As you read this article, I would like you to keep an open mind. Much of what I’m going to share with you will most likely be at odds with everything you have ever been told by your parents, doctors, and the media. I am asking you to keep an open mind about this information, no matter how difficult it may be, and continue to challenge the status quo of western medicine and nutritional recommendations, or absence of useful recommendations. You may already be familiar with this information, and if that’s the case, please share it with as many people as possible so we can help slow and eventually improve the rates of chronic disease and obesity in our society.

Before I get into the details of cholesterol and dietary fat, I want to share some statistics with you about chronic disease in our country, so that you can understand how serious of an issue it is. First off, in a 2014 report by the National Health Council, it was estimated that approximately 40% (that’s 133 million people) of the United States was affected by a chronic disease. In 2018, it was estimated that over half (51.8%) of adults in the U.S. had at least one chronic disease, and 27.2% had at least two. Currently, the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) estimates that 6 in 10 (that’s 60%) adults in the United States have a chronic disease and 4 in 10 adults have two or more! How does that translate into “healthcare” costs? Reports from the NCCDPHP estimate the following costs from treating just a few of the more common chronic diseases:

Obesity: $147 billion each year

Cancer: expected to reach $240 billion by 2030

Heart disease and stroke: $216 billion per year

Alzheimer’s disease: $305 billion each year

Diabetes: $327 billion each year

This is a very serious issue and these are absolutely appalling statistics. The really sad part is that the estimations in coming decades are even higher. I ask myself all the time “what’s it going to take for people to start taking their health into their own hands and PREVENT disease rather than waiting for it to happen, attempting to treat it with piles of prescription drugs, living a poor quality of life, and becoming yet another statistic?”

It’s not easy to make lifestyle changes, and it can be overwhelming at times to try to make changes with the plethora of conflicting information in the health and fitness space we now have at our fingertips. I believe the fitness industry has failed in this respect, as nearly all advertising for fitness programs and products is aimed at losing weight or getting people a “beach body” rather than bringing more awareness to these statistics and educating the public on practical and sustainable fitness programs they can use to prevent disease and lower these numbers. However, this is a topic for another blog post.

Anyway, the first step toward making change is becoming aware that change in necessary. Based on the previous statistics, we know that as a society, change is necessary. Another important step is keeping an open mind by questioning the information you have previously learned. Ask yourself, “what was the source of the information?” “in which context was the information provided?” “how long ago was this information published?”

With this article, I hope to shed some light on these questions by addressing one of the worst myths, created from a collection of misinformation, that has contributed to this rise in chronic disease rates. By spreading this knowledge, I hope to empower you to take your own health and well-being into your own hands, and respectfully question anyone’s recommendations to avoid dietary fat (especially saturated fat) and cholesterol, in favor of eating more carbohydrates. With that, let’s begin by taking a look at what this myth is and how it started.

A hypothesis exists that is known as the “lipid hypothesis,” which posits that consumption of foods high in dietary fat and cholesterol, and having elevated cholesterol levels significantly increases your risk of cardiovascular disease. This hypothesis was established in the 1950s by nutritional health scientist, Ancel Keys.

Dr. Keys began investigating why American businessmen were having such high rates of cardiovascular disease. So, he decided to conduct a research study across several countries, in which he studied the relationship between diet and cardiovascular disease. This is known as the Seven Countries Study. The results of the study showed that, in the countries they researched, those individuals with higher saturated fat consumption also had increased cholesterol levels, and had higher rates of cardiovascular disease. Based on this information, Dr. Keys concluded that saturated fat consumption and elevated cholesterol played a causal role in cardiovascular disease.

The results of the published study were so clean-cut that it captured the attention of the American Heart Association in 1956. Soon after, real foods that were once viewed as healthy (e.g. butter, lard, eggs, and beef) were vilified, and the low-fat, high-carb movement began around the 1980s. This led to the USDA’s Dietary Recommendations to eat fat-free or low-fat foods and limit saturated fats. These recommendations also state that elevated total cholesterol levels above 200 mg/dL (as an individual risk factor) put you at an increased risk for developing cardiovascular disease.

Furthermore, food manufacturers (i.e. “big food”) continued removing the fat out of their products and replacing it with sugar, industrial oils, and preservatives designed to prolong shelf-life (not your life), while jumping on the new opportunity to label their foods as “heart healthy.” The pharmaceutical industry (i.e. “big pharma”) also introduced cholesterol-lowering medications known as statins in 1987. “Big food” and “big pharma” contribute to other important issues I will continue to address later in this series.

