If saturated fat does not clog up arteries, what does? Cholesterol 5.

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I love this clip.  It sums up much of the madness that is the British and American attitude to food, heart attacks and their cause.  In my blog What is saturated fat?, I went into what this substance actually is and the positive sides to saturated fat. Reading it won’t take long. As the clip says, there is an assumption that eating saturated fat raises cholesterol and this blocks our arteries, leading to heart attacks.  In fact, there is no evidence linking saturated fat to heart attacks.  Eating lard, butter or goose fat does not automatically clog up your arteries. Neither does it raise cholesterol.  This blog explores why cholesterol is implicated when an artery gets damaged.

Damaged arteries make the body activate the blood clotting system, which forms a blood clot over the damaged artery wall.  The clot is called a thrombus.  This, of course, is exactly what happens if we cut our knee.  Now with the knee, the blood clot forms a scab whilst the skin underneath heals and then the scab falls off.  However if the ‘scab’ fell off the artery wall, it would then trundle through the artery until the artery narrowed where it would jam the blood flow – and we would all be dropping like flies from heart attacks or strokes.  So instead the clot is drawn into the arterial wall and disposed of.

The popular statin-led theory states that eating saturated fat raises our cholesterol level, which damages the arteries, causing blood clots which need to be removed. In other words, there is too much LDL cholesterol floating about, caused by eating too much butter or lard. As mentioned in the previous blog, LDL cholesterol is known as the bad cholesterol.  According to this theory,  LDL gets oxidised and then sticks to the artery wall, causing damage.  Resultant blood clots build up to form plaques. As cholesterol is found inside these plaques, its presence is taken to mean it caused the plaque.  This is a tenuous assumption.  Cholesterol is a natural anti inflammatory, a steroid,  and part of the body’s defence mechanism, and it might just be that this why cholesterol is there. However, its presence fits the current zeitgeist that high cholesterol causes heart attacks. 1

To be fair to current dogma, a subsection of LDL cholesterol called Lp(a) is clot forming and is attracted to damaged artery walls.  High Lp(a) levels do put people at higher risk of heart attacks. But just measuring LDL cholesterol will not give a reading of Lp(a) levels. One can have low LDL cholesterol levels, but still be a terrible risk of having a heart attack or stroke.  The previous blog explains more about Lp(a).

There is another theory which has  nothing to do with cholesterol or fat in the diet, but does explain how blood clots lead to heart attacks. Some doctors and scientists have not been completely bludgeoned by saturated fat hysteria and their research has discovered things in our blood called pre-endothelial cells.  These are produced by our bone marrow, and travel about the blood stream in their billions looking for breaches in the artery walls. Their job is to prevent arterial clots reaching too big a size.  If a blood clot has got there first, they cover the clot entirely and transform themselves into new artery walls (the medical name for an artery is endothelium).  Usually they are then broken down and the artery wall is as good as new.  The theory advanced by scientists at Duke Health.org is that as we age, our bone marrow produces less of these cells, so repair to arteries is slowed down, hence why we are more prone to heart attacks when older.  Sadly that link just leads us to the hospital now, so here is a  link to a research paper about the same topic, but positing ways of healing damaged arteries: http://hyper.ahajournals.org/content/46/1/7.short  With repeated damage to the artery wall, new clots form over the existing ones and slowly large plaques build up.  These will either block the artery or break off and trundle through the artery until they reach a narrow point, where they lodge and cause either a heart attack or stroke.

This is one of the mechanisms that statins are effective at dealing with. To prevent over formation of blood clots following a heart attack or stroke, anti-clotting medication is prescribed, eg aspirin, warfarin, ACE inhibitors and statins. But in a situation where LDL cholesterol and saturated fat are reckoned to cause heart attacks, many doctors call for everybody over 50 to be taking a statin for its cholesterol lowering abilities.  The trouble is that cholesterol is not the cause of the problem.

Incidentally, it is also the anti-clotting ability of alcohol that gives one of the health benefits of moderate drinking.

