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It's the Sugar
Sugar grains magnified to show their crystalline structure (image taken from Wikipedia)
There's been some recent discussion at CFO regarding dietary cholesterol (the cholesterol you eat) and its supposed effect on serum cholesterol (the cholesterol that ends up in your bloodstream).
Conventional wisdom on the topic (both medical and mainstream) suggests that eating foods high in cholesterol (generally animal fats) leads to high blood cholesterol levels, which in turn leads to heart disease. This view has been advocated by the medical establishment since the 1950s.
But there's an ever-growing body of evidence that's come to the fore in the last decade or so that turns this theory on its head. According to this minority of scientists and writers swimming against the (main) stream, cholesterol is not the cause of heart disease, nor is a high level of cholesterol--by itself--necessarily descriptive of anything (good or bad).
The most prominent example of this new school of thought is Uffe Ravnskov's The Cholesterol Myths, where Dr. Ravnskov shows that cholesterol is vital for cell maintenance and that there's no evidence in the medical literature or otherwise that elevated cholesterol levels lead to heart disease.
Dr. Ravnskov's cause was bolstered by Anthony Colpo in his book The Great Cholesterol Con. Colpo, just as Dr. Ravnskov does, lays out a compelling case against the cholesterol-as-devil theory that's been spouted by the mainstream for so many years.
And now Gary Taubes has written a landmark book titled Good Calories, Bad Calories (which I've just ordered) that apparently demonstrates once again that eating fat and having a high cholesterol levels do not lead to heart disease. He takes it one step further, though, and implicates excessive carbohydrate consumption as the real culprit in heart disease.
Well, enough rambling from me on cholesterol. Read the books (especially the recently released Taubes work) and change your diet where needed. And quit worrying about saturated fat (excessive carbohydrate intake is the real culprit).
Post any diet-related beliefs or practices you think are dangerous to comments.
If someone eats my food... that could be dangerous.
What Mike said is true. I've been reading similar stuff for years now, ever since I started chiropractic school. Cholesterol is an integral part of our cell membranes. Cholesterol plaquing in the arteries happens when the arteries are already damaged by inflammation, which is probably caused by excess sugar/carbs in the bloodstream, perhaps also because of excess omega-6 fatty acids, not enough omega-3's, stress, smoking, running marathons, etc.
Cholesterol is the "cop" that shows up at the scene of the crime, not the perpetrator. It is how the body attempts to deal with damage to the inside walls of the arteries.
Another piece of information that may surprise you: It has never been shown that cholesterol-lowering drugs do anything to improve health or longevity. It has been shown that they make a lot of money for drug companies though.
Look at Mercola.com (search on cholesterol to get started) for more info.
This is a very interesting subject. I started eating "good" about 5-6 years ago when my dad had to have EIGHT heart stents put in. He has also suffered from a heart attack at age 39! The interesting thing is that he eats very healthy/excercises and has taken all the cholesterol drugs for years. He had the same opinion as Allen that they didn't do anything but empty your wallet...so he quit taking them for about 6 months. His cholestoral scores skyrocketed back up! He lost several years worth of "gains" by not taking the drugs. He has since become a believer that the drugs work. Your total cholestoral score is not the only important thing; The ratio between cholestorals play a very important part as well.
My beliefs...High Fructose Corn Syrup is the root of all evil in the world.
After discussing this with Amy (who is an M.D. and knows a LOT more about drugs than I do) I'm going to modify my stance somewhat. Apparently it HAS been shown in at least one large, high quality study that if you ALREADY have heart disease, Statins (i.e. cholesterol-lowering drugs such as lipitor) are beneficial in reducing your risk of heart attacks, strokes and early death. But for people who only have moderately high cholesterol, high blood pressure, and other RISK FACTORS for heart disease, at least one high quality study in JAMA showed that one particular statin did not reduce the risk of death or heart disease any more than standard treatment (which I assume is diet and exercise modification).
They do lower your cholesterol, the question is does that make you more healthy, prevent strokes or heart attacks, or make you live longer. In the case of Daniel's dad (who already had serious heart disease and had had a heart attack) the answer is probably yes. For most people with elevated cholesterol but without heart disease, it is probably no.
