When Swedish doctor Uffe Ravnskov wrote his book the “Cholesterol Myths” in 2000, few people were publicly making the assertion that saturated fat does not cause heart disease. (OK, well, the non-profit Weston Price Foundation and its founders Sally Fallon and Mary Enig, Ph.D., were, but they were often dismissed as being a fringe group.) But today, several prominent voices are saying exactly that—author Nina Planck, science writer Gary Taubes, and journalist Michael Pollan among them.
As our national conversations about obesity and other diet-related chronic diseases continue, and provocative ideas such as a tax on soda and other sugary drinks are floated by public health officials, it seemed to me a good time to raise the question: if so many scientists, doctors, and other smart people think that a diet high in saturated fats and cholesterol is not the culprit when it comes to heart disease, then why doesn’t everybody in America know it? Why do millions of Americans still follow low-fat, low-cholesterol diets and why do cardiologists tell their patients to swear off eggs, steak, and butter? (And why, in heaven’s name, are our public schools banning whole milk?)
In an effort to better understand this controversial issue, I interviewed Dr. Ravnskov, who lives in Lund, Sweden, and who has just published a revised edition of his book, called, simply, Fat and Cholesterol are Good for You
An English Breakfast at London’s Columbia Road Flower Market
Hannah Wallace: What kind of doctor are you?
Uffe Ravnskov: I am a specialist in internal medicine and nephrology. I have studied the cholesterol issue for twenty years and published more than 80 scientific papers and letters about the subject and have also written two books in five languages.
HW: You’ve said that the “cholesterol campaign” is one of the greatest mistakes in medical science. Can you briefly define what you call the cholesterol campaign and tell us why you believe it’s a mistake?
UR: The cholesterol campaign is based on the false idea that [human consumption of] animal food and high cholesterol causes atherosclerosis and heart disease. It’s a mistake because high cholesterol is not dangerous to health; it is beneficial. For instance, high cholesterol protects against cancer and infectious diseases. Today millions of healthy people all over the world are taking medicine that may create muscle weakness, bad memory, bad temper, impotency, painful legs and cancer. But most doctors do not know it because they have been mislead by the drug industry and their researchers.
HW: But what about all the research that shows that diets high in saturated fat cause heart disease?
UR: No study has ever proved that saturated fat causes heart disease. More than 30 studies have shown that heart patients have not eaten more saturated fat than healthy people and at least 8 studies of stroke patients have found that they had eaten less saturated fat than healthy controls.
HW: It seems to me that there are two arguments being made here, and the distinction is, I think, important. Are you saying that eating high cholesterol foods does not raise blood cholesterol levels? Or are you saying that high serum levels of LDL (the so-called “bad” cholesterol) do not cause heart disease?
UR: Eggs are the most cholesterol-rich food because a lot of cholesterol is necessary to create a healthy, living creature. You can eat twenty of these cholesterol bombs per day and yet keep your cholesterol normal.
Even if your cholesterol levels should go up, there is no reason to be afraid because high cholesterol is not the cause of heart disease. Recent American studies have found that on average patients with an acute heart attack had lower cholesterol than normal and the risk of being dead three years after a heart attack was highest among those with the lowest cholesterol.
HW: In your mind, what are two of the strongest studies that contradict the theory that higher serum LDL levels causes heart disease?
UR: The first argument is that people with low cholesterol are just as atherosclerotic as people with high cholesterol—this was shown for the first time more than 70 years ago and has been confirmed again and again by more recent scientists. The second is that old people with high cholesterol live longer than old people with low cholesterol—and again, this has been documented in numerous studies. (This one, by Dr. Harlan Krumholz and colleagues at Yale followed 1000 elderly men and women for four years and found that twice as many of those with low cholesterol had a heart attack or died from one, compared with those with the highest cholesterol.)
HW: In Michael Pollan’s book In Defense of Food
UR: There is general agreement that atherosclerosis is an inflammation in the arterial wall, and also that bacteria and virus participate in some way, but few have realized that it is the microorganisms that may cause the inflammation. This is a hypothesis that I have presented together with Kilmer McCully, who discovered the association between high homocysteine and atherosclerosis. Our arguments, and we think they are very strong, were presented in a scientific paper this year and in a popular way in the last chapter of my new book. They are based on the fact that the lipoproteins, including the “bad” LDL, participate in the immune system by binding and inactivating bacteria, virus and their toxic products.
HW: And which study or studies do you think are the most convincing in showing that LDL cholesterol actually protects against infectious disease?
UR: If you inject bacterial toxins into rats they die almost immediately, but if you start by injecting them with purified human LDL, most of them survive. Normal mice die also, but mice with high cholesterol survive. Many studies have also shown that people with low cholesterol are at a greater risk of being infected than people with high.
World Vitamins Online says:
Thank you for publishing an opposing view to the mainstream. Cholesterol is bad for you because the drug companies make billions selling statin drugs. We need cholesterol in our bodies for a number of reasons including hormone production.
