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Saturated Fat & Cholesterol

Saturated Fat Causes Heart Disease?

We have all heard that saturated fat causes heart problems. It raises cholesterol. It is supposed to clog your arteries and possibly lead to a heart attack… It is an interesting theory, but does it stand up to the ultimate scrutiny? We should probably find that out since:

1) Heart disease is such a problem in today’s world.

2) We recently changed the way humans have eaten for millennia.

If we are going to fight a major disease and change the eating habits of millions (if not billions) of people, we should at least make sure we’ve got our facts straight. That’s what we are here to do.

Cholesterol and the heart

Doesn’t eating a whole bunch of fat raise your cholesterol?

For most people: yes, it does.[1][2][3][4]

Again – this happens to most people. It actually doesn’t happen to everyone. (You can see this in each study referenced above.)

There are even researchers who claim there to be no correlation at all. They claim that the studies carried out were flawed and skewed to prove a point rather than to find out the truth. One major problem is is they look at fat intake without looking at a complementary decrease in carbohydrate. No studies are going to show a positive impact of fat if there is no decrease in carbohydrate.

Raymond Reiser did a pretty extreme critical review of the notion that saturated fat raises your cholesterol. He claims it’s not true. And his arguments are compelling. “There are a large number of variables, lack of control of which make interpretation difficult if not impossible, and certainly inconclusive. These will be brought out with each paper reviewed.” Dr. Reiser the goes to town on debunking these theories.[5] If you have the time and willpower to get through his study, you will be fascinated by his findings.

He did this all the way back in 1973! He knew something was fishy back then. We are very open to his idea that eating fat alone doesn’t significantly raise your “bad” cholesterol. We can’t argue with his presentation. But we are also open to the research that says eating fat, indeed, raises your cholesterol. That is the difficult thing of science – picking the good evidence from the bad.

Worst case scenario

If we are going to start looking at the problem of fat and heart disease, then we start with the notion that eating high fat and cholesterol-filled foods raises your cholesterol. Although not totally conclusive, it just makes sense. Also, we’d rather err on the side of assuming the “worst”: saturated fat causes high cholesterol levels.

Cholesterol rides along in the lipoprotein system. The main job of very low-density lipoprotein (VLDL) is to distribute fat energy to the cells. When it drops the energy off to the cells, it turns into low-density lipoproteins (LDL). Cholesterol tags along on the lipoprotein for a ride (LDL-C)[6]. There is nothing inherently bad with LDL. It is actually very important for inflammation repair, which we will bring up later.

When you eat more fat, your body transports that fat around – thus, you have an increase in VLDL and LDL cholesterol. But does that really matter? All that says is you are delivering more fat to your cells to use for energy. That is good, especially when your main source of fuel is fat.

[Learn more about the specifics of cholesterol here.]LDL-P is part of a very important delivery system

The facts

Our approach is a bit different – we have little concern whether or not eating fat raises your cholesterol. Because cholesterol is not the problem! Doctors and researchers need to look at all the information available – not just cholesterol. We care about the facts. The facts say cholesterol does not directly lead to heart disease. [7][8][9]

The facts say there is an association. We find it important to look at cholesterol if there is a correlation, but to stop and assume it is the cause is ridiculous. Also, solely looking at LDL does not give the full picture of the fat delivery system going on in your body.

Even doctors who boast the evils of fat will acknowledge cholesterol is not really the problem. You can tell by the language they use. High cholesterol is a “risk factor,” not a root cause. Even calling it a risk factor is deceiving… Cholesterol levels are a distraction from the real problem.

The Distraction

Returning to the point, eating saturated fat can especially raise the “bad kind” – LDL cholesterol.[2][4][10] But it doesn’t matter because this isn’t causing the problem. All we know is that there are trends towards higher blood cholesterol in people who die from coronary artery disease.

Cholesterol helps with so many functions in the body. One important job of cholesterol is to come and repair lesions and inflamed tissue.[11][12] We know atherosclerosis as a disease of lesions and inflammation on the artery walls.[12][13] Thus, the cholesterol is coming in as a repair team for the arterial wall. It does “get lodged” in the arteries, but it only does that because of chronic inflammation! Stop the inflammation = stop the plaque build up.

(Many things can cause this inflammation, but we will save that topic for its own separate page.)

A better question to ask is why are cholesterol levels correlated with heart disease? Inflammation is one answer. Another one is that total cholesterol and LDL cholesterol alone aren’t correlated to heart disease at all.[8][13] There are better measurements out there such as calcium scores, ApoB/ApoA ratio, total cholesterol/HDL cholesterol, and triglyceride levels.[13][14][15][16][17]

Even though a high-fat ketogenic diet will most likely raise your cholesterol, it does not increase your risk of coronary artery disease (CAD). The PURE study – published by The Lancet in 2017 – looked at over 100,000 people in 18 countries. It is one of the largest studies ever conducted. They concluded that replacing carbohydrates with saturated fat decreases the likelihood of cardiac death. It concluded at the same time that increasing carbohydrates increases cardiac mortality.[18]

 

Don't get distracted by cholesterol


When the profession looks at the distraction rather than the real issues, giant crashes in heath occur. We have got to get a proper definition of risk.

Defining “Risk”

It is all about how the medical profession defines the word “risk.” That’s the real problem. Go ahead, take a look at any advertisement for heart-healthy food or drugs. They all say something along the lines of: “decreases your risk of heart disease.”

Sure, it decreases their definition of risk of heart disease. But what happens when that definition of “risk” is based on absolute garbage science? You get things like sudden cardiac death running wild. If we had the definition of “risk” correct, then we wouldn’t have people dropping dead out of nowhere.

