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The Cholesterol Myths : Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease
by Uffe Ravnskov

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Paperback - 320 pages (October 1, 2000)
NewTrends Publishing, Inc.; ISBN: 0967089700

 

Amazon.com Sales Rank: 9,858

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Editorial Reviews
Ray H. Rosenman, MD--Former Director of Cardiovascular Research, SRI
Dr. Ravnskov has done a magnificent service. . . must reading for all interested persons, nutritionists and physicians.

Michael Gurr, PhD--Renowned Lipid Chemist
...he is not a lone voice in the wilderness and he deserves to be taken seriously.

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63 of 63 people found the following review helpful:

Wonderful medical history, but it needs updating., July 13, 2001
Reviewer: Matthew J. Bayan (see more about me) from Reno, NV
Dr. Ravnskov makes a convincing and compelling argument against the blind use of total cholesterol as an indicator and diagnostic for heart disease. The problem with his book is that it leaves the reader with the idea that there's no way to predict heart disease and all the signposts that have been used are not accurate. This is not true. It is unfortunate that Dr. Ravnskov didn't update his material to include the latest research on the molecular composition of cholesterol particles. Since research exists on these cholesterol particles going back as far as 1965, I find it unusual that Dr. Ravnskov is either not aware of this material or chose not to discuss it.

He is right that total cholesterol is a lousy indicator of heart disease. Many people with high cholesterol levels never get heart disease while many with what doctors consider "normal" or even low cholesterol die from heart attacks. The Framingham Study data shows that roughly 80% of people already diagnosed with heart disease have "normal" cholesterol levels. How can this be so? Obviously the standard lipid panel is a bad diagnostic.

Dr. Ravnskov failed to discuss cholesterol subclasses, and I don't mean HDL and LDL. HDL (supposedly good) cholesterol and LDL (supposedly bad) cholesterol are also not great indicators of heart disease risk. But if we look at the hundreds of sub-particles that make up HDL and LDL, we get to some interesting stuff. Many studies have been performed that show that the sizes of the various subclasses of HDL and LDL are highly predictive of heart disease risk. Large particles of LDL are far less atherogenic than the smallest particles. Larger particles of HDL are far more effective at scrubbing arteries than smaller HDL particles.

Size counts. But the standard lipid panel does not provide this information.

Also, there are other blood lipids that have been shown to be very good risk indicators of heart attack and heart disease: lipoprotein (a), homocysteine, intermediate density lipoproteins, apolipoprotein B, apolipoprotein E4, etc.

If Dr. Ravnskov does nothing else but get people to no longer trust standard lipid panels, he will have performed a great service. The standard lipid panel and total cholesterol numbers are just not effective diagnostics.

As a medical author, my own personal crusade has been to inform doctors and patients that expanded cholesterol testing that shows the particle size of HDL and LDL is the only good indicator for diagnosing heart disease risk early on. It is also highly effective in monitoring the success of treatment. Unfortunately, most doctors are still unaware of expanded cholesterol testing or consider it something exotic. But it is hardly exotic when roughly 25% of the population carries the genetic predisposition for a deadly condition called atherogenic lipid profile which causes overproduction of the deadly small particles of LDL and underproduction of the beneficial large particles of HDL.

If my cardiologist had been aware of this testing five years ago, I probably could have avoided my own near-fatal heart attack....
 

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45 of 46 people found the following review helpful:

Exposing the Cholesterol Mafia, June 12, 2001
Reviewer: Joel M. Kauffman (see more about me) from Wayne, PA United States
With courage and care Dr. Ravnskov exposes the lack of experimental evidence for the diet-heart theory, which claims that eating less fat and cholesterol will prevent atheroslcerosis (hardening of the arteries) and myocardial infarctions (heart attacks). By examining original peer-reviewed literature, the author finds no support for the diet-heart theory. He gives examples of scientific fraud among efforts to support the theory, including the deliberate selective omission of data points, and the deliberate assignment of subjects in a clinical trial to treatment or to control groups by physicians with the subject's medical records in hand. He shows how the abstract or conclusions of a number of papers are at odds with the actual data in the papers. He demonstrates how the use of one statistical method in preference to another can give a false impression that there is an effect,where there is, in fact, none. He shows how the reporting of differences in fatality rates by per cent reduction (say, a 50% reduction in relative risk) is actually misleading when the actual death rates are quite small in both the treatment and control groups of subjects in diet or drug studies. For example, a treatment that changes the absolute survival rate over a multi-year period from 99.0% to 99.5% represents a 50% reduction in relative risk, from 1% to 0.5% absolute. This is often described in papers as a 50% reduction in death rate. However, when the difference is barely significant statistically, as was often the case, Ravnskov points out that there is no real reason to recommend adoption of the treatment, especially if there are serious side-effects.

