Key’s conclusion:  Cholesterol causes heart disease and saturated fat increases cholesterol and hence saturated fat causes heart disease.  This began the fat free craze that literally swept the nation…fat became nationally demonized as the cause of heart disease (along with weight gain).  And the high carb, low fat diet became the face of the “healthy heart” American diet.

The study became so engrained that an entire new national program was developed, the National Cholesterol Education Program (NCEP).  NCEP’s objective is to help educate people of the dangers of high cholesterol and how to best prevent heart disease.  Now, that seems like a great program…right?  I mean our tax money is actually going toward something that helps the general public and as supposed to some major private conglomerate that uses our money to increase their pay checks.  Well,  there’s only one problem.  The “landmark” study, which all dietary recommendation for a health heart was based on, was found to be flawed.

Not too long after Key’s study came out in 1970, an English doctor named John Yudkin, a professor of nutrition at Queen Elizabeth College in London College wrote a book, “Sweet and Dangerous” in which he re-analyzed the data from Key’s study and found the study to be flawed.  He specifically noticed that Key’s hand selected the countries that showed positive correlation between fat and heart disease, while conveniently leaving out other countries that didn’t fall nicely into his hypothesis.  According to Dr. Yudkin, the data showed a much stronger correlation between sugar consumption and heart disease, than fat/cholesterol and heart disease.

Interestingly enough, thirty years after Dr. Yudkin’s critical analysis of Key’s data, Dr. Georg Mann (associate director of Framingham Study) arrived at the same conclusion.  This prompted him to take it a step further and investigate the relationship of cholesterol to heart disease.  And not surprisingly, according to his team of researchers which included many notable scientists and doctors, they found little correlation between fat/cholesterol and heart disease.(2)  After the study was concluded Mann stated that the notion of fat/cholesterol causing heart disease is “the greatest health scam of the century”

Here are more significant studies (4) that have since clearly dissociated the relationship of fat/cholesterol and heart disease:

In 1994, Journal of American Medical Association published a study that completely dissociates cholesterol level to heart disease morality for people over 70 yrs old.

A well known study in France called the Lyon Diet Heart Study (3) followed 600 people that have already have at least one heart attack.  They were all sedentary and in poor shape.  The group was divided in to two groups.  One group ate a commonly recommended high carb, low fat (low cholesterol) diet and the other group ate a diet a “Mediterranean Diet” high in healthy fats and oils along with fruits and vegetables.  The result was nothing short of amazing.  Halfway through the study the group on the “Mediterranean Diet” had a 72% decrease in coronary event and 56% decrease in mortality without any changes in their cholesterol levels.  The results were so impressive that halfway through the study, they switched everyone over to the “Mediterranean Diet”.

Possibly the most famous study came out in 2006.  It was a study about a cholesterol lowering drug called Vytorin.  The case was controversial because the study was finished two years prior, but wasn’t made public until two years later, because the results were horrible.  The drug lowered cholesterol better than other cholesterol lowering drugs like statin, but it also increased plaque build up and increased arterial wall thickening.  Both major contributors for heart disease.

Medical evidence shows that half of all people that have heart disease actually have normal cholesterol levels, and many people with a healthy heart have an elevated cholesterol level.

So now that we know that fat/cholesterol just got a real bad rep for no good reason.  The next obvious question is what really causes heart disease?  The answer depends on multiple factors which includes genetics, lifestyle, stress factors, but from a dietary stand point the biggest causation seems to be sugar and insulin.

It’s not your imagination…sugar and insulin seems to be the culprit for pretty much everything that’s wrong with our dietary health.  Your insulin hormone can be looked at as the gate keeper to your health.  Insulin is a hormone secreted by your pancreas and it’s job is to maintain an even blood sugar level.  This is vital, since elevated blood sugar levels cause serious havoc to your body and can lead to many illnesses, including obesity, diabetes and heart disease.  The more your insulin is involved, the more likely you’re going to have health issues.

So here’s what happens in your body after you have a meal.

Let’s say that you just ate a typical carbohydrate rich meal with some pasta and bread.  When you eat, each food (macronutrient) gets broken down into their respective digestible components.  Protein into amino acids, carbohydrates into sugar and fat into fatty acids.  All components go through your liver first.  Your liver decides what to do with your basic components.  So, after a meal high in carbohydrate foods, your going to have a lot of sugar going to your liver.  And before it gets there, it passes by your pancreas where insulin is secreted.  The more sugar there is the more insulin is secreted by your pancreas.  And interestingly, the amount of insulin secreted allows your liver to make the necessary decision on what to do with all the sugar.  When sugar enters the liver it has three choices.

