"Recovered" unpublished data reveals that lowering cholesterol levels increase the risk of death by 22%

This study was published in the BMJ 2016 Apr 12;353:i1246

Study title and authors:
Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73).

Ramsden CE, Zamora D, Majchrzak-Hong S, Faurot KR, Broste SK, Frantz RP, Davis JM, Ringel A, Suchindran CM, Hibbeln JR.
USA Department of Physical Medicine and Rehabilitation, Program on Integrative Medicine, University of North Carolina, Chapel Hill, NC, USA Chris.Ramsden@nih.gov.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/27071971

The objective of this study was to review the findings (by analysing unpublished "recovered" data from the original study investigators) of the Minnesota Coronary Experiment. The Minnesota Coronary Experiment was a double blinded, parallel group, randomized controlled dietary intervention trial conducted between 1968 - 1973, and was to designed to prove that increasing the polyunsaturated fat, (linoleic acid), and decreasing saturated fat in the diet would reduce cardiovascular events and deaths. It was the largest (9,570 participants, aged 20-97 years) and perhaps the most rigorously executed dietary trial of cholesterol lowering by replacement of saturated fat with vegetable oil rich in linoleic acid.

In the study participants were recruited from mental hospitals or nursing homes in the Minnesota area. They were divided into two groups:
(1) The intervention diet group had their dietary saturated fat cut in half (from 18.5% to 9.2% of calories) and their polyunsaturated linoleic fat intake massively increased from 3.4% to 13.2% of calories (a 280% increase).
(2) The control diet group did not change their saturated fat intake but did increase polyunsaturated linoleic acid intake from 3.4% to 4.7% of calories.

The "recovered" data, included previously unpublished records of serum cholesterol and autopsy reports and an extensive collection of study documents.

Using the "recovered" data the study found:
(i) The intervention group had significant reduction in cholesterol levels of 13.8%.
(ii) The control group had a small reduction in cholesterol levels of 1%.
(iii) A 30 mg/dL (0.78 mmol/L) decrease in cholesterol levels was associated with 22% higher risk of death from any cause.
(iv) Autopsy reports showed that participants in the intervention diet group had a 90% increased risk of a heart attack compared to participants in the control diet group. 

The researchers also did a systematic review of the scientific literature and identified five randomized controlled trials that provided vegetable oil(s) rich in linoleic acid in place of saturated fat. These five trials included 10,808 participants. The average change in cholesterol levels in the course of the randomized controlled trials ranged from 7.8% to 13.8% lower in the intervention versus control groups.

The review of the five trials found:
(v) Those in the (low cholesterol) intervention groups had a 13% increased risk of death from coronary heart disease compared to those in the higher cholesterol control groups.
(vi) Those in the (low cholesterol) intervention groups had a 7% increased risk of death from all causes compared to those in the higher cholesterol control groups. 

The above investigators also "recovered" unpublished data from the Sydney Diet Heart Study (1966-73) where the results of the trial was not fully reported. Ramsden commented: "Our recovery and 2013 publication of previously unpublished data from the Sydney Diet Heart Study (SDHS, 1966-73) belatedly showed that replacement of saturated fat with vegetable oil rich in linoleic acid significantly increased the risks of death from coronary heart disease and all causes, despite lowering serum cholesterol."

Critical points arise from this study:
(1) Key findings from landmark randomized controlled trials including the Sydney Diet Heart Study and the Minnesota Coronary Experiment were not fully published.
(2) Participants who had greater reductions in cholesterol levels had a higher, rather than lower, risk of death.

The question must be asked: "Why did the original investigators suppress this information?"

Is it because the results of the studies were clearly at odds with their beliefs?

Ramsden concluded: "It is interesting to speculate whether complete publication of randomized controlled trial results might have altered key policy decisions promoting replacement of saturated fat with linoleic acid rich oils (such as the 1977 McGovern report and National Cholesterol Education Program (1984-85) or contributed to a shift in research priorities."
  

Low cholesterol levels associated with increased cardiovascular deaths

This study was published in the Journal of Korean Medical Science 2012 Jan;27(1):58-63

Study title and authors:
Low cholesterol is associated with mortality from cardiovascular diseases: a dynamic cohort study in Korean adults.

Bae JM, Yang YJ, Li ZM, Ahn YO.
Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22219615

This study was conducted to evaluate the association of  cholesterol levels with cardiovascular diseases deaths. The study included 12,740 adults aged 40 to 69 years who were followed for 15 years.