Statins deplete your levels of CoQ10, which is an extremely powerful and necessary antioxidant.
from Mercola.com: "Dangers of statin drugs include, but are not limited to, a potential increase in liver enzymes so patients must be monitored for normal liver function, muscle aches, weakness, immune system suppression, an increase in cancer risk, and a serious degenerative muscle tissue condition called rhabdomyolysis."
http://www.mercola.com/2003/nov/8/crestor_statins.htm
Here is the first study I referenced (also from mercola.com:
"In the study, which compared the effects of pravastatin versus the usual care recommended by physicians on cholesterol levels of over 10,000 people, found that the drug did not reduce the risk of death or heart disease in those with moderately high cholesterol and high blood pressure. Though statins have been the subject of many clinical trials, groups of people, such as women and certain racial groups, and individuals such as those with well-controlled hypertension and diabetes, were not adequately represented. The new study used a wide range of people -- made up of almost half women, 38 percent black, 35 percent with a history of diabetes, and 55 percent aged 65 years or older -- to assess the drug’s effects.
Results showed that pravastatin did indeed lower cholesterol, with a decrease of 17 percent in total cholesterol levels among those taking statin, compared with eight percent in the usual care group after four years of the study. Levels of LDL, bad cholesterol, had also dropped -- 28 percent among those taking pravastatin and 11 percent in the usual care group.
However, while lowered LDL cholesterol has been shown to reduce the risk of stroke and heart attack, study participants who took pravastatin and those who received usual care showed the same rates of death and heart disease."
JAMA December 18, 2002;288:1998-3007,3042-3044
First off, following the government's guidelines will probably kill you early.
On the other hand, I think over complicating things can create a lot of needless angst and stress. (To say nothing about whatever dietary imbalances arising from OCD behavior--and CFers seem prone to "all or nothing" thinking).
Aside from following simple Zone guidelines, whenever in doubt, I try to imagine how my great-grandparents ate.
My guess is they had a fairly balanced diet with plenty of butter/oil, meat and fresh legumes. Portions were reasonable. Sweets consumed in moderation. Cod liver oil a daily thing. Probably not many prescription drugs, you know?
Sure, they ate sugar and bread, but those things are easy to avoid these days--and a little bit now and then won't kill you.
Very important subject to me (same dad issues)
Mike - anything on triglycerides? My doctor is more focused on that for me than he is on C.
Also, just curious, anything about carbs being addictive?
Thanks.
Brad,
Yes, triglycerides (TG) are a much better predictor for heart disease--smart doc you have there.
There are some really useful TG/HDL ratios that have been published; more useful than total cholesterol. I'll try and dig them up and post 'em for you. Taubes makes a strong case for using TG as an indicator of one's health in Good Calories/Bad Calories.
And yes, although I don't have it on hand for you to reference, carbs are very addictive. A lot of it, ironically enough, is often due to the fact that people don't get enough fat in their diets.
Sorry if this is a double post -
Very important issue for me. My dr says he focuses more on my triglycerides than C. My C is a good range, but my Tris are too high.
So, MIKE, any word on triglycerides?
One last thing, and I'm not joking, I think carbs are addictive.
Believe it or not, I have a semi-serious post. While I do not dispute the fact that sugars are best consumed in small quantities, I do think that carbs get a bad rap. Let's look at our friends the Okinawans. They eat a low fat, low protein, high carbohydrate diet. Many of their carbs come from veggies, but they eat quite a bit of white rice, too. The Okinawans are lean, active, and long-lived. What's more, even as they age they tend to be mentally sharp and physically fit.
Come to think of it, many Asians, including the Chinese and Japanese, eat a lot of rice. They are both relatively lean (in a generalized population sense) and the Japanese are #2 in life expectancy if you break out the Okinawan sub-population.
What does this mean? Probably that dietary science cannot yet answer the question "the ideal diet." The Okinawans have a culture and a living arrangement that helps to promote health and longevity. Well, at least they used to have those things. Younger Okinawans live, eat, and look more like Americans than their parents and they are suffering some of the same disease issues. However, back to my point: we don't really know what the ideal mix of food is, nor do we know how broadly applicable dietary advice really is. We can only speak of ranges and probabilities.
