The Cholesterol Myths: Exposing the Fallacy That Saturated Fat and Cholesterol Cause Heart Disease

The first sin is misdirection. Many studies indicated there were inverse relationships between mortality and cholesterol, especially at advanced age, and with women. The researchers ignored this, and stated unequivocally the data showed a direct proportional relationship between cholesterol and mortality. The second sin is data cherry picking. Ancel Keys, leading advocate of cholesterol theory, gathered data from 22 countries. He deducted that % of calories derived from fat in diet is related to cholesterol and higher mortality rate by selecting only the 7 countries that supported his hypothesis. The third sin is ignoring qualitative differences in cultural practices. In U.S., coronary heart disease (CHD) is diagnosed related to uncertain causes of death 33% more often than in England and 50% more often than in Norway. As a result, the three countries respectively are associated with a high, moderate, and low level of (CHD). Yet, their consumption of cholesterol is similar. Keys ignored these factors and took out the countries that did not support his conclusion. The fourth sin is confusing association with causation. Researchers sometimes derived that higher cholesterol was causing CHD. Meanwhile, the true cause may have been age, weight, or diabetes. The author shows how you could similarly demonstrate that radio ownership is correlated with mortality rate! The fifth sin is not doing a random sampling. The Framingham study included a postmortem analysis concluding that cholesterol does cause atherosclerosis. But, this was after selecting only the 14% of the test subjects who died prematurely. A large proportion had familial hypercholesterolemia. This is a rare disorder associated with high cholesterol and CHD. But, this relationship between cholesterol and CHD does not exist in the general population. The sixth sin is using the wrong test to boost significance. The two-tail t test is the appropriate one in medical hypothesis testing. But, researchers often used the one-tail t test to inappropriately boost confidence level from 90% to 95%. This allowed them to claim their findings were significant when they were not. The seventh sin is not looking at the whole picture. When testing the impact of cholesterol lowering drugs, researchers focused on the reduction in death from CHD while ignoring increase in death from other causes. Those drugs often boosted total mortality. The eight sin is focusing on relative risk vs absolute risk. If a drug reduces mortality from 0.7% to 0.6%, the pharmaceutical industry will broadcast that it reduces mortality rate by 14% (change in relative risk). This improvement overstates that it will reduce mortality by only 0.1% or save only one in 1000 lives (change in absolute risk). Medical studies use relative risk to boost claims of drug merits. They use absolute risk to minimize implication of side effects. The ninth sin is adding variables to get the prediction you want

This book should be read by everyone, especially doctors and especially those who specialize in cardiology. My own heart doctor has been trying to push statins on me for two years, despite the fact that my heart "epsiode" (a very minor infarction) took place 20 years ago, my total cholesterol is just 210, and high cholesterol (250+) with *zero* heart disease runs in my family. You should see him shudder at the abnormality of that figure, warning me that yet another drop in "normal" limits is on the AHA and NHLBI horizon. In his opinion, my total cholesterol should be 160 -- or dire consequences could result! As its subtitle states, The Cholesterol Myths exposes the fallacy that saturated fat and cholesterol cause heart disease. Dr. Ravnskov is no "wacko"; his book is well-annotated and examines many of the major relevant studies over the past 50 years. I've checked a few of the references myself and have found them accurate. I've checked literature available on the AHA and NHLBI websites and seen for myself how they distort the truth. In one example, the NHLBI states flatly that "international studies find that CHD is uncommon in cultures with low levels of serum cholesterol, even when... hypertension and cigarette smoking is relatively high." A check of the footnotes cited the "Seven Countries" study and "MONICA" project, both taken to task in Dr. Ravnskov's book. What the NHLBI did was choose only a few of the datapoints from these studies (Japan, China), where their statement was indeed true -- but they conveniently ignored all 25 or so other datapoints which clearly showed that overall there was no correlation between countries' cholesterol levels and CHD whatsoever! A major contribution of Myths is its explanation of the way pro-cholesterol myth "scientists" and the drug companies use the "relative reduction" method of presenting their "wonder drugs'" value. If I, for example, take no drugs, my chances of a cadiac event might be 6% over the next 10 years. If I take statins for ten years, this might go down to 3%, which the drug companies present as a reduction of 50%! Sounds good, but the more sensible view would be to say that if I take no drugs, there's a 94% chance that nothing will happen to me, and if I take statins, there's a 97% chance -- wow, a whopping 3% gain! Would *you* take a drug (that can screw up your liver and muscles) for the rest of your life to go from 94% to 97%? Not me! This expose of statins is another fantastic contribution to medical common sense, and there are many more. The Cholesterol Myths is simply a must-read. P.S. I did confront my cardiologist, and he declined comment. I have a new one now....

