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Customer Review

416 of 439 people found the following review helpful
5.0 out of 5 stars Busting Anti-Cholesterol Bias Once and for All, October 12, 2012
This review is from: The Great Cholesterol Myth: Why Lowering Your Cholesterol Won't Prevent Heart Disease-and the Statin-Free Plan That Will (Paperback)
As a Certified Nutrition Specialist, I sometimes have clients gasp when I recommend they choose eggs over cereal for breakfast or include shrimp in their protein intake. "But... the cholesterol!" they shriek.

Anti-cholesterol bias and misinformation runs rampant, even in this supposedly enlightened era when studies show dietary cholesterol has little to do with blood cholesterol and people are fearlessly eating egg yolks again.

Thankfully we have this wonderful, meticulously researched new book from Dr. Jonny Bowden and Dr. Stephen Sinatra that dispels those myths. Despite the multi-billion dollar pharmaceutical industry and many doctors' determination to put anyone with even slightly elevated cholesterol on statins, the evidence suggests otherwise:

Cholesterol levels do not accurately predict heart attacks.
In fact, half of heart attacks occur to people with normal cholesterol levels.
And half the people with higher cholesterol actually have healthy hearts.

Why aren't we getting this information from the mainstream media, which persist in demonizing cholesterol for heart disease and numerous other health issues?

In The Great Cholesterol Myth, Drs. Bowden and Sinatra provide a compelling case to stop fearing cholesterol. They also discuss other culprits your doctor probably isn't telling you about that can contribute to heart disease.

They won't leave you hanging. They've also provided a simple yet comprehensive dietary and lifestyle action plan that helps you take the right steps to prevent heart disease. You don't have to succumb to your doctor's well-intended but wildly outdated recommendation to take statins and eat a low-fat diet.

Whether you struggle with high cholesterol or just want to knock the wind out of any so-called expert who argues you should avoid cholesterol, you must read The Great Cholesterol Myth.
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Showing 1-10 of 41 posts in this discussion
Initial post: Dec 5, 2012 9:51:15 AM PST
Edward Terry says:
Ancel Keys, in his 1952 article "Human Atherosclerosis and the Diet" in the journal Circulation, stated that "...From the animal experiments alone the most reasonable conclusion would
be that the cholesterol content of human diets is unimportant in human atherosclerosis." However, the article ends with this sentence, which is at odds with the rest of his paper, "...disregard of cholesterol intake except possibly for the restriction to an intake of less than 1 gram per week." He provided absolutely no rationale for this amount.

In reply to an earlier post on Dec 26, 2012 6:26:39 AM PST
Last edited by the author on Dec 26, 2012 6:38:57 AM PST
Warren Green says:
The thing is, dietary cholesterol generally does have major impact on blood cholesterol levels. My own experience demonstrates that. A few years back, my LDL blood cholesterol level was at 128. At last check, it was 81, a level where reversal of atherosclerotic plaque has been documented.

Usually, it's the doctors pushing statin drugs who deny that dietary change works. Although I guess this group also includes doctors pushing cholesterol laden foods.

For another perspective on this, I recommend reading Prevent and Reverse Heart Disease, or watching Forks Over Knives

In reply to an earlier post on Dec 26, 2012 7:15:25 AM PST
Edward Terry says:
That's odd. Years ago, when I ate a very low fat diet, with almost no animal products, my total cholesterol was 220 and my HDL 30.

Now I eat a high-fat diet (>300 g/day), most of it saturated fat, and almost 2,000 mg of cholesterol. I can't get my total above 185 and my HDL hovers around 60.

Please explain that. I have read forks over knives. However, I prefer science over superstition.

In reply to an earlier post on Dec 26, 2012 12:16:20 PM PST
Last edited by the author on Dec 26, 2012 12:22:55 PM PST
Warren Green says:
In the Framingham study, it was only the people who maintained total cholesterol levels below 150 who didn't develop heart disease. My total was 190, but it's now around 135, and my HDL, at last check, was 37. My doctor was about to give me a bit of a hard time, because it was no longer above 40, but then he looked at my LDL again and said, "Never mind, you're good. I wish I had your cholesterol numbers."

As far as distinguishing between science and superstition, I'll go with what works. Eat to Live: The Amazing Nutrient-Rich Program for Fast and Sustained Weight Loss, Revised Edition

In reply to an earlier post on Dec 26, 2012 1:11:07 PM PST
Edward Terry says:
Actually, the results of the Framingham study showed that for women, the higher their serum cholesterol, the longer they lived, except for those with genetically high levels. At one point, my total cholesterol was 97 and the cardiologist I was seeing at that time was thrilled. He firmly believed that lower was better. Later, I saw the results of the World Health Organization study of 164 countries, where they collected data on many biomarkers and death from various causes. Instead of a linear relationship between serum cholesterol and mortality, there was a "J" curve, where mortality was at a minimum at a cholesterol level between 200 and 220. As total cholesterol dropped to 150, death from heart disease doubled and death from all causes quadrupled. Death from infectious diseases and cancer skyrocketed the lower the cholesterol was. Turns out that HDL and especially LDL, form a large part of the non-specific immune function.

I attended a series of lectures at the National Institute of Health and one of the researchers stated that they now have evidence that a significant percentage of heart disease and cancer is caused by infectious agents, both bacterial and viral. Lowering LDL seems to weaken the immune function, leading to more infections, cancer and heart disease.

In 1978, the rule-of-thumb for a healthy cholesterol levels was "200+age". In the 1980's, after the discovery of statins, "normal" was readjusted to be much lower. Some people have pointed out that LDL does not cause heart disease but is simply an indicator of other metabolic process. As far as lower being better, most people who have heart attacks have lower cholesterol, not higher, with the exception of those few who have extremely high cholesterol because of genetic disposition.