“The truth, were it known, would send pharmaceutical stocks plunging. In most studies, the increased risk is present only above a level of cholesterol that includes just a small percentage of the total population. [These are the approximately 1% of people with a genetic defect called familial hypercholesteremia.] And women can stop worrying immediately because high cholesterol is not a risk factor for the female sex. Few comments have been made on this peculiar fact in all the vast literature on cholesterol. When it is mentioned at all, it is said that female sex hormones protect against heart attacks."

“In fact, it seems more dangerous for women to have low cholesterol than high. Dr. Bernard Forette and a team of French researchers from Paris found that old women with very high cholesterol live the longest. The death rate was more than 5 times higher for women who had very low cholesterol. In their report, the French doctors warned against cholesterol lowering in elderly women. But they could as well have warned against cholesterol lowering in any woman, or, to be more precise, in anyone at all."

Dr. Ravnskov went on to show that higher levels of high-density-lipoprotein (HDL, "good" cholesterol) are not protective against CHD, and that lower levels of low-density-lipoprotein (LDL,"bad" cholesterol) are not beneficial, although the expected associations of each with CHD are present. Here again, conclusions at odds with the researchersí own data were presented. Intimations that there are “many” or “definitive” studies in reports and papers were shown to be false by showing that citations often led to other reviews, each trusting the last, and ending at very few original studies.

“High-fat foods raise blood cholesterol." Dr. Ancel Keys was one of the main proponents of this myth. In a paper published in 1958, Keys showed a graph of the per cent calories from fat in the food of various countries vs. the mean serum cholesterol levels. The data points fell on a straight line, showing an excellent correlation. Dr. Ravnskov added data points from a number of countries deliberately ignored by Dr. Keys. These fall nowhere near the line. Furthermore, CHD death rates among subjects in Finland, Greece and Yugoslavia with similar serum cholesterol levels varied 5-fold depending on which area of the country they lived in!

Four studies in the US, one in the UK, one in Israel and one in Finland failed to show any correlation between diet and serum cholesterol levels.

“Numerous studies have shown that in people who eat a normal Western diet, the effect on blood cholesterol of eating 2 or 3 extra eggs per day over a long period of time can hardly be measured..."

Ravnskov presents the results of a number of trials of statin drugs in which total death rates are slightly lower than those of the controls. In an early trial of lovastatin (EXCEL) on 8,000 subjects the absolute death rate from all causes after just 1 year was 0.5% vs. 0.2% in the placebo group.

Kilmer S. McCully, Ph. D., M. D., in technical papers and a book: “The Heart Revolution: the Extraordinary Discovery that Finally Laid the Cholesterol Myth to Rest”, Harper Perennial, 2000, wrote: “But no study anywhere has ever proven that lowering the amount of cholesterol in the diet reduces the risk of heart disease. And lowering cholesterol through drugs won’t prevent arteries from hardening if homocysteine is high.” McCully is the discoverer of the fact that the undesirable amino acid called homocysteine is an actual cause of atherosclerosis and CHD.

Based on Ravnskov’s meticulous analyses as well as the considerable support for his stance shown by others who have also studied the cholesterol data, this book is recommended without reservation. Physicians and other health professionals as well as anyone threatened with cholesterol-lowering treatments would be enlightened, and better able to resist worthless treatments. Health insurers might reconsider compensation for frequent (or any) clinical assays for cholesterol or triglycerides, let alone expensive treatments to lower cholesterol levels that reduce quality of life without prolonging it significantly.

...
53 of 54 people found the following review helpful:

A book worth reading, February 24, 2001
Reviewer: Ira Pilgrim, Retired cancer biologist (see more about me) from Laytonville, CA USA
I am 76 years old and have had a high blood cholesterol level for at least the past 25 years. A normal cholesterol is considered to be under 200 mg/dl and mine ranges from 250 to 316. My LDL (the so-called bad cholesterol) is high and my HDL (the so-called good cholesterol) is low. While I have had health problems, they do not include heart or blood vessel disease. My blood pressure is about 130/80 which is pretty good for an old man. Yet, according to what I have read, I am at high risk for heart and blood vessel disease. A number of years ago I decided to look into it. I plugged the word "cholesterol" into Yahoo, and one site that I came up with was a web site by Uffe Ravnskov called The Cholesterol Myth. It said that what I had been hearing and reading about high cholesterol being bad for you was hokum. He made a good case for the thesis that if you exclude those people who have the gene for high cholesterol and early death, that cholesterol levels are meaningless. Also, that cholesterol level is not appreciably influenced by diet. That was not enough for me; I wanted the documentation, so I started a correspondence with him. One consequence was that, several years ago, he e-mailed me a copy of the English version of his book The Cholesterol Myths which had been published in Swedish and Finnish. That book, revised, expanded and fully documented, has just been published by New Trends Publishing. Ravnskov is both a physician and researcher. His publications have been in first rate medical journals and he is highly respected by his peers, including me. His book is extremely well researched and is well documented. It is clearly written; much more clearly than many publications that I have read by people whose native language is English. Ira Pilgrim For the complete review , go to Ira Pilgrim's Home Page
 