With courage and care Dr. Ravnskov exposes the lack of experimental evidence for the diet-heart theory, which claims that eating less fat and cholesterol will prevent atheroslcerosis (hardening of the arteries) and myocardial infarctions (heart attacks). By examining original peer-reviewed literature, the author finds no support for the diet-heart theory. He gives examples of scientific fraud among efforts to support the theory, including the deliberate selective omission of data points, and the deliberate assignment of subjects in a clinical trial to treatment or to control groups by physicians with the subject's medical records in hand. He shows how the abstract or conclusions of a number of papers are at odds with the actual data in the papers. He demonstrates how the use of one statistical method in preference to another can give a false impression that there is an effect,where there is, in fact, none. He shows how the reporting of differences in fatality rates by per cent reduction (say, a 50% reduction in relative risk) is actually misleading when the actual death rates are quite small in both the treatment and control groups of subjects in diet or drug studies. For example, a treatment that changes the absolute survival rate over a multi-year period from 99.0% to 99.5% represents a 50% reduction in relative risk, from 1% to 0.5% absolute. This is often described in papers as a 50% reduction in death rate. However, when the difference is barely significant statistically, as was often the case, Ravnskov points out that there is no real reason to recommend adoption of the treatment, especially if there are serious side-effects. "The truth, were it known, would send pharmaceutical stocks plunging. In most studies, the increased risk is present only above a level of cholesterol that includes just a small percentage of the total population. [These are the approximately 1% of people with a genetic defect called familial hypercholesteremia.] And women can stop worrying immediately because high cholesterol is not a risk factor for the female sex. Few comments have been made on this peculiar fact in all the vast literature on cholesterol. When it is mentioned at all, it is said that female sex hormones protect against heart attacks." "In fact, it seems more dangerous for women to have low cholesterol than high. Dr. Bernard Forette and a team of French researchers from Paris found that old women with very high cholesterol live the longest. The death rate was more than 5 times higher for women who had very low cholesterol. In their report, the French doctors warned against cholesterol lowering in elderly women. But they could as well have warned against cholesterol lowering in any woman, or, to be more precise, in anyone at all." Dr. Ravnskov went on to show that higher levels of high-density-lipoprotein (HDL, "good" cholesterol) are not protective against CHD, and that lower levels of low-density-lipoprotein (LDL,"bad" cholesterol)

I am 76 years old and have had a high blood cholesterol level for at least the past 25 years. A normal cholesterol is considered to be under 200 mg/dl and mine ranges from 250 to 316. My LDL (the so-called bad cholesterol) is high and my HDL (the so-called good cholesterol) is low. While I have had health problems, they do not include heart or blood vessel disease. My blood pressure is about 130/80 which is pretty good for an old man. Yet, according to what I have read, I am at high risk for heart and blood vessel disease. A number of years ago I decided to look into it. I plugged the word "cholesterol" into Yahoo, and one site that I came up with was a web site by Uffe Ravnskov called The Cholesterol Myth. It said that what I had been hearing and reading about high cholesterol being bad for you was hokum. He made a good case for the thesis that if you exclude those people who have the gene for high cholesterol and early death, that cholesterol levels are meaningless. Also, that cholesterol level is not appreciably influenced by diet. That was not enough for me; I wanted the documentation, so I started a correspondence with him. One consequence was that, several years ago, he e-mailed me a copy of the English version of his book The Cholesterol Myths which had been published in Swedish and Finnish. That book, revised, expanded and fully documented, has just been published by New Trends Publishing. Ravnskov is both a physician and researcher. His publications have been in first rate medical journals and he is highly respected by his peers, including me. His book is extremely well researched and is well documented. It is clearly written; much more clearly than many publications that I have read by people whose native language is English. Ira Pilgrim For the complete review , go to Ira Pilgrim's Home Page

Would you buy a book that was literally set on fire by its critics on a television show about it in Finland? I would and so should you. The long-awaited English version of debunker extroidinaire Dr. Uffe Ravnskov's notorious book is now available from New Trends Publishing. Ravnskov, a medical doctor with a PhD in Chemistry, has had over 40 papers and letters published in peer-reviewed journals criticizing what Dr. George Mann, formerly of Vanderbuilt University, once called "the greatest scam in the history of medicine": the Lipid Hypothesis of heart disease, the belief that dietary saturated fats and cholesterol clog arteries and cause atherosclerosis and heart disease. If one thing comes through as you read the book, it is this: Ravnskov has done his homework. In painstaking detail, he critically analyzes and demolishes the nine main myths of the Lipid Hypothesis: (1) High-fat foods cause heart disease, (2) High cholesterol causes heart disease, (3) High fat foods raise blood cholesterol, (4) Cholesterol blocks arteries, (5) Animal studies prove the diet-heart idea, (6) Lowering your cholesterol will lengthen your life, (7) Polyunsaturated oils are good for you, (8) The cholesterol campaign is based on good science, and (9) All scientists support the diet-heart idea. Equipped with a razor-sharp mind, an impressive command of the literature, and a deadly, needling sarcasm, Ravnskov methodically slaughters the most famous Sacred Cow of modern medicine and the most profitable Cash Cow for assorted pharmaceutical companies. Sparing no one, Ravnskov again and again presents the tenets of the Lipid Hypothesis and the studies which supposedly prove them, and shows how the studies are flawed or based on manipulated statistics that actually prove nothing. Ravnskov then answers the objections or rationalizations offered by diet-heart supporters, desperate to explain away inconsistencies and contradictions in their own data. For example, Ravnskov opens with an analysis of the study that kicked off the Lipid Hypothesis in the 1950s: Ancel Keys' Six Countries Study (and later, the more famous Seven Countries Study). As most health professionals know, Keys' study showed that countries with the highest animal fat intake have the highest rates of heart disease. Keys' conclusion was that there was a cause and effect relationship because the country with the lowest animal fat intake (at that time, Japan) had the lowest rates of heart disease. Sounds convincing, right? Not so, says Dr. Ravnskov. And in a few pages the reader is informed how Keys hand-picked the countries he included in his studies, namely, the ones that supported his hypothesis, and conveniently ignored all of the other countries that didn't. And this is just the beginning! Ravnskov approaches true brilliance in his review of the studies that supposedly showed benefit from the current wonder-drugs pushed by the pharmaceutical industry: the statins. Hailed as miracle substances that "significantl