Keeping all this in mind, I’d like to revert back to the Seven Countries Study. As I’ve alluded to, this study had a huge influence on current nutritional recommendations, modern “prescribe and treat” medicine, and the food industry (all of which are important issues in our society). Unfortunately, the study wasn’t as clean as it seemed. One very important flaw was that Dr. Keys could have included other countries in his study where people ate lots of saturated fat and had less cardiovascular disease, and those countries where people ate little saturated fat and had more cardiovascular disease. Instead, he chose to omit these countries, maybe because they didn’t fit his hypothesis.

Also, perhaps even more important, is this excerpt from page 262 of his study that reads “The fact that the incidence of the rate of coronary heart disease significantly correlated with the average percentage of carbohydrates from sucrose in the diet is explained by the intercorrelation of sucrose with saturated fat.” What does this mean? Essentially, he was saying that carbohydrate intake was just as significantly correlated to coronary heart disease as saturated fat, but he apparently downplayed the role of carbohydrate intake in favor of saturated fat as the main contributor.

Finally, although the study concluded that saturated fat intake and elevated cholesterol levels were causative, they were no more than associations, and many more lifestyle factors are associated with cardiovascular disease. It is very difficult to say whether one factor alone can be the sole cause, and just because two variables are associated does not mean one causes the other.

So, now that you know the history about where this cholesterol and dietary fat myth came from and why it should not be regarded as true, I’d like to conclude part 1 of this series with these overarching key points:

1. Obesity and chronic disease are major issues in our country and they need to be addressed through proper lifestyle choices (i.e. proper individualized nutrition, exercise, stress management, etc).

2. The recommendation of cutting out your fat and cholesterol intake is incredibly misleading. Our modern nutritional recommendations are based on flawed science and have contributed to this modern epidemic of obesity and chronic disease. There are more nutritionists, researchers, and doctors coming to this realization, but the process is very slow. A paradigm shift, especially in the medical and research communities, takes a long time to be realized when one particular way of thinking has predominated for so long. As the research continues, we should not fear dietary saturated fat and cholesterol, but rather consider the quality of the source the fat is coming from. Is it coming from fattened, sick, grain-fed animals or is it coming from healthy, vigorous, pasture-raised, grass-fed and finished animals?

3. The “prescribe and treat” approach toward elevated cholesterol levels, which is evident in modern medicine, needs to be questioned. The human body is far too complex to look at total cholesterol in isolation as a primary risk factor for disease and attempt to artificially lower it immediately with statin drugs (unless in dire situations) without considering other biomarkers and lifestyle risk factors.

4. In my opinion, big processed food manufacturers do not have your best interests or health in mind. They will continue to find clever ways to market their food to you so they can keep profits high (case in point…I’m still seeing Cheerios marketing its cereal as “heart healthy” and “cholesterol lowering” because it contains some fiber and whole grain oats. But let’s not forget other ingredients like corn starch and sugar that are included in that “heart healthy” cereal. These are highly processed, stripped of any nutrients, and anything but heart healthy, especially when consumed in high quantities. How ironic…

In part 2 of this series, I will cover why dietary fat and cholesterol are important, what their roles are in the body, what your cholesterol numbers actually mean, and what you should really be paying attention to on your next blood panel.

References

Moore, J., Westman, E. C. MD. Cholesterol Clarity: what the HDL is wrong with my numbers? Victory Belt Publishing. 2013. ISBN 13: 978-1-936608-38-6.

Bowden, J. Ph.D, C.N.S., Sinatra, S. T. M.D., F.A.C.C. The Great Cholesterol Myth: Why Lowering Your Cholesterol Won’t Prevent Heart Disease-and the Statin-Free Plan That Will. 2012. Fair Winds Press, 1 Edition. ISBN-13: 978-1592335213.

about the author

Coach Adrian Wolff has been working in the fitness industry as a personal trainer and group fitness coach since 2016. He grew up in Chicago, IL playing ice hockey, soccer, and tennis, and developed his passion for fitness while serving as an officer in the U.S. Navy.

Shortly after leaving active duty, he began a career in the fitness industry as a volunteer CrossFit coach. Then he decided to pursue a master’s degree in Kinesiology from the University of Illinois at Chicago. While working on his degree, he continued to coach people of various backgrounds in the aspects of sports performance, functional fitness, and nutrition.

He graduated with a Master of Science in Kinesiology with a concentration in Exercise Physiology in 2019, and moved to Las Vegas. He continues to work with youth to Division 1 collegiate athletes, and everyday people to help them achieve their fitness goals.