The study found:
(a) Those with high density lipoprotein (HDL) cholesterol levels below 41 mg/dL (1.06 mmol/L) had an 139% increased risk of death from cardiovascular diseases compared to those with high density lipoprotein levels (HDL) cholesterol above 59 mg/dL (1.52 mmol/L).
(b) Those with cholesterol levels below 160 mg/dL (4.13 mmol/L) had a 69% increased risk of death from cardiovascular diseases compared to those with cholesterol between 200-240 mg/dL (5.17-6.2 mmol/L).

Bae concludes: "Based on the results of this study, caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk".

Links to other studies:
Low cholesterol increases the risk of death by 75% after a heart attack
Low levels of low density Lipoprotein (LDL) cholesterol are associated with higher death rates in patients with acute heart failure
Low cholesterol levels are associated with higher death rates



Lower cholesterol levels associated with an 89% increased risk of coronary heart disease death rates in women

This study was published in PLoS One 2014 Dec 5;9(12):e114283

Study title and authors:
Health factors and risk of all-cause, cardiovascular, and coronary heart disease mortality: findings from the MONICA and HAPIEE studies in Lithuania.

Tamosiunas A, Luksiene D, Baceviciene M, Bernotiene G, Radisauskas R, Malinauskiene V, Kranciukaite-Butylkiniene D, Virviciute D, Peasey A, Bobak M.
Institute of Cardiology, Academy of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25479610

This study investigated the association of various health factors with all-cause and cardiovascular death rates. Data was collected over 25 years on 9,209 men and women aged 45-64.

Regarding cholesterol levels the study found:
(a) Men with cholesterol levels less than 5.2 mmol/L (201 mg/dL) had a 29% higher death rate than men with cholesterol levels more than 6.2 mmol/L (240 mg/dL).
(b) Women with cholesterol levels less than 5.2 mmol/L (201 mg/dL) had a 4% higher death rate than women with cholesterol levels more than 6.2 mmol/L (240 mg/dL).
(c) Men with cholesterol levels less than 5.2 mmol/L (201 mg/dL) had a 15% higher cardiovascular disease death rate than men with cholesterol levels more than 6.2 mmol/L (240 mg/dL).
(d) Women with cholesterol levels less than 5.2 mmol/L (201 mg/dL) had a 52% higher cardiovascular disease death rate than women with cholesterol levels more than 6.2 mmol/L (240 mg/dL).
(e) Men with cholesterol levels less than 5.2 mmol/L (201 mg/dL) had a 19% higher coronary heart disease death rate than men with cholesterol levels more than 6.2 mmol/L (240 mg/dL).
(f) Women with cholesterol levels less than 5.2 mmol/L (201 mg/dL) had a 89% higher coronary heart disease death rate than women with cholesterol levels more than 6.2 mmol/L (240 mg/dL).

Tamosiunas concluded: "We found that total cholesterol concentrations of less than 5.2 mmol/L (201 mg/dL) were associated with increased higher risk of mortality."

Low levels of LDL cholesterol associated with a 65% increased risk of death in heart attack patients

This study was published in Critical Care Medicine 2015 Jun;43(6):1255-64

Study title and authors:
Lipid paradox in acute myocardial infarction-the association with 30-day in-hospital mortality.

Cheng KH, Chu CS, Lin TH, Lee KT, Sheu SH, Lai WT.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/25738856

The Killip classification (four classes - I to IV) is a system used in individuals with a heart attack. Individuals with a low Killip class are less likely to die within the first 30 days after their heart attack than individuals with a high Killip class.

This study was designed to clarify the relationship between cholesterol levels, Killip classification, and 30-day mortality in patients with a heart attack. The study included 724 heart attack patients.

The study found:
(a) Low-density lipoprotein (LDL) cholesterol and triglyceride levels were significantly lower in high-Killip (III + IV) patients compared with low-Killip (I + II) patients.
(b) Patients with low-density lipoprotein (LDL) cholesterol less than 62.5 mg/dL (1.6 mmol/L) had a 65% increased risk of death compared with patients with patients with low-density lipoprotein (LDL) cholesterol more than 62.5 mg/dL (1.6 mmol/L).
(c) Patients with triglyceride levels less than 110 mg/dL (1.24 mmol/L) had a 405% increased risk of death compared with patients with patients with triglyceride levels more than 110 mg/dL (1.24 mmol/L).
(d) Patients with a high-Killip classification and with with triglycerides less than 62.5 mg/dL (1.6 mmol/L) and low-density lipoprotein (LDL) cholesterol less than 110 mg/dL (1.24 mmol/L) had a 10.9-fold higher risk of death than patients with a low-Killip classification with triglycerides greater than 62.5 mg/dL (1.6 mmol/L) and low-density lipoprotein (LDL) cholesterol greater than 110 mg/dL (1.24 mmol/L).

