Uffe Ravnskov - The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease

Title Page

The Cholesterol Myths

Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease

by Uffe Ravnskov, MD, PhD

Copyright

Copyright @ 2000, 2002 and 2014 by Uffe Ravnskov

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic tape, mechanical, photocopying, recording or otherwise, without permission in writing from the publisher.

Foreword

by Michael Gurr, PhD

Whether diet plus plays a major role in heart disease is a question that interests us all. Author Ravnskov has a mission. To inform his readers that there is a side to this question other than the view usually presented to us.

Government and health authorities never tire of remaining those of us who live in industrialized countries that heart disease is a major cause of death. They go further and tell us that heart disease is eminently preventable. While conceding that genetic background interacts with numerous environmental factors to influence each individuals risk of succumbing to heart attack, they insist that diet is foremost among these factors as a cause of heart disease, and that modifying diet provides a straightforward means of preventing heart attacks. If only people would do what they are advisedreduce their intake of fats, especially those rich in saturated fatty acidsthen the high toll of death and disability from this disease could be readily reduced. If only!

What is the scientific basis on which this advice is based? Although the many reports of expert committees acknowledge that diet may influence the underlying pathology of heart disease in several ways, current dietary guidelines are based mainly on what Dr. Ravnskov calls the diet-heart idea. Greatly simplified (which it normally is!), this idea proposes that dietary fats rich in saturated fatty acids raise the concentration of cholesterol in the blood. This in turn is involved in the initiation if arteriosclerosis, which through its restriction of blood flow to the myocardium and its tendency to generate thrombi, leads to myocardial infarction.

Dr. Ravnskovs contention is that the diet-heart idea is built on sand. He leads us through the history of the concept in an interesting and readable way. His writing clearly demonstrates the enormous depth and range of his reading on this subject. Step by step he examines the evidence for the diet-heart idea, and step by step he shows us how that evidence may be flawed and contradicted by other research that is rarely acknowledged and quoted.

Medical science has generally been highly regarded by the public, who have rarely questioned its findings because it is perceived as helping to improve mankinds lot. It will come as a surprise to many readers to learn how many studies of diet and heart disease were poorly designed and conducted, how many did not produce the results that have been claimed for them and have been quoted irrelevantly or misleading, and how many published studies exist whose results seriously question or contradict the diet-heart idea but are never acknowledged or quoted. Some of these tactics are not only misleading but also sometimes amount to scientific fraud.

Dr. Ravnskov is well qualified to write such a book. He is a general practitioner who regularly needs to advice patients who have heart disease or who are worried that they might have it. The book begins with an insight into problems of one such patient, an otherwise healthy woman who began to worry after a company health screen revealed that she had high cholesterol and who was told by the company medical officer that she might have a heart attack in five years if she didnt do anything. Dr. Ravnskov and many like him are concerned that public health messages based on poor science may not only be ineffective but also may cause unnecessary worry to people who were previously free of health cares.

As well as conducting his medical practice, Dr. Ravnskov is also a scientist who has published a number of papers, including some penetrating analyses of the diet-heart literature. He is one of a growing number of scientists who have found what they have read disconcerting.

Why do we hear so little about this alternative view? Few scientists seem willing to stand up and question what has been accepted dogma? Dr. Ravnskov lists a few at the end of his book and outlines their views and credentials. Most are, like the author, individuals with inquiring minds who are not directly involved in heart disease research. Some, however, have been eminent researchers into heart disease; their firm stand against conventional has often alienated them from the establishment community. By contrast, many who support the consensus view have made their reputations in this view, have been supported by research grants often amounting to millions of dollars and have a vested interest in continuing to support and sustain the diet-heart idea.

Another dimension is this story that Dr. Ravnskov discusses is the approach to lowering cholesterol by drugs, which has almost always been more effective than diet. The cholesterol story, therefore, has the backing of the multimillion-dollars drug industry. While this backing is not reprehensible to itself, the distinction between the ability of drug and dietary treatment to lower blood cholesterol has often become so blurred that lay people are frequently confused into believing that dietary modification could achieve exactly the same effect as drug treatment when it clearly cannot. Alternatively, many may be persuaded that they need drugs when clearly they do not.

Quite apart from showing us the flimsiness of the scientific evidence upon which dietary advice to prevent or reduce heart disease is based, Dr. Ravnskov also addresses an even more serious problem. Could attempts to reduce cardiovascular mortality by lowering blood cholesterol actually do harm? Several authors have reflected that it might and have cited the evidence. To this end, Ravnskov discusses the worrying observation that even when cardiovascular deaths have been reduced in some intervention trials, subjects died of other causessometimes cancer, sometimes suicide or other forms of violenceresulting in no overall change in death rate. Many expert committees reviewing this evidence have tended either to ignore this phenomenon or have argued that it can safely be disregarded, but the admonition do no harm comes back to haunt us.

Many with establishment views will regard Dr. Ravnskov as a crank. That would be a grave mistake. He has done his homework, he is not a lone voice in the wilderness, and he deserves to be taken seriously. Above all, this book will make us all think more deeply about the true role of diet in heart disease and about the quality of the information that we receive.

Michael Gurr, PhD

Visiting professor in Food Science and Technology

University of Reading, Reading, UK

Visiting professor in Human Nutrition

Oxford Brookes University, Oxford, UK

St. Marys, January 1996

Authors Foreword

When the cholesterol campaign was introduced in Sweden in 1989 I became much surprised. Having followed the scientific literature about cholesterol and cardiovascular disease superficially I could not recall any study showing a high cholesterol to be dangerous to the heart or the vessels, or any type of dietary fat to be more beneficial or harmful than another one. I became curious and started to read more systematically.

Anyone who reads the literature in this field with an open mind soon discovers that the emperor has no clothes, and so did I. But I also learned that the critical analyses or comments, that I sent to various medical journals, were most often met with little interest from the editors and mocking answers from the reviewers. Besides, the inaccuracies, the misinterpretations, the exaggerations and the misleading quotations in this research area were so numerous that to question them all demanded a book.