1 - Get directly transported for immediate energy use (ie. brain)
2 - Get converted into glycogen for storage in muscles and some in the liver
3 - Convert all other excess sugar into triglycerides (fat)

As the liver is metabolizing sugar, the stimulation of insulin also triggers another metabolic process that produces cholesterol.  The cholesterol being produced is then combined with the triglycerides, made from excess sugar, to make Very Low Density Lipoproteins (VLDL).  When the triglycerides get dropped off the VLDL becomes Low Density Lipoproteins (LDL), commonly known as the “bad” cholesterol.

LDL is commonly associated with plaque build up in your arteries.  But that’s not the entire story.  LDL actually has two types, one is harmless and the other can be harmful depending on the circumstances.  Without getting into too much detail, the LDL only becomes harmful if it’s damaged through oxidation and then exposed to excessive amounts of sugar.  Again, it comes down to too much sugar.  So, if you’re cholesterol level goes up and you see you have an elevated LDL, you need to know which type of LDL is elevated.  If it’s the harmless type, you have nothing to worry about, and if it’s the other type, just make sure that your sugar consumption is low so that it doesn’t become harmful.

According to Harvard Medical School research headed by J. Michael Garziano. (5) The most significant indicator of heart disease is the ratio of triglycerides to HDL.  Their study showed people with the highest ratio (triglycerides to HDL) had sixteen times greater risk for heart attack than people with the lowest ratio.  So keep your triglycerides low and your HDL’s high, to ensure a healthy heart.

Just to clarify, since I really haven’t talked too much about fat, consuming dietary fat (except trans fat) does not increase your level of triglycerides.  And, in fact eating saturated fat is completely fine for your health, as long as you’re consuming low amounts of sugar.  But I’ll get into the whole fat subject on another day.

Sadly, even with all the studies and information indicating that fat/cholesterol isn’t what causes heart disease, and that sugar consumption is the real culprit. The NCEP is still spreading false information.  Political and financial reasons are probably the main reason behind this.  The makers of cholesterol lowering drugs sell approximately 20 billion dollars annually.  And these powerful pharmaceutical lobbyists practically own the politicians.  Even worse, the American Academy of Pediatrics is now recommending cholesterol screening for kids as young as 2 years old and treating kids with statin (cholesterol lowering drugs) as young as 8 years old. (6)

So, if you’ve been stuck on lowering your cholesterol by eating low fat foods to keep your heart healthy…it’s time that you stopped worrying so much about fat/cholesterol and start watching your sugar intake.  Since all carbohydrates break down to sugar, your best bet is to eliminate or “really” limit refined carbohydrates (grains) and stick to unrefined carbohydrate foods (vegetables and fruits with low sugar contents) that has much less impact on your insulin as well as having lower sugar content.

So here’s how sugar and insulin can increase your risk of heart disease:

• Carbohydrate foods = sugar

• Sugar increases insulin

• Insulin stimulates cholesterol

• Sugar increases triglycerides

• Cholesterol + triglycerides = VLDL

• VLDL - triglycerides = LDL

• Excess sugar can damage (possible harmful type) LDL , and initiate plaque build up

• Ratio of triglyceride to HDL is the best indicator of heart disease

And here’s the best way to prevent heart disease:

• Control your insulin levels by limiting your sugar intake to minimize triglycerides

• Limit (or eliminate) refined carbohydrate foods and consume unrefined carbohydrates instead

Did your doctor put you on a low fat, restricted diet to keep you cholesterol in check?

Does your diet consist of mainly low fat foods and foods generally high in carbohydrates?

Did you know that cholesterol level has little to no bearing at all on the health of your heart?

What did you think about the article?  I’d love to know what you think.  Please post you comments below.

P.S.  Much of the information of this article came from the book “

Living Low Carb” by Jonny Bowden Phd. CNS

.  Which I highly recommend.  If you want to know how nutrition affects your body, this book is a must.  Please note that I’m not affiliated with him or the product in anyway, it’s just my own personal recommendation.