A production crew from Korea came to the Fat Head farm on Sunday to interview me and to film us collecting eggs and cooking them up with some sausage. The segments will go into a TV special about the controversy over whether saturated fat and cholesterol cause heart disease. I will, of course, be one of those who says nope, they don’t. They’ll interview several other people who share my opinion (Uffe Ravnskov and Chris Masterjohn among them, if I remember correctly) and, of course, the usual suspects who still promote the artergycloggingsaturatedfat! theory.
I wasn’t sure how specific they’d want me to be as far as citing research, so I took some time over the weekend to poke through my database of articles and studies. Turns out their questions were more general (“Do you worry at all about how much saturated fat you eat?”), but what the heck, since I came across a couple of interesting items in what I now think of as the Cold Case Files, I thought I’d share them.
The first is a study published in – wait for it – the Journal of the American Heart Association. The AHA is, of course, one of the organizations most responsible for scaring people away from saturated fat. Saturated fat raises cholesterol, and high cholesterol causes heart attacks, doncha know. At least that’s been their position ever since Ancel Keys joined the AHA board of directors.
But this study is from 1961 – before Keys joined the AHA board. So I find the study’s conclusions rather fascinating. The researchers gathered data on serum cholesterol levels and coronary artery blockage taken from 200 autopsies. Here’s what they found:
The mean atherosclerotic indices, i.e., the amount and severity of atherosclerosis in the aorta and the coronary and cerebral arteries, showed progressive increase with age.
The mean serum total cholesterol concentration rose progressively from the first decade to a maximum level in the fifth decade and subsequently declined.
In other words, cholesterol tends to rise until sometime around age 50, then drop a bit. The buildup of plaque in the coronary arteries, meanwhile, progresses throughout life. The researchers noted those facts because they wanted to avoid a false association:
The mean serum total cholesterol showed a progressive rise from the first to sixth groups of aortic atherosclerosis, but, at the same time, the mean age for each group also increased. Since the amount of atherosclerosis in the aorta increased with age and the serum cholesterol concentration also rose up to the fifth decade, it is important to determine if the significant correlation between the concentration of serum total cholesterol and aortic atherosclerosis is a correlation with severity of atherosclerosis per se or is merely due to the effect of age, or both.
So they compared serum cholesterol and coronary blockage within age groups. The results:
No correlation could be found between the two, indicating that, when the age factor was removed, the positive correlation between aortic atherosclerosis and serum total cholesterol is statistically insignificant.
And later in the same paper:
In the present study, we did not find any significant correlation between the blood serum total cholesterol and atherosclerotic index as a representation of the extent and severity of atherosclerosis for any of the vessels studied. The mean serum total cholesterol concentration in the six groups of aortic atherosclerosis showed a successive rise but, when the age factor was taken into consideration, the correlation between atherosclerosis and serum cholesterol in these same groups was found statistically insignificant.
No significant association once you take age into account. Doesn’t that just make you want to run out and get a prescription for statins?
In my research database, I also found an abstract from a European Journal of Clinical Nutrition study of diets in the U.K. vs. France. It’s a bit of a silly study, based on dietary recall and all that, but I saved it because of this gem:
There were positive and negative trends in food consumption in each country. UK respondents reported eating more beans and pulses, less cheese, red meat, and processed meats than French respondents. However, on the negative side, they ate less fruit and vegetables, fish and poultry, cereals, and more sweets and chocolates and cakes, pastries, biscuits and puddings.
Hey, way to go, UK! Sure, the Brits reported eating more sweets and biscuits. But by gosh, they also reported eating less meat, processed meat and cheese than the French. I’m pretty sure they also eat less butter than the French. And aren’t foods like meat, cheese and butter the causes of heart disease? They raise cholesterol levels, ya know.
The study was published in 2000. I happen to have spreadsheets of World Health Organization data on average cholesterol levels and heart-attack deaths from that period. (Some of it’s from 2000, some from 2002.) I plucked the data for the UK and France. I also added data for the Czech Republic, Germany and Russia. Why? Well, the Russians have low average cholesterol, the Czechs have the same average cholesterol as the French, and the Germans have one of the highest average cholesterol levels in the world.
Here are the average cholesterol levels among men, from lowest to highest:
Russia 189
UK: 197
France: 209
Czech Republic: 209
Germany: 220
According to the Cholesterol Kills! theory, the Russians are in great shape as far as heart disease, while the Germans are probably grabbing their chests and dropping like flies.
Here’s a chart I created in Excel to plot cholesterol levels against rates of heart-attack deaths. The blue line is average cholesterol levels among men; the orange line is annual heart-attack deaths per 100,000 men.
Hmmm, things aren’t looking so good for the Russians after all. And German men have fewer fatal heart-attack deaths as a group than men in the UK, despite an average cholesterol level that’s 23 points higher.
The Russian heart-attack rate is so high, including Russia scrunches the chart. So here it is again with Russia removed.
If high cholesterol causes heart disease, those lines should more or less rise together. But they clearly don’t. If anything, they tend to move in opposite directions.
It was fun digging through the Cold Case Files. But I’ll be happy when the entire Cholesterol Kills! theory is a cold case file.
