tag:blogger.com,1999:blog-36840063.post2077827626681037499..comments2024-03-27T22:57:00.742+00:00Comments on Hyperlipid: Best ever statin study comment?Peterhttp://www.blogger.com/profile/14527788116058656094noreply@blogger.comBlogger59125tag:blogger.com,1999:blog-36840063.post-6874461710433454142011-03-22T21:03:39.367+00:002011-03-22T21:03:39.367+00:00I see that Emily (Evolutionary Psychiatry) has a s...I see that Emily (Evolutionary Psychiatry) has a similar idea, with some core posts linked to from the top of her blog. No idea which ones I could use and my ideas do change slowly over the years.....<br /><br />PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-48514925463458729692011-03-22T14:06:33.963+00:002011-03-22T14:06:33.963+00:00Peter, I know you don't have the time to re-ha...Peter, I know you don't have the time to re-hash all of the de-bunking you have done on this blog just to try to convince Brian of something which is obviously tabu in his religion. But a lot more people with (fat)fears and doubts read your blog. I would just want to plead with you that you copy+paste the top 3-4 blog post links to what you have already written on the subject, that might be a good introduction into the other side of the lipid hypothesis.Tessanhttps://www.blogger.com/profile/04999658304819441579noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-46232501899833163962010-06-26T18:00:03.843+00:002010-06-26T18:00:03.843+00:00Hi Brec,
The world is full of people like Brian w...Hi Brec,<br /><br />The world is full of people like Brian who can copy paste a list of studies showing associations, statin studies and citations of the NCEP. Gary Taube's book is excellent but I doubt it would comfort a lipophobe. I have no perosnal interest in trying to save Brian. He has his own deep belief structure. He assures me that I have got it all wrong. That's his problem. I actaully wish him luck. He's going to need it.<br /><br />PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-27134543873541555442010-06-15T18:14:27.360+00:002010-06-15T18:14:27.360+00:00I have been on a very low sugar/grain/PUFA diet fo...I have been on a very low sugar/grain/PUFA diet for a couple of months, primarily influenced by some paleo bloggers and Taubes's book. Via a link, I came to hyperlipid and then to Brian's original long comment (that Peter highlighted in a subsequent post).<br /><br />In the debate here, Brian is the one who has shown a civil and scientific attitude. Most others, including Peter, have not.<br /><br />Somewhat separately, for Brian, in case he's still around: Taubes is not a researcher in the sense of one who does studies; he is a journalist and researcher in the sense of one who *reads* studies. His book, "Good Calories, Bad Calories" cities hundreds of references and would, I think, be of interest to you.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-75011227855997565202010-02-07T12:36:07.885+00:002010-02-07T12:36:07.885+00:00This ancient post needs an update.
Peter's Ag...This ancient post needs an update.<br /><br />Peter's Agatston (CAC) score is 7. <10 =minimal risk of CHD or MI.<br /><br />/discussionNigel Kinbrumhttps://www.blogger.com/profile/03368973941328529619noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-73165974759712951232009-06-05T13:30:06.161+00:002009-06-05T13:30:06.161+00:00P.S. Brian is ALSO unaware that Dean Ornish's ...P.S. Brian is ALSO unaware that Dean Ornish's Lifestyle trial was MULTI FACTORIAL. He violated the control you variables rule. Participants meditated, exercised, reduced stress, included fruits vegetables ( rich in anti- oxidants ) ALL these things have been shown in clinical trials to reduce CAD mortality<br /><br />Saturated fat restriction has NEVER been shown.<br /><br /><br />NO ONE can make the claim low fat diets reverse heart disease UNTIL Ornish has low fat group and saturated fat rich group and EVERYTHING ELSE is the SAME that they do. <br /><br /><br />LOW FAT DIETS SEVERELY LOWER ANTI OXIDANT status and REDUCE absorption of EPA and DHA and nutrients from fruits and vegetables.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-90542571493310188472009-06-05T13:24:37.448+00:002009-06-05T13:24:37.448+00:00Brian
You are obviously not aware of the 18 rando...Brian<br /><br />You are obviously not aware of the 18 randomized clinical dietary intervention trials to date that have NEVER shown saturated fat restriction to lower CAD mortality, CAD incidence or total mortality.<br /><br />You obviously have NOT read the LRC-CPPT or you would know thew difference between the treatment group taking cholestyramine ands the controls was 30 vs 38 CAD deaths Total mortaluty was 68 vs 71 This trial WAS NOT supportive of cholesterol lowering.<br />Nice try though using the "relative risk"......<br /><br />You are obviously not aware that statins have at least 11 other strong pleotropic effects besides mere cholesterol reduction. The PROSPER trial numbers, you ask ?<br />participants treatment controls<br />2891/2913<br /><br /><br />treatment controls CAD deaths 94/122 <br /><br />298/306 <br /> total mortality <br /><br /><br /><br />Lastly you are obviously not aware of Ancel Keys chioncanerty in the Seven Countries Study, deliberately omitting data available at the time that did nto fit his false idea. And even with this trickery CAD rates varied 2-6 fold WITHIN nations.<br /><br />All the info needed to DEBUNK Brian's nonsense is in Anthony Colpo's The Great Cholesterol Con.<br /><br />I suggest you strat reading the studies, Brian, FULL TEXT and VERY CAREFULLY next time. NO MISLEADING SUMMARIES<br /><br />Thank youAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-76453615269244133922008-05-29T19:34:00.000+00:002008-05-29T19:34:00.000+00:00You are not alone, Peter. I stopped reading Brian ...You are not alone, Peter. I stopped reading Brian when he said my claim about Dean Ornish having a bad diet was a "pathetic" comment and should be deleted. I've read reports about how Dean eats in public: white rice and steamed vegetables with no fat. Maybe some egg white omelettes. His diet is absurd and he is very pudgy and unhealthy looking. I don't feel it's pathetic to point out that Dr. Ornish looks pasty and overweight.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-82735403596352605282008-05-20T20:25:00.000+00:002008-05-20T20:25:00.000+00:00Hi pc,I never could be bothered to slog through Br...Hi pc,<BR/><BR/>I never could be bothered to slog through Brian's posts. Once people start confusing the cholesterol lowering effects of statins with their antithrombotic effects my eyes glaze over and I'm asleep within 15 seconds. Whatever else they come up with is dwarfed by this mistake...