Cheng concluded: "Low low-density lipoprotein (LDL) cholesterol, low triglycerides, and high Killip severity were associated with significantly higher 30-day in-hospital mortality in patients presenting with acute myocardial infarction".

The Academy of Nutrition and Dietetics say that cholesterol and saturated fat do not cause heart disease

The 2015 Dietary Guidelines Advisory Committee (DGAC) recently released the new draft dietary guidelines for Americans.

A press release from the Academy of Nutrition and Dietetics commented on the draft guidelines. The release contained the following:

(a) The Academy supports the DGAC in its decision to drop dietary cholesterol from the nutrients of concern list and recommends it deemphasize saturated fat from nutrients of concern, given the lack of evidence connecting it with cardiovascular disease.
(b) Low sodium intake levels recommended by the DGAC are actually associated with increased mortality for healthy individuals.
(c) The evidence is strongest that a reduction in the intake of added sugars will improve the health of the American public.

I'm glad the Academy of Nutrition and Dietetics are at last coming around to my way of thinking.



Doctors say cholesterol and saturated fat do not cause heart disease and statins do not save lives

Please watch the two videos, each last about 30 minutes.

In the first video Dr Maryanne Demasi follows the road which led us to believe that saturated fat and cholesterol cause heart disease, and reveal why it's been touted as the biggest myth in medical history.



The second video reveals the dangers of statin drugs.



The take home messages from the videos:

(i)Don't worry about cholesterol and saturated fat - they do NOT cause heart disease.
(ii)Taking statins will not add a day to your life and they expose you to many debilitating side-effects.

For the last four or five decades we have been misled about the causes of heart disease.

Please tweet or put this post on facebook to help the following message go viral.

Cholesterol and saturated fat do NOT cause heart disease - Statins do NOT save lives and have many detrimental side-effects.

People with the lowest cholesterol levels have the highest rate of death from coronary heart disease

This study was published in the Annals of Internal Medicine 1997 May 15;126(10):753-60

 

Study title and authors:

Clarifying the direct relation between total cholesterol levels and death from coronary heart disease in older persons.

Corti MC, Guralnik JM, Salive ME, Harris T, Ferrucci L, Glynn RJ, Havlik RJ.

National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20892-9205, USA.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/9148647

This study investigated the association of cholesterol levels and the risk of death from heart disease. The study included 4,066 men and women who were followed for five years.

The study found:
(a) Those with the lowest cholesterol levels (less than 4.15 mmol/L [160 mg/dL]) had the highest rate of death from coronary heart disease.
(b) Those with the highest cholesterol levels (more than 6.20 mmol/L [240 mg/dL]) had the lowest rate of death from coronary heart disease. 

Low-fat, low-cholesterol diets increase the risk of heart disease

This study was published in the Journal of Clinical Investigation 1990 Jan;85(1):144-51

 

Study title and authors:

A low-fat diet decreases high density lipoprotein (HDL) cholesterol levels by decreasing HDL apolipoprotein transport rates.

Brinton EA, Eisenberg S, Breslow JL.

Laboratory of Biochemical Genetics and Metabolism, Rockefeller University, New York, New York 10021.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/2104877

Scientific evidence suggests that high levels of high density lipoprotein (HDL) cholesterol and apolipoproteins A-I may offer protection from heart disease, see here, here and here. Other studies reveal that high triglyceride levels are associated with heart disease see here and here.

This study compared the effects of a high-fat diet and a low-fat diet on heart disease risk factors. The study included 13 subjects who were kept on either a high-fat or low-fat diet for four weeks each.

The fat and cholesterol content of the diets comprised of:
(i) 41.9% fat of which 23.6% was saturated fat + 215 mg of cholesterol per 100 calories (high-fat diet).
(ii) 8.6% fat of which 2.1% was saturated fat + 40 mg of cholesterol per 100 calories (low-fat diet).

