Cholesterol just might be the most misunderstood molecule in the whole world. Dr. John Abramson, professor of medicine at Harvard University, says this: “It is important to keep in mind that cholesterol is not a health risk in and of itself. In fact, cholesterol is vital to many of the body’s essential functions.” Cholesterol is the “parent” molecule of some of the body’s most important compounds, including the sex hormones and vitamin D. It’s also an integral part of the cell membrane.
What a lot of people don’t realize is that the vast majority of cholesterol is made in your body, by the liver. If you take in more from the diet, the liver makes less. If you take in less, the liver makes more. You need cholesterol. Without it, you’d die.
Doing justice to the whole cholesterol question in an introduction as short as this is a real challenge, but I’d like you to have a few basic take home points. The first is that dietary cholesterol— like the kind you find in egg yolks—has minimal impact on serum cholesterol (the kind your doctor measures). Minimal. Not only that, but the effect of eggs on heart disease can’t be predicted by looking only at their cholesterol content. Eggs contain many other nutrients that are good for you—protein, some polyunsaturated fats, folic acid, and other B vitamins. As Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a professor of medicine at Harvard Medical School, has said, “No research has ever shown that people who eat more eggs have more heart attacks than people who eat few eggs.”
The second point has to do with the demo nization of saturated fat in general. Yes, saturated fat raises cholesterol, but it raises both the good and the bad cholesterol. And though there may be a relationship between saturated fat and cholesterol, the relationship between saturated fat in the diet and heart disease or mortality is far less clear. In fact, an entire nexus of researchers, doctors, and statisticians led by the brilliant Swedish scientist Uffe Ravnskov, M.D., Ph.D., has been questioning some of the “conventional wisdom” on saturated fat and cholesterol for years. They have an organization called The International Network of Cholesterol Skeptics (http://www.thincs.org/). If the science doesn’t scare you off, it’s worth a visit to get a “second opinion.” (Also worth checking out: Ravnskov’s “The Cholesterol Myths,” available both as a book and online at http://www.ravnskov.nu/myth1.htm).
Lowering cholesterol is big business. In 2005, the two top-selling drugs on Forbes magazine’s list of pharmaceutical juggernauts were Lipitor and Zocor, both cholesterol-lowering statin drugs. Together, they did a combined business of more than $13 billion. It’s worth noting that many researchers believe that the good that statin drugs accomplish has much less to do with their ability to lower cholesterol than their ability to lower inflammation, which is indeed a definite risk for heart disease, as well as a component of Alzheimer’s, obesity, and diabetes. The foods in this book are filled with natural anti-inflammatories like the flavonoid quercetin, for example. Spices like turmeric are so incredibly healthy largely because they are anti-inflammatory. Maybe we wouldn’t need $13 billion a year’s worth of drugs if we were eating more of the foods that accomplish the same thing.
Finally, in my opinion, we’ve been way too focused on lowering cholesterol and not focused enough on lowering heart disease and mortality. They are not the same thing. In the Lyon Diet Heart Study, people who had had a heart attack were either counseled to eat a Mediterranean-type diet (fish, fruits, vegetables, whole grains, olive oil, nuts) or given routine post–heart attack advice (watch your cholesterol, eat less saturated fat). The people on the Mediterranean diet experienced 70 percent less heart disease than the group getting the “standard” advice, about three times the reduction in the risk of further heart disease achieved with statin drugs! Their overall risk of death was 45 percent lower than that of the group getting the conventional advice. And—get this— their cholesterol levels didn’t change much. Though they had significantly less heart disease and less risk of dying, their cholesterol levels pretty much didn’t budge.
Though some studies have shown a reduction in heart disease with cholesterol-lowering medications, the amount of reduction pales when compared to what’s achievable with lifestyle changes. High-risk men in the WOSCOP study (a statin drug study) achieved about a 30 percent reduction in heart disease by going on drugs, but the women in the Nurses’ Health Study showed 31 percent reduction in heart disease just by eating fish once a week. As Harvard’s Dr. Abramson puts it, “Most of our health is determined by how we live our lives.”