<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-87839635228608106932008-05-20T19:00:00.000+00:002008-05-20T19:00:00.000+00:00The problem with the current theory of heart disea...The problem with the current theory of heart disease is that we have a lot of data that can used to both prove and disprove that cholesterol is the main factor. There are many papers sited by Brian that strongly suggest that an elevated LDL be a major cause of CHD. Unfortunately there is not a doctor or scientist on the planet that can definitively explain the mechanism by which LDL causes atherosclerosis. Then, there are the anomalies that go against the current thinking. The people (like my aging dad and his sister) who both have high cholesterol (7 and upwards) but do not have any sign of heart disease. We have whole countries that go against the grain. France and Switzerland both have high saturated fat intakes and have average cholesterol levels in the high 5’s. Yet their heart disease rates are one quarter of those in the UK. Then we have fit athletes that have low cholesterol but still go on to develop heart disease.<BR/>The main problem I have with all this is that you would think after all these years (about 50 years have passed since Ancel Keys released his 7 countries study) that somebody somewhere would have nailed the cause of the biggest killer in the Western world. Yet, here we are, still arguing what we should do about CVD.<BR/>For the moment, the best I can say on the subject is that raised LDL is one risk factor amongst many (such as diabetes, raised blood pressure, sedentary lifestyle, family history... etc). But to call it THE cause of heart disease is unsupported.pchttps://www.blogger.com/profile/00808287270809999305noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-29037136306957626212008-03-27T15:01:00.000+00:002008-03-27T15:01:00.000+00:00This comment has been removed by the author.Dave Lullhttps://www.blogger.com/profile/01053227199985293516noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-77711626275245932312008-03-27T13:12:00.000+00:002008-03-27T13:12:00.000+00:00Nice link, thanks. I tend to keep Bill Sardi at ar...Nice link, thanks. I tend to keep Bill Sardi at arms length, but he does come up with some good stuff occasionally. This is one! Pity my Athens account doesn't get me access to NEJM.<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-30643741927788416772008-03-27T12:36:00.000+00:002008-03-27T12:36:00.000+00:00Bill Sardi reports that Coronary Calcification Pre...Bill Sardi reports that <A HREF="http://www.knowledgeofhealth.com/blog/2008/03/cholesterol-does-not-predict-future.html" REL="nofollow">Coronary Calcification Predicts Future Heart Attacks and Coronary Death. Cholesterol Not Found To Be A Significant Risk Factor</A>.<BR/><BR/>He cites this new study: <A HREF="http://content.nejm.org/cgi/content/abstract/358/13/1336" REL="nofollow">Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups</A> in The New England Journal of Medicine, v358 n13, March 27, 2008, pages 1336-1345.Dave Lullhttps://www.blogger.com/profile/01053227199985293516noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-73040846091066426902008-03-04T10:56:00.000+00:002008-03-04T10:56:00.000+00:00Here is another Kendrick article for you on Statin...Here is another Kendrick article for you on Statins:<BR/><BR/>http://tinyurl.com/2a3ar5Chrishttps://www.blogger.com/profile/00223657383325055342noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-34151144689723885932008-03-03T07:32:00.000+00:002008-03-03T07:32:00.000+00:00Brianyou are obviously doing a lot of work on this...Brian<BR/><BR/>you are obviously doing a lot of work on this, which is to be commended. <BR/><BR/>One point - there is more to look at than is on pubmed. Kendrick and Colpo have written books on this and Masterohn has a <A HREF="http://www.cholesterol-and-health.com/Cholesterol-Myths.html" REL="nofollow"> website</A>: <BR/><BR/>Kendrick 's book and Colpo's book are both called "The Great Cholesterol Con" of the two I'd recommend Kendrick's.<BR/><BR/>There is a series of <A HREF="http://tinyurl.com/37edmc" REL="nofollow"> videos </A> on YouTube of a talk Kendrick did to doctors in Leeds explaining his position.<BR/><BR/>This is also a good point from Kendrick re MONICA:<BR/><BR/>http://tinyurl.com/2c3yj8Chrishttps://www.blogger.com/profile/00223657383325055342noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-84484325141142724872008-03-03T05:05:00.000+00:002008-03-03T05:05:00.000+00:00I have been absent for some time investigating you...I have been absent for some time investigating your gurus – at least the names you gave me – more on these later. Turning to your comments on Blankenhorn, the study people were, as I said earlier, all in the placebo group and therefore did not take any Colestipol and so this cannot be a cause of anything. My apologies on the OR’s. There were a number of OR tables. The odds ratios I gave you from this study were correct, but were per 1% increase in the quoted dietary source. The actual overall OR of developing lesions over 2 years from nothing were as below, for each quartile of each type of fat:<BR/><BR/>Total fat; 1.0/5.0/6.67/12.31<BR/>Sat Fat; 1.0/1.06/1.87/3.23<BR/>PUFA; 1.0/3.53/8.57/12.31<BR/>Mono; 1.0/2.0/0.3/4.91<BR/><BR/>Remembering that carbs were nearly the same in both the lesion and non-lesion groups, (and in fact the non-lesion group were a bit higher on carbs), it is clear that total fat, saturated fat , PUFA and monounsaturated fat were each independent risks for lesion development. I started off quoting this study as one showing that a high fat diet caused lesion development. I still maintain this, and for those of you who like to blame PUFA’s, here is some evidence, but we aren’t told what the split of PUFA’s between natural and unnatural is. Higher saturated fats also had twice or three times the risk of lower or no saturated fats. Higher monosaturated fats had a fivefold increase in risk over low monosaturated. I realise that acceptance that saturated fat is in any way to blame will be difficult for you to accept, and that this is why you have been trying hard to wish away this study blaming first carbs, possibly Colestipol and then PUFA. <BR/><BR/>I have been urged by some of you to look at your gurus as quoted to me – Colpo, Ravnskov, Kendrick , Taubes and Masterjohn. My local bookshops did not have any of their books so I searched on Pub Med for studies by them, then got the full text. <BR/><BR/>Colpo, Masterjohn and Kendrick <BR/><BR/>I can’t find any research on Pub Med by A Colpo. Masterjohn seems to have published only two papers– one on safflower oil and the other on Vit D. Kendrick has published a number of papers but out of the 50 I looked at going back 7 years I could only find 3 with relevance to fats/cholesterol. One was whether women should be offered statins, another on stroke in the Japanese and the third about insulin resistance and its connection to CHD. Nothing controversial or new in them. Amongst this trio, no new studies about fats/cholesterol, and nothing that hinted that high fat diets of any kind are good, or that the diet/heart association is wrong.