The study found:
(a) Those on the low-fat diet had 29% lower levels of high density lipoprotein (HDL) cholesterol compared to those on the high-fat diet.
(b) Those on the low-fat diet had 23% lower levels of apolipoproteins A-I compared to those on the high-fat diet.
(c) Those on the low-fat diet had 32% higher levels of triglycerides compared to those on the high-fat diet.

The results from this study reveal that a low-fat, low-cholesterol diet increases the risk factors associated with heart disease compared to a high-fat, high-cholesterol diet.

High cholesterol levels predict higher survival rates in patients with acute coronary syndromes

This study was published in Clinical Cardiology 2009 Sep;32(9):E22-8

 

Study title and authors:

Hypercholesterolemia paradox in relation to mortality in acute coronary syndrome.

Wang TY, Newby LK, Chen AY, Mulgund J, Roe MT, Sonel AF, Bhatt DL, DeLong ER, Ohman EM, Gibler WB, Peterson ED.

Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27705, USA. wang0085@mc.duke.edu

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/19645040

This study (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines registry - CRUSADE) investigated the association of cholesterol levels with in-hospital death rates in patients with acute coronary syndromes. (Acute coronary syndromes is an umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked). The study included 84,429 patients with acute coronary syndromes and examined data regarding patients with (i) a history of existing high cholesterol and (ii) newly in-hospital diagnosed high cholesterol.

Patients were defined as the following:
(i) A history of existing high cholesterol was defined as more than 200 mg/dL (5.2 mmol/L) or treatment with cholesterol lowering drugs.
(ii) Newly in-hospital diagnosed high cholesterol was defined as low density lipoprotein (LDL) cholesterol levels more than 100 mg/dL (2.6 mmol/L).

The study found:
(a) Patients with a history of existing high cholesterol had a 29% reduced death death rate compared to patients with a history of existing low cholesterol.
(b) Patients with no history of existing high cholesterol, but with newly in-hospital diagnosed high LDL cholesterol had a 14% reduced death death rate compared to patients with normal LDL cholesterol.

The data from the study reveals that high cholesterol levels predict higher survival rates in patients with acute coronary syndromes.

Links to other studies:
Higher cholesterol levels predict survival in heart transplant patients
The cholesterol/heart disease hypothesis is false
Doctor says: The Diet/Heart Hypothesis is the greatest deception of our times

Higher cholesterol levels predict survival in heart transplant patients

This study was published in Cardiology 1998 Mar;89(3):184-8

 

Study title and authors:

Low serum cholesterol levels predict high perioperative mortality in patients supported by a left-ventricular assist system.

Richartz BM, Radovancevic B, Frazier OH, Vaughn WK, Taegtmeyer H.

St. Luke's Episcopal Hospital, Texas Heart Institute, and Department of Internal Medicine, University of Texas-Houston Medical School, 77030, USA.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/9570432

The study investigated the association of cholesterol levels with survival rates in 45 heart transplant patients.

The study found that cholesterol levels were 62.5% higher in heart transplant patients that survived compared to those that died.

Low consumption of animal protein, fat, saturated fat, cholesterol and red meat is associated with higher rates of heart disease

This study was published in the American Journal of Clinical Nutrition 1999 Aug;70(2):221-7

 

Study title and authors:

Dietary protein and risk of ischemic heart disease in women.

Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Speizer FE, Hennekens CH, Willett WC.

Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA. frank.hu@channing.harvard.edu

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/10426698

The study examined the association between dietary protein intake and incidence of heart disease. The study included 80,082 women, aged 34-59 years, who were without a previous diagnosis of heart disease, stroke, cancer, hypercholesterolemia, or diabetes.

The study found:

(a) Women who consumed the most protein had a 26% reduced rate of heart disease compared to the women who consumed the least protein.

(a:i) Women who consumed the most protein also ate 7.8% more fat than women who consumed the least protein.

(a:ii) Women who consumed the most protein also ate 12.8% more saturated fat than women who consumed the least protein.

(a:iii) Women who consumed the most protein also ate 64.0% more cholesterol than women who consumed the least protein.

(a:iv) Women who consumed the most protein also ate 16.1% more red meat than women who consumed the least protein.

(a:v) Women who consumed the most protein also ate 32.1% less carbohydrate than women who consumed the least protein.

(b) Women who consumed the most animal protein had a 16% reduced rate of heart disease compared to the women who consumed the least animal protein.

The data from the study shows that low consumption of protein, fat, saturated fat, cholesterol and red meat is associated with higher rates of heart disease in women.

