We have been told for the last sixty years saturated fat and cholesterol cause heart disease, so the hesitancy some people have about starting an LCHF lifestyle is very understandable.
The cholesterol idea
The idea about cholesterol and heart disease appears to have started in the late 1850’s when the German pathologist, Rudolf Virchow, suggested that the build-up of cholesterol inside artery walls leads to cardiovascular disease.
Then, in 1913, Russian pathologist Nicolaj Anitschkow published the results of his experiments.
In one, he fed rabbits a diet high in fat and cholesterol, and after their demise, he examined their hearts and blood vessels. He found plaque in the walls of their arteries, and suggested cholesterol was the cause of their deaths.
He also tested guinea pigs and rats with the same diet.
Unfortunately, he appears to have overlooked the fact that rabbits and guinea pigs are herbivores. They have no ability whatsoever to digest saturated fat and cholesterol so it’s not surprising that meals of high animal fat and cholesterol polished them off.
The same diet had no effect on the rats – they’re omnivores like us – and they did not get plaques in their arteries.
Seven Countries Study
In 1951 an article about heart disease, with the title ‘Lipid Hypothesis’, was published in the American Journal of Medicine. It caught the eye of Dr Ancel Keys.
In the early 1950’s, the seed was being set for the idea cholesterol had something to do with heart disease. After observing that some of the famous and affluent people were getting heart attacks (President Eisenhower, for example, suffered two heart attacks), Keys wondered if it had something to do with their rich food, in particular the saturated fat and cholesterol.
Among other studies Dr Keys conducted, his ‘Seven Countries Study’ was the most publicised. The study appeared to show cholesterol in the blood stream was connected with heart disease.
Dr Keys was a very persuasive man and was able to convince leading figures in the medical fraternity of the time, that cholesterol in the diet should be reduced in order to prevent heart disease.
In 1956, the American Heart Association publicly stated that eating a diet containing butter, lard, eggs, and beef would lead to heart disease, and the American government subsequently recommended a low fat diet.
Keys also claimed that vegetable oils lower LDL, the so-called ‘bad cholesterol’. Actually that’s true. However, it is now known that it does so at the expense of increasing disease-causing inflammation.
Dr Barry Sears explained how vegetable oils drive inflammation, and I’ve written about his work in the post ‘What’s the fat in our food?’.
Both ‘low fat’ and ‘vegetable oil’ were seized upon by the food industry, and refined vegetable oils, margarines, and low-fat foods soon flooded the market.
Glucose and fructose
On the other side of the Atlantic, in England, Professor John Yudkin, medical doctor, physiologist, and nutritionist, founded the Department of Nutrition at Queen Elizabeth College, University of London.
He wrote several books recommending low carbohydrate for weight loss, including ‘The Slimming Business‘, published in 1958. The book has been re-published several times, and even inspired ‘The Slimmer’s Cook Book‘ in 1961 and ‘The Complete Slimmer‘ in 1964.
Prof. Yudkin researched for many years how carbohydrates make people fat, and he developed a particular interest in two sugars, glucose and fructose. They’re present liberally in processed carbohydrate foods, fruits, and fruit juices, and are the two components of sucrose (table sugar) often added to drinks.
He also examined the official records of causes of death in several countries, and found no evidence that fat was the direct cause of heart attacks. In fact, the only common factor he could find in the deaths, was sugar.
In 1972 he published a book with the title ‘Pure, White, and Deadly: The Problem of Sugar‘, in which he wrote that sugar consumption was a factor in dental decay, obesity, diabetes, and heart attacks.
As you can imagine, the American medical fraternity, and Dr Keys in particular, were not happy with Professor Yudkin’s findings. They had pinned their reputations on fat causing heart disease, and did not want to admit they had backed the wrong horse.
In addition, the food industry had jumped on the gravy train with refined vegetable oils and a plethora of low fat offerings and there were massive financial interests to protect.
A campaign was started to vilify Professor Yudkin, in which, apparently, Ancel Keys was particularly vehement, and Prof Yudkin’s valuable work was largely discounted.