<BR/><BR/>Ravnskov<BR/><BR/>Most of Ravnskov’s papers seem to be complaints to medical journals about cholesterol/fats papers they have published. He seems to be an independent researcher whose area may be glomerulonephritis – about which he has published a few papers. Going back over 50 of his papers, there is a scarcity of any study on fats/cholesterol he has done himself or with others. The main thrust of his argument against the diet/heart association seems to be a statistical review he did in 1998 entitled The Questionable Role of Saturated fat and Polyunstaurated Fatty Acids in Cardiovascular Disease. This was published in the Journal of Clinical Epidemiology. It is difficult to summarise as it is 15 pages long with 7 tables of statistics and 112 references. In a nutshell, he looks at mostly old studies and national food consumption data and challenges their support of conventional thinking that saturated fatty acids(SFA) and/or PUFAs are an important cause of CHD. My concerns with this paper are listed below.<BR/><BR/>• The data often combines SFA with PUFA and this disguises any individual effect<BR/>• Other types of fats are not mentioned – eg trans fats<BR/>• I was concerned that unpublished data was used – what data we aren’t told, or how it affected anything he did<BR/>• In the first set of studies – observational, 5 were in support of conventional wisdom, 3 were not.<BR/>• In the second set, he attempts to correlate changes in food consumption data in many countries and mortality changes. However, there seems to be no logic between the years of one against the other. For example, consumption changes for 1947-1962 are compared with mortality changes for 1955-1965 in 23 countries. Since there is no group of people being followed, I cannot see the connection. It is impossible to draw inference from this because any consumption change would need to be followed up for many years to see a difference in mortality. His ‘follow up’ period is almost identical to the consumption period, lagging by only 3 years. This same method is used for all the countries and periods. The results are that some changes in fat consumption seem to support conventional thinking, some do not. I question the basis of this methodology<BR/>• The third analysis is of racial differences. There are some very small numbers in the 38 studies he looks at - <100 people is common. He performs a number of mini meta analyses by grouping say 5 or 6 studies of the same race. Whether these meta analyses are valid or not I can’t judge. I counted 17 studies in support of convention, 21 against,<BR/>• A fourth analysis looks at cohort studies – 28 groups with follow ups over 4-23 years. In 3 groups, high fat was associated with CHD, in 1, the opposite, and in 24 no difference. The difficulty with this is the data presented doesn’t show the source of fat - hydrogenated etc and so I can’t comment on why there were apparently no major differences in fat consumption between those who got CHD and those who didn’t. Cholesterol levels including LDL are not stated.<BR/>• The fifth table looks at CHD on autopsy in 4 studies. Its major problem is that diet/fat information was, typically, a one-shot look 12-17 years prior to death and so tells us nothing about diet in the intervening period. In my view this is worthless.<BR/>• Table 6 is on case control studies, 6 groups, mainly small groups of around 150 people. There were no significant differences between these<BR/>• Table 7 shows experimental studies – 9 in all,2 primary in which fat was reduced. One study found lowered CHD in the lower fat group, the others, no difference. The so-called reduced fat levels were far too high – between 20-38% to expect any substantial benefit in CHD/mortality. Another worthless comparison.<BR/><BR/>So, out of this, many studies in support of the diet/heart concept, some not, some irrelevant and a good number neutral. This analysis, if we are to believe its accuracy, does not demolish anything – least of all the diet/heart connection. It raises some inconsistencies, but that is all. It also does not support the view that a high fat diet is beneficial.<BR/><BR/>A critique of this study was also published in the same journal. (Dr Golomb). Whilst acknowledging Ravnskov brought to light some important limitations in these mostly early studies, she makes the following critical comments:<BR/>• A rather less extreme conclusion would be warranted in her view<BR/>• Ravnskov gives insufficient consideration to the impact of diet as a whole on CHD <BR/>• He does not consider the separate impact of SFA’s and PUFA’s, or monounsaturated and trans fats<BR/>• Studies he cites seem more consistent with a relation of SFA rather than PUFA to CHD<BR/>• Other important covariates that may modify risk of CHD are inadequately considered<BR/>• Some of his own analysis serve to support rather than discredit a relation of SFA to coronary mortality<BR/>• He has a tendency to label as contradictory evidence that is at least partially supportive.<BR/><BR/>My impression is that he has carefully cherry picked studies to find those with inconsistencies in the fat/cholesterol/CHD argument and used these. He did not find a universal connection damning this argument – there were many studies which supported it. Additionally some of his analysis did not prove anything as I’ve mentioned above. A common problem in dietary interventions is that, typically through lack of compliance, they do not reduce fat consumption by enough(eg down to levels around 10%). It is typically only at this sort of level that benefits of improved mortality are seen. (This is also a common problem in some statin trials, where diet was not altered – people simply took a pill. They did not achieve a substantial enough cholesterol reduction nor alter their postprandial blood fat levels and thus the mortality benefits were lower than could be achieved with dietary improvements as well as the statins).<BR/><BR/>My biggest criticism is the concentration on very old studies, whose authors are generally not around to explain/defend, and his omission of pertinent studies which would have shown the opposite of what he is claiming. A Pub Med search on ‘Saturated Fat’ revealed 6047 papers – Ravnskov looked at some 60,deliberately chosen to help his pitch.<BR/><BR/>The second paper by Ravnskov that I obtained was published in the same journal as that above, 2002 55 1057-1063. (A Hypothesis Out of Date: The Heart Diet Idea). The first part of this is a repeat of the data from his 1998 study above. He commits the crime of exaggeration fairly early when he says that the epidemiological and experimental studies he reviewed in 1998 were ‘almost all inconclusive or, indeed, flatly contradictory’. Thus is untrue. Many studies were supportive in the 1998 paper, depending on what categories he wants to count in epidemiological – as this is not a category in the 1998 paper. The same omissions apply here as to the 1998 paper, but more so. In 2002 there would have been more studies to consider, yet he does not. He rests on those he included in 1998, yet even these were not a reasonable cross section. <BR/><BR/>He claims (exaggeration again) that ‘almost all’ postmortem studies show the degree of atherosclerosis to be independent of cholesterol levels, then cites only two postmortem studies.(One of which is 1936). See later comments on these. <BR/><BR/>He makes the same point as in 1998 that the dietary intervention trials showed little effect on mortality. I have dealt with this above as being largely because such interventions fail, through lack of compliance, to reduce fat and cholesterol by enough to show up in mortality. This is another example of omission. Why hasn’t he reported this well-known aspect? Because it isn’t convenient to his theory.