To reiterate, arteries are not physically clogged up by eating lard – they are clogged up by scabs on damaged arterial walls 2 .  Returning to the assumed fact that eating saturated fat pushes up cholesterol levels, even Ancel Keys, father of the low fat myth, said:

There’s no connection whatsoever between cholesterol in food and cholesterol in blood.  And we’ve known that all along.  Cholesterol in the diet doesn’t matter at all unless you happen to  be a chicken or a rabbit.  Ancel Keys, PhD, Professor Emeritus at University of Minnesota, 1997.3

So what is the basis for this myth? Well, the reason Dr Keys referred to rabbits is due to the amusing beginning of research linking saturated fat to heart attacks.  An 18th Century  Russian researcher, Dr Nikolai Anitschkov, fed rabbits a high cholesterol diet – full of the dreaded animal fats. And indeed their arteries did thicken and fill with cholesterol, and so the myth that saturated fats lead to increased cholesterol levels was given life.  Of course, it is another well known fact that bunny rabbits are not lard eaters –  it wasn’t Mr McGregor’s lardy thighs that Peter Rabbit was after – but Mr McGregor’s lettuces.  In fact, what Dr Nikolai Anitschkov proved is that eating a diet that is very wrong for us raises our cholesterol levels.  There is no doubt that this would happen, as one of the many good things cholesterol does for us is lower inflammation in the body, and raised levels indicates there is serious inflammation going on somewhere.  If we eat a diet full of transfats, rancid fat, highly processed and refined foods, this is highly unnatural for us and ultimately makes us ill.  But to blame raised cholesterol is like seeing many fire engines driving past.  The next day huge devastation is found some miles from where we live – so therefore the fire engines, making all that dee dah noise, must have caused all that damage.  So excessive chip consumption will not do our arteries any good at all.  However there is another culprit, and that will be explored in another blog: stress.

 

  1. A theory of why HDL cholesterol is good is that somehow HDL cholesterol is supposed to burrow through into the plaque that forms, extract the LDL cholesterol, burrow back out of the plaque and take the scab to the liver for disposal. []
  2. What causes the damage to these walls is the subject of another blog []
  3. Ancel Keys,  “Letter-Normal Plasma Cholesterol-Heart disease Theory Is Wrong,”  New England Journal of Medicine 325 (1991): 584 []

15 Responses to “If saturated fat does not clog up arteries, what does? Cholesterol 5.”

  1. Ellie 2013-04-17

    Read about the Linus Pauling Therapy. We need L-lysine and ascorbic acid to help the lysine to form collagen which will repair the arterial walls. Lysine acts like teflon, and the cholesterol doesn’t stick. Why don’t doctors become more knowledgeable about nutrition?

    Reply
    • Clare Harding 2013-04-17

      Indeed. It fills me with despair that doctors start with pharmaceuticals instead of good quality supplementation. Linus Pauling was a terrific man who made many discoveries, including the importance of Vitamin C. His ideas are hardly new any more. But still they push statins over basic things like lysine and Vitamin C. Statins over high quality fish oils. Anti-depressants instead of vitamin D3 or an amino acid chelated magnesium to help deepen sleep. The world is a whole lot better after a decent night’s sleep, after all – and we will also be healthier. There are so many basic minerals and vitamins that help us become much healthier and happier. But these do nothing for the pharmaceutical bank account, of course.

      Reply
  2. Jen 2016-01-20

    Can you comment on this article? It’s from 2015 and it talks about 12 studies that prove saturated fat is a health hazard. I am concerned because I need to adjust my diet, (I am pre-diabetic and I have high cholesterol )and I don’t know what to do. I keep reading various articles on what is healthy and other articles that contradict those articles. Carbs, no carbs, plant diet, fat and protein diet, eat oatmeal, don’t eat oatmeal… It’s mind boggling. Here is the link, if you can comment Id appreciate that. http://www.pcrm.org/nbBlog/index.php/these-12-studies-show-saturated-fat-is-not-just-a-heart-hazard

