High Cholesterol is Good
When Swedish doctor Uffe Ravnskov wrote his book the “Cholesterol Myths” in 2000, few people were publicly making the assertion that saturated fat does not cause heart disease. (OK, well, the non-profit Weston Price Foundation and its founders Sally Fallon and Mary Enig, Ph.D., were, but they were often dismissed as being a fringe group.) But today, several prominent voices are saying exactly that—author Nina Planck, science writer Gary Taubes, and journalist Michael Pollan among them.
As our national conversations about obesity and other diet-related chronic diseases continue, and provocative ideas such as a tax on soda and other sugary drinks are floated by public health officials, it seemed to me a good time to raise the question: if so many scientists, doctors, and other smart people think that a diet high in saturated fats and cholesterol is not the culprit when it comes to heart disease, then why doesn’t everybody in America know it? Why do millions of Americans still follow low-fat, low-cholesterol diets and why do cardiologists tell their patients to swear off eggs, steak, and butter? (And why, in heaven’s name, are our public schools banning whole milk?)
In an effort to better understand this controversial issue, I interviewed Dr. Ravnskov, who lives in Lund, Sweden, and who has just published a revised edition of his book, called, simply, Fat and Cholesterol are Good for You. He is also founder of the International Network of Cholesterol Skeptics.
An English Breakfast at London’s Columbia Road Flower Market
Hannah Wallace: What kind of doctor are you?
Uffe Ravnskov: I am a specialist in internal medicine and nephrology. I have studied the cholesterol issue for twenty years and published more than 80 scientific papers and letters about the subject and have also written two books in five languages.
HW: You’ve said that the “cholesterol campaign” is one of the greatest mistakes in medical science. Can you briefly define what you call the cholesterol campaign and tell us why you believe it’s a mistake?
UR: The cholesterol campaign is based on the false idea that [human consumption of] animal food and high cholesterol causes atherosclerosis and heart disease. It’s a mistake because high cholesterol is not dangerous to health; it is beneficial. For instance, high cholesterol protects against cancer and infectious diseases. Today millions of healthy people all over the world are taking medicine that may create muscle weakness, bad memory, bad temper, impotency, painful legs and cancer. But most doctors do not know it because they have been mislead by the drug industry and their researchers.
HW: But what about all the research that shows that diets high in saturated fat cause heart disease?
UR: No study has ever proved that saturated fat causes heart disease. More than 30 studies have shown that heart patients have not eaten more saturated fat than healthy people and at least 8 studies of stroke patients have found that they had eaten less saturated fat than healthy controls.
HW: It seems to me that there are two arguments being made here, and the distinction is, I think, important. Are you saying that eating high cholesterol foods does not raise blood cholesterol levels? Or are you saying that high serum levels of LDL (the so-called “bad” cholesterol) do not cause heart disease?
UR: Eggs are the most cholesterol-rich food because a lot of cholesterol is necessary to create a healthy, living creature. You can eat twenty of these cholesterol bombs per day and yet keep your cholesterol normal.
Even if your cholesterol levels should go up, there is no reason to be afraid because high cholesterol is not the cause of heart disease. Recent American studies have found that on average patients with an acute heart attack had lower cholesterol than normal and the risk of being dead three years after a heart attack was highest among those with the lowest cholesterol.
HW: In your mind, what are two of the strongest studies that contradict the theory that higher serum LDL levels causes heart disease?
UR: The first argument is that people with low cholesterol are just as atherosclerotic as people with high cholesterol—this was shown for the first time more than 70 years ago and has been confirmed again and again by more recent scientists. The second is that old people with high cholesterol live longer than old people with low cholesterol—and again, this has been documented in numerous studies. (This one, by Dr. Harlan Krumholz and colleagues at Yale followed 1000 elderly men and women for four years and found that twice as many of those with low cholesterol had a heart attack or died from one, compared with those with the highest cholesterol.)
HW: In Michael Pollan’s book In Defense of Food, in his chapter on “The Melting of the Lipid Hypothesis,” he describes a study that implicates trans-fats as the culprit for causing heart disease. Gary Taubes believes refined carbs are to blame. What do you think causes heart disease—is there another hypothesis that you think has more science behind it than the current lipid hypothesis?
UR: There is general agreement that atherosclerosis is an inflammation in the arterial wall, and also that bacteria and virus participate in some way, but few have realized that it is the microorganisms that may cause the inflammation. This is a hypothesis that I have presented together with Kilmer McCully, who discovered the association between high homocysteine and atherosclerosis. Our arguments, and we think they are very strong, were presented in a scientific paper this year and in a popular way in the last chapter of my new book. They are based on the fact that the lipoproteins, including the “bad” LDL, participate in the immune system by binding and inactivating bacteria, virus and their toxic products.
HW: And which study or studies do you think are the most convincing in showing that LDL cholesterol actually protects against infectious disease?
UR: If you inject bacterial toxins into rats they die almost immediately, but if you start by injecting them with purified human LDL, most of them survive. Normal mice die also, but mice with high cholesterol survive. Many studies have also shown that people with low cholesterol are at a greater risk of being infected than people with high.
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