<BR/><BR/>On the statin trials, he makes the comment that these have been successful, but this success was due to their pleiotropic effects and had nothing to do with cholesterol lowering. A 1998 reference is given (55)but this does not deal with pleiotropic effects. I have seen many papers on these effects and none of them that I can recall got close to saying this explained ALL of the benefit of statins. He floats this contentious theory without foundation. <BR/><BR/>He argues that an excess of saturated fat may raise cholesterol in a laboratory but then invents a new theory why this should not apply in humans. He contends that high cholesterol may be a marker, not a cause. A marker for something else that causes CHD. What is this secret, I eagerly read? His answer, smoking, lack of exercise and mental stress. These he claims are probably the most important elements in causing CHD. They all raise cholesterol he says, and that is the only connection of cholesterol. THE EVDENCE FOR THIS EARTH-SHATTERING THEORY COMES FROM JUST 3 STUDIES. Wow! There you have it folks. Everything everybody has missed/falsified for 50-100 years is undone by these three studies. He had over 60 studies in his 1998 paper trying to tear down conventional wisdom, but only 3 to support his theory. I got the full text of two of these, thinking they must be very important.<BR/><BR/>Let’s agree immediately that smoking is a definite CHD risk – though I have no idea whether it raises cholesterol. But lack of exercise and stress as the other major contributors? What happened to the other possible major culprits such as hypertension and diabetes/refined carbs. Are we to believe these have gone away? If we don’t smoke, meditate and exercise that’s us all fixed? What happened to the hundreds of thousands of people who never smoked but died from CHD? Jim Fixx ran a lot and also died from CHD. I ran thousands of kms and didn’t smoke for long, but I got it. What happened to the importance of genetic tendencies such as hypercholesterolemia and others which hasten CHD? I found it hard to give this theory any time, but I read on hoping to find something useful.<BR/><BR/>Sure, lack of exercise is an issue, and I have dozens of studies showing adding exercise will reduce the risk of CHD- mainly through it raising HDL and assisting lowering inflammatory conditions. However I have never found any study that said it would protect us from or fix heart disease and his single reference study from 1999 doesn’t say this either – see later.<BR/><BR/>On stress reduction, his 1995 study examined the effects of short term frustration test on blood lipids etc. A stress effect has not figured as a main culprit in any study I have seen, and stress as a major cause of CHD is certainly not supported by this one – see later. <BR/><BR/>I’m afraid his theory just ignores many studies showing the conventional risk factors, has no evidence to support it, and, importantly for me, no advice on a lifestyle approach that would fix my CHD. <BR/> <BR/>The final paper that I looked at by Ravnskov was ‘Should We Lower Cholesterol As Much As Possible? BMJ 2006 1330-1332. Here he criticises NCEP guidelines published in 2001 for advocating lowering LDL in those with CHD to less than 1.8(70). As is now his pattern, he omits much evidence that lowering LDL is beneficial in saving cardiovascular events and improving mortality and cherry picks studies which don’t support this. He also raises FUD about very low cholesterol and implies a cancer risk which isn’t there. (An earlier blog of mine gave a number of references to papers explaining the association of low cholesterol to cancer is not causal.) Again this shows he’s not trying to be impartial and is selling a particular line. A correspondent claims that a Q10 study he references does not support his point; something I have fund occurs too often with him. <BR/><BR/>Omissions, Misrepresentations and Spin<BR/><BR/>Unfortunately Ravnskov is guilty of what can only be misrepresentation – mainly by omission. I did not have time to check all his referenced studies but I found serious misrepresentation in some of the ones I did with omissions enabling him to portray a study as having a completely different result. This cannot have been accidental. On this showing, I would be confident of finding more – why would I have, by chance, found all of them? Here are some examples.<BR/><BR/>His 1998 paper(and also the 2002 paper) makes a big splash about an Indian study from 1967 in which apparently CHD in railway workers in the South was 7 times higher than in the North, despite the fact that those in the North ate up to 19 times the fat of people in the South. Inexplicable on the surface and a great advertisement for Ravnskov’s arguments. However, this Indian study is full of surprises which are completely at odds with conventional thinking – and in fact Ravnskov’s own new theory of CHD. The same study found that high sugar consumption resulted in less CHD, higher smoking also. In addition, CHD was lower in sedentary workers against those in high physical exercise jobs. Who would believe all this? Yet Ravnskov did not report these anomalies. Nor did he report that diet was measured in three ways – and how these were combined we aren’t told; interviews with ‘a number’ of railway workers and their wives, ‘several’ roadside eating houses and diet surveys from the Indian Research council. Though the study author states the higher fat consumption in the North, the diet graph does not show fats. There is a much higher milk consumption in the North, and higher oils, but this would not explain a statement like between 8 and 19 times the fat. Where are these data? Certainly not published in the study. Finally, in an attempt to explain the apparent contradiction of CHD versus fat, the author says at the end of the paper that food preparation methods, North and South, were markedly different, resulting in a change to the nature of the fats such that in the North, fats would have been mostly short chain fatty acids, whereas in the South, mostly long chain. This, combined with the bile flow effect these fats have, could have resulted in less damage from the greater fats consumed in the North. Ravnskov prefers you do not know this, since it spoils his story.<BR/><BR/>In his 2002 paper he describes data from the Framingham study as showing that a decreasing cholesterol level predicted an increased risk of CHD and total mortality. He quotes a 1mg/dL drop in TC as generating an 11% increase in risk in both types of mortality. The actual figure is 1mg.dL per year. However, he omits to tell us that this effect is only seen for the first 14 years of follow up, and the authors’ explanation is that spontaneously falling TC levels(there being no treatments for reducing TC in the 1950’s) indicates the onset of diseases which can reduce TC levels,(eg cancer) and leading to death. Another big omission is the major conclusion of the study – that for people under 50 years at follow up, there was a definite association between higher TC levels and death from CHD/all causes with respective increased risks of 9% and 5% for each 10mg/dL increase in TC. (Over 50 years old this increased risk was not evident). This omission enables Ravnskov to completely misrepresent the study’s findings.