 



Men taking gemfibrozil have a 117% increase in cardiac deaths

This study was published in the Annals of Medicine 1993 Feb;25(1):41-5

Study title and authors:

Efficacy of gemfibrozil in dyslipidaemic subjects with suspected heart disease. An ancillary study in the Helsinki Heart Study frame population.

Frick MH, Heinonen OP, Huttunen JK, Koskinen P, Mänttäri M, Manninen V.

First Department of Medicine, Helsinki University Central Hospital, Finland.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8435186

The study examined the effects of gemfibrozil (a cholesterol lowering drug) on death rates in male patients who had symptoms and signs of possible coronary heart disease. The study included 626 patients, average age 49, who were followed for five years.

The men were given either:
(i) 600 mg gemfibrozil twice daily.
(ii) Placebo.

The study found:
(a) The men taking gemfibrozil lowered their cholesterol levels by 8.5%.
(b) The men taking gemfibrozil had 61% more deaths than the men taking a placebo.
(c) The men taking gemfibrozil had 117% more cardiac deaths than the men taking a placebo.

The results of the study show that taking the cholesterol lowering drug gemfibrozil results in lower cholesterol levels and higher cardiac death rates and higher total death rates.  

Low cholesterol levels are associated with lung disease

This study was published in Circulation 2003 Mar 25;107(11):1514-9

Study title and authors:

Why are patients with chronic obstructive pulmonary disease at increased risk of cardiovascular diseases? The potential role of systemic inflammation in chronic obstructive pulmonary disease.

Sin DD, Man SF.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12654609

This study analysed the association of cholesterol levels with the severity of airflow obstruction in people with chronic obstructive pulmonary (lung) disease. The study included 6,629 people aged 50 or over.

Sin notes that air flow obstructions elevate the risk of ischemic heart diseases, strokes, and sudden cardiac deaths 2- to 3-fold.

The study found:
(a) People with no air flow obstruction had the highest cholesterol.
(b) People with the most severe air flow obstruction had the lowest cholesterol.

The results of the study show that low cholesterol is associated with a higher severity of chronic obstructive pulmonary disease which leads to a  2- to 3-fold increased risk of ischemic heart disease, stroke, and sudden cardiac death.

Higher cholesterol levels and higher meat consumption are associated with decreased rates of heart disease deaths

This study was published in the Journal of Internal Medicine 1995 Jan;237(1):49-54

 

Study title and authors:

High serum alpha-tocopherol, albumin, selenium and cholesterol, and low mortality from coronary heart disease in northern Finland.

Luoma PV, Näyhä S, Sikkilä K, Hassi J.

Oulu Regional Institute of Occupational Health, University of Oulu, Finland.

 

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/7830030

The study investigated the risk factors for, and the rates of heart disease deaths in northernmost Finland compared with southern areas of Finland. The study lasted for nine years and included 350 participants, average age 46 years.

The study found:
(a) The death rates from heart disease were 17% lower in northernmost Finland compared with southern areas of Finland.
(b) Cholesterol levels were 6.3% higher in northernmost Finland compared with southern areas of Finland.
(c) Low density lipoprotein (LDL) cholesterol levels were 7.0%  higher in northernmost Finland compared with southern areas of Finland.
(d) Vitamin E levels were 14.2% higher in northernmost Finland compared with southern areas of Finland.
(e) Vitamin E levels increased with the consumption of reindeer meat.

The results of the study show that higher cholesterol levels and higher meat consumption are associated with decreased rates of heart disease deaths.

Low HDL cholesterol levels are associated with increases in deaths from heart disease and cancer

This study was published in Arteriosclerosis 1988 Nov-Dec;8(6):737-41

Study title and authors:

High density lipoprotein cholesterol and mortality. The Framingham Heart Study.

Wilson PW, Abbott RD, Castelli WP.

Framingham Epidemiology Research Section, NHLBI, Massachusetts.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/3196218

This 12 year study examined the association of high density lipoprotein (HDL) cholesterol levels with death rates from heart disease and cancer. The study included 2,748 participants aged 50 to 79.