Serum cholesterol is determined by a number of factors, internal production and dietary intake. If dietary consumption drops, internal synthesis increases proportionally. Similarly, when dietary intake is high, internal production slows down.

Most of the information on this topic assumes that LDL is dangerous, which has never been shown to be true in normal individuals. Ancel Keys later research, which purported to show a link between serum cholesterol and heart disease was so riddled with methodological errors, so any results of his are wrong. It's very difficult to know what information is valid and which is not. However, there is one commonality between paleo and vegetarian diets: the elimination of processed food and food-like substances.

By the way, I fired my first cardiologist because he wanted me to start taking a statin again because my LDL was wildly elevated. It was 80. A couple of years later, I saw another cardiologist to get a second coronary artery calcium scan performed, and my calcium score had decreased. He stated he had never seen that happen. I then told him how I ate. His eyes got really big and his response was priceless, "That's not what we were taught in school."

Good luck on your quest for the truth.

In reply to an earlier post on Dec 26, 2012 1:43:30 PM PST
Last edited by the author on Dec 26, 2012 1:59:04 PM PST
Warren Green says:
If you think Forks Over Knives was built on superstition, then I suspect you believe The China Study to be the same. Never-the-less, I'll provide a quote here for others: "But when we measured the blood cholesterol levels in China, we were shocked. They ranged from 70-170mg/dL! Their high was our low, and their low was off the chart you might find in your doctor's office! It became obvious that our idea of "normal" values (or ranges) only applies to Western subjects consuming the Western diet." ( from page 106 )

I guess at least for the time being, we've both taken sides on who we trust. Good luck to you also.

In reply to an earlier post on Jan 18, 2013 10:03:32 AM PST
Taco Bell says:
Hi Warren: There are a few excellent anaylses of both the China Study and Forks Over Knives that I would like to refer you to.

In reply to an earlier post on Jan 20, 2013 9:29:43 AM PST
firmus says:
Warren, I think your cholesterol levels are dangerously low, especially your HDL. You're part of the 'risk group'.
The book The China Study is incredibly flawed and has been debunked already (see Denise Minger or Chris Masterjohn on Campbell's rat experiment).
There are parts in China where liver cancer is a frequent cause of death. Liver disease leads to low cholesterol levels. (or maybe the other way around, who knows) You shouldn't be so intrigued by their low levels.
Most centenarians have cholesterol levels above 200.

Even if you follow a vegan diet, I would recommend you to include organic coconut oil to boost your HDL levels.

In reply to an earlier post on Jan 23, 2013 10:43:12 AM PST
Last edited by the author on Jan 23, 2013 10:44:06 AM PST
Yes, "The China Study" is an example of junk science, and Denise Minger thoroughly destroyed it in her comprehensive treatment of it on her blog.

Additionally, there are two types of LDL (which, technically, are not cholesterol but lipids): relatively small, dense particles and larger, less dense ones. It is the former which are deleterious, while the latter are apparently benign. Thus the basic HDL/LDL ratio of itself is not a reliable indicator for risk. Triglyceride level is more significant and relevant.

Jason, thanks for your excellent review. And kudos to Edward for his cogent and informative posts. Edward, as in your case, my blood profile improved significantly when I switched from a low-fat to a restricted carb ("Paleo/Primal") regimen. A large portion of my diet consists of calories from fat and since making the change my total cholesterol level has dropped (although, as has been noted total cholesterol is not a relevant indicator for coronary disease risk); my HDL/LDL ratio improved; and, most importantly, my triglyceride measurement is now around 67, far below the accepted threshold of 150. All of this was enabled by increasing my fat intake.

The edifice of the prevailing mythology that fat is unhealthy and should be severely limited in the diet is steadily crumbling but remains pervasive. Hopefully books such as "The Great Cholesterol Myth" will be influential in turning the tide.

Posted on Jan 29, 2013 8:40:49 AM PST
D.M. says:
Effect of long-term exposure to lower low-density lipoprotein cholesterol beginning early in life on the risk of coronary heart disease: a mendelian randomization analysis.

Ference BA, Yoo W, Alesh I, Mahajan N, Mirowska KK, Mewada A, Kahn J, Afonso L, Williams KA Sr, Flack JM.

The purpose of this study was to estimate the effect of long-term exposure to lower plasma low-density lipoprotein cholesterol (LDL-C) on the risk of coronary heart disease (CHD).
LDL-C is causally related to the risk of CHD. However, the association between long-term exposure to lower LDL-C beginning early in life and the risk of CHD has not been reliably quantified.
We conducted a series of meta-analyses to estimate the effect of long-term exposure to lower LDL-C on the risk of CHD mediated by 9 polymorphisms in 6 different genes. We then combined these Mendelian randomization studies in a meta-analysis to obtain a more precise estimate of the effect of long-term exposure to lower LDL-C and compared it with the clinical benefit associated with the same magnitude of LDL-C reduction during treatment with a statin.
All 9 polymorphisms were associated with a highly consistent reduction in the risk of CHD per unit lower LDL-C, with no evidence of heterogeneity of effect (I(2) = 0.0%). In a meta-analysis combining nonoverlapping data from 312,321 participants, naturally random allocation to long-term exposure to lower LDL-C was associated with a 54.5% (95% confidence interval: 48.8% to 59.5%) reduction in the risk of CHD for each mmol/l (38.7 mg/dl) lower LDL-C. This represents a 3-fold greater reduction in the risk of CHD per unit lower LDL-C than that observed during treatment with a statin started later in life (p = 8.43 × 10(-19)).
Prolonged exposure to lower LDL-C beginning early in life is associated with a substantially greater reduction in the risk of CHD than the current practice of lowering LDL-C beginning later in life.
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