However, eventually his book was published in America, the guidelines were altered, and in 1977 it was recommended to reduce sugar consumption by 40%. Three years later the US government advised a very weak ‘don’t eat too much sugar’, from which one might conclude food-industry profits had prevailed.
The Coronary Primary Prevention Trial conducted between 1973 and 1984 added further impetus to the low-fat, low-cholesterol fraternity, even though the trial was shown to have been seriously flawed.
Notwithstanding the dubious validity, the National Institutes of Health backed the claims of the study and declared no more evidence was necessary, which the American Heart Association supported. Later, both institutions lent their weight to the development of statin drugs to reduce cholesterol, which have turned out to be mega-blockbusters generating billions in annual sales.
In 2009, Professor Robert Lustig, a pediatric endocrinologist with a special interest in childhood obesity, at the University of California, San Francisco, made a video with the title ‘Sugar: The Bitter Truth‘. You may have watched it. I have, and so have over 6.5 million other people, which shows how important this subject is.
Dr Lustig and members of his research team examined the effects of sugar on health, and came to the same conclusions Dr Yudkin and his team came to, all those years ago. It’s sugar – not fat – driving the epidemic of heart disease, obesity, and diabetes.
The book, ‘Pure, White and Deadly: Problem of Sugar‘ was re-published in 2012, some 40 years after Professor Yudkin first published it, with a foreword by Professor Lustig.
In 2013, Dr Lustig released an updated version of his 2009 video with the title ‘Fat Chance: Fructose 2.0’ to incorporate the new research. I’ve added the video to Thrive Low Carb’s YouTube playlist, if you’d like to watch it.
After Ancel Keys published his Seven Countries Study, several medical scientists disagreed with his conclusions. Among them, the lipid and cholesterol expert, Professor Raymond Reiser, formerly at Texas A&M University, found errors in the way Keys had interpreted his data in forty of his trials.
Others suggested Keys should have included all twenty-one countries he looked at, not just the seven he ‘cherry-picked’ and wrote about in his Seven Countries Study. Recent analysis of Ancel Keys’ complete data shows there was no conclusive evidence that fat causes heart disease.
Dr Fred Kummerow published a research paper in 1979, in the American Journal of Clinical Nutrition, in which he stated: ‘…you don’t induce heart disease by consuming dietary cholesterol.’
Born in 1914, Dr Kummerow is a remarkable scientist who has dedicated his life to lipid research, and he is still doing it. He was one of the first to show the link between trans fats and heart disease, and was involved in proving that oxidised cholesterol – not cholesterol itself – causes heart disease.
Another outstanding doctor/scientist was Dr Margaret Albrink, at Yale University School of Medicine and later West Virginia University. She was one of the first medical researchers and clinicians to find that triglycerides mattered more in heart disease than the total cholesterol level.
And because dietary carbohydrate increases the amount of triglyceride the liver makes, carbohydrate therefore is instrumental in heart disease, not fat.
I briefly described how the liver makes triglyceride from glucose in the post ‘Eating starch raises blood sugar and fat‘.
Professor Ken Sikaris, a doctor and expert in human physiology and biochemistry in Australia, explains very clearly how sugar and fat are metabolised in the liver in his video ‘Sugar and Fat Metabolism‘.
I’ve added his videos to Thrive Low Carb’s YouTube channel, so you can find them easily. It’s worth investing the time to watch them if you’re thinking about starting an LCHF lifestyle and are concerned about fat.
Cholesterol is not the villain: it is a very important nutrient.
It is a component of the bile fluid that helps us digest fats, is an essential part of the structure of our cell membranes, and is the building block of the steroid hormones: progesterone, oestrogens, testosterone, cortisol, vitamin D, and aldosterone.
The steroid hormones help in the control of our metabolism, inflammation, immune system, and water and electrolyte balances. They influence our ability to fight infections, and recover from injuries, and determine our gender characteristics.
In other words, we cannot live without cholesterol.
The liver makes 85% of the cholesterol we need, and only 15% of our daily requirement is taken from the food we eat. Any excess cholesterol we eat is put into our bile and dumped into the intestines, eventually being expelled in our faeces.
