainly in oily fish to about 1.5g a week from current levels which are 50% of that level at time of printing due to the possible link between PUFA and their ability to reduce tendency of blood to clot and thus a reduction possibility of heart disease. An improved increased heart cell membrane is also mentioned due to PUFA intake.

    Just wondering could you answer my question when you have a chance and maybe comment on the above recommendations and research on PUFA.

    Thanks for your time


  39. Mark Haub says

    Good points Mark…Cherry-picking is becoming mainstream to illustrate one’s point/bias in science. It happens on both sides of issues (kind of like politics). With the vast number of studies being published now, it is easier to pick as it is difficult for reviewers to keep up with the new results coming out. I do think there is ample evidence to say that we don’t know what we think we know about the link between diet, blood cholesterol, and actual heart disease — one thing often overlooked is whether people actually have or develop disease, risk is often assumed with elevated LDL or decreased HDL. That may or may not be true, but more data are being published indicating those values might not be as clean/direct as we have thought (imagine that). For example, for numerous years Lipitor included ‘not proven to reduce heart disease’ (paraphrase as I am not sure of the exact small text statemet) in their adds. That has since changed recently, but it is evidence that lowering cholesterol does not necessarily lower the incidence/occurrence of the associated disease.

    I think energy/calories (both diet and physical activity) play a role in health outcomes regardless of nutrients per se’. That is, the same nutrients can exhibit different health outcomes when eating an energy deficit diet (fat loss) vs energy excess (fat gain). For example, eating the same amount of HFCS/sugar (say ~80g/d) while losing body fat “seems” (based a recent ‘case study’ by a nutty professor in Kansas) to decrease heart disease risk based on cholesterol, lipids, visceral adiposity, and blood glucose changes. While, I would suppose that those biomarkers would increase if that same amount of HFCS/sugar were eaten in a scenario where fat mass was increasing over time.

    Great discussion and evidence that more clinical trials with human volunteers are needed to better understand the diet – health interactions.

    Cheers — Mark

  40. Mark says

    I don’t even know where to begin.

    Your constant use of phrases like “recent studies show…” is misleading, as most of them were submitted about 15 years ago. If cholesterol really wasn’t a big risk, you’d think the scientific community wouldn’t continue to invest so much time and money studying it. But that’s not the case, is it. Instead, the vast majority of research DOES suggest a strong connection between high cholesterol levels and CVD… that’s kind of why we continue to study it.

    Regardless of their date of publication, these studies don’t say what you imply in your article. The JAMA article looked at cholesterol as a risk factor for mortality in people older than 70. Now, that’s pretty close to average life expectancy, so whether or not an individual has high cholesterol, at that point, probably isn’t that big an issue compared to all the other stressors their aging body is handling. This is not an issue of cholesterol suddenly ceasing to become a risk factor, as you imply, rather the study simply confirms that people over 70 are at no greater risk of dying from cholesterol-linked CVD than anything else. If you actually read through that Framingham Heart Study you reference, you’ll find their method of assigning risk factors follows the same logic I’ve outlined, and does in fact assign greater mortality risk to individuals with high cholesterol.

    As for that Japanese Lipid Intervention trial, you may recall that correlation does not mean causation. Pretty basic statistical principle, but one that you seem to have overlooked here. Do you really think that a study of that magnitude could possibly identify which factors were responsible for lower incidence of CVD and which weren’t? There could be hundreds of possible reasons why CVD declined, reasons which may have outpaced the still detrimental effects of high cholesterol, yet you cite this 1991 study as definitively proving that cholesterol was a zero-risk factor. The study never made that claim, rather you are extrapolating correlation into causation and that, sir, is very poor science.

    This article and the conclusions it reaches are simply more evidence that the current stigma surrounding integrative/naturopathic medicine is well-justified. Cherry-picking evidence and still managing to misrepresent the conclusions does your profession a discredit.

    • Andy says


      That would be one point of view. Another less naive one could be that we continue to study it because about 50 billion dollars is at stake from peddling statin drugs.


      I would agree if someone could show that smoking or heavy drinking also cease to be a factor over 70, just like high cholesterol.

        • Lucy says

          you have to treat 100 people to get 4 people who benefit from a Statin for 5 years. 1 person will get diabetes. Cancer risk of Statin was not factored in. Nobody knows if STatin helps for primary pervention at all.