The study found:
(a) Both men and women with the highest HDL cholesterol levels also had the highest total cholesterol levels.
(b) Men with the lowest HDL cholesterol levels had a 92% increase in death rates compared to the men with the highest HDL cholesterol levels.
(c) Women with the lowest HDL cholesterol levels had a 47% increase in death rates compared to the women with the highest HDL cholesterol levels.
(d) Men with the lowest HDL cholesterol levels had a 309% increase in heart disease death rates compared to the men with the highest HDL cholesterol levels.
(e) Women with the lowest HDL cholesterol levels had a 207% increase in heart disease death rates compared to the women with the highest HDL cholesterol levels.
(f) Men with the lowest HDL cholesterol levels had a 17% increase in cancer death rates compared to the men with the highest HDL cholesterol levels.
(g) Women with the lowest HDL cholesterol levels had an 8% increase in cancer death rates compared to the women with the highest HDL cholesterol levels.

The results of this study show that men and women with the lowest HDL cholesterol levels also had the lowest total cholesterol levels, and that low HDL cholesterol levels are associated with increases in deaths from heart disease and cancer.

Eating a diet rich in saturated fat is the best way to raise HDL cholesterol levels. See here.

The metabolic syndrome may be caused by a high fructose, and relatively low fat, low cholesterol diet

This paper was published in the Archives of Medical Science 2011 Feb;7(1):8-20

Study title and authors:
Is the metabolic syndrome caused by a high fructose, and relatively low fat, low cholesterol diet?

Seneff S, Wainwright G, Mascitelli L.
Department of Electrical Engineering and Computer Science, MIT, Cambridge, MA, USA.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22291727

The metabolic syndrome is a term that has been used to describe a number of risk factors such as elevated triglyceride levels, small sized dense low density lipoprotein (LDL) cholesterol particles, low levels of high-density lipoprotein (HDL) cholesterol, obesity, insulin resistance, glucose intolerance and elevated blood pressure, and it is associated with an increased risk of type II diabetes and coronary heart disease.

The authors have developed a new hypothesis regarding metabolic syndrome; namely it is a consequence of a high intake in carbohydrates and food with a high glycemic index, particularly fructose, and relatively low intake of cholesterol and saturated fat.

The authors show how the risk factors for metabolic syndrome may be exacerbated by the above way of eating:
(a) Elevated triglyceride levels: Studies show that higher levels of dietary fructose lead to increased triglyceride levels and that zero-cholesterol diets have been shown to increase triglyceride levels.
(b) Small sized low density lipoprotein (LDL) cholesterol particles: The liver normally clears the dangerous small sized dense low density lipoprotein (LDL) cholesterol. However in conditions of excess dietary fructose (fructose is converted to fat by the liver) the liver is overwhelmed and cannot keep up in clearing all the dangerous small sized dense low density lipoprotein (LDL) cholesterol.
(c) Low levels of high-density lipoprotein (HDL) cholesterol: The scientific literature shows that low levels of high-density lipoprotein (HDL) cholesterol is the best predictor of heart disease and is associated with an increased risk of type II diabetes. This may be because that low concentrations of bile salts correspond to a reduction of HDL levels and that low-fat, high fructose diets lead to reduced bile salts because of the reduced need for the bile salts to digest fats.
(d) Obesity: Studies reveal that the obese are often deficient in vitamin D. The best sources of vitamin D are foods rich in saturated fat such as lard, butter and egg yolk.
(e) Insulin resistance: Scientific papers reveal that the overconsumption of fructose leads to liver insulin resistance.
(f) Glucose intolerance: In high carbohydrate, low fat diets, glucose and fructose enter the bloodstream very rapidly due to the abundance of carbohydrates and the lack of buffering in the gut by dietary fats. This causes a sharp rise in blood glucose levels and the excessive glucose and fructose may damage proteins.
(g) Blood pressure: Depleted amounts of cholesterol in the outer shells of fat cells weaken the structure of the cell walls and leads to sodium leakage, which results in excess sodium in the bloostream. This causes the blood vessels to constrict with the resulting increase in blood pressure.

The findings of this paper suggest the metabolic syndrome may be caused by a high fructose, and relatively low fat, low cholesterol diet.

Seneff concludes: "We would urge medical practitioners to encourage individuals exhibiting metabolic syndrome to strongly limit the consumption of dietary fructose and other high-glycemic-index carbohydrates, and to stop discouraging them from consuming foods rich in cholesterol."

