Cholesterol and Atherosclerosis
Statements of Diet-Heart Proponents
When cholesterol levels are high, it passes through vessel walls transforming vessel walls into the rocky rapids of atherosclerosis. Ancel Keys said “It is a fact that a major characteristic of the sclerotic artery is the presence of abnormal amounts of cholesterol in that artery. This cholesterol is derived from the blood”.
One problem with this statement is that every blood vessel in every organ contains the same amount of blood cholesterol.
We are urged to alter our diet by eating less red meat and animal fat, and exercising more. If this is not enough, and proponents of the diet-heart idea realize it is difficult to lower cholesterol by diet, then drugs should be used.
Cholesterol in the diet has only a marginal effect on blood cholesterol. One source says that up to 850 mg dietary cholesterol per day has little or no effect on blood cholesterol. The human metabolic machine is frugal. What is provided in the diet is not produced by the body.
Advertisements that tout the “two sources of cholesterol” are not credible in human beings.
Arteriosclerosis may be caused by excessive levels of homocysteine, which is the normal breakdown product of the amino acid methionine.
High levels of homocysteine can cause damage to artery walls. The walls become hardened containing calcium deposits called plaque. Arteries containing plague are more disposed to become atherosclerotic.
The normal metabolic breakdown of homocysteine is disrupted when amounts of vitamins B6, B12, and folic acid are inadequate.
Some physicians say that high homocysteine levels are better correlated with atherosclerosis and heart disease than cholesterol.
Many physicians are not concerned with homocysteine levels even though a test for homocysteine is readily available. Medicare will pay for it in older people.
Two internists, one cardiologist, and one family practice physician never mentioned homocysteine to me. Only when I discovered East Texas cardiologist Peter Langsjoen M.D. was a concern for blood homocysteine level manifested. He immediately prescribed the requisite vitamins.
Why weren’t other physicians concerned about homocysteine levels? I could only guess.
Medical education in this country is controlled by the pharmaceutical industry. And the pharmaceutical industry can’t make millions of dollars recommending vitamins. They do have many much more expensive means to prescribe for ailing hearts however.
Atherosclerosis is an advanced form of arteriosclerosis characterized by deposits of cholesterol, fats and blood clots within the plaque. Atherosclerosis and high blood pressure increase with age.
Atherosclerosis which blocks an artery in the heart my result in a heart attack.
I had 3 arteries completely blocked but did not have a heart attack because collateral circulation had developed. The blockage developed after I had to give up jogging/running because of joint problems.
Veins never become sclerotic possibly because of the low pressure in them. But veins used in bypass operations do become sclerotic.
Arteries may become stiff as a protective measure to prevent the pressure inside them from widening too much.
But highly trained athletes and some isolated tribes who run all day in taking care of their cattle have wide clean arteries according to reports.
More details of atherosclerosis and its relation to coronary heart disease (CHD) are given in the book The Cholesterol Myths by Uffe Ravnskov M.D., Ph.D.
In the Framingham, Massachusetts study, the population had their blood cholesterol measured several times over the years.
Framingham study leaders ignored the studies of Landes and Sperry, Paterson and team in Canada, and Mathur and coworkers in India, that found no correlation between cholesterol levels and atherosclerosis in those who died.
For a review of Landes and Sperry, Paterson, and Mathur go to the link at the bottom of this page.
They criticized Paterson’s studies that showed no correlation between atherosclerosis and cholesterol levels, but did not reveal their own strategies and certain aspects of their results.
They also ignored the other US study and those in Poland, and Guatemala that also found no correlation of cholesterol levels and atherosclerosis.
Dr. Manning Feinlab of the NHLBI began to document the atherosclerosis in the coronary arteries of those in the Framingham study who had died. There were many bodies to choose from, 914 to be exact. They examined 281 0f the 914. They finally chose 127 (14 percent) for investigation of the heart and its vessels.
The investigators said nothing about their selection criteria, even though this could be critically important in understanding the results.
Dr. Ravnskov, author of The Cholesterol Myths made the statement that this was not a random sampling as other studies had been.