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62 of 64 people found the following review helpful:

A Hot Book Indeed!!!, December 4, 2000
Reviewer: Stephen Byrnes (see more about me) from Honolulu, HI.
Would you buy a book that was literally set on fire by its critics on a television show about it in Finland? I would and so should you. The long-awaited English version of debunker extroidinaire Dr. Uffe Ravnskov's notorious book is now available from New Trends Publishing.

Ravnskov, a medical doctor with a PhD in Chemistry, has had over 40 papers and letters published in peer-reviewed journals criticizing what Dr. George Mann, formerly of Vanderbuilt University, once called "the greatest scam in the history of medicine": the Lipid Hypothesis of heart disease, the belief that dietary saturated fats and cholesterol clog arteries and cause atherosclerosis and heart disease.

If one thing comes through as you read the book, it is this: Ravnskov has done his homework. In painstaking detail, he critically analyzes and demolishes the nine main myths of the Lipid Hypothesis: (1) High-fat foods cause heart disease, (2) High cholesterol causes heart disease, (3) High fat foods raise blood cholesterol, (4) Cholesterol blocks arteries, (5) Animal studies prove the diet-heart idea, (6) Lowering your cholesterol will lengthen your life, (7) Polyunsaturated oils are good for you, (8) The cholesterol campaign is based on good science, and (9) All scientists support the diet-heart idea.

Equipped with a razor-sharp mind, an impressive command of the literature, and a deadly, needling sarcasm, Ravnskov methodically slaughters the most famous Sacred Cow of modern medicine and the most profitable Cash Cow for assorted pharmaceutical companies. Sparing no one, Ravnskov again and again presents the tenets of the Lipid Hypothesis and the studies which supposedly prove them, and shows how the studies are flawed or based on manipulated statistics that actually prove nothing. Ravnskov then answers the objections or rationalizations offered by diet-heart supporters, desperate to explain away inconsistencies and contradictions in their own data.

For example, Ravnskov opens with an analysis of the study that kicked off the Lipid Hypothesis in the 1950s: Ancel Keys' Six Countries Study (and later, the more famous Seven Countries Study). As most health professionals know, Keys' study showed that countries with the highest animal fat intake have the highest rates of heart disease. Keys' conclusion was that there was a cause and effect relationship because the country with the lowest animal fat intake (at that time, Japan) had the lowest rates of heart disease. Sounds convincing, right? Not so, says Dr. Ravnskov. And in a few pages the reader is informed how Keys hand-picked the countries he included in his studies, namely, the ones that supported his hypothesis, and conveniently ignored all of the other countries that didn't.

And this is just the beginning!

Ravnskov approaches true brilliance in his review of the studies that supposedly showed benefit from the current wonder-drugs pushed by the pharmaceutical industry: the statins. Hailed as miracle substances that "significantly reduce cholesterol and incidence of heart attacks," Ravnskov shows that these substances are probable carcinogens (women on the drugs had a much higher incidence of breast cancer) and that the overall statistical reduction of heart disease in the drug trials is negligible. Nevertheless, despite the dismal results of the very first trial (the EXCEL Trial which Ravnskov soberingly describes to the reader), the industry and its well-funded doctors urge their use, even in people who do not have heart disease.

Ravnskov warns: "Because the latent period between exposure to carcinogen and the incidence of clinical cancer in humans may be 20 years or more, the absence of any controlled trials of this duration means that we do not know whether statin treatment will lead to . . . cancer in coming decades. Thus, millions of people are being treated with medications the ultimate effects of which are not yet known."

If there is one weakness of the book, it is its lack of explanations of what DOES cause heart disease. Ravnskov comes close to fingering a few factors such as high stress, excessive polyunsaturated fat intake, trans-fatty acids, and smoking, but he never offers his own theory as to what causes the Western world's number one killer.

This is, however, a minor glitch. Ravnskov has done the world a major service in presenting his findings. All health professionals need to listen to this scholar and listen very carefully for the advice offered by the medical establishment for the last 50 years to beat heart disease has failed miserably. It is time to turn away from cholesterol-lowering drugs that have frightening side effects. It is time to turn away from tasteless low-fat diets that harm children and deprive people of fat-soluble vitamins. And it is time to turn away from the junk science that characterizes the Lipid Hypothesis and its supporters. It is time, instead, to listen to reason and view all of the evidence against a failed hypothesis and discover the true and varied risks and causes of heart disease. It is time to listen to Uffe Ravnskov....
 

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