Ever since Ancel Keys named it as the cause of heart disease in 1958, we have been fighting a bitter war against fat. Now it’s becoming clear that war was misguided. Keys’ infamous report, the seven countries study, provoked a wholesale change in what the US and then the rest of the West allowed on their dinner plates. The USDA released eating guidelines based upon the report, and an aggressively low fat world was created almost overnight. Saturated fat, which was thought to be associated with increased levels of blood cholesterol, was demonized and removed from our diets.
But rather than lose weight and get healthier, we became fatter and sicker. The level of obesity skyrocketed and two generations later it is still climbing, bringing with it an entourage of deadly diseases.
For many years there have been voices questioning the anti-fat narrative, but they have been ridiculed or ignored. Now the latest research is showing cholesterol is not associated with heart disease at all, and removing it has made us unhealthier.
High Cholesterol Is Good?
In February this year a 20 year study of more than 1000 men in Finland concluded with a report in the British Medical Journal that found eating high cholesterol food, particularly eggs, did not increase the risk of heart disease. At the same time another report on a study involving 70,000 people showed that those with high levels of “bad” LDL-cholesterol actually lived longer. Instead of being damaging, the high cholesterol levels were found to increase life expectancy in people over 60 years of age. The reports are not the exception, far from it. There have been many recent studies that arrived at the same conclusion - the accepted lipid hypothesis that cholesterol causes heart disease is wrong.
The evidence is now so strong that last year the US dropped cholesterol from its list of problem foods, stating “cholesterol is not a nutrient of concern for overconsumption”. In other words the USDA – the same organization that created universal dietary guidelines based around a reduction of fat and greatly increased carbohydrate intake - admitted they'd been wrong about the war against fat they initiated single-handedly almost 60 years ago. The UK has this year followed suit, revisiting the country's Eatwell dietary guide after severe criticism of its low-fat advice.
What is Cholesterol?
So what do we actually know about cholesterol that is still true? Cholesterol is a fat-like substance produced by our bodies that is used in the formation of cell membranes, nerve sheaths, the production of hormones, and a range of other processes fundamental to life including building much of our brains. Far from being dangerous on its own, we could not live without it. Cholesterol has been divided into two forms, LDL and HDL, although there is actually only one type of cholesterol with the chemical formula C27H46O. Because it is not water soluble on its own cholesterol can't be transported in our blood unless it is carried by other molecules. LDL (Low Density Lipoprotein) and HDL (High Density Lipoprotein) are those molecules, and cholesterol behaves differently depending upon which one it is attached to.
LDL-cholesterol has been known as the “bad” form of cholesterol because it was thought that if there was too much of it, it could attach to artery walls creating a plaque build up leading to heart disease. HDL-cholesterol has been called “good” for its supposed ability to bind with excess LDL and remove it.
But these oft-repeated “facts” are being questioned as our understanding of what cholesterol does undergoes a fundamental change. There is growing evidence that even the most basic assumptions about cholesterol have been wrong, and that it appears at sites of inflammation and arterial damage not because it caused the problem, but because it is there to help fix it.
In support of this, a recent examination of WHO data available freely on the internet revealed that countries with higher average blood cholesterol levels had less heart disease, not more. The same study that showed people with high cholesterol lived longer also showed that those with low cholesterol suffered more heart attacks and strokes as they aged - the opposite of what the lipid hypothesistells us should happen.
The truth will set you free
Due largely to Ancel Keys' 60-year-old report and later assumptions, it has long been believed that eating foods containing cholesterol increased the amount of it in our bodies in an unhealthy way (although Keys himself did not say that). Research has since shown conclusively that for most people, eating food containing cholesterol does not change the body’s level of cholesterol at all. Even if it did, growing evidence shows cholesterol was not the problem in the first place. What all this means is that we can stop worrying about eating too much fat (with the exception of trans fat, which we should avoid).
In an ironic turnaround that is causing embarrassment for the scientific and medical communities, it’s quite possible we should actually be eating more.