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Does Cholesterol Matter?



The demonization of cholesterol began in 1959, when nutrition researcher Ancel Keys and his wife, Margaret, published Eat Well and Stay Well, which linked diet, cholesterol, and heart disease. The idea that excessive cholesterol causes atherosclerosis and heart disease has since become close to dogma.



Yet the notion has plenty of detractors, including Swedish physician Uffe Ravnskov, author of the book The Cholesterol Myths and spokesman for the International Network of Cholesterol Skeptics, a vociferous group of physicians, researchers, and others.



“Many autopsy studies have shown there is no association between the degree of arteriosclerosis in the arteries and cholesterol concentration in the blood, taken either shortly or immediately after death,” Ravnskov says. At his Web site (www.ravnskov.nu/cholesterol.htm), he lists dozens of such studies from medical journals. Ravnskov vigorously disputes the lipid hypothesis, the view that dietary cholesterol and fat clog arteries and can ultimately harm the heart. Detractors of the idea have become so numerous that last May, the Weston A. Price Foundation devoted an entire conference in Washington, D.C., to the subject, titled, “Heart Disease in the 21st Century: Beyond the Lipid Hypothesis.” The subtitle: “Exposing the Fallacy That Cholesterol and Saturated Fat Cause Heart Disease.”



A featured speaker was Kilmer McCully, author of The Heart Revolution and a professor of pathology at Brown University. McCully proposed in 1969 that the cause of spiraling heart-disease rates was the modern diet of processed foods, which lack three B vitamins—folic acid, vitamin B6, and vitamin B12—that hold the amino acid homocysteine in check. Studies have shown that too much homocysteine in the blood correlates with an increased risk of heart disease. Denounced at first, the idea is catching on. Other researchers say rising rates of obesity and insulin resistance, linked to increased consumption of refined carbohydrates, are better predictors of heart disease than high cholesterol.



So why does the lipid hypothesis continue to hold so much sway? “There is prestige and money at stake,” contends Ravnskov, and much of it flows from the cholesterol-lowering class of drugs known as statins. Ravnskov does not dispute studies that show statins can lower the risk of heart disease, but he contends that they do this by a different mechanism from simple cholesterol reduction and says the drugs can cause severe side effects. Ravnskov and other critics of the lipid hypothesis argue that a vitamin and/or unprocessed-food regimen for keeping homocysteine levels low has no special interests to promote its utility.