Gregg A. Miller says:
I think Dr. Ravnskov makes an interesting point when he highlights the role that inflammation (not just cholesterol) plays in heart disease, and I'm curious to see over the next few years if anyone succeeds in linking heart disease to an infectious agent. I also think the role of LDL in infection could prove to be very interesting.
However, I disagree with the implication that high cholesterol (at least, high LDL, the 'bad cholesterol') is good. The studies Dr. Ravnskov refers to also do not support his argument. The researchers in the "American study" referred to above actually argue that cholesterol goals should be even lower than they are--completely contradicting Dr. Ravnskov. The other studies cited only looked at people over 70 and over 85, a very different group than the general population. The very elderly are at relatively high risk of dying from other diseases besides heart disease, and presumably, survived the heart disease that killed their friends with higher cholesterol in their 50s and 60s.
Data from many, many studies show a higher risk of heart disease as cholesterol levels increase. The MRFIT study in the 1980's showed a clear relationship, as cholesterol levels increased to 300, the risk of heart disease more than quadrupled. Many subsequent studies continue to support these findings.
WVO is certainly right to be suspicious of the role Pharma plays in promoting statins. Sometimes, though, the mainstream view is the mainstream view because it's the view all the good science supports.
Uffe Ravnskov says:
It is correct that the authors of the American study (Sachdeva et al. Am Heart J 2009;157:111-7)argue that cholesterol goals should be even lower than they are. However, as is usual for most researchers in this area, they haven’t understood their own findings. If cholesterol should be lowered even more, how come that three years later (Al-Mallah et al. Cardiol J 2009;16:227-33) those whose cholesterol was lowest had the highest mortality?
It is not true, as Gregg Miller claims, that “many, many studies show a higher risk of heart disease as cholesterol levels increase”. It is not true for women, nor for diabetics, nor for Canadian men, nor for patients with renal disease, nor for Maori people, and most studies have shown that it isn’t true for old people either. The last finding is particularly at odds, because at least in Sweden, more than 90 percent of those who die from a cardiovascular disease have passed age 65 years.
Miller also refer to the MRFIT study as an argument for high cholesterol being a risk factor. The result from that study is not thrustworthy, however. Read my book and you will understand why you can´t believe in the figures from MRFIT.
hannah says:
I just read an interesting article by Mark Hyman on this very topic. (It's in the air!) He has a lot to say about the inefficacy of statins in preventing heart disease in all but the tiniest minority (middle-aged men who have high risk factors for heart disease and people who have previously had heart attacks). http://www.huffingtonpost.com/dr-mark-hyman/why-cholesterol-may-not-b_b_290687.html
what do you guys think?
G Wainwright says:
Uffe is correct. The mountain of recent research in cholesterol-rich lipid rafts show it to be an essential part of every healthy lipid transaction in the body. Falling cholesterol levels in lipids indicate a very poorly statte of health. Well done Uffe, for exposing this ignorance of basic bioscience!
Cholesterol Lady says:
Now I'm a little perplexed. Does this point of view mean that what your doctor is telling you about your cholesterol numbers is not the only truth?
Dr Neville Wilson says:
I dont blame Cholesterol Lady for being perplexed, since very few doctors explain to patients that total cholesterol numbers on their own are irrelevant unless their ratios to lipoproteins are considered. The lipoprotein HDL-C has more significance for predicting your risk of having a heart attack, and the ratio of total cholesterol/HDL-C needs to be evaluated in order to assess that risk, with a figure of 4 or less being ideal.Many studies have shown that even when LDL levels have been substantially reduced, by statins, to target levels, those subjects still remained at risk if their HDL levels were not elevated. And HDL levels can be raised by adopting simple lifestyle habits such as exercising, not smoking,and eating fruit and vegetables, while favouring complex over simple carbohydrates, eating fish regularly and including saturated fats and moderate wine in the diet.
So yes, the cholesterol numbers,which more than often determine whether you will be given drug treatment, are not the only truth - in fact, on their own they are very far from the whole truth !
John says:
I read "The Cholesterol Myths" years ago after I was diagnosed with "high cholesterol". I was told to get on a statin immediately and was redirected when I asked about details. Suffice to say I never went on them and have never regretted it. My cholesterol is still "high" but I am not high risk as I dont smoke, I exercise and eat normal food (ie: real food ;)).
I have also recently read "The Great Cholesterol Con" which I highly recommend (also with a forward by Dr. Ravnskov.)It goes into more details on case by case studies and provides the authors suggestions for foods and vitamins etc that can help to keep homocysteine levels down among many others things.
I am absolutely convinced that cholesterol is not a cause of heart disease because of the science....It is that clear. How that science can be used to sell the heart disease/cholesterol myth and millions of people drugs they dont need and can hurt them is mind boggling!
