Contrary to the saturated fat/cholesterol theory, the most significant risk factors for cardiovascular disease (CVD) are actually insulin resistance, Type 2 diabetes and the chronic inflammation associated with these conditions. The damage to interior layers of arteries that invites cholesterol-rich plaque buildup can also be induced by elevated blood sugar, smoking, stress and high blood pressure.
A two-part documentary called "Heart of the Matter," which ran on the Australian Broadcasting Corporation show ABC Catalyst in 2014, does an excellent job of exposing the cholesterol/saturated fat myths behind the statin fad and the financial links which lurk underneath. In fact, the documentary was so thorough in debunking the myths behind the popularity of statins, that vested interests1 convinced ABC TV to rescind the series.
The credentials of the documentary's producer, Maryanne Demasi, were impeccable: She has a Ph.D. in neurology, no conflicts of interest and a long history of investigative journalism. But the Australian Heart Foundation, the three largest statin makers (Pfizer, AstraZeneca and Merck Sharp & Dohme) and Medicines Australia, Australia's drug lobby group, complained2 and all the documentaries were expunged from ABC TV. Luckily they remain online.
Saturated Fat Theory of Heart Disease Began With Ancel Keys
According to the "Heart of the Matter," American physiologist Ancel Benjamin Keys can be credited with originating and cementing the saturated fat/cholesterol theory of heart disease (though perhaps we should say indicted instead of credited).3
In the 1950s, Keys produced research that showed perfect correlations between cardiovascular disease and the dietary consumption of fat in several prominent Western countries. But there was just one problem with the research. Keys "withheld the data from 16 other countries," Demasi notes in the documentary.4
Keys was scientifically influential and got a board position at the American Medical Association, which caused wide medical acceptance of the theory that continues today. His research also shaped the ubiquitous USDA food pyramid of years past (now replaced by MyPlate), which emphasized heavy portions of breads, cereals, rice and pasta.5
While Keys' research was adopted years before the invention of statins, other groups of financial beneficiaries already existed — the sugar and grain industries. Sugar soon became a popular stand-in in low-fat foods to improve taste. In fact the dangers of growing sugar consumption inspired British professor John Yudkin to write a 1972 book, "Pure White and Deadly." Fat was also replaced with carbohydrates, a move that benefited the grain lobby.
Bad Dietary Advice Resulted From Keys' Research
Few scientific studies have confirmed Ancel Keys' broadly adopted but skewed research, and several have reached opposite conclusions, says "Heart of the Matter." But the tenacity of his theory has resulted in bad dietary advice. Take the case of margarine.
One of the worst examples of switching from saturated fats to something believed to be less conducive to heart disease is the embrace of margarine, according to cardiologist Dr. Stephen Sinatra in the documentary. When you switch to margarine and other "double-bonded" transfats — also called polyunsaturated and omega 6 fats — you are putting your health at risk, he says.
Such fats, which are the basic ingredients in most processed and snack foods, are prone to become rancid, causing oxidation and free radical attacks in the human body. Those chemical reactions produce the inflammation that is the real cause of heart disease, Sinatra says, adding that the damage from omega 6 fats is best combated by consuming omega 3 fats found in salmon, flaxseeds and walnuts.
Beware of Other Unsafe Alternatives
In "Heart of the Matter," David Sullivan, associate professor and lipid expert with Royal Prince Alfred Hospital in Sydney, Australia, cautions against replacing saturated fats with carbohydrates because it contributes to obesity and may even make people hungrier.6
Many marketers of processed and snack foods also add refined sugar and processed fructose to improve taste when they try to advertise themselves as "low-fat," but these products are in fact the primary drivers of heart disease, as I have pointed out in numerous newsletters.
Any meal or snack high in carbohydrates like fructose and refined grains creates a quick rise in blood glucose and, subsequently, a rise in insulin to compensate for the rise.
The blood sugar rise not only increases the risk of heart disease, the insulin released from these foods makes it harder to lose weight because it encourages fat accumulation, especially abdominal fat. Of course, abdominal fat is one of the major contributors to metabolic syndrome which, in turn, contributes to heart disease.
Many Flaws Are Found in the Saturated Fat Theory
"Heart of the Matter" features several experts who dispute the saturated fat theory based on their own clinical experience. For example, Dr. Rita F. Redberg, a cardiologist who practices in the University of California San Francisco cardiology unit, says, "cholesterol is just a lab number" and only one factor in heart disease along with general lifestyle.