<BR/><BR/>His 2002 paper refers to two papers – one 1936 and one in 1982 which looked at severely narrowed arteries – 5mm segments after autopsy and their correlation with cholesterol levels. He uses this study to justify the words ‘ In almost all post mortem studies the degree of atherosclerosis was independent of blood cholesterol’. Firstly, ‘almost all’ is a huge exaggeration. There were only 40 people in the 1982 study and there would have been many more post mortem studies in the 66 years between his paper and the 1936 study which of course are not included. Secondly, the degree of atherosclerosis WAS correlated significantly with cholesterol. Cholesterol correlated significantly with the number of severely narrowed arteries per person (but not the overall % of severely narrowed segments). Secondly, triglceride level correlated with the overall % of severely narrowed arteries. The 1982 authors also mention the results of 6 other similar studies, of which 4 found associations between cholesterol/triglyceride levels and narrowed arteries, but Ravnskov doesn’t tell us any of this. For completeness, I should note that 5 people had severely narrowed arteries despite the fact they had low cholesterol – an anomaly that Ravnskov should have picked up since it helps his argument. <BR/><BR/>His 2002 paper references a 1998 study(55) with the claim (about statins); ‘...the effect on CHD reduction has been achieved independently of the initial cholesterol level or the degree of cholesterol lowering’. Once again this is totally misleading. This paper actually says ‘ The rate of coronary events was associated strongly with the plasma LDL concentration during treatment...’ His comment that CHD reduction was not associated with initial cholesterol level is correct, but so what?<BR/><BR/>In Ravnskov’s 2002 paper, he claims one of the main causes of CHD is lack of exercise and quotes a 1999 study to support this. The problem is this paper does not support the proposition at all. The 1999 study was a meta analysis of 33 randomised trials looking at the effect of exercise on cholesterol levels. These trials did not even look at CHD, and so Ravnskov’s use of this study to support lack of exercise as a major factor in CHD is invalid. In fact the study only showed that over all trials, exercise had a modest and beneficial effect on cholesterol levels. The authors did not in any way suggest exercise will help avoid a heart attack. They even urge caution in drawing conclusions because of the significant heterogeneity in the 33 trials, and also poor quality in some of them. <BR/><BR/>Another study Ravnskov cites to underpin his new theory of CHD is a 1995 study on stress. Remembering that he is claiming a new theory, one would expect a little more than one stress study, and more than 41 people being frustrated in a 20 minute test. Their cholesterol levels rose(as well as BP and heart rate), but, to the delight of the Hyperlipids, both LDL and HDL rose – an effect I believe some use to justify eating saturated fat. I think we all need a little more than this to believe that stress is a major factor in CHD, although it may well be a contributor. <BR/><BR/>The problem for Ravnskov is that he makes himself out to be the white knight of truth – writing to journals railing about biased studies with omitted and misrepresented data yet commits the same crime himself and ruins his credibility. He has cherry-picked studies that show anomalies he can manipulate rather than look more closely for their possible cause. Instead he invents a new theory of CHD which is not based on anything, and fails to support this with substantial data. For his theory of CHD to hold water, he has to explain away the scores of studies showing the association between fat/cholesterol and CHD not just some old studies which are no longer even relied upon for this evidence. Applying his own logic about theories to his theory, if there is evidence that supports another explanation(plenty of studies showing a fat/cholesterol/heart link) he must abandon it and look for another.<BR/><BR/>Taubes<BR/><BR/>I found Taubes had 114 articles published. In the first 50, all looked to be in the Science magazine on anything from magnets for cancer to black holes. There were 4 touching on cholesterol/saturated fat. I couldn’t see any new research he’d done in these areas. I found 2001 articles described below where he argues against conventional wisdom on heart disease. <BR/><BR/>I read both 2001 articles – What If Americans Ate Less Saturated Fat, and the Soft Science of Dietary Fat. The first is completely irrelevant in my view. It seems to be a ‘conspiracy’ article about the burying of three computer analyses that modelled life expectancy in the USA after reducing saturated fats. I lost interest as soon as I saw computer modelling, and also that the ‘reduced’ level of fats was 30%. The fact that little extra life expectancy was forecast at this level of fats does not surprise me, as it has been shown many times that dietary fat must be much lower for any mortality improvements. In any case, computer models are not studies of real people with measured outcomes. <BR/><BR/>The lengthy article on the so-called Soft Science of Dietary fat I found boring in that it concentrates on how American Health decisions were made(if correct), all the while trying to build a picture of incompetence and political/commercial/personal influence. He also tries to paint the picture of poor science. <BR/><BR/>However, ignoring the history lesson, there is s startling lack of references to studies to support the bad science claim. I could only find 16 studies on CHD or related topics mentioned. This is totally inadequate to cover what he describes as a 50 year old history. As does Ravnskov, Taubes omits many studies supporting the diet-heart connection, since these are inconvenient for the line he is selling. The same applies to the experts who are quoted. The full picture of pros and cons is not presented. I understand some of the experts complained that what Taubes wrote did not represent what they had told him. <BR/><BR/>He agrees that LDL can lead to plaque –in contrast to Ravnskov who seems to be saying cholesterol doesn’t matter. I had to laugh at the fallacy that rasing both LDL and HDL through eating saturated fat is somehow OK. It isn’t! The HDL won’t protect you enough. A much healthier way to raise HDL and lower LDL is through exercise. He touches on the old potato of low cholesterol causing cancer, but at least reports the other view. The Lyon Diet Heart Study is mentioned with two groups - one on a Mediterranean-style diet. Despite similar cholesterol fractions in the two groups, the Mediterranean group had less CHD. What Taubes doesn’t say about the Lyon Study is that the Mediterranean group ate significantly less saturated fat than the control group, instead, olive oil. There