Paul McGlynn says:
Hannah,We need more people like you.I so wish we could have Dr.Ravnskov or Kendrick sit down on a show like 60 minutes with a Dr from the AHA or the like and do battle.People have been brainwashed for so long they know no better.I have "high cholesterol" and have read both of Ravnskov's books, Kendricks and Colpo's Cholesterol Con's and many other articles.I am convinced cholesterol doesn't mean much unless it is "very high".Here is an example of how brainwashed we are.My mother had to enter a rest home and she was complaining she wasn't getting what she ordered for meals.I inquired to the nurse why that was and she responded my mother had high cholesterol and was on a low fat diet.My mother was 95 years old with a cholesterol of 220.I could not help but think these people should be asking how did she live so long with this cholesterol level.I had a few words with the doctor and her diet resumed to normal.She is now 98.Let's stop the cholesterol madness!! Go Hannah!!
Dr Neville Wilson says:
Paul, lets hope that your experience served as a wake up call for the doctor involved!
The practice of imposing a low cholesterol, or low fat, diet for healthy persons with "high " cholesterol levels is a common daily occurrence in the average mainstream medical practice and many respite homes for the elderly, and is rooted in the prevailing perception that saturated fat is unhealthy and should be restricted in favour of carbohydrates and polyunsaturated fats.
Not only is this policy devoid of scientific basis, but it is inherently harmful in that it serves to diminish a vital energy source, and deprives the body of nutrients that are essential to hormone production, mineral absorbtion and vitamin utilization.
While this is of particular importance for the elderly, it applies to all age groups, for whom the added risk of heart disease is in fact increased by low fat intake. (Am J Cardiol 2000;85:45-48)
Gregg, from a fellow practitioner, may I appeal for a sense of caution and discernment when looking at summaries of trial reports, and an awareness that few studies are devoid of powerful vested economic interests which don't necessarily serve the best health interests of the people we are caring for.
Findings from the oft quoted MRFIT study are suspect, and their purported claim of risk reduction through cholesterol lowering must be seriously questioned, given the unscientific and somewhat unscrupulous methods employed in the study, as revealed by Prof Lars Wenko in his report, following a detailed scrutiny of publications linked to the study. His conclusion reads, "The often- repeated statement that the MRFIT screenees constitute the largest and most exact base regarding the relation of risk factors to mortality in the healthy male US population has no foundation"
Steve M says:
So does this mean that someone who has already suffered a heart attack would or would not benefit from the use of statins, as it is not at all clear?
Bob Biggard says:
The definition of "high" needs to be examined. 225-275 should be the normal range, not below 200 as main stream says. Second elevated cholesterol & tryglycerides CAUSE NO DISEASE. Let me repeat, THEY CAUSE NO DISEASE, cardio events included. "High, relatively speaking (ie you used to be 225, but now you are 350) means you have a problem whether it is low thyroid (hypothyroidism), pre-diabetes, liver disease, deficiencies of niacin, fatty acids, etc. Want the cause of heart disease, clogged arteries, go look at free radical damage by vegatable oils, margarines, oxidized oils of any kind, burned animal protein, fried foods of all kinds, nitrates & nitrites...just to name a few. Nobody talks about these things except for Dr. Wallach (at least publically & visibly..I do applaud this website!!!!). All these statins do is cover up another symptom, "let's lower this number whether it is LDL or HDL"..poisoning your liver is a minor inconvenience; never mind that cholesterol is essential to every cell in your body and is the precursor to all your hormones (gee why do all these men taking statins have E.D.?..DUH) Your body doesn't know how to take care of itself & neither do you) this is what Pharma is saying. What doc Wallach is saying & me too is stay away from the bad stuff & get the good stuff (you nutients all mighty-90) & give your body the raw materials, and you will not have to fall into the medical systems hands!
Nathan Cookson says:
How can someone find a local Dr that is up on this issue, or at least
understand the different opinions?
Regards
Nate
bd says:
You people are higher than a kite. Get off the hallucinogens would you!!!
Scott says:
Too many web sites are promoting coconut oil, palm oil and soy bean oil. All of these oils will eventually harm you. I only use olive and grape seed oil. I do not use saturated oils, butters, margarines, Trans fats (hydrogenated or partially hydrogenated oils), any processed soy product, and vegetable oils like cotton seed, corn, and canola. Three years ago I switched to olive and grape seed oil. It has made such a change to my body, it lowered my total cholesterol over 100 points and I do not eat oat meal or take meds. My blood pressure is now 60 over 105 it was 90 over 135. I now have a pulse of 58. I am over 40 years old. My doctor is baffled how I achieved this with out meds. I mostly eat egg whites, chicken, turkey, lean pork, some fish - not too much because of mercury, vegetables, fruits, rice, home made bread, and my favorite chocolate peanut butter muffins only sweetened with apple sauce! I avoid eating out, you cannot control what's in that food. I do not eat deli meats, hot dogs, and bacon, all have high sodium and nitrates that can cause colon and prostate cancers. I do not eat soy products because they cause hormone issues and inflammation of arteries around the heart. I also do not drink tap water because it contains chlorine and high amounts of iron which can be harmful if you have hemochromotosis - genetic disorder that goes undetected by most doctors in the U.S. that makes the body store too much iron and will eventually kill you by the time your in your 50’s and is usually misdiagnosed as either a heart attach or liver cancer
Scott says:
I am not a doctor. The paragraph I wrote is from personal experience and is not
intended to treat or diagnose any medical problems.