Sinatra says he believed the saturated fat theory, too, until he actually looked carefully at the X-rays of those with heart disease. The angiograms showed both high and low levels of plaque-filled arteries, and therefore were not predictive or helpful in deciphering the cause of heart disease. Cholesterol is only harmful when it's oxidized, he says.
Dr. Ernest N. Curtis, a cardiology specialist, agrees that saturated fat is not the cause of heart disease and adds that human levels of cholesterol are "preset" and mostly do not come from diet. If cholesterol from food is reduced, the human body tends to compensate by replacing it to keep the same levels, the documentary's experts agree.
Cholesterol also serves valuable functions in the human body, and elimination should not be a goal, says Dr. John Abramson of Harvard Medical School Public School of Health in "Heart of the Matter." Rather, it is "the precursor to many of the hormones in our body," he asserts. Cholesterol also protects cell membranes, digests food and manufactures vitamin D after exposure to the sun.
Problems With the LDL Hypothesis
At the heart of the theory that saturated fat/cholesterol causes heart disease (pun intended) is the high-density lipoprotein hypothesis which designates high-density lipoprotein (HDL) as the "good" cholesterol and low-density lipoprotein (LDL) as the "bad" cholesterol. But, says "Heart of the Matter," the lipoproteins neither deposit nor remove cholesterol as the theory holds but, rather, simply "ferry" cholesterol in the body.
It is stress and damage on the artery wall that allows the inflammation and degradation that leads to heart disease, says Curtis. That's why plaque is usually seen at arterial "branches," where there is more pulsating pressure as arteries divide. Since veins escape the pressure of returning blood that arteries perform, plaque is not seen in them, he says — unless veins are recruited to serve as arteries through bypass operations. Clearly, such surgery is not a solution to the problem.
More Problems With the LDL Hypothesis
"Heart of the Matter" is not the only source of skepticism about the LDL hypothesis. Here is what Dr. Malcolm Kendrick, a Scottish general practitioner, writes on the theory and its implausibility.7
"For the LDL hypothesis to be correct, it requires that LDL can travel past the lining of the artery, the endothelial cells, and into the artery wall behind. This is considered the starting point for atherosclerotic plaques to form. The problem with this hypothesis is ... the only way for LDL to enter any cell, is if the cell manufactures an LDL receptor — which locks onto, and then pulls the LDL molecule inside. There is no other passageway.
There are no gaps between endothelial cells. Endothelial cells are tightly bound to each other by strong protein bridges, known as 'tight junctions.' These tight junctions can prevent the passage of single ions — charged atoms — which makes it impossible for an LDL molecule to slip through, as it is many thousands of times bigger than an ion. This, too, is an inarguable fact."
The Boom of Statins Rests on the Saturated Fat Theory
Needless to say, the boom in statins seen since 1996 — Lipitor was the best-selling drug in the world before its patent expired — has rested on the theory that saturated fat/cholesterol is the cause of CVD. Yet, expert after expert in "Heart of the Matter" not only say that studies show statins only lengthen a life by a few days, but they are shockingly ineffective for all but a few people, despite their hype and popularity.
Statins' serious side effects have been downplayed by those who drank the saturated fat/cholesterol "Kool-Aid" theory, either because of professional hubris or because they are directly profiting from statins.8 Yet, the side effects of statins are serious and include an increased risk for diabetes, decreased heart function,9 depleted CoQ10 and vitamin K2 (which are important nutrients), birth defects,10 an increased risk of cancer,11 and nerve damage.12
Statins Still Popular From an Unproved Theory
When this documentary was produced in 2014, at least 40 million people worldwide were taking statins — today, that number is estimated from a low of 100 million13 to as many as 200 million14 — and what was spent annually on statins during their boom was "more than the GNP of some countries," the documentary claims — and this was no accident.
Thanks to pressure from the drug industry, official guidelines for what constitutes too-high cholesterol are continually being revised downward to recruit more patients and sell more product, says "Heart of the Matter."
Yet, the harms from statins far outweigh their benefits. They may reduce your chance of heart attacks, but will not improve your general health, Abramson declares in the film. And, in women and the elderly, the risks are especially high, adds Dr. Beatrice Golomb of the University of California at San Diego.
In fact, both Abramson and Golomb agree the overprescription of statins, especially for those who do not need them, is unethical and even "criminal." When statins first surfaced they were "hailed as nirvana," Curtis remembers. Today we know they clearly are not.