The Great Cholesterol Myth

Long-standing dietary advice has told us to reduce cholesterol intake, but a closer look suggests that advice may be misguided. Learn more about the history of this information, studies surrounding cholesterol’s effects on heart health and how to protect your heart’s health.

| November/December 2015

  • Salmon with avocado on toast
    For decades we've been misinformed about the effects of cholesterol on heart health. Learn how to properly protect your heart's health and more.
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  • Blueberries
    Eat plenty of antioxidant-rich foods, such as blueberries.
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  • Couple by a campfire
    Reducing stress levels and cultivating intimacy are both key for optimal heart health.
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  • Dark chocolate squares
    Dark chocolate that contains 70 percent cocoa has much less sugar than other sweets, plus it's packed with antioxidants.
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  • Green tea
    Antioxidant-rich green tea makes an excellent substitute for a sugary drink habit.
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  • Man with Tea
    Relaxing with a cup of tea in the morning can help jump-start good heart-health habits, such as meditation and deep breathing.
    Photo by iStock
  • Olives and oil
    Research into the diets of the Mediterranean region has shown that eating cholesterol-rich foods is not necessarily harmful to health.
    Photo by Veer

  • Salmon with avocado on toast
  • Blueberries
  • Couple by a campfire
  • Dark chocolate squares
  • Green tea
  • Man with Tea
  • Olives and oil

In 1953, a young, ambitious biologist named Ancel Keys proposed the then-radical theory that heart disease was caused by consuming too much fat in the diet. It’s hard to imagine that this theory was radical given how widespread its acceptance is today, but at the time the prevailing belief was that diet had little to do with heart disease. However, Keys felt he was on to something. Previous research by Russian scientists had shown that when you fed rabbits large amounts of cholesterol and then dissected them later on, their arteries were filled with cholesterol-containing plaque and looked suspiciously like the arteries of people who died of heart disease. Never mind the inconvenient fact that rabbits are herbivores and the amount of cholesterol they normally get in their diets is pretty close to zero. And that other animals, such as rats and baboons, do not react in the same way as rabbits to a high-cholesterol diet; they metabolize cholesterol very differently.

The recommendation to eat “no more than 300 mg of cholesterol” a day remains the standard dietary advice of every major health organization to this day. Because fat in the diet and cholesterol in the blood were believed to be linked, Keys began to investigate dietary fat and its connection to heart disease. He looked at data on fat consumption and heart disease from various countries and published the results in his famous Seven Countries Study, which supposedly demonstrated a clear link between the amount of dietary fat consumed and the incidence of heart disease. Those countries eating the most fat also had the highest rates of heart disease. Sounds like an open-and-shut case against dietary fat, doesn’t it?

Except it was anything but. Keys actually had available to him reliable food consumption data from 22 countries, but he used only seven. By hand-selecting the seven countries that supported his preconceived hypothesis, Keys was able to make a convincing case that there was a direct connection between fat consumption and heart disease. The fact that Keys chose to include only seven countries and ignored the other 15 didn’t go unnoticed. Many researchers criticized Keys for conveniently omitting data that didn’t support his theory. When analyzing the data from all 22 countries, researchers found that the correlation between fat, cholesterol and heart disease vanished.

The Rise of the Cholesterol Theory 

The Seven Countries Study is the cornerstone of current cholesterol and fat recommendations and official government policy, so it’s worth looking at in some detail. Keys examined saturated fat consumption in seven countries: Italy, Greece, the former Yugoslavia, the Netherlands, Finland, the United States and Japan. It hardly went unnoticed that Keys chose only the countries that fit his hypothesis. In fact, British physician Malcolm Kendrick used the same data available to Keys and quickly discovered that if you simply chose different countries, you could easily prove that the more saturated fat and cholesterol people consumed, the lower their risk of heart disease.



Another researcher who questioned Keys was a British doctor named John Yudkin from the University of London. He found that, in some countries, the intake of fat was virtually the same, but the rates of cardiovascular disease were vastly different. For example, Finland had a high per capita fat intake and a high rate of heart disease. But Yudkin found that the people of West Germany ate the exact same amount of fat as the people of Finland, yet they had about one-third the rate of heart disease. In addition, the Netherlands and Switzerland had only one-third the rate of heart disease seen in Finland, even though the Dutch and Swedes consumed even more fat than the Finns.

Cherry-picking the countries that proved the theory was only one of the many problems with the Seven Countries Study. There were also tremendous variations in heart mortality within these countries, even though saturated fat consumption was identical. In Finland, for example, the intake of saturated fat was almost identical in two population groups from Turku and North Karelia. But heart mortality was three times higher in North Karelia. Similarly, saturated fat intake was also equal on two Greek islands, Crete and Corfu. But heart mortality was a whopping 17 times higher on Corfu than it was on Crete.

LISAF
9/11/2018 10:22:00 AM

Hmmmm, then how do you explain the reversal of heart disease in those that start following a low fat diet? Sounds to me like this is just support to sell high fat "diets" like Atkins and Keto.


LISAF
9/11/2018 9:15:17 AM

Hmmmm, then how do you explain the reversal of heart disease in those that start following a low fat diet? Sounds to me like this is just support to sell high fat "diets" like Atkins and Keto.


tim
12/17/2015 11:01:05 AM

This article is not a researched publication, it is an except from a book by Bowden who is trying to sell his book. The readers of this magazine may enjoy this type of article as it tells them to do what they want to do - eat free range eggs and grass fed beef. I feel it is tremendously irresponsible to the readers to publish this as new factual truth when it is basically an advertisement to buy a book which has been rebutted repeatedly. I'm hoping to someday see a balancing article by someone like Ornish, Esselstyn, Campbell or Greger someday. I recognize that it is a challenge as readers would face a learning curve that challenges their beliefs rather than reinforcing destructive and unhealthy lifestyles.




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