With that said, I think the Zone Diet has merit, but Okinawans arguably do not eat in the zone. Are they wrong? Hard to say. Barry Sears is overweight despite his claims that he follows his own diet. All this leads me to think that diet, like life, has many more shades of gray to it than we would like to think.
I'm now off to eat a reasonably sized portion of beans and rice (and sausage and collard greens).
I can only share my personal experience. Despite vastly improved fitness, my cholesterol remained stubbornly high. My doctor suggested that the high LDL cholesterol was due to high level of body fat, in particular something called hepatic fat - fat stored in the liver. (Look up NAFLD [Non-Alcoholic Fatty Liver Disease]).
My doc mentioned that the majority of LDL and HDL cholesterol is synthesized in the liver (and does not come from dietary sources). A high level of fat stored in liver cells decreases the efficiency of the synthesis process so basically you end up with too much LDL and not enough HDL.
He suggested losing about 15 lbs and see what happens. I did this with a half-assed paleo and my LDL dropped 32 points leaving my HDL unchanged.
Here's some of the scientific evidence:
http://www.wjgnet.com/1007-9327/12/345.asp
Re Brad's question about tryglycerides, it's true, most recent research shows that tryglycerides (or VLDL) and high blood pressure are much more closely correlated with heart disease than anything else. The optimal ratio is TG/HDL < 1.
By the way, re statins - my doc compared taking statins to putting a lighter under a thermometer. The thermometer will give you a higher reading but the room won't be any warmer.
Carlo
I was just diagnosed with a chronic illness and was told that while there is no "cure" studies have shown that avoiding bread, sugar, and milk (among a long list of other this that will basically make me be a person on a Paleo diet who cannot eat tomatoes, citrus, and spicy foods.)
Of course, I questioned the doctor extensively to see if he had been talking to Mike or Max and also asked if he had visited Santa Cruz in the last three months...but it looks like no one from CF put him up to it.
So I am headed down the Paleo road--the doctor is making me do it. So while I will apparently have to deal with a variety of medical issues, and never enjoy ice cream again...maybe I will have a complete body composition transformation like Mr. Max.
I think that Tim raises a valid point. Obsession and stress over food consumption could counter balance the benifits. It goes with out saying how detrimental stress is on our health and energy levels.
TomC: All I have ever read from Dr. Sears is "do as I say not as I do."
TomC: I think you have a point about the Okinawans, and I seem to recall they also have a culture of only eating until they're 80% full, eating slowly, and savoring their food. These are probably also factors in staying lean (and seem like good ideas in general).
There are some good observations among the above comments. Brad said, "...diet, like life, has many more shades of gray to it than we would like to think."
We tend to think only in terms of adequate nourishment and ignore the importance of appropriate nourishment. Due to wide variations in biochemical and physiological makeup, people vary all over the charts in terms of what they can extract and utilize from any given dietary approach. Some seem to thrive on a vegan diet and others absolutely must consume animal products to meet nutrient needs.
Population studies linking one dietary approach or another to longevity tell us little about what is appropriate for us as individuals. What is important is to experiment to determine what works for ones own biochemical makeup. What ones parents and grandparents thrived on can be helpful in this regard unless they happened to consume a poor quality diet and died early. A retired dairy farmer once told me that his own father lived remarkably long and was exceptionally healthy despite how bad his diet was. It turned out the father ate plenty of pork fat, butter, eggs, and red meat all his life and lived to be 88.
Which brings up "Good Calories, Bad Calories" by Gary Taubes. It's a remarkable piece of work. However, an important consideration, barely discussed in the book, is the "Biochemical Individuality" issue. To be sure, it was not his aim to discuss all aspects of and issues related to food intake and health. So if anyone cares to read material from an earlier era that covers this ground, I recommend "Diet Against Disease" and "Biochemical Individuality" by Roger J. Williams, PhD.
David Brown
Nutrition Science Analyst
Statins have been shown to both reduce cholesterol levels in post CHD patients and reduce their risk of another coronary incident. What has *not* been shown is that the cholesterol reduction is the mechanism for CHD risk reduction and not just a side effect.