was a trend towards reduced LDL and increased HDL in the M group and, CHD risk was reduced in this group by 78% at the two year point, and 65% at the 4 year point. This emphasises do not eat saturated fats –replace them with healthier oils. <BR/><BR/>There are various criticisms of his article by Scott Grundy and Hegsted. The former makes the point that Taubes has underestimated the bad effect of SFA’s which have a bad effect on LDL and then CHD. Grundy says there are many high quality studies to demonstrate this. I tend to agree with him as mentioned above, and it is remiss of Taubes to have carefully avoided these. Hedsted says when he was in the health system loop, he recommended reduced salt and sugar and increased unsaturated fats, whole grains and fruit and vegetables in place of SFA’s. He also makes the point I’ve been making in a different way. A 30% fat diet, (dangerously low for brain function says Taubes), cannot be regarded as low in terms of effect on the brain, and Hegsted says he hasn’t noticed too many brain dead Japanese or Chinese whose traditional diet is lower in fat. Someone called Anne Astrup also argues with Taubes and emphasises that low-fat diets high in fruit, vegetables and fish have other beneficial effects through pathways such as blood pressure, thrombotic, fibrinolytic and arrhythmic factors. I see also that Ravnskov gets in on the act and argues with Grundy about the correctness of his references. I haven’t had time to follow these up.<BR/><BR/>In a nutshell, Taubes tells a good political conspiracy story and chooses studies and people to complement this, but does not portray a useful overview of both sides of the diet-heart debate. In the context of you Hyperlipids, and my search for what benefits are in high fat diets for me, he does not advocate, nor do any of the people or research he mentions, a high fat diet as being beneficial for anything, certainly not CHD. <BR/><BR/>How Do My Gurus Stack Up?<BR/><BR/>I won’t bore you with dozens of these, and remember they are picked not because I am coming from a direction, with a placard, having had my training(eg vegetarianism). I found these by following many trails on heart disease – particularly regression.<BR/><BR/>These people, in contrast to the Hyperlipids’ gurus, are experts in heart disease. They have studied it, treated it and sometimes regressed it. Esseltyn’s published studies showed he had regressed the heart disease of people given up by their cardiologists who then lived on for many years, but you say this is vegan propaganda, destroyed by others. I don’t think his thankful survivors would agree with you. Gould’s 700 page textbook on heart disease and regressing it is used world wide. I have it and it has over 500 referenced studies to back up what he says, apart from his own published regression research. There is a chapter dedicated to regressing heart disease, and some 85 clinical case studies with positron emission tomography scans showing before and after blood flows to the hearts. Amongst the many other experts I originally cited, these are people who have cured heart disease apart from researching it for 30 years. Against them we have the Hyperlipid gurus above who I suspect have never cured anyone of heart disease, nor done any new research in it themselves and whose published papers contain misrepresentations. How credible can I regard these?<BR/><BR/>More on Diet/Fat/Heart<BR/><BR/>Over the past week, and in the absence of any studies from the Hyperlipids about high fat diets regressing CHD, I did a Pub Med search just to make sure I haven’t missed anything vital in my earlier research going back some years. I entered ‘Saturated fat and CHD’ and got 216 hits. I looked at the abstracts of the first 100 of these. Excluding about 20 as being not relevant (eg educating people/ gender and ethnic differences....etc), some 76 said that saturated fat was associated with CHD and many advocated replacing most of this with PUFA (n-3 type).<BR/><BR/>These studies are additional to my list of 80 I gave you a couple of weeks ago, yet are of the same mind. There were only 4 in this 100 that had different views. The 100 went back to 2000.<BR/> <BR/>This new Pub Med search didn’t reveal any advice about a high fat diet being good for CHD(or anything), and study after study stressed the connection between saturated fat and CHD. I hasten to emphasise I did this search in order to satisfy myself I had not missed something useful about high fat diets that you were not telling me, not to convert anyone. However, as usual, I share this information with you. Out of the first 100, here are just a few, which do not rely on the old studies that Ravsnkov tried to discredit.<BR/><BR/>1. Lipoproteins nutrition and heart disease ( American Journal of Clinical Nutrition 2002 75 191-212 Schaefer EJ).<BR/><BR/>This 20 page review of what is known about these topics does not rely on the studies Ravnskov tried to discredit in 1998. I can only find about 6 of these out of 219 references. Instead it uses much later(eg 1990) studies on fat metabolism. The paper is a comprehensive background(given as a lecture) on all the major contributors to heart disease and the mechanisms by which these work. It covers all the cholesterol fractions, lipoprotein(a), particle size, saturated fat(giving stearic acid a tick), PUFA, mono, trans....genetic factors....Dietary fat is a major contributor to CHD it says. The conclusion lists smoking, high glucose, high blood pressure, high LDL and obesity as risks for CHD and recommends decreasing saturated fats, total fats, sugar, trans fats and increasing fruits, vegetables and grains, coupled with exercise.<BR/><BR/>2. Diet and Coronary Heart Disease: Clinical Trials (Current Atherosclerosis Reports 2000 2 387-493. Brousseau ME et al)<BR/><BR/>This deals with many dietary intervention trials and the effects of fats. Of interest is the number of very early studies showing beneficial effects of reducing fats from the 1950/60’s which I had never heard of and which are not those Ravnskov tried to discredit. No wonder he didn’t mention these. The review also looked at Vit E supplementation and concluded there was little evidence of benefit. The conclusion was that restrictions on total and saturated fat significantly lowers CHD risk, whereas a relative increase in n-3 fatty acids is protective. Smoking cessation and an active lifestyle are recommended.<BR/><BR/>3. Dietary Fat Intake And The Risk of Coronary Heart Disease : The Strong Study.(American Journal of Clinical Nutrition 2006 84 894-902. Jiaqiong Xu, et al)<BR/><BR/>This starts off with words to gladden the hearts of the Hyperlipids – listing some studies which showed a diet/heart association, some that did not, and talking about inconsistencies and deciding to do a study of their own – of about 3000 North American Indians. The people were free of CHD at baseline and second examination and were followed up for 7 years. The conclusions were that total fat, saturated fat and monounsaturated fat were strong predictors of CHD mortality. The hazard ratios for people in the highest quartile of each type of fat intake were; total fat 3.57, saturated fat 5.17, mono 3.57, all after controlling for confounders. These associations were in people aged 47-59 and were not seen in people 60-79. The authors propose this may be because the 60-79 group might be a specialsed group in that existing CHD people were excluded at the outset, and these would have been predominantly in this age group. <BR/><BR/>Which Theory Wins?