Cholesterol Hypothesis or “Diet Heart Hypothesis” given by Dr Ancel keys in 1950s got entrenched into medical system by 1970s. It was proposed by Ancel Keys that the heart diseases are caused by elevated levels of cholesterol in blood. However in spite of wide acceptance in medical community, this view has not been tested clinically till now. There are lots of research to prove that cholesterol is not responsible for heart diseases. The fallouts of the hypothesis can be summarized as under:-
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- It was advised that foods rich in cholesterol (eggs, meat, milk and milk products etc) should be restricted and dietary intake of cholesterol should be restricted to 300 mg/day. Though FDA has removed cholesterol as nutrient of concern, this view is still widespread.
- People were advised to reduce consumption of foods rich in saturated fats to less than 10% of total calorie intake. Consumption of ghee, coconut or coconut oil, full fat milk, red meat, organ meat etc became a taboo. Consumption of chicken with skin removed became a norm. Price of mutton increased while price of chicken decreased due to over production.
- Consumption of oils rich in poly unsaturated fats (PUFA) were encouraged as they were found to decrease cholesterol.
- Ancel keys recommended consumption of carbs and fat restriction to 30% of total Calorie intake. He recommended consumption of whole grains cereals. Food industry also reacted positively to these recommendations and market became flooded with tasty cereals and fat free & cholesterol free products (breakfast cereals, bread, pasta, bakery products, & malt foods). People welcomed them as they were hyperpalatable, ready to use and marked healthy by medical community. Cold drinks, malt foods and commercial fruit juices also became widely accepted as health drinks.
After Effects of Cholesterol hypothesis
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- Excessive carbs consumption specially of refined carbs has created persistent hyperinsulinemia giving rise to an array of disorders. For details on carbs read my posts on carbs.
- PUFA buzz led to flourishing of a new industry of refined seed oils rich in omega-6 fatty acids. Sunflower, soybean, cotton seed, rice bran etc, became an integrated part of Indian household. Vanaspati ghee (Fats made artificially by hydrogenation of seed oils) became a popular cooking media. Indigenous oils of India; cold pressed Mustard oil, Coconut oil, Sesame and Groundnut oils went out of fashion in favour of refined oils like sunflower oil, soyabean rice bran, cotton seed oil etc, rich in omega-6 fatty acids. The omega-6 fatty acids are known to promote inflammatory pathways in the body. The proportion of omega-6 to omega-3 fatty acids should be ideally 1:1. Ratio of more than 5:1 promotes inflammation in body. Most of the chronic diseases are now been linked to this low grade chronic inflammation. As per Dr Chris Knobbe, seed oils may be responsible for our present epidemic of chronic diseases like heart diseases, diabetes, joint problems and Alzheimer’s.
- Extensive deficiency of micronutrients (also called hidden hunger) has become rampant globally. AS per estimates, globally 60-80% people are suffering from hidden hunger. The deficiency has resulted due to shunning of micronutrient rich foods like whole fat milk, eggs, organ meat etc for fear of cholesterol and intake of unbalanced processed food rich in refined starch & low in micronutrients. Industrial processing and farming methods for bulk production has also added to micronutrient deficiencies. The rise in NCDs has also been linked to micronutrients deficiency.
- Since the cholesterol reduction became the new mantra of health, pharmaceutical industry rose to the occasion by drugs/medicines to reduce cholesterol. Cholesterol reduction by use of statins has become a rule than exception, in spite evidences to contrary that statins do not protect against heart diseases by reducing cholesterol. Medical literature is full of such studies narrating statins as cure for our heart problems.
After the recommendations were adopted by US Govt, American also responded positively and complied with the guidelines. However, In spite of all adherence to dietary guidelines and extensive use of statins, the incidence of heart attacks and other chronic diseases (or non communicable diseases or NCDs) has not only shown a rising trend, but also the age of onset of NCDs has been progressively declining for last 50 years in US and India is not an exception. A 30 years old person suffering from NCDs has become a common scene in India as well.
Instead of considering these disease as one problem of metabolic derangement and searching for the cause, the medical fraternity unfortunately label these diseases as life style diseases and put the blame entirely on patients. To complicate the matter further, new super specialties have evolved, which work in isolation without any lateral communication with other super specialists. For example; a patient goes to cardiologist, who observes that the cholesterol is elevated. The cardiologist prescribes statins as per the norms. Statins have their own adverse effects. Patient develops diabetes (20-30% patients develop diabetes on statins) and now the patient is referred to a endocrinologist or diabetologist. He may also develop memory problems and erectile dysfunction (a debated topic) and then he gets referred to a neurologist and andrologists respectively. Now all superspecialists prescribe their own medicines without considering the drug interactions between individual prescriptions. All of his problems would have disappeared, if statins are stopped. Due to multispecialty approach, the treatment has become more expensive and the patients ultimately lands up consuming more than 6-8 tablets every day. Each medicine has its own side effects as well as affects of interaction with each other. In spite of all, there is no certainty that he will not get a heart attack.
The guidelines has harmed our overall health in general. The heart diseases has not reduced as postulated, but other diseases like diabetes, cancers, thyroid problems, autoimmune diseases, joint diseases and Alzheimer’s disease (called as non communicable diseases or NCDs) have also shown similar trends. Our life span has increased, but, our health span has decreased considerably. Doctors blame on genes, but no major change in human genome has been reported.
The proof of the pudding is in the eating. In spite of adherence to low fat, high carb and low cholesterol recommendations, the onslaught of chronic diseases goes unabated. Its high time that medical fraternity gives a relook to its recommendations.
Hope you liked the article. Your criticism, comments and feedback are welcome. You may read my posts on fats, carbs and proteins for detailed information.