Links to other studies:
High dietary intake of fructose leads to diabetes
LDL cholesterol size: does it matter?
Beneficial effects of a high fat, low carbohydrate diet on fat reduction in type 2 diabetic patients with obesity

Small LDL cholesterol size (caused by a high carbohydrate diet) is the highest risk factor for heart disease in type II diabetics

This study was published in Metabolism 2005 Feb;54(2):227-34

Study title and authors:

Low-density lipoprotein size and subclasses are markers of clinically apparent and non-apparent atherosclerosis in type 2 diabetes.

Berneis K, Jeanneret C, Muser J, Felix B, Miserez AR.

Department of Internal Medicine and Central Laboratories, Basel University Hospital Bruderholz, Switzerland 4101. kaspar@berneis.ch

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15690318

This study investigated the significance of various risk factors in the development of heart disease in type II diabetics. The investigators measured ten different risk factors in 38 overweight type II diabetics, such as  body mass index, blood pressure, smoking, high density lipoprotein (HDL) cholesterol, and low density lipoprotein (LDL) cholesterol particle size.

Berneis found that small low density lipoprotein (LDL) cholesterol particle size was most strongly associated with the highest risk of heart disease in type II diabetics.

Small particle sizes of low density lipoprotein (LDL) cholesterol are caused by diets high in carbohydrate and low in fat see here and here.

Professor says the cholesterol hypothesis is false and should be buried

This paper was published in the Scandinavian Cardiovascual Journal 2011 Dec;45(6):322-3

Study title and author:

The cholesterol hypothesis: time for the obituary?

Scherstén T, Rosch PJ, Arfors KE, Sundberg R.

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22070401

Dr. Schersten is a professor of Vascular Surgery, University of Göteborg and was previously Principal Secretary of the Swedish Medical Research Council.

Professor Schersten finds that the cholesterol hypothesis that links cholesterol intake and blood cholesterol levels to cardiovascular disease has little or no scientific backing that is relevant for the human species.

He concludes that the hypothesis is false and should be buried.

The cholesterol/heart disease hypothesis is false

This study was published in Medical Services Journal Canada 1963 Jun;19:410-20

Study title and authors:

Serum lipid levels and the severity of coronary and cerebral atherosclerosis in adequately-nourished men, 60-69 years of age.

PATERSON JC, ARMSTRONG R, ARMSTRONG EC.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/13941824

This study measured the cholesterol levels of 42 war veterans aged 60-69 at post-mortem to investigate the relationship between cholesterol levels and blockage of the arteries.

The study found:

(a) There was NO correlation between cholesterol levels and the amount of blockage in the arteries.

(b) Those who had lower cholesterol had suffered from more previous heart attacks and blood clots than had those who had higher cholesterol.

(c) One man had a cholesterol level of only 111mg/dL (2.8 mmol/l). He had suffered a heart attack and had severe blockage of the arteries.

This study shows that the cholesterol/heart disease hypothesis is false.

As saturated fat and cholesterol increase in the diet, then rates of heart attack and death decrease

This study was published in Arteriosclerosis 1989 Jan-Feb;9(1):129-35

Study title and authors:
Test of effect of lipid lowering by diet on cardiovascular risk. The Minnesota Coronary Survey.

Frantz ID Jr, Dawson EA, Ashman PL, Gatewood LC, Bartsch GE, Kuba K, Brewer ER.
Department of Medicine, University of Minnesota, Minneapolis 55455.

This study can be accessed at: http://atvb.ahajournals.org/content/9/1/129.long

This study compared the effects of 2 diets cholesterol levels and the incidence of heart attacks, sudden deaths, and all-cause mortality. The trial included 9,057 men and women.

The diets were either:

(i) 39% fat control diet (18% saturated fat, 5% polyunsaturated fat, 16% monounsaturated fat, 446 mg dietary cholesterol per day) (High saturated fat, high cholesterol diet)

(ii) 38% fat treatment diet (9% saturated fat, 15% polyunsaturated fat, 14% monounsaturated fat, 166 mg dietary cholesterol per day) (Low saturated fat, low cholesterol diet)

The study found:

(a) Cholesterol levels remained similar on the high saturated fat, high cholesterol diet.

(b) Cholesterol levels fell by 16% on the low saturated fat, low cholesterol diet.

(c) Those on the low saturated fat, low cholesterol diet had a 5% increased risk of of heart attack and sudden death compared to those on the high saturated fat, high cholesterol diet.

(d) Those on the low saturated fat, low cholesterol diet had a 6% increase in death rates compared to those on the high saturated fat, high cholesterol diet.

This study reveals that as animal fat and animal protein increase in the diet, then rates of heart attack and death decrease.