<BR/><BR/>It is true there are unexplained anomalies in the diet/heart approach, (eg the Nurses Study which I haven’t had tome to look into), but it’s also true that the ‘high fat/cholesterol doesn’t matter’ idea is not supported by many numbers of robust studies – rather mostly by exploiting the anomalies above. It’s also true that people on both sides of the debate are guilty of omission and misrepresentation to sell their stance. However, I am not persuaded by the evidence from Ravnskov and Taubes which seems to be trying hard to find facts to fit a theory, with both of them omitting and misrepresenting data. The number of studies that show the fat/cholesterol connection is overwhelming, particularly those which show the regression of CHD by extreme low fat diets/lowering LDL/exercise....fibre, fruit and vegetables etc. I keep on saying that after all this searching I have still not seen a study that shows such regression on a high fat/high cholesterol regime.<BR/><BR/>Summary<BR/><BR/>Some have complained about my excessive free time. I am spending too much time at the moment explaining what is in studies in answer to various questions. I have also spent a large amount of time looking into the gurus you put up. This is becoming a one way street. I originally listed various studies supporting the diet/heart concept which were howled down without being looked at. Ravnskov, I was told had demolished all these except he hasn’t, and his credibility is lacking as shown above. The recent Pub Med search above showed over 70 more in support of the diet/fat/heart concept. I doubt many of you would have checked ‘my’ studies or even Ravnskov’s. I get the impression you are getting your ‘facts’ from books with controversial slants, and don’t seem to go to the actual studies upon which the books are based and question these. Dissident medical theories seem to be readily-accepted, whether there are substantial studies to support them or not. In contrast, I have been slogging it out at the medical library at the University for the past 7 years getting and reading the full studies in nearly all cases. I’ve answered Peter’s objections to the MR FIT study but he hasn’t had the good grace to help me with some vital information. One of you raised the theory that all the successes of low fat regimes are to do with weight loss. I don’t have time to list for you the ‘same weight’ studies that have been done or keep on answering your questions and looking into your unproven theories, especially when the information I asked you to volunteer has not been forthcoming.<BR/><BR/>You know my background, I have heart disease. I am on an extreme low fat/low GI carbs/high fibre/vegetarian plus fish/exercise program that I think will either regress it, or arrest it. In an earlier blog I presented some 12 regression studies which supported this approach. I my recent trawls I found another one I had forgotten about – Morrison 1946, JAMA 1955 159 1425 and JAMA 1960 173 884) in which people who had survived heart attacks were split into two groups - an extreme low fat group and a control group. At the 12 year follow up the low fat group had much less CHD mortality. I was astounded by the philosophy your blog expounded, I picked Peter up on his invitation to learn about where he may be going wrong, then from his responses I realised this was facetious. From the strength of the responses, I was intrigued that perhaps I had missed something vital. I can’t find it. You seem to think my program is wrong, yet I cannot get one of you one to contribute any studies which show that a high fat diet, versus what I am doing, will help me regress my heart disease. Despite Anna trying to make me into a disciple of some sort, I am, to the contrary, actually still asking for this assistance. All I get is read this that or the other book. Books by people I’ve now investigated and who do not have heart disease credentials, and without any hint that these books refer to such studies. Are you, as a group, really this uncharitable in the way of information? The other things I’ve asked for include whether any of you have had tests to see whether you are clear of heart disease on your high fat diets, and what your LDL levels are – again nothing forthcoming though I have told you mine. These are reasonable questions that anyone coming to this blog might ask to try and determine the soundness of your beliefs. <BR/><BR/>The gurus you mention seem lightweight to me and not experts in the CHD field. Ravnskov’s new CHD theory is unsupported. None of the gurus you’ve given to me advocate a high fat diet in any case. <BR/><BR/>Once again – let’s by-pass the debate entirely and cut to the bottom line as I’ve asked before – are there any studies supporting a high fat diet with regression or heart disease that might question my program? And – how are you people travelling in terms of heart disease yourselves –do you know the state of your coronary arteries, what are your LDL’s? <BR/><BR/>I could raise all sorts of other matters with you which might be at issue with your chosen diet – well at least the one Peter says he’s on – like the beneficial associations between cereals, fruit and vegetables, exercise, fibre and CHD. Also the increased risk of certain cancers from meat/meat products, but I see no point in opening up the debate into these areas, because to me, you seem, as a group, encouraged by Peter, closed-minded, and overly defensive if anyone questions your beliefs on high fat consumption. <BR/><BR/>So, there seems to be nothing much in this exercise for me, if no one is willing to volunteer this simple information. I have asked for this now I think three times. You leave me with no other impression that as far as the studies go, they just doesn’t exist and that the case for a high fat diet being safe for CHD or helping fix it has no evidence.<BR/><BR/>I think by the way that the comment by Bruce K about Ornish dying from his poor diet is a pretty pathetic level of comment which he ought to delete.AlexBhttps://www.blogger.com/profile/14929433237061247136noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-41526635481071909072008-02-25T20:24:00.000+00:002008-02-25T20:24:00.000+00:00I didn't mean that "bash" was slang for "promote."...I didn't mean that "bash" was slang for "promote." Is it? I just didn't get why you said there was "enough" cholesterol hypothesis bashing like that bothered you. There will never be enough! Until Dean Ornish admits he was wrong, or dies from his poor diet. Reading it again, your remark makes more sense, but thank you for clarifying your meaning.