The Cholesterol Myth

Part 9: Dangers of a Healthy Diet

'Healthy eating' tells us to eat low-fat, high-carbohydrate diets but in the last few years of the Twentieth Century several papers demonstrated the harm this could do.

Obesity

Back in 1932 obese patients on different diets lost weight thus:

Average daily losses on high carbohydrate/low fat diet - 49g
Average daily losses on low carbohydrate/high fat diet - 205g

Drs Lyon and Dunlop say:

"The most striking feature of the table is that the losses appear to be inversely proportionate to the carbohydrate content of the food. Where the carbohydrate intake is low the rate of loss in weight is greater and conversely."

It's no coincidence that the numbers of people getting fat has risen dramatically since 'healthy eating' was advocated. As long ago as 1863 it was shown that low-fat, high-carbohydrate diets make people fat. The medical world is at last waking up to this fact. In 1994 Professor Susan Wooley of the University of Cincinnati's College of Medicine and David M Garner, Director of Research at the Beck Institute for Cognitive Therapy and Research wrote that:

"The failure of fat people to achieve a goal they seem to want and to want almost above all else must now be admitted for what it is: a failure not of those people but of the methods of treatment that are used."

In other words, blaming the overweight for their problem and telling them they are eating too much and must cut down, is simply not good enough. It is the dieticians' advice and the treatment offered that are wrong. Wooley and Garner conclude:

"We should stop offering ineffective treatments aimed at weight loss. Researchers who think they have invented a better mousetrap should test it in controlled research before setting out their bait for the entire population. Only by admitting that our treatments do not work and showing that we mean it by refraining from offering them can we undo a century of recruiting fat people for failure."

In 1997 two more Americans, Drs AF Heini and RL Weinsier noticed the trend and blamed it on low-fat diets saying:

"Reduced fat and calorie intake and frequent use of low-calorie food products have been associated with a paradoxical increase in the prevalence of obesity".

Heart disease and diabetics

Obese people tend to go on to suffer type II diabetes (NIDDM) and diabetics are more prone to heart disease. For this reason patients with NIDDM are counselled to eat a 'healthy' low-fat, high-carb diet. But as a paper in the medical journal, Diabetes Care , pointed out

"Low-fat, high-carbohydrate diets eaten by patients with diabetes (NIDDM) have been shown to lead to higher day-long plasma glucose, insulin, triglycerides, and VLDL-TG, among other negative effects. In general, study has demonstrated that multiple risk factors for coronary heart disease are worsened for diabetics who consume the low-fat, high-carbohydrate diet so often recommended to reduce these risks."

In June 1999 the 81st Annual Meeting of The Endocrine Society was told:

" A very high-fat, low-carbohydrate diet has been shown to have astounding effects in helping type 2 diabetics lose weight and improve their blood lipid profiles. The thing many diabetics coming into the office don't realize is that other forms of carbohydrates will increase their sugar, too. Dieticians will point toward complex carbohydrates . . . oatmeal and whole wheat bread, but we have to deliver the message that these are carbohydrates that increase blood sugars, too ."

. . .and postmenopausal women

In 1997 it was discovered that

"Low-fat, high-carbohydrate diets [15% protein, 60% carbohydrate, 25% fat] increase the risk of heart disease in post-menopausal women."

. . . in fact everyone

Dr. Gerald M. Reaven, of Stanford University School of Medicine in California, and colleagues compared the effects of a low-fat, high-carbohydrate diet [25% fat, 60% carb, 15% protein] with a high-fat, low-carbohydrate diet [45% fat, 40% carb, 15% protein], on blood fats and cholesterol. They found their subjects had significantly higher fasting plasma triglyceride concentrations, remnant lipoprotein cholesterol concentrations, and remnant triglyceride concentrations when they were on the high-carbohydrate, low-fat diet, both after fasting and after breakfast and lunch. The study participants also had significantly lower HDL (the 'good' cholesterol) concentrations on this diet. The authors conclude:

"Given the atherogenic potential of these changes in lipoprotein metabolism, it seems appropriate to question the wisdom of recommending that all Americans should replace dietary saturated fat with [carbohydrate]."

But then, in 1992, from the Framingham study again came:

"In Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person's serum cholesterol" . . . "we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories, weighed the least and were the most physically active."

Low-fat, high-carb diet and breast cancer

And that's not all:

The largest and most comprehensive study on diet and breast cancer to date found that:

women with the lowest intake of fat had a significantly higher incidence of breast cancer and
women with the highest intake of starch also had a significantly higher incidence of breast cancer.
Saturated fats were not implicated in breast cancer.

The biggest study so far into the relation between breast cancer and fat intake is the Nurses' Health Study, conducted by Harvard University Medical School. A total of 88,795 women free of cancer in 1980 were followed up for 14 years. Comparing breast cancer rates in women who derived more than thirty percent of their calorie intake from fat with women who derived less than twenty percent of calories from fat, they show that those on low-fat diets had a higher rate of breast cancer than those who ate more. They went on to look at the various different types of fats and found that breast cancer rates were lower for all types except one: omega-3 fish oils, which are touted as 'healthy', were the only ones that increased cancer rates. However, the increase was small. Dr Michelle Holmes and colleagues conclude:

"We found no evidence that lower intake of total fat or specific major types of fat was associated with a decreased risk of breast cancer" .

