Sunday 27 April 2014

Time to Help Bust that Cholesterol Myth



So, the elephants in my room at night are Fats, and in particular Saturated Fats.  I am eating lots of them for breakfast, lunch and dinner. The received wisdom suggests that I will die of a heart attack, perhaps as early as next week.  

My wife Jane started using a LCHF diet last year and it was her growing prowess on a bike that really impressed me. As she trained more she bacame less and less reliant on extra energy to power her through the long training runs leading up to the RideLondon-Surrey 100 bike event last August. This made me start thinking about the effect this could have on long distance running.

Up until about a year ago I was definitely in the low-fat camp. I ate lots of good and some not-so-good carbs and I avoided fatty foods. I have never liked margarine and so there was always butter in the fridge. I disliked low-fat food as it is often very sweet (got to make it taste nice after removing the good stuff!) . We ate healthily but it was easy to put on weight, even when running a fair bit.

Opinions have been changing fast in recent years.  

The belief that saturated fats and their association with Cholesterol have a direct relationship with heart disease has led to a demonization of natural foods like meat and butter, and the growth of huge industries for low-fat food and cholesterol-lowering foods and drugs. One of the first studies to refute this belief came from the American Journal of Clinical Nutrition in 2010. (http://ajcn.nutrition.org/content/early/2010/01/13/ajcn.2009.27725.abstract).

Here are a couple of  recent findings – you may have heard about them recently on the news:

When Jane and I started looking at LCHF diets this seemed like a giant leap of faith. What if the research is wrong? What if it is just a fad? But our interest in this subject has coincided with a wave of new research. Almost every week there is a new study published or another scientist or doctor ‘coming out’.  The mainstream is starting to shift, like all rivers do over the years.

What I particularly like about the latest research is that far from being bad for your heart health, a high-fat diet is quite likely to be better for it. This is not so suprising; as Jane put it the other day, "If a high fat diet is bad for you then how did our species ever evolve in a world governed by the survival of the fitest?".
 
There is compelling evidence that the relationship between cholesterol and heart disease lies not simply in your level of ‘bad’ LDL cholesterol, but in the size and number of the LDL particles themselves http://www.internationaljournalofcardiology.com/article/S0167-5273%2899%2900107-2/abstract. The lower the size, and hence greater the number of LDL particles, the higher the risk. This particle size is known as LDL-p (or alternatively LDL patterns A and B as shown below) . 


This LDP-p value is not reported in the standard UK cholesterol test and is not mentioned on the NHS web sites or that of HEARTUK “The Cholesterol Charity”.   Perhaps because this ‘charity’ like several other charities are sponsored by companies that make cholesterol-lowering foods. 

Research also suggests that the high-carb diet recommended by most dieticians, doctors and the NHS promotes a higher LDL-p (pattern B) value, whereas the high-fat diet that most humans have followed for the last million years promotes a lower (healthier) LDL-p value.

Now this is relatively new science, but the drugs industry and health authorities have yet to seriously challenge any of the data being produced. This may be because a debate might draw more attention to the facts. Or it may be because the research that they produce in support of their own views is generally so weak that most A level students studying research methods and statistics would be tempted to tear it apart (read this and see what I mean http://en.wikipedia.org/wiki/Seven_Countries_Study). This study formed the basis of the ‘cholesterol myth’. 

While you are at it, watch the Cerealkillers movie (http://www.cerealkillersmovie.com/) for a description of LDL-p and how it relates to your diet. This documentary also discusses the success being achieved by Tim Noakes and others in treating Type 2 Diabetes with a controlled LCHF diet. It’s a fascinating programme.

Take a look at the graphs below. The left hand side of the first graph below has a lot of scatter, but then there are lots of other causes of heart disease. The right hand side is more interesting as the dots are mostly closer to the line (less deviation implies a stronger trend).  So while the graph does not necessarily prove that less saturated fat will always lead to more heart disease than average it does suggest that more saturated fat will normally lead to less heart disease than average.

So if the countries that eat the most saturated fats appear to have the lowest levels of heart disease then why would we want to lower our cholesterol?

Can you spot France and the UK in the graphs?




This is known as the French paradox - the French eat the most saturated fat, their cholesterol is not that high and they have the least death from heart disease. They also have the lowest levels of obesity. This may be because the French are very resistant to anything that changes their national character, particularly their food; they are still eating the same way they have for decades. So why aren’t they having so many heart attacks as us? Perhaps because their higher saturated fat diet is actually protecting them. I’d be very interested to know if they have a lower LDL-p value than we do in the UK. 

The graphs above were taken from the following web sites. Well worth a read.


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