For more than five decades Americans have been told that cholesterol causes heart disease. That’s why nutrition experts, cardiologists and family practice physicians advised their patients to limit egg consumption and avoid butter. It’s also why statin-type cholesterol-lowering drugs have been billion-dollar bonanzas for the pharmaceutical industry.
To this day, many people think of eggs as a sinful indulgence. The dairy counter is filled with low-fat or no-fat yogurt, skim milk and cheese substitutes. And a lot of health professionals still tell people to ration foods containing cholesterol. After all, beliefs die hard.
The Finnish Heart Study:
A new study from Finland, however, may be the final nail in the cholesterol coffin (American Journal of Clinical Nutrition, online, Feb. 10, 2016).
The researchers in Kuopio have followed more than 1000 healthy middle-aged men for over 20 years. At the beginning of the study in the 1980s the men filled out detailed records of their eating habits.
Dietary Cholesterol OK:
Now, the results are in and both eggs and cholesterol have been exonerated. After analyzing the decades-long data, the investigators found no connection between egg consumption and heart disease. There was also no link between cholesterol in the diet and atherosclerosis in the carotid arteries.
The Finnish Heart Study included a group of high-risk patients. Approximately one third of these men carry a gene called ApoE4 that predisposes them to both heart disease and Alzheimer’s. In other words, these highly susceptible individuals were a little like canaries in the coal mine. As much as an egg a day or moderate-to-high cholesterol consumption did not appear to increase the likelihood of a heart attack or stroke among these men.
Could Eating Eggs Actually Be Healthy?
Even more surprising, there are studies suggesting that people who eat more eggs have larger, less dense artery-clogging LDL cholesterol particles (Metabolism, March, 2013). Such “fluffy” particles are less likely to contribute to arterial plaque. Other research demonstrates that egg consumption raises good HDL cholesterol, lowers inflammation and improves blood sugar control (Lipids, June, 2013).
Diet Dictocrats Beginning to Change Course:
It takes the nutrition establishment a long time to reconsider long-established policies. That’s because “experts” hate to look foolish and appear to flip flop on long-held beliefs and recommendations.
But American policy makers are finally beginning to catch up with the science. After years of strict prohibitions on high-cholesterol foods, especially eggs, the new Dietary Guidelines for Americans issued in 2015 no longer limit cholesterol intake to 300 mg/day (one egg contains 180 mg of cholesterol). They do recommend, however, that “individuals should eat as little dietary cholesterol as possible…”
It’s hard to teach old dogs new tricks. Many health professionals will find it challenging to accept the new data from the Finnish Heart Study. But the writing has been on the wall for quite a few years that the evidence supporting dietary cholesterol as the culprit behind heart disease was weak.
What About Saturated Fat?
Despite the reversal on eggs and dietary cholesterol, saturated fat remains forbidden. The cardiology community is still convinced that this fat will clog arteries and the 2015-2020 Dietary Guidelines frown upon “sat fat”.
A Canadian meta-analysis (BMJ, online, Aug. 12, 2015) of the data on saturated fat intake and its relationship to heart disease, stroke, type 2 diabetes and death found:
“In this synthesis of observational evidence we found no clear association between higher intake of saturated fats and all cause mortality, CHD [coronary heart disease], CHD mortality, ischemic stroke, or type 2 diabetes among apparently healthy adults”
Conversely, trans fats that were found in margarine and so many so-called heart-healthy foods produced decidedly disastrous results:
“Consumption of trans unsaturated fatty acids, however, was associated with a 34% increase in all cause mortality, a 28% increased risk of CHD mortality, and a 21% increase in the risk of CHD.”
So, the very foods we were told to eat for decades to protect are hearts were actually causing coronary heart disease.
The Dutch Drive the Nail Deeper:
As if the Canadian analysis weren’t enough, there is now the Netherlands Cohort study published in the American Journal of Clinical Nutrition (Feb., 2016). Over 35,000 Dutch men and women were recruited between 1993 and 1997 and followed for 12 years.
The more saturated fat these people consumed, especially from dairy products, the less coronary artery disease they experienced. Highly processed carbohydrates found in bread, pizza, pasta, cookies and cakes were linked to a higher risk of heart disease.
In other words, the advice we have all been given for the last 50+ years has been turned upside down.
We Predicted This:
To learn more about this controversy and the other risk factors that may play an important role in heart disease, you may wish to read our chapter “Heart Disease and High Cholesterol” in Best Choices from The People’s Pharmacy. You can purchase the book online at PeoplesPharmacy.com.
Other nutritional disputes remain unresolved. Salt is still considered a dietary evil. Only time will tell if we will need to reevaluate this prohibition as well. You can read about the “Salt Wars” in Best Choices to find out why this dietary advice also remains controversial.