    • Robert M Sargent says

      It is you who does a discredit to we who have to suffer the stupidity of people like you who do not know nor begin to understand what it is like to have a heart disease, that is also very hard to find any truth through the Medical Profession.I had a triple bypass in Jan.1989 and spent the first 4 years sitting in a chair with no life at all.Finally I got the guts to get on the computer and research Heart disease and what I learned turned my life around.Everybody who went on Cholesterol tablets died as their Cholesterol went down to 4 – 5 .I never took another Cholesterol Tablet and wont touch them again.That was back in 1994 and even though I have had a dozen Heart attacks and 2 Strokes since I still get around well and can still do almost anything I want, and I turn 77 next year, and thanks to what you called CHERRY PICKING I owe my life till now and all the years still to come. But had I still taken those useless Cholesterol Tablets I wouldn’t be here,or if I was,I would be a vegetable. Robert

    • says

      Yes, correlation does not mean causation, but lack of correlation makes causation extremely difficult!

      If having high cholesterol is not even correlated with heart disease, are you really going to say that it is still a causative factor?

    • mary L says

      Perhaps you should read this well cited article. It is a FACT (as in universal truth) the doctors who created the cholesterol requirements were being paid by pharmaceutical companies. Cholesterol is necessary to rebuild cells, regulate serotonin, combat, disease, and manage stress. The ONLY correlation between head disease and cholesterol is that high levels are present because the body naturally produces it to fight disease and infection, therefore what needs to be addressed is the root cause ie. the disease, infection, sickness, or high stress.

    • Z.M. says

      Mark: “Instead, the vast majority of research DOES suggest a strong connection between high cholesterol levels and CVD… that’s kind of why we continue to study it. ”

      Total cholesterol and LDL-C are poor predictors, which is why other markers are used such as particle number or cholesterol ratios.

      Mark: ” If you actually read through that Framingham Heart Study you reference, you’ll find their method of assigning risk factors follows the same logic I’ve outlined, and does in fact assign greater mortality risk to individuals with high cholesterol.”

      The Framingham Heart Study did not find any meaningful correlation between total cholesterol and CHD. They stated in one paper that the HDL influence on CHD risk was about twice as strong as LDL, and in another analysis found a direct association between falling cholesterol levels over the first 14 years and mortality over the following 18 years (11% overall and 14% CVD death rate increase per 1 mg/dL per year drop in cholesterol levels).

      Framingham is not an isolated case, as many studies find that total cholesterol poorly predicts CVD and that lower cholesterol is associated with increased mortality (in some cases even increased CVD). You can attempt to ad hoc your way out of this, but this is what is found. Yes, correlation does not imply causation, but the same principle applies to those studies associating high cholesterol with CVD.

      So please Mark, if you have the evidence of the alleged “detrimental effects of high cholesterol” please provide the evidence.

    • says

      Yes, there is certainly no clear consensus on this with much support for the view that keeping cholesterol in check and avoiding the excesses of the Western diet (too much meat, fats and dairy) is a valid way to go. Doctors Ornish and Esselstyn have made many relevant contributions here and are worth checking out before one (un) happily stared tucking into the meats and cheeses again.

  41. Graph? says

    The “Average Serum Cholesterol Levels” graph lacks both a y-axis and error bars. It’s difficult for the reader to grasp the true significance of such an image.

  42. says

    This is true, Bruce, and thanks for making the distinction.

    However, in practice I’m not sure how important the distinction is since all trans-fats used in this country (to my knowledge) contain high amounts of PUFA and MUFA. They should be avoided completely.

  43. Bruce says

    You can probably correlate trans fat with sugar and HFCS and flour and other junk carbs. Most people nowadays also eat a lot of PUFAs. On CNN’s special “Fed Up: America’s Killer Diet”, they said the average Americans eat 10% of their calories calories from soybean oil alone. So, the question is whether the trans fats are really as bad as we are led to believe, or is it the refined carbs and PUFA oils that are the problem? Most of the studies on trans fat seem to be epidemiological and I have yet to find long-term controlled studies which prove the assertion that trans fats are bad. Partially hydrogenated oils still contain PUFAs and MUFAs (double bonds). It would be good to test a fully hydrogenated coconut oil (100% saturated) to see if it caused problems. It’s hard to isolate the trans fat from rancid unsaturated fat, you see.