Carbohydrates are not healthy

As we have seen so far, the emphasis on increasing carbohydrates at the expense of fats has not been an unqualified success. And there are good reasons for this.

We have known since 1863 that carbohydrates cause obesity; since 1935 that they cause diabetes; since 1941 that they increase aggressiveness and criminality in children; for almost 30 years promote coronary heart disease; and more recently that they increase the risk of cancers. So is it merely coincidence that diseases in whose aetiology carbohydrates are implicated have risen so dramatically since we have eaten more carbohydrates?

No. Healthy eating is becoming something of a disaster. The best advice appears to be that we should:

reduce carbohydrate intake and
increase our intake of animal fats.

To sum up, what emerges from this discussion is:

Fats

The totality of evidence suggests that we should eat animal fats in preference to vegetable oils because:

Polyunsaturated fats found in margarines and cooking oils may lower cholesterol levels but they increase cancer risk.
Trans-fats found in highly processed margarines and oils also increase CHD risk.
'Healthy' omega-3 oils may increase cancer risk.
Monounsaturated fats are no better as far as heart disease is concerned but they may reduce cancer risk.
Saturated fats are healthier in CHD, particularly if you have already had a heart attack. They are not implicated as a cause of cancer.
Conjugated linoleic acid found only in animal fats is a powerful anti-cancer agent.
Animal fats are just under half saturated and just under half monounsaturated, with a small, but sufficient proportion of polyunsaturated fats.

Carbohydrates

Carbohydrate intake from sugars and starches in breakfast cereals, bread, pasta, rice, et cetera, should be reduced because they increase diseases including obesity, cancer, diabetes and CHD.

Bran

Bran (cereal fibre) should be avoided like the plague.

Conclusion

An assessment of all the cholesterol-lowering dietary trials published in 1987 showed an aggregate six percent more deaths in those who adopted a cholesterol-lowering diet over those on a free diet. A similar review of drug trials showed an aggregate of over thirteen percent more deaths in those taking cholesterol-lowering drugs.

More resources, time and money have been spent over the last fifty years on coronary heart disease than any other disease in medical history and all it has proved is that doctors don't know as much as they thought they did. If half a century of serious research has failed to find a causal link between a fatty diet and heart disease, it can only be because there is no link.

To make intelligent decisions you must be given advice that is based on proven facts rather than unfounded assumptions. And the facts at present seem to be that milk, cream, butter, meat and fresh fruit and vegetables are the healthy foods whilst high-in-polyunsaturates spreads and oils, bran flakes and packaged foods are not.

Seventy years after it began we still do not know what caused the dramatic rise in coronary heart disease deaths in the 1920s or why coronary mortality is now falling. But one thing that the last fifty years of studies has demonstrated is that cholesterol has had very little to do with it.

The research has also demonstrated no evidence of a need to endure an unpalatable, fatless, bran-laden diet. Apart from being less pleasurable to eat, it is now clear that 'healthy eating' is not so healthy after all.

References:

Lyon DM, Dunlop DM.. The treatment of obesity: a comparison of the effects of diet and of thyroid extract. Quarterly Journal of Medicine 1932; 1: 331-52
S C Wooley, D M Garner. Dietary treatments for obesity are ineffective. Br Med J 1994;309: 655.
AF Heini, RL Weinsier. Divergent trends in obesity and fat intake patterns: the American paradox. Am J Med 1997; 102: 259-64
YD Chen, et al. Why do low-fat, high-carbohydrate diets accentuate postprandial lipemia in patients with NIDDM? Diabetes Care 1995; 18: 10-16
J Jeppeson, et al. Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. Am J Clin Nutr 1997; 65: 1027-33
F Abbasi, et al. High carbohydrate diets, triglyceride-rich lipoproteins and coronary heart disease risk. Am J Cardiol 2000; 85: 45-48
Castelli WP. Arch Int Med 1992; 152: 1371-1372
S Franceschi, et al. Intake of macronutrients and risk of breast cancer. Lancet 1996; 347: 1351-6
M D. Holmes, et al. Association of Dietary Intake of Fat and Fatty Acids With Risk of Breast Cancer. JAMA . 1999; 281: 914.
W Banting. Letter on Corpulence addressed to the Public . 1863.
N Rojas, AF Sanchi. Hypoglycemia and delinquents. Arch Legal Med 1941; 11: 29
J Yudkin. Sucrose and cardiovascular disease. Proc Nutr Soc 1972; 31: 331-7
C La Vecchia, et al . Refined-sugar intake and the risk of colorectal cancer in humans. Int J Cancer 1993; 55: 386-9;
RM Bostick, et al. Sugar, meat, and fat intake, and non-dietary risk factors for colon cancer incidence in Iowa women. Cancer Causes Control . 1994; 5: 38-52.

To see more about cholesterol and health, www.Cholesterol-and-Health.org is 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

Return to Part 8: A Question of Ethics