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Thread: The Great Cholesterol Debate

  1. #1
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    Default The Great Cholesterol Debate

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    I was looking through the list of Dr. Kilgore's posts on this forum looking for a draft of a completely cholesterol-unrelated review article (with no avail I might add). As is often the case however, the search resulted in another question arising.

    One of the search results was a thread by the title Statins and Muscle Damage. A poster in that thread asked if Dr. Kilgore cared to comment on the work of Uffe Ravnskov MD, PhD The Cholesterol Myths, whom, if I am correct, has done much of the leg work dispelling the status quo belief of cholesterol = instant death. The question was probably lost in the shuffle and was never answered. But I think this would be a good question to have answered given the nature of much of the dietary concerns the poster's on this forum exhibit (I have searched the forum for an answer and read MOMG and didn't find a satisfactory answer). A number of additional books of a similar theme have been published in recent years, particularly Malcolm Kendrick's The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It (2008), and Anthony Colpo's The Great Cholesterol Con (2006).

    I personally have not read Ravnskov's, or Colpo's books, but I did recently finish reading Malcolm Kendrick's (Scottish MD) and found it quite compelling (at least until his theory), especially his interpretation of large scale epidemiological studies to dispel the link between cholesterol and heart disease.

    However I may be easily compellable for reasons such as my rudimentary understanding of lipid biochemistry, difficulty to discern what may constitute dubious interpretation to the trained eye, the distrust for all things status quo that you've fostered within me, low mental capacity on account of being Polish (just playing into the stereotype), and my own unwillingness to give up delicious, cholesterol filled foods I've grown up eating and loving.

    So I guess I would like an opinion of someone more knowledgeable than myself on the matter. Would you, Dr. Kilgore or Dr. Bradford care to comment on an the accuracy and relevancy of the works of Uffe Ravnskov (The Cholesterol Myths), Malcolm Kendrick (The Great Cholesterol Con), and Anthony Colpo (also The Great Cholesterol Con)? Are they just successful at promoting their dogma? Maybe you care to add something yourselves?

    Thank you for taking your time answering this.

    Disclaimer:
    I am not, and have never been one of "those" people afraid to eat large amounts of saturated fat or cholesterol ("Smalec", a staple in Polish cuisine, is lard laced with bacon bits and fried onion, spread on bread and served as an appetizer ) or lose his six pack (unless its my Guinness). I'm simply curious.

  2. #2
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    That would require that we've read the books, and I can tell you that we haven't. What specifically did you have a question about regarding this material?

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    Last year on Charlie Rose, I heard a famous heart surgeon (who's name I forget) say that one's chance of having a heart attack or stroke is almost nil if you are on the good side of all these factors:
    --blood pressure
    --blood sugar
    --obesity
    --exercise
    --smoking
    --cholesterol

    There may have been another factor, but I can't remember what it was. He indicated that while heredity may have some influence, it's not as significant as the factors above. In any case, note that cholesterol is one of the risk factors. This is well established, no matter how many people are selling books claiming there's a cholesterol "con" (also see what the American Heart Assoc has to say, or ask your family doctor or cardiologist). There's also people out there claiming that obesity is not a health hazard (Paul Campos) and that vaccines are a hazard--in spite of overwhelming evidence to the contrary. In short, there's no shortage of bullshit on the wire. That's not to say we should never be skeptical of "common knowledge" (we should) but beware of snake oil salesmen. They haven't gone away. They've just changed their threads and the style of their presentation.

    On the other hand, there appears to be some controversy over the use of statin drugs (used to treat cholesterol).

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    What is your clinical/research experience, Mat?

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    Quote Originally Posted by matclone View Post
    Last year on Charlie Rose, I heard a famous heart surgeon (who's name I forget) say that one's chance of having a heart attack or stroke is almost nil if you are on the good side of all these factors:
    --blood pressure
    --blood sugar
    --obesity
    --exercise
    --smoking
    --cholesterol

    There may have been another factor, but I can't remember what it was. He indicated that while heredity may have some influence, it's not as significant as the factors above. In any case, note that cholesterol is one of the risk factors. This is well established, no matter how many people are selling books claiming there's a cholesterol "con" (also see what the American Heart Assoc has to say, or ask your family doctor or cardiologist). There's also people out there claiming that obesity is not a health hazard (Paul Campos) and that vaccines are a hazard--in spite of overwhelming evidence to the contrary. In short, there's no shortage of bullshit on the wire. That's not to say we should never be skeptical of "common knowledge" (we should) but beware of snake oil salesmen. They haven't gone away. They've just changed their threads and the style of their presentation.

