Friday, May 15, 2009

What About Cholesterol?

Here is Part 4 in a series of blog posts adapted from my paper, "Modern Health, Primitive Wisdom: American Health History and the Findings of Weston A. Price."

It is commonly believed that saturated fat and cholesterol are primary culprits in the current heart disease epidemic in the United States. We have already taken a look at saturated fat, but what about cholesterol? Is there any substantiation behind the claim that a high-cholesterol diet leads to clogged arteries or dangerously high blood cholesterol levels? What about early Americans and other traditional people who ate cholesterol rich foods and did not suffer from heart disease?

Returning to Weston Price's studies of traditional cultures, one finds that the most prized foods were very rich in fat and cholesterol. Some of these foods include liver, butterfat, fish eggs, and a variety of rendered animal fats, such as lard, tallow, and chicken fat. These cholesterol-rich foods are also rich in fat-soluble vitamins, the catalysts responsible for proper protein and mineral assimilation, and may be the key to rearing healthy children with round faces. Price found no evidence of heart disease, cancer, and other degenerative diseases in the people who enjoyed such nutrient-dense foods. On the contrary, he found primitive people to be the most vibrant and healthy people he'd ever seen.

Like other traditional cultures, early Americans saw no reason to avoid cholesterol-rich foods. They savored hearty, nutrient-dense foods that were high in cholesterol. Butter, cream, egg yolks, lard, tallow, and untrimmed animal meats (including organs) were not disdained -- these foods were thoroughly enjoyed and used extensively in recipes of all kinds. Before the advent of nutritional sciences and USDA food pyramids, turn-of-the-century Americans were enjoying such foods while having no knowledge of cholesterol and its function in the human body. They were unknowingly supplying their bodies with a nutrient that is very supportive to good health.

Cholesterol is not a fat -- it is a waxy alcohol that is not utilized for energy by the body; it does not supply calories. Rather, it is absorbed directly by the intestinal wall without needing to be broken down like fats, proteins, and carbohydrates. The amount that is absorbed by the body generally amounts to less than 50%. Cholesterol plays a key role in brain growth and development (especially in infants), cell membrane integrity, and the healing processes of the body -- thus, it is usually present in scar tissues where there is a repair process happening, as in arteriosclerosis (scarring of the arteries). In addition to all of these functions in the body, cholesterol is the raw material for our hormones. This includes sex hormones and adrenal hormones (also known as "stress hormones"). The adrenal hormones are especially needed in the modern world where stress is a constant part of our lives (Enig, 2000, pp. 48-50, 56-58).

The story of how such a vital nutrient went from being revered in the early century, to being maligned and feared in modern times, is well-documented in The Cholesterol Myths, by Uffe Ravnskov. In this book, Ravnskov makes it clear that there is very little reason for Americans to fear the theory that dietary cholesterol contributes to heart disease and high blood cholesterol levels (the diet-heart theory). (Interestingly, according to the author, blood cholesterol levels may not have any pertinence in evaluating the risk of heart disease.) Several population groups are cited by Ravnskov that consume substantial amounts of cholesterol-laden foods and do not have heart disease or high blood cholesterol levels. This includes both modern and primitive populations. It is also noted by Ravnskov that the studies upon which the diet-heart theory are based are either flawed or skewed to prove the truth in the theory.

One of the pillars of the diet-heart theory is The Framingham Heart Study, which is often referred to as proof that high cholesterol levels lead to a greater risk of heart disease. Ravnskov found this study to be flawed in a number of different ways. The director of The Framingham Heart Study had this to say about the final results of the project:

In Framingham, Massachusetts, the more saturated fat one ate, the more calories one ate, the lower the peoples' serum cholesterol ... 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 (as cited in Enig & Fallon, 2001, 5).

Such inconsistencies in the diet-heart theory have spawned an entire network of scientists, researchers, and health professionals who call themselves The International Network of Cholesterol Skeptics, or THINCS. This organization has among its members many reputable individuals who have taken it upon themselves to disseminate unbiased information and engage in discussions concerning the science and health effects of dietary cholesterol. Armed with this information, the interested individual can arrive at his or her own conclusions about whether or not one should worry about cholesterol in the diet, as well as determine whether or not high-cholesterol foods were detrimental to early Americans.

Sources:

Enig, Mary G. (2000). Know Your Fats : The Complete Primer for Understanding the Nutrition of Fats, Oils and Cholesterol. Silverspring, MD: Bethesda Press

Ravnskov, Uffe (2000). The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease. Washington, D.C.: New Trends Publishing.

Next up, the thrilling conclusion: "So What's For Dinner?"

4 comments:

chlOe said...

I was talking to a friend I have that's Swedish; she moved back there actually, to Sweden, and was telling me how it's in the news all

over Sweden that most people know that saturated fats and cholesterol aren't/isn't bad. She told me how her dad had been told to lower

his cholesterol by removing cholesterol rich foods - so he didn't listen to his doctor and ate mooore cholesterol rich foods (probably

excluded processed foods) and the doctor said to him that he'd never seen a cholesterol level lower so naturally before.

Anyway, thought that was worth sharing for any skeptics. It's sad because most people don't even know what cholesterol is - they just

know from all the media-whoring that it's associated with heart disease and obesity.

Does Ravnskov talk about "good" and "bad" cholesterol? Like HDL, LDL and things of that sort? I definitely have been wanting to read a

book more about that.

Nice work

Ryan Koch said...

Interesting stuff about Sweden. Might be easier for them to be skeptical about cholesterol in the diet since they're not too far removed from traditional cholesterol-rich foods.

If I remember correctly from Ravnskov's book, he shows that the whole HDL and LDL hypotheses are questionable, as well -- no real solid research to back any of it up. I wonder what he thinks about all the hubbub surrounding "small, dense LDL" and "large, fluffy LDL" -- a distinction that Gary Taubes makes in his book.

Trinkwasser said...

It has only just now struck me how ironic is the concept of a "hearty" meal.

Unlike current dietary propaganda a "hearty" meal actually IS good for cardiovascular health . . .

. . . the Swedish doctor is Annika Dahlqvist

http://blogg.passagen.se/dahlqvistannika/entry/my_lowcarb_dietary_programe_in

who came close to losing her job through being right.

I absolutely concur, my lipids were dreadful all my life (undiagnosed diabetes) and actually got *worse* on a Heart Healthy diet. By significantly dropping carbs and eating more of those instantly fatal saturated fats I doubled my HDL, reduced my LDL and decimated (literally) my trigs.

Not by any means an uncommon story.

(I got here via Stephan's blog which I am currently trying and failing to read through, in addition to numerous others, all pointing in more or less the same direction)

Ryan Koch said...

Trinkwasser,

Thanks for sharing your experience with diet. I really like your comment about hearty meals. I certainly believe such meals are good for the heart!