In the guardian today is a very extensive and detailed article asking whether headlines like "butter is back" should be heeded. The article can be read at theguardian.com/lifeandstyl...
The article is written with a powerful sub-title, "This is not just bad science – it will cost lives, say experts." It goes on to make the case for the overwhelming evidence that butter & cholesterol deniers seek to suggest is bad. To do this it cites Public Health England, the World Health Organization, the British Heart Foundation (BHF), Heart UK as all organisations who think butter and cholesterol intake should be severely limited.
So why now? Because more than 170 academics signed a letter accusing the British Journal of Sports Medicine of bias. This bias is that they have contributed to the headlines about "butter being good for you" but have continually blocked responses putting the other side of the argument.
At least on this forum whoever joins the debate, from whatever side or angle, has an equal opportunity to express their opinion.
Written by
andyswarbs
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I don't really have any concept of what cholesterol raising foods are... I've always tended towards full fat products simply because my mum had concerns about the free radicals that come from spreads and fat removed products, and so she tended to always feed us full fat versions. My cholesterol is pretty much ideal, so I figure there's not need for me to make any changes... I wouldn't call it denial for me, but more "if it ain't broke, don't fix it".
My OH does have slightly raised cholesterol (probably tied to his coeliac diagnosis not long before the test). The advice we read online seemed to favour reducing salt intake, more than anything else.
I find it unutterably depressing that people like the BHF and their ilk believe that this all boils down to which expert can shout the loudest. Here's how science works: if reality does not accord with your theory, then you theory is wrong. It doesn't matter how much evidence you can muster to support your theory. If it doesn't explain contradictory results, it is wrong.
For example, there are hundreds of millions of people who have never heard of cholesterol, calorie-counting, saturated fats, or My Wellness Plate (or whatever it's called this month) and yet aren't all keeling over with heart attacks. There are an inconvenient number of French people who eat fat and lard, smoke, drink, and consistently have one of the lowest rates of heart disease on the planet.
There are two remaining elephants in the room:
-The experts recommend that we all substitute margarine for butter and lard. Margarine actually contains roughly the same ratio of saturated and unsaturated fatty acids as lard - they're just assembled into unconventional triglycerides. Yet apparently one is healthy and the other is not. Sorry, does not compute.
- Why is it that the entire Western population is (apparently) so desperately unhealthy that they all need to be on statins, whereas the aforesaid peoples who have never heard of "healthy eating" are not, and do not? In fact there seems to be a suspicious correlation between the presence of experts dispensing dietary advice, and ill-health.
I'm with happycook on this one: I'm sick of listening to windbags whose career depends on finding an endless list of things that are bad for us.
The point of the guardian article was not about who shouts the loudest. Instead it was about organisations that distort the debate by deliberately suppressing one side of the debate. If I am in a soundproof room it does not matter how loud I shout!
Or if one is more cynical I'd suggest that the loud shouting is coming from the "nothing wrong with saturated fat, nothing wrong with high cholesterol, nothing wrong with salt" brigade. Because when you don't have the facts all you can do is shout loud to drown out the other side.
And journalists (including editors of medical journals) are often complicit in this.
A headline that says "doctors are wrong" sells a lot more newspapers or gets more clicks online than one that says "nhs dietary advice basically correct".
andyswarbs : that wasn't my takeaway from the article. The author (like most journalists) clearly thinks that the science is a matter of debate. Science does not use debate to address questions, which is why it is so very powerful at delivering answers. Something is either wrong or it is not-wrong. There is no room for "expert opinion". If something remains unknown, then the duty of the scientist is to formulate an experiment that settles the question. The fact that the BHF are not doing this - worse, they are blustering with arguments that amount to "ohh, won't someone think of the children?" - suggests to me that they are incompetent.
benwl : the "nothing wrong with..." brigade aren't shouting. A few facepalms, occasionally. Mostly they're just being inconveniently slim and healthy. Most conspicuously, they're not having heart attacks, and that upsets the nutritional puritans no end.
There are plenty of headlines saying the NHS is correct. They appear roughly as often as the ones saying the NHS is wrong. The fact remains that everyone following the NHS advice is fat and ill, which strikes me as the ultimate triumph of superstition over science.