Autopsies are seldom done on older people who die peacefully in old age. But people who die at a younger age, perhaps of unusual circumstances, are the ones who are autopsied. For those who pay attention to crime reports in the news, this frequently happens.
Over half of those whose coronary arteries were examined in the Framingham study were under 65 years of age. Quite likely this included a number of those who had been afflicted with familial hypercholesterolemia.
Another page explains familial hypercholesterolemia in more detail.
And the likelihood is great that those chosen were done so with a view to the results desired. This conclusion is mine.
The correlation coefficient of those autopsied at Framingham was weak, only 0.36. Such a weak correlation coefficient denotes only a slight relationship between variables, which in this case is between cholesterol and atherosclerosis.
Some strange results showed up in the Framingham study as the years rolled by. The authors noted that for each "1% mg/dL drop in cholesterol there was an 11% increase in coronary and total mortality”.
An 11% increase in total and coronary deaths with a 1% decrease in cholesterol levels. This could be considered an alarming discovery.
And yet in subsequent reviews they claimed the Framingham study supported the saturated fat-cholesterol cause of heart disease.
Japanese Atherosclerosis Studies
Two studies similar to the Framingham project were done in Japan. In both studies a correlation between cholesterol levels and atherosclerosis was claimed.
However in one study the relationship was found only in those with low or normal cholesterol levels.
In the second study the small correlation coefficient was found only in elderly people.
No figures or data were presented in the reports of the studies, except the small correlation coefficient. They did not explain why the correlation was found in some groups but not in others.
Going back to the original data, Dr. Ravnskov found that in the dead Japanese with high cholesterol, the degree of atherosclerosis was the same whether young or old.
And all degrees of atherosclerosis, low, moderate or high, were present in those who died.
Conclusion? There was no correlation of cholesterol level with atherosclerosis.
Aorta Atherosclerosis and Blood Cholesterol in Japanese and Americans
In a 1950s study researchers looked at the aorta, the main artery from the heart to the body, in 659 Americans and 260 Japanese after death. They graded all signs of atherosclerosis.
At that time the average blood cholesterol for Americans was 220 mg/dL. For the Japanese the average cholesterol level was about 170 mg/dL.
Atherosclerosis increased in both groups after age 40 as expected. However there was hardly any difference between Americans and Japanese.
Between ages 40-60, Americans were a little more sclerotic than Japanese. Between 60-80 years there was practically no difference in sclerosis. Above 80 the Japanese were alittle more sclerotic than Americans.
Brain Arteries and Atherosclerosis in Japanese and Americans
A similar study looked at arteries of the brain in 1408 Japanese, and more than 5000 Americans. In all age groups Japanese were more sclerotic than Americans.
Why are the aorta and arteries of the brain in Japanese just as sclerotic as Americans when the cholesterol levels are much lower in Japan than in America?
If high cholesterol causes sclerotic lesions it should do it in any vessel, whether coronary arteries, or aorta, or brain vessels, since cholesterol is the same in all vessels, not just in one particular blood vessel.
Older people with high cholesterol should be more sclerotic than younger ones with lower cholesterol. But this wasn’t the case.
It seems much more likely that something else causes atherosclerosis. There is the possibility that blood pressure may vary greatly between arteries. Dr. Ravnskov, the author of The Cholesterol Myths, points out that the tension of coronary vessels increases, but not necessarily other vessels, when we are mentally stressed.
Diet-Heart Idea on the Rocks
All of the above data argues against dietary cholesterol contributing to CHD.
Dr. Ravsnkov also notes that, in general, coronary arteries of Japanese are less sclerotic than coronary arteries of Americans. Could this be why Japanese have fewer heart attacks than Americans?
Could Japanese society with its group consciousness have been shielded from the striving ambition and its tension typical of individuals in the American way of life?
What makes LDL cholesterol "bad" and HDL cholesterol "good".
To review Landes and Sperry, and others who showed atherosclerosis and cholesterol are not correlated.
Home Page where Nutritional Diseases are defined.