After many years, both the United States government and the American Heart Association (AHA) have changed their policy and taken dietary cholesterol off the “Most Wanted List”.
British heart specialists have also called for the United Kingdom National Health Service guidelines to be overhauled, while questioning whether the millions of patients who are prescribed cholesterol-lowering drugs are being unnecessarily medicated.
Health officials and nutritionists have long championed the eating of healthy sources of dietary cholesterol as it plays many vital roles in the body, none more important than its use as the building blocks of the very hormones that keep us healthy and strong as we age.
Increased cholesterol levels are also needed when we are under stress as our primary stress hormone cortisol hijacks the cholesterol that should be used to build other hormones like testosterone, oestrogen and DHEA from pregnenolone.
This process is called “pregnenolone steal” and leads to adrenal fatigue, thyroid dysfunction and the general chaos in the endocrine system that are some of the well-known side effects of living life too long in the fast lane.
So why the sudden reversal in the dietary cholesterol policy?
Well, a recent survey of 19 studies involving 68,094 elderly people found that in 92% of cases, LDL cholesterol levels (bad cholesterol) did not increase the chance of death caused by heart disease.
The study also found that people with high levels of LDL cholesterol were less likely to die prematurely from other diseases, such as cancer.
The results, published in the journal BMJ Open, are the latest from a series of studies that undermine accepted theories involving diet and health.
“The truth has always been out there,” suggests Dr Malcolm Kendrick, co-author of the study.
“There is no link between high cholesterol and heart disease in people over 60.”
Dr Kendrick went on to accuse health officials of fear mongering as his comprehensive analysis reveals that not only is high cholesterol not an accurate indicator of heart disease, but older people with high levels of “bad” cholesterol actually live longer.
“What we found in our detailed systematic review was that older people with high LDL levels – the so-called bad cholesterol – lived longer and had less heart disease.
“Many of us suspected this may be true, but the consistency of the results was astonishing.
“The diet/heart cholesterol hypothesis has been called the greatest scam in the history of medicine. It seems that is right.”
When did cholesterol get a bad rap?
As far back as the 19th century, scientists recognised that the plaque that clogged arteries consisted, in part, of cholesterol, and so, dietary sources of cholesterol naturally came under the spotlight.
In 1913, Niokolai Anichkov and his colleagues at the Czar’s Military Medicine Institute in St Petersburg, Russia, decided to try out the dietary link in the lab.
The group fed cholesterol to rabbits for four to eight weeks and saw that the cholesterol diet affected their circulatory system and general health.
Anichkov figured they were on to something big and other studies that followed the diets of human populations provided further evidence to link high cholesterol diets to heart disease, with the longest running being the Framingham Heart study.
In 1948, the US National Heart Institute and Boston University embarked on an ambitious project to understand the risk factors of cardiovascular disease (CVD).
At the time, little was known about the general causes of heart disease and stroke, but the death rates for CVD had been increasing steadily since the beginning of the century and had become an American epidemic.
The study was carried out on 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachu-setts, and is still ongoing today with the third generation of participants.
The initial findings, however, concluded that among the highest risk factors for heart disease was smoking, high blood pressure and elevated cholesterol levels, and so, the link became established and was never questioned again.
Public warnings soon followed. In 1961, the AHA recommended that people reduce cholesterol consumption, and eventually set a limit of 300mg a day. (For comparison, the yolk of a single egg has about 200mg.)
Eventually, the idea that cholesterol is harmful so permeated the country’s consciousness that marketers advertised their foods on the basis of “no cholesterol”.
That advice had never been challenged by the medical community until recently.
Where did the science go wrong?
Lawrence Rudel, a professor at the Wake Forest University School of Medicine in the US, came across Anichkov’s paper as a graduate student at the University of Arkansas in the late 1960s.
What he noticed was a rabbit anomaly: When the study was performed on lab rats, there was no indication of any health issues at all.
In fact, If Anichkov had focused on any other animal besides the rabbit, the effects wouldn’t have been so clear as what Rudel concluded was that rabbits are unusually vulnerable to a high-cholesterol diet.
This is in part due to the fact that rabbits are herbivores and cholesterol or animal fat forms no part of their natural diet.
Rats on the other hand are scavenging omnivores, just like humans, and require some form of dietary cholesterol from fats and lipids for optimum health.
In the Framingham study, researchers noted those who weighed more and had abnormally high blood cholesterol levels were slightly more at risk for future heart disease.
What wasn’t widely publicised is the fact that the more cholesterol and saturated fat people ate, the lower their serum cholesterol levels.
In a 1992 editorial published in the Archives of Internal Medicine, Dr William Castelli, a former director of the Framing-ham Heart study, stated: “In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol. (The opposite of what Keys et al would predict.)
“We found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active.”
So, why did the AHA jump on the cholesterol bandwagon when faced with these greatly conflicting results?
And why is it that billions of dollars worth of cholesterol-lowering drugs are being sold when the studies show that, for the most part, there is no link between dietary cholesterol and blood serum cholesterol?
This begs the bigger question: What other nutritional and health advice are we getting from flawed studies and bad science?
In the meantime, here are my favourite healthy sources of saturated and monounsaturated fats that can now be included as part of healthy eating programmes:
• Avocados: High in oleic acid. Supports weight loss and heart health.
• Eggs: High in many nutrients.
• Grass-fed beef: Rich in conjugated linoleic acid. Supports weight loss and heart health.
• Wild fish: Rich in the omega-3 fats, DHA and EPA. Supports weight loss and heart health.
• Flax and chia seeds: Rich in omega-3 fats. Supports weight loss and heart health.