This is not a simple issue, as you look deeper the paradox can unwind in ways such as how different countries report CVD. I am not saying the paradox is rubbish, rather further study is worth looking for.
And here it is. ncbi.nlm.nih.gov/pubmed/799... points out that CVD takes years of eating high fat diet to develop. Only in recent years has France begun to adopt the SAD diet, and that explains much of the so-called French paradox.
That first paper refers to a graph from 1977 to "prove" correlation between something they call the "cholesterol saturated fat index" and mortality. Why do you think that might be?
It certainly isn't a simple issue. One of the problems I have with mainstream nutritionists is that they love to boil everything down to carbs, fat and protein, which seems to get them nowhere. If they would just focus on actual food they might have a bit more luck unravelling the problem.
As for the French, it doesn't really matter what the reason is. If saturated fats->high cholesterol->heart disease isn't true in the French population, then it isn't true anywhere. French people are human, whatever jokes might be made to the contrary. So as far as fat/cholesterol is concerned, perhaps it is simple. Bias in reporting might well be a factor, but that swings both ways: doctors may be over-reporting in other countries. The problem here is that a doctor has to put something on a death certificate, and CVD is the simplest cop-out ... because almost every corpse shows signs of heart disease.
Besides, if vegetables really do reverse (not just offset, but reverse) the supposed association between saturated fats and heart disease, why aren't doctors prescribing vegetables? Ah yes: patient choice. The patient must be free to make bad choices, and food manufacturers must free to confound those choices with their advertising, and drug manufacturers must be free to make as many sales as possible. Even if the drugs don't even work. So here we are, with an NHS spending 25% of its not-inconsiderable budget on diet-related illness, and doctors who stand up and say "eat proper food and do some exercise" are pilloried.
What we're interested in here, really, is chronic ill-health, not death (as I argued in my 'I want to die of heart disease' post). Or, if we're looking at deaths, we should be ignoring those that happen in old age - over 60, say. I make regular attempts to find good-quality research on this sort of thing. It just isn't there. In particular, I've turned up literally zero papers in my searches on high-fat diets.
TAD said "- Why is it that the entire Western population is (apparently) so desperately unhealthy that they all need to be on statins, whereas the aforesaid peoples who have never heard of "healthy eating" are not, and do not? In fact there seems to be a suspicious correlation between the presence of experts dispensing dietary advice, and ill-health."
I am all for evidence-based medicine. Many people take vitamind D tablets daily because good VitD levels are associated with better health outcomes. BUT, and it is a big BUT, research shows that better health outcomes are not associated with taking VitD tablets!
We live in a society that tries to find the one magic ingredient that if we can isolate and/or synthesize we wll all live happy lives. I don't think statins are a magic long term pill. They are a pragmatic solution that could save lives today. Better health advice based on food choices is the long term solution.
Research also shows that statins have no impact on all-cause mortality, so they don't even save lives. Even in the case of heart disease, they reduce the rate of incidence in a narrow subset of the population (middle-aged men who have already had a CVD-related event). In every other case, they have zero impact. There could be no clearer proof that cholesterol has nothing to do with heart disease - since statins do effectively reduce LDL-C. Even the pharmaceutical companies are now suggesting that the mechanism of action is something to do with reducing generalized inflammation, not cholesterol.
>> We live in a society that tries to find the one magic ingredient that if we can isolate and/or synthesize we wll all live happy lives.
Indeed. And I think this is a fool's errand. The truly sad part is that "eat proper food and do some exercise" actually WORKS. It's worked for millennia. But that isn't good enough, because we all want to eat rubbish food and watch TV all day, and we get upset when that makes us fat and ill. We expect doctors today not just to fix those things that strike out of the blue, but to fix the inevitable consequences of our own choices.
I like the original post because what it's saying is "Listen carefully, dig deeper into studies and arguments on both sides before deciding for yourself. In that spirit, I would like to present a completely "crazy" idea that I believe in, but which might rub many of you the wrong way. What we consider to be "normal" levels may well be lethal. "Normal" in a society that has out-of-control heart attack levels is not "ideal". What is the ideal LDL cholesterol level? 50-70 mg/dl.
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