Fat and Cholesterol Are Good For You
by Uffe Ravnskov
Book Review

Fat And Cholesterol Are Good For You (2009) is the in-your-face title of a provocative book by Danish medical researcher Dr. Uffe Ravnskov, MD. Dr. Ravnskov demolishes the "diet-heart hypothesis," also known as the "lipid hypothesis."

Ravnskov publishes in medical journals on this and other topics; his website displays his credentials and links to his journal articles. (A further website, for The International Network of Cholesterol Skeptics, has additional information.)

The diet-heart hypothesis is familiar to everyone thanks to public health efforts. It goes like this: eating saturated fat causes high cholesterol; high cholesterol causes atherosclerosis; and atherosclerosis causes coronary heart disease. It turns out that there is no good evidence for the hypothesis, while there is some good evidence that could disprove it.

Many of the studies usually quoted in support of the diet-heart hypothesis actually say something very different; others lack data. Other rather definitive studies that could disprove the hypothesis have been ignored.Fat And Cholesterol Are Good For You includes analysis (expressed in lay terms) of the crucial studies, notes of the results of his literature searches, and explains the broader reasoning behind his critique. Further in the book, he addresses the dangerous side effects of statin drugs, explores familial hypercholesterolemia, and supports an infection theory of coronary heart disease.

To begin with, he finds no connection between saturated fat and high cholesterol, no connection between saturated fat and coronary heart disease, and no connection between high cholesterol and atherosclerosis.

  • The Masai, and other cow herders of Africa, live almost entirely on meat and fresh milk. They have the lowest cholesterol readings in the world and no coronary heart disease. They do, however, have atherosclerosis.
  • The Japanese, who have low cholesterol, have the same amount of atherosclerosis as Americans, but a much lower rate of coronary heart disease.
  • The French, who have high cholesterol, have a low rate of heart disease.
  • Extensive autopsy studies in the U.S., Canada, and India have found no relationship between cholesterol level and amount of atherosclerosis.

Meanwhile, high cholesterol levels are shown to have a protective effect. "Old people with high cholesterol live the longest," Ravnskov writes. And, if anything, the diet studies tend to show that smoking and lack of omega-3 fats may cause heart disease.

The Cause Of Heart Disease?

But what causes coronary heart disease if atherosclerosis alone does not?

The massive diet studies contain clues: cardiac mortality was sixteen times higher in Corfu than in Crete, two Greek islands whose inhabitants eat a similar diet. Unfortunately, the obsession with promoting the diet-heart hypothesis has prevented this research. Ravnskov writes, "Any opportunity for discovery is allowed to slip by."

Ravnskov suggests that it is the immune system's failure to keep the "vulnerable plaque" from forming in the arteries. (The Masai had no "vulnerable plaque.") If the "vulnerable plaque" lesions are actually small boils within the artery wall, they could cause clots when they burst. These clots would cause angina, heart attacks, and stroke. He discusses the evidence for this theory.

He mentions the interesting situation of lipoproteins. Lipoproteins are the fat-protein particles that encapsulate cholesterol and transport it to tissues that need it. A little-known fact is that lipoproteins also "eliminate microorganisms and their toxic products."

In that case, "high cholesterol indirectly may prevent the development of atherosclerosis and coronary heart disease." Thus: fat and cholesterol are good for you!

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