| Does a High Cholesterol Diet Really Contribute to | | | | buildup does in fact lead to hardening and constriction |
| Heart Disease? | | | | of the arteries, but what causes this buildup of plaque? |
| A high cholesterol diet would be on most people's list | | | | It has been theorized, yet never proven that |
| of risk factors when it comes to heart disease, but | | | | cholesterol causes the buildup. |
| much of the relevant research does not support this | | | | Unless it can be proven that cholesterol is responsible |
| widely held assumption. Many doctors, public health | | | | for this buildup of plaque, we should not rule out other |
| agencies, and public health advocacy groups advise | | | | possible causes. If cholesterol is the culprit, we would |
| the public to lower the amount of cholesterol in their | | | | expect that replacing cholesterol with other, healthier, |
| diet, and Americans have heeded this advice by | | | | fats would lead to a decrease in heart disease. A |
| steadily replacing animal fats, (those high in cholesterol), | | | | comparison of animal fat consumption as a proportion |
| with processed vegetable oils, (those without | | | | of total fat intake with death rates from coronary |
| cholesterol), over the past century. Death rates from | | | | artery disease over a sixty year period actually |
| heart disease however have not decreased; in fact | | | | showed the opposite to be true. As the proportion of |
| they have risen dramatically. We are told by trusted | | | | animal fats decreased from 83% to 62% of total fat |
| sources that we can reduce our risk for heart disease | | | | intake, the death rate actually increased over 3,000%. |
| by consuming less cholesterol, but what is the science | | | | If it is accepted that a buildup of arterial plaque is a |
| behind this advice? | | | | major cause of heart disease, but cholesterol is not |
| The science linking high cholesterol and heart disease | | | | accepted as the cause of this plaque buildup, what |
| began in the middle nineteenth century with the | | | | else should we look at? Newer studies have |
| publication of a study conducted by Rudolph Virchow. | | | | demonstrated a correlation between elevated |
| His "Lipid Hypothesis of Atherosclerosis" proposed that | | | | homocysteine, (an amino acid) levels and |
| heart disease is caused by the deposition of blood | | | | atherosclerosis. Ironically, homocysteine levels can be |
| lipids in the walls of the arteries. Other studies followed, | | | | lowered by consuming more b vitamins and folic acid, |
| but most of our modern assumptions about cholesterol | | | | nutrients found in the fatty animal foods we have been |
| and heart disease are based on one study, The | | | | told to avoid. (5). Researchers have also discovered a |
| Framingham Heart Study. This study begun in 1948 and | | | | correlation between C - reactive protein levels and |
| continuing today is the basis for the widely held view | | | | heart disease. C-reactive proteins are not thought to |
| that consumption of cholesterol leads to a greater risk | | | | be a cause, but rather a marker for injury to the |
| of heart disease. The study concluded in 1961 that high | | | | arteries that the body is trying to repair. Interestingly, |
| serum cholesterol levels were a significant risk factor | | | | statin drugs have been found to reduce levels of |
| in coronary disease. The early results of this study | | | | C-reactive proteins in the blood, possibly by reducing |
| were given a strong public endorsement that same | | | | the damage and inflammation that the proteins are |
| year in a "Time Magazine" interview with Ancel Keys | | | | reacting to. It may turn out that statin drugs are |
| who earned the nickname "Mr. Cholesterol" for his | | | | effective in fighting heart disease not by reducing |
| many speeches and writings advising Americans to | | | | cholesterol, (their intended purpose), but by reducing |
| lower their cholesterol intake. The Framingham Study | | | | inflammation in the arteries and the resultant buildup of |
| results along with Ancel Keys's recommendations led | | | | soft plaque. 6) |
| the National Institutes of Health, the American Heart | | | | Why do most Americans believe that a diet high in |
| Association and others to propose a national campaign | | | | cholesterol will lead to greater risk of heart disease? |
| to reduce cholesterol consumption. | | | | Because their doctors, the American Heart |
| More recently, and much more dramatically, the fight to | | | | Association, and The National Institutes of Health, all |
| reduce dietary cholesterol and presumably heart | | | | trusted and reliable sources of health information, have |
| disease was championed by the advocacy group | | | | told them repeatedly that this is the case. Why do |
| Center for Science in the Public Interest (CSPI). This | | | | these groups and individuals believe there is a |
| group in a famous 1994 study of Italian food | | | | correlation between consumption of cholesterol and |
| restaurants dubbed the classic dish fettuccini Alfredo, | | | | heart disease? Because for many years the best |
| "A heart attack on a plate". The quote which was | | | | science available indicated that this was the case. The |
| often repeated on television and in print was a useful | | | | Framingham study and many others that supported |
| tool to those advocating low cholesterol diets. The | | | | their conclusions are scientifically sound and conducted |
| CSPI's assertion is supported by the public information | | | | ethically, yet they are limited by the available |
| distributed by the American Heart Association and the | | | | technology and research methods of their time. |
| National Institutes of Health. The effects of a high | | | | Medical research is a slow, methodical process that |
| cholesterol diet are dramatized in this image from the | | | | does not lead to quick answers to complex problems. |
| National Institutes of Health website: | | | | Public policy decisions are based on need and often |
| Too much cholesterol in the blood, or high blood | | | | cannot wait for incontrovertible truth before being |
| cholesterol, can be serious. People with high blood | | | | devised and implemented. People are dying from heart |
| cholesterol have a greater chance of getting heart | | | | disease today and the public will not wait for the |
| disease. High blood cholesterol on its own does not | | | | decades it may take to prove beyond reasonable |
| cause symptoms, so many people are unaware that | | | | doubt exactly what causes it. We are fortunate to live |
| their cholesterol level is too high. Cholesterol can build | | | | in an age where the latest medical information is |
| up in the walls of your arteries (blood vessels that | | | | available to the general public via the internet. The |
| carry blood from the heart to other parts of the body). | | | | research is time consuming, and littered with sites |
| This buildup of cholesterol is called plaque (plak). Over | | | | promoting ineffective, sometimes dangerous products |
| time, plaque can cause narrowing of the arteries. This | | | | to cure the disease you are researching, but with a |
| is called atherosclerosis (ath-er-o-skler-O-sis), or | | | | reasoned scientific approach, the information can be |
| hardening of the arteries. | | | | found to help us make wise medical and nutritional |
| The image is dramatic, believable, and flawed. Plaque | | | | decisions. |