disease
are not linked. In 2005, the Journal of American Physicians and Surgeons reported that as many as half of the people who have heart disease have normal or "desirable" LDL. 8 Also in 2005, researchers found that older men and women with high LDL live longer. 9 When the rule— high LDL is dangerous— doesn't apply in the elderly or in half of the heart disease cases, the honest scientist
can only conclude one thing: the rule needs a second look. Some cholesterol experts believe the rule needs more than just
tweaking. "There is nothing bad about LDL," says Joel Kauffman, Professor of Chemistry Emeritus at the University of the Sciences
in Philadelphia. "There never was." 10
What might account for the inconsistent findings on LDL and heart disease? First, the link some studies show between high
LDL and heart disease could be explained by oxidation. Research in humans and animals shows that natural LDL is a normal part
of a healthy body, but oxidized or damaged LDL is bad news. Perhaps high LDL readings really represent high oxidized LDL. Second, does cholesterol really clog arteries? Probably not. According to Kauffman, there is no relationship between
total cholesterol (or LDL) and atherosclerosis. As we'll see later, an amino acid called homocyste'me, not cholesterol, actually damages arteries.
Later, we'll look at cholesterol in more detail, but for now, let me say this: I believe the "good" and "bad" cholesterol
story has failed to explain heart disease fully— and worse, it has failed to prevent it. The narrative of evil LDL and knightlike
HDL oversimplifies a complex reality.
What about diet? Other things being equal, does eating foods like butter and eggs, rich in natural cholesterol and natural
saturated fat, have an undesirable effect on blood cholesterol and lead to heart disease? From what I can gather, the answer
is no. High cholesterol and heart disease are rare in cultures where people eat cholesterol-rich foods, including butter,
eggs, and shrimp. The same is true in tropical cultures where they eat saturated coconut oil daily. Studies of traditional
diets are only one reason I eat butter, cream, and coconut oil with impunity. Happily, clinical studies confirm this observation
about saturated fats.
The story about diet and disease is more complicated than just saturated fats and cholesterol, of course. As we'll see, reductionist
thinking is precisely the mistake the experts, who focused everything on cutting fat and cholesterol, made. Traditional diets
are also rich in many other nutrients that prevent heart disease, including omega-3 fats in fish and B vitamins. But one thing is clear: if beef and butter were to blame for
heart disease, heart disease would not be new. We've been eating them for too long.
Look at the traditional diets in the accompanying table. They contain more calories, and many more calories from animal foods,
than the modern American diet. Yet Americans are overweight with higher cholesterol levels. Evenki reindeer herders in Russia
derive almost half their calories from meat, almost twice as much as the average American. Yet Evenki men are 20 percent leaner
than American men, with cholesterol levels 30 percent lower. 11
MODERN AMERICAN DIET VERSUS TRADITIONAL DIETS
* A healthy BMI is 18.5-24.9. Above 25 is overweight, and above 30 is obese.
Source: William R. Leonard, "Food for Thought," Scientific American, August 2003, Vol 13, No 2 (updated from the December 2002 issue).
Clearly, the Americans are doing something wrong. Even though we eat fewer calories and more calories from plant foods than
the Inuit and Evenki, we're fat and have "high" cholesterol. The fault may well lie in our diets, but judging from these cases—
and many similar studies of modern hunter-gatherers such as Australian aboriginals— it's unlikely that saturated animal fat itself causes unhealthy cholesterol. These lean, healthy people eat a lot of saturated
John B. Garvey, Mary Lou Widmer