  44. says

    That’s exactly right. Those studies were hopelessly flawed, and it was revealed that Ancel Keys (the researcher who published them and the “father” of the lipid hypothesis) deleted data from them that didn’t support his hypothesis. When the original data were later reexamined by George Mann, the association between saturated fat/cholesterol and heart disease disappeared. In fact, of all the dietary factors that were recorded in that original study, sugar was the one that had the greatest correlation with heart disease.

    As you point out, early studies did not differentiate between saturated and trans fats. When researchers distinguished between trans and saturated fats in subsequent analyses, again the association between saturated fat and heart disease disappeared – and a strong correlation between trans fat and heart disease became apparent.

    So keep eating that saturated fat, and don’t worry about cholesterol!

    • Reticuli says

      Funding from the processed foods industries. Big soy, canola, and corn. We’re not talking local farmers, but the mega conglomerates that contract out these farmers and then do all the soy and corn product processing. They control the vast majority of the contracts these farmers are signed to around the world.

      You also have to go back to the original regulations that did not allow these to be categorized as ordinary foodstuffs that these industries had changed to be grouped in with normal, local food. These were experimental foods, turned emergency war rations and additives, that are now treated just like normal sugar, butter, milk, eggs, meat, etc.

      These big firms have even spent money on trying to find innovative ways too make some of these synthetic “foods”, like the isolates, less dangerous for long-term consumption, only to not even utilize their discoveries because it would add a slight cost. Sure, something like dextrose is really not that big a deal because chemically it’s so pure (it’s pure glucose derived from corn). But a lot of these other products are no where close to that purity.

  45. Marc Marshall, D.C. says

    corection: He asserted that it was the high level of these and especially the trans fats that resulted in the higher levels of disease and the cholesterol.

    should read:

    He asserted that it was the high level of these and especially the trans fats that resulted in the higher levels of disease and NOT the cholesterol.

  46. Marc Marshall, D.C. says

    I had a nutrition teacher in chiropractic school who told us that when the early animal studies on high cholesterol diets were conducted high concentrations of pufas were added to the animal feeds. He asserted that it was the high level of these and especially the trans fats that resulted in the higher levels of disease and the cholesterol.

  47. Bruce says

    Campbell’s studies and conclusions are the most outrageous. Here is one of his studies, claiming that a high (animal) protein diet causes liver cancer. When you look at table 1 on page 2 of the pdf, you see that the animals got diets of powdered casein, fractionated methionine, table sugar, corn starch, and corn oil. He also exposed them to large doses of aflatoxin to initiate the cancers.

    As Michael Eades would say, ‘the data shows what it shows,’ but it doesn’t show that natural animal protein would cause cancer (except in the context of sucrose, corn starch, corn oil, protein powders, and aflatoxin). Campbell and other vegan activists confuse correlation with causality when they look at epidemiological studies. They also tend to confuse ‘whole animal protein’ with fractionated powders and isolated amino acids, even though evidence clearly shows these two things are not the same.

    I don’t think we can ignore all of the confounding variables in his study, like refined sugar, corn starch, corn oil, DL-methionine, cellulose, etc. Maybe the results would be different if the animals were fed natural animal foods, and saturated fats like butter, tallow, coconut oil, etc. We have to consider the interaction of variables in a study, nad how the results might be different if one food (sugar) was changed for another (comb honey).

    • BeachMan says

      Calling Campbell a vegan activist is misleading. He was a pro-dairy enthusiast who was convinced that animal protein would save the world from malnutrition. It was his non-biased research that drew him to the conclusions he has made — and publishing his results was a very difficult decision for him to make. He could have made 10-100x more $$$ working for the American Dairy Council, but had the courage to speak the truth about what he and others had found. He also blames junk food vegetarians and says eating processed vegetable is just as bad. While correlation may not equate to causation, you can’t ignore how unhealthy we have become. Animal protein and dietary cholesterol in its most natural form, when consumed at too high a concentration (which nearly all Americans now do, as well as other more affluent Asian countries as they introduce more meat into their diet) does correlate to higher cancer, heart disease and diabetes. This is the “epidemic” we now face… Got Milk? Have you had your complete protein today? Have a nutritious “protein bar”? No thanks, I’ll have a salad — with chicken and cheese of course? Notice how our food has become inundated with animal proteins, processed ingredients, and sodium. T C Campbell, Esselstyn, and many others have a very consistent message: a varied plant-based, whole foods diet is the healthiest. So far the data I’ve reviewed supports this, and I made the plunge a year ago into this diet when I turned 42, and I have been healthier than I ever have.