What a lot of people don’t realize is that the vast majority of cholesterol is made in your body, by the liver. If you take in more from the diet, the liver makes less. If you take in less, the liver makes more. You need cholesterol. Without it, you’d die.
Doing justice to the whole cholesterol question in an introduction as short as this is a real challenge, but I’d like you to have a few basic take home points. The first is that dietary cholesterol— like the kind you find in egg yolks—has minimal impact on serum cholesterol (the kind your doctor measures). Minimal. Not only that, but the effect of eggs on heart disease can’t be predicted by looking only at their cholesterol content. Eggs contain many other nutrients that are good for you—protein, some polyunsaturated fats, folic acid, and other B vitamins. As Dr. Walter Willett, chairman of the department of nutrition at the Harvard School of Public Health and a professor of medicine at Harvard Medical School, has said, “No research has ever shown that people who eat more eggs have more heart attacks than people who eat few eggs.”
The second point has to do with the demo nization of saturated fat in general. Yes, saturated fat raises cholesterol, but it raises both the good and the bad cholesterol. And though there may be a relationship between saturated fat and cholesterol, the relationship between saturated fat in the diet and heart disease or mortality is far less clear. In fact, an entire nexus of researchers, doctors, and statisticians led by the brilliant Swedish scientist Uffe Ravnskov, M.D., Ph.D., has been questioning some of the “conventional wisdom” on saturated fat and cholesterol for years. They have an organization called The International Network of Cholesterol Skeptics (http://www.thincs.org/). If the science doesn’t scare you off, it’s worth a visit to get a “second opinion.” (Also worth checking out: Ravnskov’s “The Cholesterol Myths,” available both as a book and online at http://www.ravnskov.nu/myth1.htm).
Lowering cholesterol is big business. In 2005, the two top-selling drugs on Forbes magazine’s list of pharmaceutical juggernauts were Lipitor and Zocor, both cholesterol-lowering statin drugs. Together, they did a combined business of more than $13 billion. It’s worth noting that many researchers believe that the good that statin drugs accomplish has much less to do with their ability to lower cholesterol than their ability to lower inflammation, which is indeed a definite risk for heart disease, as well as a component of Alzheimer’s, obesity, and diabetes. The foods in this book are filled with natural anti-inflammatories like the flavonoid quercetin, for example. Spices like turmeric are so incredibly healthy largely because they are anti-inflammatory. Maybe we wouldn’t need $13 billion a year’s worth of drugs if we were eating more of the foods that accomplish the same thing.
Finally, in my opinion, we’ve been way too focused on lowering cholesterol and not focused enough on lowering heart disease and mortality. They are not the same thing. In the Lyon Diet Heart Study, people who had had a heart attack were either counseled to eat a Mediterranean-type diet (fish, fruits, vegetables, whole grains, olive oil, nuts) or given routine post–heart attack advice (watch your cholesterol, eat less saturated fat). The people on the Mediterranean diet experienced 70 percent less heart disease than the group getting the “standard” advice, about three times the reduction in the risk of further heart disease achieved with statin drugs! Their overall risk of death was 45 percent lower than that of the group getting the conventional advice. And—get this— their cholesterol levels didn’t change much. Though they had significantly less heart disease and less risk of dying, their cholesterol levels pretty much didn’t budge.
Though some studies have shown a reduction in heart disease with cholesterol-lowering medications, the amount of reduction pales when compared to what’s achievable with lifestyle changes. High-risk men in the WOSCOP study (a statin drug study) achieved about a 30 percent reduction in heart disease by going on drugs, but the women in the Nurses’ Health Study showed 31 percent reduction in heart disease just by eating fish once a week. As Harvard’s Dr. Abramson puts it, “Most of our health is determined by how we live our lives.”
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