    Reply
    • Clare Harding 2016-01-21

      Well, Jen, I completely agree that dietary advice is contradictory and confusing. And fat has been in the naughty corner for about 60 years now, ever since Ancel Keys published his decidedly shonky study on saturated fats and cholesterol. I hope you have read ‘The Great Cholesterol Con’ by Dr Malcolm Kendrick. You could also google scholar high protein diets – there are multiple studies on high protein v low fat diets and so on and draw your own conclusions.
      Yes, the link shows multiple studies apparently slamming saturated fats. What is interesting is that we should really be eating wild meats – rabbits, venison, grouse and so on. Wild meats are naturally low in fat. To make a tasty rabbit stew, for example, we need to add an astonishing amount of olive oil. So are we designed to eat a low fat diet????? (I don’t know).
      There is another issue with fat: it is very common for people to find it hard to digest; basically their gallbladder is not up to the job. If we eat something we don’t digest well, it does us no good at all. If this is the case, I recommend finding a digestive aid to help fat digestion, but do be careful of how much fat is eaten, no matter what type.
      Another fat complication: when cooking at temperature, saturated fat is much healthier than polyunsaturated fat. Polyunsaturated fats, like sunflower oil, are not very stable. They need to be cold pressed, kept out of sunlight and not heated or they change structure and become transfats.
      So what to do?? Experiment. Bluntly, the most successful long term diets/way of eating is high protein with plenty of low carb vegetables. How much fat is up to the individual. If you eat well, you will feel better. Now when we change diet dramatically, we usually feel much better. People going vegetarian or vegan often feel much better at first and that will be because they had a hard time digesting meat, so their guts feel much more comfortable without that load. But as time goes on there is a slow deterioration since the brain needs nutrients only found in meat/birds/fish and the diet causes high insulin, which is not so bad if you handle insulin well. The people who can do that are easily slim; those that don’t handle insulin well get well fat. Therefore we need to be able to digest animal proteins. And this starts with chewing your food exceedingly well. And the other key to learning how to eat well is variety, variety, variety. At each meal, not just at dinner. Finally ask yourself what your grandmother ate – low fat yoghurts?? Cheese strings? Pizza?? And as a guidance, eat what she would recognise and cook it yourself. Hope this helps.

      Reply
        • Clare Harding 2016-12-16

          It is true that meat is hard to digest. But we should be able to digest it and difficulties digesting it is one of the many signs the body gives us to show that all is not well. Level 1 – chew all food extremely well indeed; it should be a paste before we swallow it. This saves the stomach bashing it about to try to break it down into tiddly bits. If there is no history of stomach ulcers, you can try HCl with pepsin. The stomach should produce this acid to break down proteins. It is very common that HCl production is not up to snuff, so taking HCl supplementation will help considerably.

          Reply
  3. Michael Foerster 2016-11-8

    Fascinating information!
    I got a stent 4 years ago with one of my arteries 100% clogged at age 52 – despite running ~ 10 miles per week. Since then I am obsessed with learning about nutrition & the impact on the body; Gary Taubes “Good Calories, Bad Calories” opened a completely new view. Sadly to say that my cardiologist(s) (wanted a second opinion) & family physician only look at the total Cholesterol level and comment with the same stereotype advises. Now, since my wife & I are avoiding carbs as much as possible – except alcohol – we dropped 30 lbs and kept it since 4 years.

    Reply
    • Clare Harding 2016-11-8

      Ah, Michael. Medical history shows that doctors are very slow to change! Which makes it a brave step to walk away from their standard advice – yet it seems you and your wife are doing very much better. To lose 30 lbs and then keep it off is something to be very proud of – I really mean that. Gary Taubes is a very interesting journalist who has made this low fat madness a mission to debunk. And things are slowly changing now – but so slowly! Good to hear from you.

      Reply
      • Jeff 2017-03-6

        It’s not that doctors are slow to change, it’s that they won’t nor cannot change. You don’t think that a doctor in his/her own private life doesn’t know or implement the types of things this article speaks of? The medical field is a money making racket combined with malpractice lawsuit avoidance. They only treat symptoms according to the medical guidelines established by that industry which of course has heavy influence from big pharma. Doctors don’t tell you much of anything in the way of lifestyle changes that can correct a health issue. That would take too much of their time and they see time as money. Plus malpractice fears come into play, so they need to follow the established medical guidelines of simply writing a prescription for a statin. Tell the doc you’ve been feeling sad lately, they’ll write you a prozac prescription. The big corporate execs that sit on boards of pharma companies, also sit on medical boards that establish industry practices. It doesn’t make pharma big money if a doctor examined a blood profile and then created a diet specifically tailored to your needs. Of course not. He just prescribes a drug. If you don’t take the drug, then the doctor just sees that as your problem and you cannot sue for malpractice. If you do take the drug, big pharma makes money.