Dr Ken Sikaris made an excellent video about cholesterol called: ‘Cholesterol – When to Worry‘, which you’ll find at Thrive Low Carb’s collection on YouTube.
To sum up
1. There is no evidence cholesterol in our food goes from the intestines to our artery walls.
2. There is no evidence saturated fat or cholesterol in our food cause heart disease.
3. Although humans can burn either glucose or fat for energy, in people eating a high carbohydrate diet, glucose from the carbs is used as fuel, not the fat in the meal. The fat in the meal is stored in the liver, hips, and belly.
If you start an LCHF lifestyle, you need to make sure your carbohydrate intake is low enough to burn fat for fuel instead of carbs.
Eating the same amount of carbs you always have, while increasing your fat intake, will worsen any health challenges you have.
A food tracker is very helpful to get the balances right when you first start on LCHF. I wrote about a good one I use at the page Online Food Tracker.
4. People regularly eating processed carbohydrates and using refined vegetable oils have a higher amount of inflammation. The inflammation is a factor in the development of plaques in artery walls, and in many other diseases.
The low carb, healthy fat lifestyle is very effective at reducing all the markers of inflammation.
5. Many people regularly consuming high carbohydrate foods and drinks have high triglyceride levels, low HDL levels, and higher numbers of small dense LDL. Along with increased inflammation, these are the risk factors for cardiovascular disease.
The risk factors are not the result of eating fat. They are the result of eating an abundance of carbohydrates and sugars.
The most effective way of reducing the risk factors, is to reduce the intake of processed carbohydrate, sugar, sweet fruit, fruit juices, and drinks with added sugar. And the most effective way to do that, is a diet low in carbohydrates – LCHF.
Before you commit to the LCHF lifestyle, you need to be sure in your own mind that all the fat you’ll be eating is actually good for you.
There’s a lot of evidence to show how wrong the advice to avoid fat was, and there are many websites, books and videos to help you reach the same conclusion.
A good book
In his videos, Dr Ken Sikaris mentioned he contributed to the book, ‘Cholesterol Clarity‘ by Jimmy Moore and Dr Eric Westman, MD.
The book features interviews with 29 top medical experts, but there’s no confusing medical jargon. Here’s an excerpt from the write-up:
‘… Has your doctor told you your total and/or LDL cholesterol is too high and thus requires you to take immediate action to lower it? Has the solution to your “high cholesterol” been to cut down on your saturated fat intake, eat more “healthy” whole grains and vegetable oils, and possibly even take a prescription medication like a statin to lower it to “desirable” levels? If so, then this is the book for you. Learn what the real deal is from some of the leading experts on the subject. Not only will ‘Cholesterol Clarity’ tell you what your cholesterol tests – LDL, HDL, triglycerides, and other key cholesterol markers – really mean, but it will also arm you with nutritional guidance that will lead you to optimal health.’
Many of the experts giving video talks have their own websites, which are usually noted in the blurb beneath their videos. For example:
Dr Eenfeldt’s DietDoctor.com is an interesting website with lots of weight-loss and diabetes success stories, food recipes, and articles about LCHF.
Professor Grant Schofield, professor of public health at Auckland University of Technology, New Zealand, is a vociferous advocate of the LCHF lifestyle on YouTube, and his interesting blog is packed with straight-talking articles and news of latest developments from around the world. Well worth a visit.
And for both the scientifically-trained and those who have forgotten their school science, Butter Bob Briggs has a wonderful way of explaining medical matters with his YouTube videos, and with articles on his blog, so everyone can understand.
If you prefer to get your information by watching videos only, I’ve put a good selection of LCHF ones on Thrive Low Carb’s YouTube channel playlist for your convenience – will save you time hunting around for good ones.
If you are being treated for high blood pressure, diabetes, or swollen ankles, or you are expecting a baby, it is important to read the notes on the page ‘Medical Cautions‘ before starting an LCHF lifestyle.
And as usual, if you have any questions about the LCHF lifestyle please type them in the comment box below, and I’ll get back to you asap.