All who have studied and trained in Medicine know this to be. How did Medicine then succumb to initially a faulty thesis and subsequently allow very marginal and inconsistent research data maintain the concept? My short answer would be, because during the ‘Period of Decadence’, my term, from WW2, the Dumbing Down of Medicine commenced and grew, where crudely too many without training in Medicine stained the mechanisms, the processes of Medicine, so the patient and Public suffered. Fortunately there is a cabal of commentators and writers giving this issue overdue publicity.
Cholesterol is ubiquitous, manufactured in all mammal cells and the majority is synthesized in the liver. Near 4% is sourced from animal nutrition. There is no plant source, so we as a species are essentially independently, the source of our own cholesterol. Its as if we in our evolution adaption, ensured our own responsibility for cholesterol and avoided leaving it to chance from an unpredictable nutrition source. That is a measure of how important it was for our adaption and survival. And yet certain protagonists with power, seduced ‘health’ and some ‘medical’ entities, to believe cholesterol was a poison and a perpetrator of atheroma in arteries. If so, why now in the early 20th century, when our species and fore-bears survived at least 5-7 million years? It seems arguably the US Dept., of Agriculture and Keys, by providing inaccurate data on fats in the 1960’s, indicating saturated fat consumption had increased 34% , fitted the theory of the Lipid Hypothesis ;consumption of saturated fat and cholesterol was the basis of Coronary Heart Disease.This fat data did not appear to undergo Medical scrutiny until much later and found to be false.This is but one example of the ‘Dumbing Down of Medicine’.
Cholesterol is critical as a cellular template for the synthesis of pituitary, hypothalamic, adrenal, renal and sex hormones. These hormones with Vitamin D are the chemical initiators, maintainers of important cellular and organ function. Cholesterol as an ester inhabits the skin and responds to UV light to synthesise Vitamin D. It is the structural basis of the bile acids, that physico-chemically facilitate the gut absorption of all the fats in nutrition, saturated, mono-unsaturated and poly-unsaturated, which would include all fat soluble micronutrients.
Cholesterol, with saturated and unsaturated fats forms the bi-lipid cell wall membrane of all animal cells. The postulated oily or fatty vesicle was the fore-runner of the prokaryotic cell we suspect. Aside from structural strength, it is responsible for physiological selective permeability of compounds and cell elements, including nutrients and waste products, as well as ‘receptor’ sites. Cholesterol, with saturated and unsaturated fats,(poly) form over 60% of brain matter. It is integral to all nerve conduction as an important component of the myelin sheath of all nerves.
So when I and I suspect all medical students and doctors trained in medicine heard ‘noises’ that saturated fat and cholesterol were responsible for coronary heart disease, the planets leading killer, skepticism was rife. The theory that Cholesterol, this absolutely critical compound for our existence, survival, had early in the 20th century started killing us and reached epidemic proportions in the mid 1970’s, was biologically screwy! The fact it was driven by a determined and poorly informed nutritionist, Keys blaming saturated fat as responsible, when only 4% of our total cholesterol came from nutrition, and Keys believing in the previous 50 years saturated fat consumption had increased 34%, when it had not, was faulty. In retrospect it looks like a Monty Python skit, but we have the benefit of hindsight and of course data accumulated slowly over time. Another example of the ‘Dumbing Down of Medicine’, that has proven to be ‘deadly’.
When the Dean of the Otago Medical School a Cardiologist, explained to five medical students that populations of some south Pacific Islands, consumed very large quantities of saturated fat, up to 50% daily calories and had no evidence of the consequences of atheromatous vascular disease, or risk factor precursors, I don’t believe I was ever convinced of this theory. The study was known as the TIMS lead by Professor Ian Prior, from Otago Medical School. Keys ignored this study, which in the 1960’s was the most ‘scientific’ showing saturated fat and cholesterol had no link to coronary or other vessel disease, in that population.
So how does Cholesterol find its way into atheroma lesions in arteries? This type cholesterol is Low Density Lipoprotein in small dense mainly oxidized particles that has its origin from Triglyceride Fatty Acids produced in the liver. When there is ‘excess for needs’ carbohydrate from processed same and sucrose sugar or manufactured fructose, the liver produces Triglyceride Fatty Acids, the source of the atheroma cholesterol, small dense oxidised LDL.
This metabolic state has degrees of insulin resistance, hyperglycemia, with chronic inflammation that at this stage appears to be initiated from adipose tissue releasing factors, that may initially arise from abdominal omental fat.
Its of interest historically that Keys fed a cohort of young males, before his 7 Countries Study and during his starvation studies, generous quantities of saturated fat and cholesterol for three weeks and did not shift their blood cholesterol levels. He reportedly accepted these results. So what changed his mind? Was it really the trip to Italy?As I have said some of the science was very suspect.