    On the other hand, there appears to be some controversy over the use of statin drugs (used to treat cholesterol).
    When the surgeon discussed cholesterol as a risk factor, was he referring to elevated total and/or LDL cholesterol levels, or ingestion of dietary cholesterol? My understanding is that elevated "bad" cholesterol is clearly recognized as a risk factor, but that it is unclear whether ingestion of cholesterol causes raised cholesterol levels, which is why eggs are not thought of as negatively as they once were. (Note: I don't have a medical or science background, but I try to stay informed on this stuff due to a family history of heart disease.)

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    Quote Originally Posted by matclone View Post
    Last year on Charlie Rose, I heard a famous heart surgeon (who's name I forget) say that one's chance of having a heart attack or stroke is almost nil if you are on the good side of all these factors:
    --blood pressure
    --blood sugar
    --obesity
    --exercise
    --smoking
    --cholesterol

    There may have been another factor, but I can't remember what it was. He indicated that while heredity may have some influence, it's not as significant as the factors above. In any case, note that cholesterol is one of the risk factors. This is well established, no matter how many people are selling books claiming there's a cholesterol "con" (also see what the American Heart Assoc has to say, or ask your family doctor or cardiologist). There's also people out there claiming that obesity is not a health hazard (Paul Campos) and that vaccines are a hazard--in spite of overwhelming evidence to the contrary. In short, there's no shortage of bullshit on the wire. That's not to say we should never be skeptical of "common knowledge" (we should) but beware of snake oil salesmen. They haven't gone away. They've just changed their threads and the style of their presentation.

    On the other hand, there appears to be some controversy over the use of statin drugs (used to treat cholesterol).
    Quote Originally Posted by matclone
    I can recognize a misleading argument even if I don't know everything about the subject at hand. This might even be on Heinlein's list of things a man should be able to do. Of course, he died before the advent of the unfiltered internet or talk radio as we know it, but I believe he predicted the former (in some fashion), and a version of the latter (e.g. Tokyo Rose) was already known in his day.
    Interesting.

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    Quote Originally Posted by Mark Rippetoe View Post
    That would require that we've read the books, and I can tell you that we haven't. What specifically did you have a question about regarding this material?
    I probably should have asked if they are familiar with them first huh. Well in any case I will compose a digested list of arguments Kendrick makes along with some of his proof and post it here.

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    I have no clinical experience or research. My opinion is based on my experience in ferreting out good information and bad. Of course, I could be totally wrong, but I don't think so. If I were to write a book and claim that the sun rises in the west, or that the Texans won at Alamo, most people would be able to figure out that it was bs on its face without having actually been to the Alamo. But, if I were inclined to pepper the book with fallacious arguments, appeal to my reader's prejudices, and tell them what they wanted to hear, I might yet have a best seller.

    Quote Originally Posted by coldfire View Post
    Interesting.
    Take it for what it's worth.

    Quote Originally Posted by Need2Lift View Post
    When the surgeon discussed cholesterol as a risk factor, was he referring to elevated total and/or LDL cholesterol levels, or ingestion of dietary cholesterol? My understanding is that elevated "bad" cholesterol is clearly recognized as a risk factor, but that it is unclear whether ingestion of cholesterol causes raised cholesterol levels, which is why eggs are not thought of as negatively as they once were. (Note: I don't have a medical or science background, but I try to stay informed on this stuff due to a family history of heart disease.)
    As I recall, the heart surgeon did not get into that sort of detail. I'm sure you're right about the bad cholesterol. As for what we ingest, the handouts I get from my family doctor still suggest that eggs should be avoided where lowering cholesterol is the goal but there may be some question on that and in any case it sounds like you are well informed on the subject. I was just railing against those claiming that cholesterol is a "con" and all that portends (i.e., ignoring the recommendations of medical doctors).
    Last edited by Mark Rippetoe; 01-03-2010 at 08:23 PM.

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    Mat, post here a link to the study that demonstrates that serum cholesterol causes CVD. Then post a link to the study that demonstrates that serum cholesterol varies directly with dietary cholesterol. We have discussed this before.

  10. #10
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    I missed the prior discussion. I'm not an expert on the subject of cholesterol and don't pretend to be. Maybe tnumrych will share his findings, and that would be a better starting point for discussion.

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