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Ravnskov, a medical doctor with a PhD in Chemistry, has had over 40 papers and letters published in peer-reviewed journals criticizing what Dr. George Mann, formerly of Vanderbuilt University, once called "the greatest scam in the history of medicine": the Lipid Hypothesis of heart disease, the belief that dietary saturated fats and cholesterol clog arteries and cause atherosclerosis and heart disease.
If one thing comes through as you read the book, it is this: Ravnskov has done his homework. In painstaking detail, he critically analyzes and demolishes the nine main myths of the Lipid Hypothesis: (1) High-fat foods cause heart disease, (2) High cholesterol causes heart disease, (3) High fat foods raise blood cholesterol, (4) Cholesterol blocks arteries, (5) Animal studies prove the diet-heart idea, (6) Lowering your cholesterol will lengthen your life, (7) Polyunsaturated oils are good for you, (8) The cholesterol campaign is based on good science, and (9) All scientists support the diet-heart idea.
Equipped with a razor-sharp mind, an impressive command of the literature, and a deadly, needling sarcasm, Ravnskov methodically slaughters the most famous Sacred Cow of modern medicine and the most profitable Cash Cow for assorted pharmaceutical companies. Sparing no one, Ravnskov again and again presents the tenets of the Lipid Hypothesis and the studies which supposedly prove them, and shows how the studies are flawed or based on manipulated statistics that actually prove nothing. Ravnskov then answers the objections or rationalizations offered by diet-heart supporters, desperate to explain away inconsistencies and contradictions in their own data.
For example, Ravnskov opens with an analysis of the study that kicked off the Lipid Hypothesis in the 1950s: Ancel Keys' Six Countries Study (and later, the more famous Seven Countries Study). As most health professionals know, Keys' study showed that countries with the highest animal fat intake have the highest rates of heart disease. Keys' conclusion was that there was a cause and effect relationship because the country with the lowest animal fat intake (at that time, Japan) had the lowest rates of heart disease. Sounds convincing, right? Not so, says Dr. Ravnskov. And in a few pages the reader is informed how Keys hand-picked the countries he included in his studies, namely, the ones that supported his hypothesis, and conveniently ignored all of the other countries that didn't.
And this is just the beginning!
Ravnskov approaches true brilliance in his review of the studies that supposedly showed benefit from the current wonder-drugs pushed by the pharmaceutical industry: the statins. Hailed as miracle substances that "significantly reduce cholesterol and incidence of heart attacks," Ravnskov shows that these substances are probable carcinogens (women on the drugs had a much higher incidence of breast cancer) and that the overall statistical reduction of heart disease in the drug trials is negligible. Nevertheless, despite the dismal results of the very first trial (the EXCEL Trial which Ravnskov soberingly describes to the reader), the industry and its well-funded doctors urge their use, even in people who do not have heart disease.
Ravnskov warns: "Because the latent period between exposure to carcinogen and the incidence of clinical cancer in humans may be 20 years or more, the absence of any controlled trials of this duration means that we do not know whether statin treatment will lead to . . . cancer in coming decades. Thus, millions of people are being treated with medications the ultimate effects of which are not yet known."
If there is one weakness of the book, it is its lack of explanations of what DOES cause heart disease. Ravnskov comes close to fingering a few factors such as high stress, excessive polyunsaturated fat intake, trans-fatty acids, and smoking, but he never offers his own theory as to what causes the Western world's number one killer.
This is, however, a minor glitch. Ravnskov has done the world a major service in presenting his findings. All health professionals need to listen to this scholar and listen very carefully for the advice offered by the medical establishment for the last 50 years to beat heart disease has failed miserably. It is time to turn away from cholesterol-lowering drugs that have frightening side effects. It is time to turn away from tasteless low-fat diets that harm children and deprive people of fat-soluble vitamins. And it is time to turn away from the junk science that characterizes the Lipid Hypothesis and its supporters. It is time, instead, to listen to reason and view all of the evidence against a failed hypothesis and discover the true and varied risks and causes of heart disease. It is time to listen to Uffe Ravnskov....
“The truth, were it known, would send pharmaceutical stocks plunging. In most studies, the increased risk is present only above a level of cholesterol that includes just a small percentage of the total population. [These are the approximately 1% of people with a genetic defect called familial hypercholesteremia.] And women can stop worrying immediately because high cholesterol is not a risk factor for the female sex. Few comments have been made on this peculiar fact in all the vast literature on cholesterol. When it is mentioned at all, it is said that female sex hormones protect against heart attacks."
“In fact, it seems more dangerous for women to have low cholesterol than high. Dr. Bernard Forette and a team of French researchers from Paris found that old women with very high cholesterol live the longest. The death rate was more than 5 times higher for women who had very low cholesterol. In their report, the French doctors warned against cholesterol lowering in elderly women. But they could as well have warned against cholesterol lowering in any woman, or, to be more precise, in anyone at all."
Dr. Ravnskov went on to show that higher levels of high-density-lipoprotein (HDL, "good" cholesterol) are not protective against CHD, and that lower levels of low-density-lipoprotein (LDL,"bad" cholesterol) are not beneficial, although the expected associations of each with CHD are present. Here again, conclusions at odds with the researchersí own data were presented. Intimations that there are “many” or “definitive” studies in reports and papers were shown to be false by showing that citations often led to other reviews, each trusting the last, and ending at very few original studies.
“High-fat foods raise blood cholesterol." Dr. Ancel Keys was one of the main proponents of this myth. In a paper published in 1958, Keys showed a graph of the per cent calories from fat in the food of various countries vs. the mean serum cholesterol levels. The data points fell on a straight line, showing an excellent correlation. Dr. Ravnskov added data points from a number of countries deliberately ignored by Dr. Keys. These fall nowhere near the line. Furthermore, CHD death rates among subjects in Finland, Greece and Yugoslavia with similar serum cholesterol levels varied 5-fold depending on which area of the country they lived in!
Four studies in the US, one in the UK, one in Israel and one in Finland failed to show any correlation between diet and serum cholesterol levels.
“Numerous studies have shown that in people who eat a normal Western diet, the effect on blood cholesterol of eating 2 or 3 extra eggs per day over a long period of time can hardly be measured..."
Ravnskov presents the results of a number of trials of statin drugs in which total death rates are slightly lower than those of the controls. In an early trial of lovastatin (EXCEL) on 8,000 subjects the absolute death rate from all causes after just 1 year was 0.5% vs. 0.2% in the placebo group.
Kilmer S. McCully, Ph. D., M. D., in technical papers and a book: “The Heart Revolution: the Extraordinary Discovery that Finally Laid the Cholesterol Myth to Rest”, Harper Perennial, 2000, wrote: “But no study anywhere has ever proven that lowering the amount of cholesterol in the diet reduces the risk of heart disease. And lowering cholesterol through drugs won’t prevent arteries from hardening if homocysteine is high.” McCully is the discoverer of the fact that the undesirable amino acid called homocysteine is an actual cause of atherosclerosis and CHD.
Based on Ravnskov’s meticulous analyses as well as the considerable support for his stance shown by others who have also studied the cholesterol data, this book is recommended without reservation. Physicians and other health professionals as well as anyone threatened with cholesterol-lowering treatments would be enlightened, and better able to resist worthless treatments. Health insurers might reconsider compensation for frequent (or any) clinical assays for cholesterol or triglycerides, let alone expensive treatments to lower cholesterol levels that reduce quality of life without prolonging it significantly.
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