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-82224476959852362672008-02-25T05:53:00.000+00:002008-02-25T05:53:00.000+00:00Hi Bruce,I bash the cholesterol hypothesis! That i...Hi Bruce,<BR/><BR/>I bash the cholesterol hypothesis! That is I put up info that shows it to be the garbage it is. It never occurred to me that the term "bash" could be used as meaning promoting!!!!!! But yes, I agree it can and is used this way. As you say, Brian is the main "basher" in these terms.<BR/><BR/>So to re phrase, I and most commentators spend too much time criticising the cholesterol hypothesis.<BR/><BR/>That is, none of us believe it (I hope) and wasting our time on it is pointless. The more amusing papers which come to hand I'm happy to post and discuss, but if any of us sat down and trawled through all of Brian's references and tried to explain to him the difference between an anti inflammatory like lovastatin and a simple toxin like cholestyramine we'd be there all day for weeks and who want's to read this again and again?<BR/><BR/>So yes, not the clearest phrase!<BR/><BR/>PeterPeterhttps://www.blogger.com/profile/14527788116058656094noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-10566588879806453862008-02-24T10:15:00.000+00:002008-02-24T10:15:00.000+00:00"Thanks for the list of references, but I already ..."Thanks for the list of references, but I already feel there is far too much cholesterol hypothesis bashing on my blog."<BR/><BR/>I don't understand this sentence at all. Most of us here agree with you that cholesterol and animal fat has been wrongly blamed. We are bashing the cholesterol hypothesis.<BR/><BR/>Maybe you meant to say "cholesterol bashing"? If so, then only Brian is bashing that, AFAIK. Please clarify what you mean here. Thanks.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-54544143012168229562008-02-24T10:13:00.000+00:002008-02-24T10:13:00.000+00:00This comment has been removed by the author.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-50141663034784213792008-02-24T10:09:00.000+00:002008-02-24T10:09:00.000+00:00This comment has been removed by the author.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-82225410136676787152008-02-23T23:12:00.000+00:002008-02-23T23:12:00.000+00:00Brian, Brainwashed, huh? My husband got a laugh o...Brian, <BR/><BR/>Brainwashed, huh? My husband got a laugh out of that because he thinks I can't possibly "just accept" anything without looking for more info. What about the low-fat brainwashing? Most of the people who follow the low-fat theory haven't questioned it at all. And Peter must be brainwashed, too. His recently mentioned book list is nearly exactly like mine, though I have finished the Taubes book and didn't finish the Colpo book due to the tedious faint, small type.<BR/><BR/>You could be right about me taking too much time to respond, though. But slow cooking a nice fatty cut of chuck roast allows for that, unlike tasteless, dry skinless, boneless chicken cutlets.<BR/><BR/>And I'll cop to the "proof" copout. Of course I wouldn't bother trying to convince you saturated fat doesn't cause CVD any more than I would try to convince a Jehovah Witness to stop their door-to-door conversions. Changing a mindset has to come from within a person, not an external challenge. I started questioning the low fat dogma because it did look like brainwashing to me, and certainly I wasn't seeing healthy outcomes from it, not for me, nor for my family.<BR/><BR/>You don't really sound open to new ideas at all; you sound like you are extremely opposed to what is presented and discussed and bandied about on this blog and you want to convert us to your view, one that the vast majority of this blog's readers (the vocal ones anyway) have either begun to question or have already dismissed. And the comments to this particular post, while remaining cordial, don't have their usual tone: the friendly exchange of a variety of ideas (discussion) has taken on a more debate-like exchange. <BR/><BR/>If one doesn't need/want to get into a debate, then there is no point responding to a challenge of "proofs". For those who want to debate, great. I'm learning from that, too. But it doesn't mean I want to debate.<BR/><BR/>Best wishes in your quest to correct the heretics,<BR/>AnnaAnnahttps://www.blogger.com/profile/17033443643442246531noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-82705222215883955502008-02-23T07:52:00.000+00:002008-02-23T07:52:00.000+00:00"Chainey, enjoy your reading. Have you hit page 63..."Chainey, enjoy your reading. Have you hit page 63 yet? Anyone looking for the effects of WW2 and rationing on heart disease really needs to see this graph."<BR/><BR/>Yep. Interesting, I remember that Pritikin based his theory on his privileged access to those wartime records. Seems he got it wrong, but maybe ended up with something useful anyway.<BR/><BR/>P.S. <A HREF="http://chainey.blogspot.com/" REL="nofollow">My blog</A> is now up and running (plug, plug). I hope to make it a kind of clearing house for LC info (including rational criticisms).^https://www.blogger.com/profile/14209117357558394101noreply@blogger.comtag:blogger.com,1999:blog-36840063.post-30908202732010119742008-02-23T07:51:00.000+00:002008-02-23T07:51:00.000+00:00Not just restaurants and fast food. All the junk f...Not just restaurants and fast food. All the junk foods (just about) are made with PUFA oils: corn, soybean, canola, rapeseed, safflower, cotton seed, sunflower, etc. Almost all of the prepared foods and frozen food. Mayonnaise, salad dressings, and so forth. Even things like salsa often have PUFA oils added. It has become pervasive. It takes a lot of effort to avoid these oils, because you're getting them in restaurants and all kinds of prepared foods.<BR/><BR/>Very few people eat "high saturated fat" diets any more, because it's a full time job to avoid PUFAs. Peter is doing pretty good, IMO, but it's getting harder every day. Everybody wants low-fat dairy and lean meats, so who is eating high saturated fat diets? They're eating fat, but they got rid all the saturated fats, and replaced them with PUFAs.<BR/><BR/>This is one of the reasons there is so much disease, I think. Back when food was made saturated fats (suet, coconut oil, butter, palm oil, palm kernel oil), people were healthier. Vegetable oils are sabotaging human health on a massive scale.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-36840063.post-26425001486588353062008-02-23T04:34:00.000+00:002008-02-23T04:34:00.000+00:00Bruce,You may be right about PUFA. Vegetable oils ...Bruce,<BR/><BR/>You may be right about PUFA. Vegetable oils now form a majority of fats served in restaurants and fast food. Based a personal observation most people around us (Canada) rarely consume any natural saturated fats since everything is low fat or fat free, and the cooking fats are all veg oils. Probably most saturated fat they ever get is from hydrogenation. <BR/><BR/>You are of course correct that the first thing that got rationed in Europe during WWII was sugar! You could still buy some black market pork (it was strictly controlled under occupation in Poland) and butter - it was extremely expensive but there was no sugar. Heart disease came down indeed but infectious diseases like TB, typhoid etc skyrocketed.<BR/><BR/>Stan (Heretic)Stan Bleszynskihttps://www.blogger.com/profile/03922719716458272303noreply@blogger.com