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Saturated Fat, Cholesterol and Heart Disease Part One - Challenging the Connection
Since the early 1980’s doctors and dietitians have encouraged patients to decrease both their saturated fat and cholesterol intake, in order to decrease the risk of coronary heart disease. Food manufacturers have been using this to market low fat and cholesterol free products. Recently the ABC program ‘Catalyst’ aired a two part programme which questioned the link between saturated fat, cholesterol and heart disease.
Cholesterol is essential for life. Our body creates its own cholesterol which it uses in nearly every single cell in the body. It is a very important component of brain and nerve tissue and also vital in the production of a number of crucial hormones. Cholesterol can build up on the sides of the arterial walls, causing blockages and ruptures that lead to heart attacks. It is thought that eating saturated animal fats leads to an increase in cholesterol levels. At a regular health check-up, a doctor will often check cholesterol and if it is above the recommended 5.5mmol/L, the patient will be told to actively try and reduce it with dietary changes, or start a cholesterol lowering medication. Some cardiologists are questioning this advice.
The large Framingham study (of over 5000 participants) showed that both smoking and stress drastically increased ones risk of a heart attack, however, after the age of 40 ones cholesterol level gave no indication of increased heart attack risk. The equally well know Lyon study shows that although the Mediterranean style diet is effective at reducing the risk of heart disease, there is actually no change in an individual’s cholesterol levels when consuming the diet.
Some cardiologists believe that the reason cholesterol has been blamed for heart disease is a case of ‘wrong place, wrong time’. Yes, cholesterol is found in plaque build ups and is released when these plaques burst, but they do not believe that cholesterol is the causative factor. They hypothesise that high blood pressure (caused by environmental and genetic factors) leads to high pressure in the blood flowing through the arteries. This blood excerpts force on the artery walls, overtime causing damage. As a defence mechanism, the body goes into an inflammatory response. Inflammation or a burst of these plaques can lead to blockages.
Some cardiologists believe that we should not be actively trying to reduce cholesterol with medications, and that we should be focusing more on stress and other lifestyle components when looking for a causational factor for heart disease.
This is all a lot to take in, for both health professionals and the broader public. Perhaps saturated fat may not affect cholesterol levels as we once thought, and perhaps cholesterol is not solely blame for heart attack risk, but much more research is needed before any public health messages can be made. We should take a look at the whole person, lifestyle factors and diet, before taking any steps towards medication. It just may be that a balanced diet, weight loss, cessation of smoking, moderate exercise and some increased leisure time might be more beneficial to heart health. In part two of this article, we will look at the cholesterol lowering medication that keeps the drug world in business, Statins.
Added to site on : Monday, 2 December 2013