      • Rich D says

        It is entirely legitimate to call Campbell a vegan activist. It doesn’t matter how he got there, that’s what he is now. (And he’s doing quite alright with book sales and lecture fees, I imagine.) He is one of five or six of the leading lights of veganism (or anti-meatism, if you want to stipulate that not all vegetarianism is healthy). You know how they are — McDougall, Esselstyn, Ornish, Fuhrman. I’m a former vegan who followed these guys religiously. (I lapsed for no particular reason.) After I read Gary Taubes and Denise Minger, I realized these guys were pushing bad science. Also see the new book The Big Fat Surprise. For an academic’s discussion of the evolution of humans as meat eaters, see Daniel Lieberman’s new book. The diet the vegan squad pushes isn’t unhealthy — it’s a whole foods diet without junk — so I wouldn’t dispute your personal health claims or say you should eat meat. There’s just no evidence that meat is the poison behind all chronic diseases in Western civilization, as the vegan squad claims.

    • Richard says

      You should read and understand the whole China Study rather than pick and choose sentences.

      However, there are more recent studies that verify much of what is brought to light in the China Study of 2006.

  48. admin says


    Yes, the deeper one digs into this myth the more outrageous it becomes.

    T. Colin Campbell’s China Study has unfortunately been widely read and has further contributed to the false idea that animal protein causes cancer.

    Thanks for your contribution and participation here!


    • Richard says

      In the range studied, cholesterol was not related to CHD…so what?

      Find one person in the whole world with a level below 150 that has CHD and you will have documented the first such person.

      Continue to laugh at a whole plant-based diet and stick with your diet. I know it has done wonders for me and I thank some of the people you laugh at like Campbell, Ornish, Fuhrman, McDougall and Esselstyn.

      • Juan Cazador says

        I agree 100% with you.
        And another thing….why don´t these proponents of the “cholesterol is a myth” nonsense show before and after photos of CHD patients whose artery blockages have reversed on the diet that they advocate? NONE of them have done that, yet Ornish, Esselstyn, Pritikin, McDougall, etc., have shown such proof many times, over and over and over.
        Let these shills for the dairy and meat industry keep speading their lies. It’ll come back to bite them and we’ll have the last say in it all.

        • Rachelle says

          Juan, I say that all the time. Show me someone who has cured themselves of major disease by eating a meat-based diet. And I’m not talking about weight loss. We all know that thin does not necessarily mean healthy.

  49. Bruce says

    Also, the animal studies used oxidized cholesterol and they fed the animals vegetable oils high in PUFAs. They used fractionated processed cholesterol and PUFA vegetable oils. All of their conclusions should have been suspect, from the beginning. None of them have been proven in human studies with real food prepared in natural ways. Even animals don’t get atherosclerosis when fed non-oxidized cholesterol and saturated animal fats. Most studies feed animals refined sugar/grain and casein powder and assume the same thing will happen on a diet with natural foods.

    T. Colin Campbell is the biggest proponent of this brand of junk science. He says that animal protein causes cancer, but his studies actually show that casein powder causes cancer, in the context of a diet of refined sugar, corn starch, and PUFA oils (like corn oil). That doesn’t show that a diet of natural foods causes cancer. It only shows that the diet he fed the animals caused cancer and it could be related to the other foods.

    • Reticuli says

      Actually, all Campell’s studies showed was that casein promotes cell growth and division. We already knew that as it is the optimal form of protein due to its slow continuous digestion in the gut. Protein cannot be stored by mammals for later use as protein and has a relatively low maximum rate limit at which it can be absorbed and processed for use by the body. Going over this maximum only causes it to get converted into fats and sugars depending on the amino acid profile. Going below that is suboptimal. It did not cause the cancer, though. These were pre-existing cancers that got worse with an enhanced, superior diet. The rodents were not cancer-free to begin with, fed casein for an extended amount of time, and the carcinogenic quality of casein was thus demonstrated when they came down with tumors. This is not news, as the best way to kill cancer is to starve the cells. Duh. Cancer cells are just cells. They may have corrupt genetic material, but casein is not contributing to those defects.

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