The Cholesterol Myth

Part 7: Where Does That Leave Heart Disease?

All published efforts to help by drug or dietary reduction of blood cholesterol have uniformly failed.
Sir John McMichael, Professor Emeritus of Medicine, University of London

Is coronary heart disease really the major killer it's made out to be? It is true that a large percentage of deaths in Britain are attributed to CHD. The question is: Is this a cause for concern? As you can see in Table I, CHD deaths have increased in people over seventy-five years of age. But does this illustrate a problem?

It is a fallacy to believe that if these people had modified their diet or lifestyle, they would still be alive. Despite what the health industry tells us, we are not an immortal species and cannot expect to live forever. I suggest that these figures merely show that people tended to live longer in 1995 than in 1975. This is true of both sexes and that, surely, is a good thing.

Table I: - CHD Mortality in UK Over Age 70 by Sex and Age
Ages	70-74	75-79	80-84	Over 85
Men
1975	16297	12561	8666	6270
1995	13379	12975	12223	10254
Women
1975	10598	12868	12589	14617
1995	7695	9915	13717	21263

ICD 410-414

Premature death from CHD is a legitimate concern. If dietary change can reduce premature deaths it is arguably to their advantage that people be urged to change their ways. However, Table VII illustrates clearly that CHD deaths have fallen considerably in all under-seventy age groups and both sexes over the past two decades.

Table VII: ? CHD Mortality in UK Under Age 70 by Sex and Age
Ages	40-44	45-49	50-54	55-59	60-64	65-69
Men
1975	1290	2914	5783	7214	11678	15448
1995	643	1473	2261	3766	6170	9591
Women
1975	202	473	1072	1902	3950	7104
1995	124	262	480	979	2028	4188

ICD 410-414

Some say that this is evidence that 'healthy eating' is working. Do not be misled. This reduction cannot be the result of the 'healthy diet' recommendations - they only began with the COMA report of 1984, but premature CHD deaths had started to decline nearly twenty years before in 1965, as is graphically illustrated below in men aged 40-44.

This was a time when people were brought up or spent the greater part of their lives with the recommendations with which this paper began. They had free, full-cream milk at school, ate bread and dripping and fried breakfasts. During the period after World War II when deaths from CHD peaked and started to fall, rationing had ended and a diet that was relatively high in fat was the vogue.

Not that this will come as any surprise to the Medical Research Council. In its report on the Caerphilly Study published in 1993, the MRC's Epidemiology Unit at Cardiff showed that men who drank more than a pint of full-cream milk a day had only one tenth the incidence of heart disease as those who drank none. They also demonstrated that those who ate a high-energy diet lived longer than those who cut dietary fats. Their findings indicate that far from being a killer, the diet we are told to avoid by the nutritionists may actually protect us against heart disease!

These findings confirmed a Japanese study of 1992. Japan has low levels of death from coronary heart disease but Okinawa has the lowest of all. While blood cholesterol levels are generally low in Japan, Okinawa's levels are much higher: similar to those in Scotland. In 1994 a paper examined the relationship of nutritional status to further life expectancy and health in the Japanese elderly based on three epidemiological studies. It found that Japanese who lived to the age of one hundred were those who got their protein from meat rather than from rice and pulses. The centenarians also had higher intakes of animal foods such as eggs, milk, meat and fish. Significantly, their carbohydrate intake was lower than that of their fellow countrymen who died younger.

An example of increasing risk

I have noticed, as I preach my gospel, that many women say "I'd rather drink skimmed milk. I don't like the taste of full-cream milk now, it's too rich". This is a trend that worries me.

We all need calcium but women need a good supply to prevent osteoporosis in later life. Milk is the best dietary source of calcium. As all the calcium in milk is in the milk, not in the cream, skimmed milk contains slightly more calcium than full-cream milk. On the face of it, therefore, it looks like a good idea to drink skimmed milk. BUT for calcium to be absorbed from the gut, it has to be there in the presence of fat and vitamin D - and skimmed milk contains neither. As a result, while just over fifty percent of the calcium in full-cream milk is absorbed, only about five percent is absorbed from skimmed milk. AND if you drink your skimmed milk with bran muesli for breakfast, you probably won't absorb even that five percent.

In 1979 the late Professor Sir John McMichael performed an inquest on the diet/heart hypothesis. Pointing out that

"All published efforts to help by drug or dietary reduction of blood cholesterol have uniformly and convincingly failed" . . . "we need a fresh approach to the problem at scientific level and should avoid further public speculation and confusion by repeated propaganda through the media until we have clarified our own professional minds and shaken off what most critical doctors are likely to regard as an untenable hypothesis of causation."

It is a pity that no-one seems to have taken any notice of him.

Fat has over twice the energy value of either carbohydrates or proteins, and other essential nutrients: lipids used in the brain and central nervous system without which we become irritable and aggressive; sterols, precursors of the bile acids and a number of hormones (including the sex hormones); and the fat-soluble vitamins A, D, E and K. The late Dr. John Yudkin, when Professor of Nutrition and Dietetics at London University, called fat the most valuable food known to man. It is both stupid and wasteful to throw it away.

References:

Registrar General's Mortality (Cause) Statistics 1961 to 1995.
A M Fehily, et al. Diet and incident ischaemic heart disease: the Caerphilly Study . Br J Nutr 1993; 69: 303.
H Shibata, et al. Nutrition for the Japanese elderly. Nutr. Health. 1992; 8(2-3): 165-75
McMichael JM. Fats and atheroma: an inquest. Br Med J 1979; 279: 890. /p

Return to Part 6: Has Anyone Gained? | Part 8: A Question of Ethics

See also www.Cholesterol-and-Health.org.uk, an easy to read website about this whole topic from what cholesterol is, why you need it, and how it is made in the body, to what happens if you take cholesterol-lowering drugs such as statins.

Last updated 18 September 2000

"One must attend in medical practice not primarily to plausible theories but to experience combined with reason." Hippocrates

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The Cholesterol Myth

Part 7: Where Does That Leave Heart Disease?

An example of increasing risk

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