Risk needs to be defined based on actual disease or deaths. We showed above that there are risk factors more applicable than LDL measurements. But even then, they need to be looked at in conjunction with one another. Even having the more correlated risk factors does not mean you are at risk for heart disease. Once we understand most of these “risk factors” are a response to a root problem, then we can move away from the distractions.

What is really causing the problem? LDL is simply trying to delivery fat energy to cells. But it gets caught up in the arteries when they realize there is Inflammation, and they want to help. They end up getting stuck there. They can also change form through oxidation and this adds to the problems. It would be nice if the cholesterol didn’t have to come in and repair in the first place.

Wrapping up

There is so much more to talk about with this topic, so we have created an entire section of information all on heart disease and cholesterol. This is where you will find most of the information to make sure you properly understand the risk of heart disease. Cholesterol is not the risk. It is present, but it is not the main driver. To summarize, we will look at a simple analogy.


Seeing a bunch of police cars around a house indicates there is a problem. We don’t know what the problem is, but we know there is one. There are so many causes that we can’t pinpoint the exact one. However, we do know the police did not cause the problem. Rather, they arrived as a response unit. Their presence interrupts the functions of the neighbors, and it may even cause traffic. They are there to help the situation, but it does not come without a cost. It isn’t a big deal if they can solve the crime and move on. But when there are perpetual crimes, or they just can’t figure out what’s going on, it causes massive problems.


Cholesterol in an artery could be a sign that something is wrong – not the actual root cause. Maybe you have chronic inflammation. Maybe your cells are not taking in fatty acids like they used to. Maybe it’s not even a problem at all because it is simply delivering fat! That’s when the other biomarkers come into play. Either way, cholesterol is gathering in your arteries, which is good thing… Except in excess. When they are modified, or they can’t fix the actual problem, they stay there and build. This leads to more accumulation and possible myocardial infarction in the future.

Cholesterol is not the problem. It is the solution of other bodily processes are in tune. That’s why we love the ketogenic diet. It helps stabilize all other bodily processes to make sure your heart is protected.

References:

[1] “Saturated Fat”. American Heart Association. (2018). [Online]. Available: https://healthyforgood.heart.org/eat-smart/articles/saturated-fats. Accessed: 10 May 2018.

[2] Lichtenstein AH, Ausman LM, Carrasco W, Jenner JL, Ordovas JM, Schaefer EJ. (1994). Hypercholesterolemic effect of dietary cholesterol in diets enriched in polyunsaturated and saturated fat. Dietary cholesterol, fat saturation, and plasma lipids. Ateriosclerosis, Thrombosis, and Vascular Biology 14: 168-175.

[3] Mensink RP, Zock PL, Kester AD, Katan MB. (2003). Effects of dietary fatty acids and carbohydrates on the ratio of serum total to HDL cholesterol and on serum lipids and apolipoproteins: a meta-analysis of 60 controlled trials. The American Journal of Clinical Nutrition 77(5): 1146-1155.

[4] Weggemans RM, Zock PL, Katan MB. (2001). Dietary cholesterol from eggs increases the ratio of total cholesterol to high-density lipoprotein cholesterol in humans: a meta-analysis. The American Journal of Clinical Nutrition 73(5): 885-891.

[5] Reiser R. (1973). Saturated fat in the diet and serum cholesterol concentration: a critical examination of the literature. The American Journal of Clinical Nutrition 26(5): 524-555.

[6] “Cholesterol, lipoproteins and the liver”. Courses.washington.edu. (2018). [Online]. Available: https://courses.washington.edu/conj/bess/cholesterol/liver.html. Accessed: 10 May 2018.

[7] Hoenselaar R. (2012). Saturated fat and cardiovascular disease: The discrepancy between the scientific literature and dietary advice. Nutrition 28(2): 118-123.

[8] Ravnskov U, Diamond DM. Hama R, et al. (2016). Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review. The British Medical Journal Open

[9] Ramsden CE, Zamora D, Majchrzak-Hong S, et al. (2016). Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). The British Medical Journal 353: i1246.

[10] Tan MH, Dickinson MA, Albers JJ, Havel RJ, Cheung MC, Vigne JL. (1980). The effect of a high cholesterol and saturated fat diet on serum high-density lipoprotein-cholesterol, apoprotein A-I, and apoprotein E levels in normolipidemic humans. The American Journal of Clinical Nutrition 33(12): 2559-2565.

[11] Berghoff SA, Gerndt N, Winchenbach J, et al. (2017). Dietary cholesterol promotes repair of demyelinated lesions in the adult brain. Nature Communications 8:14241.

[12] Kaunitz H. (1978). Cholesterol and repair processes in arteriosclerosis. Lipids 13: 373-374

[13] Malhotra A, Redberg R, Meier P. (2017). Saturated fat does not clog the arteries: coronary heart disease is a chronic inflammatory condition, the risk of which can be effectively reduced from healthy lifestyle interventions. British Journal of Sports Medicine 51(15): 1111-1112.

[14] Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. (2005). Coronary Calcification, Coronary Disease Risk Factors, C-Reactive Protein, and Atherosclerotic Cardiovascular Disease Events. Journal of the American College of Cardiology 46(1): 158-165.

[15] Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. (2010). Saturated fat, carbohydrate, and cardiovascular disease. The American Journal of Clinical Nutrition 91(3): 502-509.

[16] Yusuf S, Hawken S, Qunpuu S, et al. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. The Lancet 364(9438): 937-352.

[17] Gaziano MJ, Hennekens CH, O’Donnel CJ, Breslow JL, Buring JE. (1997). Fasting Triglycerides, High-Density Lipoprotein, and Risk of Myocardial Infarction. Circulation 96(8): 2520-2525

[18] Dehghan M, Mente A, Zhang X, et al. (2017). Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. The Lancet 390(10107): 2050-2062.

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