        Reply
        • Clare Harding 2017-03-6

          As they say, follow the money: Kerching! Of course, a problem is that double blind trial testing with a high number of subjects is extremely expensive, and only big pharma can afford to do this. Doctors will only pay attention to double blind tests with a high number of subjects. Small experiments are treated with either disregard or great caution. It is a big mess – and what makes it really sad is that people still have great faith in what their doctor says, which, as you rightly point out, is based on fear of prosecution and the short, easy, tick box route. All the rest of us can do is keep pedalling hard to try to make people think for themselves a bit more. Thank you for your comment.

          Reply
  4. Arnaldo 2016-11-28

    That was a very informative reading, miss Harding. Thank you for all the work put into it…

    I’m looking for foods or supplements that can actually start “unclogging” my arteries… Is there such a thing?

    Reply
    • Clare Harding 2016-11-29

      Good question, Arnaldo. The easiest answer is keep sugar intake low, including fruit. And, as much as possible, cook everything yourself, so avoiding processed food. The exact balance of proteins/fats and carbs is very individual, nevertheless, every meal should contain some high quality protein. The human body does best with proper food, and not weird stuff like cheese strings or cakes that stay fresh for months. That and some exercise that suits you should bring cholesterol levels down, unless you have inherited high cholesterol, of course. Even so, eating and living generally as healthily as possible will help.

      Reply
      • Arnaldo 2016-11-30

        So I don’t know what’s going wrong with me… :/

        1) I don’t eat much sugar, as I don’t like the taste of anything sweet. That includes fruits. I have been know for drinking unsweetened coffee even as a kid, which I believe is rare…

        2) In my country raw, unprocessed food is very cheap, while processed food is very expensive. I buy everything raw myself, and I am the one cooking for my family… I believe it’s a reasonably balanced food in terms of nutrition, with lots of vegetables, a good quantity of meat and also a source of carbohydrates whose biggest part goes to the kids, because they need such high energy… :/

        And still I just had an unexpected heart attack, at the age of 39. Almost died, and my cardiologist said that there is arteriosclerosis everywhere in my arteries, and he believes I will have the need to make several coronary artery bypass surgeries in the near future… I don’t smoke or drink alcohol, never had blood pressure problems, no one in my family has health problems related to the circulatory system… I’m overweight by 16 Kg, but I’m so tall and strong that even so don’t think much people would say I’m fat…

        Before the infarction my cholesterol level was as low as 132, and now, with Lipitor, it is of just 88…

        Of course it could be some genetically particularity, but something in my mind keeps pushing me back to the diet, and I feel strongly like it’s trying to tell me I have overlooked something important there! But I don’t know what the problem could be… I know it may sound like madness, but those are the feelings I have and can’t explain:

        a) whenever I’m going to eat Italian pasta (that’s rarely) I feel dizzy and feel some pain in my chest… It’s like if my body rejects it…
        b) also I feel a strong need to ingest anything with ascorbic acid, be it a salad with lemon juice or even just by looking at an effervescent vitamin C pill…It’s like I needed those in high quantities…
        c) I feel very strong urges to drink alcohol, but only wine or beer. That’s strange indeed, because as I said I don’t drink alcohol… And everyone who knows me well knows that I hate the taste of beer, in particular… :/

        I’m still trying to make some sense of all that strange feelings and sensations…

        Reply
  5. Eliot 2016-12-28

    Hi. I was looking for that Ancel Keys quote and found it here first. I wanted to read the Duke Health article but the link is bad. Do you have a new link or the title of the article? It sounds quite similar to the theory of “What Causes Heart Disease” that Dr Kendrick is currently posting on his blog.

    Thanks.

    Reply

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