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Saturated Fats, Cholesterol, and Heart Disease


by Michael Chu
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So, last Wednesday I made a Coconut Creme Pie and brought it into work. No surprise, it was completely consumed with other coworkers on the waiting list for slices that were disappointed. What was surprising was a couple of the consumers commented on how bad the pie must be for their bodies. I assured them that I used no additives and kept the ingredients as fresh as possible. I admit that there were some trans fats in this particular pie because I was unable to get graham crackers without partially hydrogenated oils. It turned out that they were concerned mainly about the coconut. One of my coworkers who was watching his cholesterol levels said, "It's high in cholesterol!" I assured him that as a plant product, it was impossible for coconut to have cholesterol. Then he said, "Well, it's high in saturated fat then."

Ah, saturated fat. The most maligned and misunderstood "bad" food in the last thirty years. During the last year, I've been trying to figure out why everyone thinks saturated fat is evil and I have been unable to discover any evidence that there is evidence that saturated fats are bad for you. In fact, quite the opposite. I'll take this space and discuss briefly (although it might seem long to you) saturated fats, polyunsaturated fats, cholesterol, and the misconceptions we've been brought up with. I'll touch briefly on trans fatty acids too, but that topic is so nasty that it really deserves it's own article along with the possible manipulation of the American diet by food oil companies. Okay, back to saturated fat.

Something that doesn't help is that saturated fat is specifically called out on nutrition labels on food products as well as a Daily Value Percentage. This makes it seem that we need to limit the intake of saturated fat but not monounsaturated or polyunsaturated. This implies that saturated fats are worse than the other two fats and that is not the case.

A little background first:
Fats are comprised of fatty acids which are long chains of carbon atoms with hydrogen atoms hanging off them:
     H H H H H H H H H H H

COOH-C-C-C-C-C-C-C-C-C-C-C-H
H H H H H H H H H H H
(lauric acid)
(This molecule can be written as CH3(CH2)10COOH.) If all the carbons between the carboxyl (COOH) group and the methyl (CH3) group have two hydrogen atoms attached to them then the fatty acid is considered to be saturated. A saturated fatty acid is more or less straight (in reality the carbons zigzag a bit, but the overall chain is straight). This causes the fatty acid to have a high melting point. The longer the chain, the straighter the chain, the higher the melting point. That means most saturated fats are solid. In addition, the carbon single bond is quite strong resulting in a molecularly stable fatty acid.

Unsaturated fats refer to fats containing fatty acids that do not have as many hydrogens attached as is possible. Instead of bonding to hydrogen, one or more carbon atoms form a double bond with the next carbon:
     H H H H H H H     H H H H H H H H

COOH-C-C-C-C-C-C-C-C=C-C-C-C-C-C-C-C-C-H
H H H H H H H H H H H H H H H H H
(oleic acid)
This is a monounsaturated fatty acid because it has only one carbon double bond. This particular fatty acid (oleic acid) has a double bond in the ninth position from the methyl (CH3) group making it an omega-9 fatty acid. The majority of olive oil's monounsaturated fat is comprised of oleic acid. The double bond causes a bend in the chain (away from the missing hydrogens) so that the chain is no longer straight. This lowers the melting point and causes unsaturated fats (like olive oil) to be liquid at room temperature. Also every double bond in a fatty acid "weakens" the structure.
When a fatty acid has more than one carbon double bond, then it is considered polyunsaturated:
     H H H H H H H     H     H     H H

COOH-C-C-C-C-C-C-C-C=C-C-C=C-C-C=C-C-C-H
H H H H H H H H H H H H H H H H H
(alpha-linolenic)
This particular fatty acid (alpha-linolenic acid) has the first double bond in the third position from the methyl (CH3) group making it an omega-3 fatty acid. This fatty acid is found most commonly in flaxseed oil and salmon. Because of the three double bonds, this fatty acid is fragile and very sensitive to light and heat. Also, because of the three double bonds, this fatty acid curves back on itself and has a very low melting point.

When exposed to free radicals (molecules with unpaired electrons that are highly reactive), polyunsaturated fatty acids can undergo a process called lipid peroxidation which results in the polyunsaturated fatty acid to release additional free radicals. Lipid peroxidation has been directly linked to artherosclerosis (the constriction of the arteries due to build up of a plaque composed of fats, cholesterol, and other substances) and coronary heart disease (artherosclerosis of the coronary arteries that lead to the heart). Free radicals have little or no effect on the more stable monounsaturated and saturated fats.

It is commonly believed that the build up in the arteries is predominantly saturated fat and cholesterol. This is an inaccurate or incomplete statement. The plaque in the arteries varies from subject to subject, but it has been demonstrated that 3/4 of the fatty acids present in arterial plaque is unsaturated. [1] Also, cholesterol's role in the body is ignored when discussing artherosclerosis. The plaque formed in the arteries does contain substantial amounts of cholesterol, but probably because cholesterol is used as a healing agent. The damaged interior artery walls are patched up with cholesterol and then additional plaque builds up and more cholesterol is used to patch up the walls. The cholesterol is most likely not a cause of the plaque build up, but instead a body reaction to the plaque. The fact that no cholesterol is found sticking to the interior vein walls (where cholesterol concentration is the same as in the arteries) as you would expect if you were to believe the predominantly advertised theory that cholesterol causes circulatory disease. [2]

This brings us to the common belief that saturated fat increases the blood LDL cholesterol levels which in turn cause artherosclerosis. Low Density Lipoproteins (LDL) carry cholesterol from the liver to the tissues while High Density Lipoproteins (HDL) carry cholesterol in the blood back to the liver to be broken down. The buzz words "good" cholesterol and "bad" cholesterol have been used to label HDL and LDL, respectively. The belief that saturated fat lowers HDL in the blood is backed by several scientific studies, but there are also a number of studies that show that saturated fat intake can result in an increase in HDL as well. [3]Currently, there is no conclusive proof that saturated fat intake can be correlated to change in HDL/LDL ratio in the bloodstream.

An even more interesting fact is that the claim that LDL and HDL levels play an important part in heart disease and that there is a fight between "good" and "bad" cholesterol is short on supporting evidence (but long on media support). There seems to be as much scientific data that populations with high incidents of coronary heart disease tend to have higher levels of HDL (so-called good cholesterol). In addition, low levels of HDL do not correlate to an increased risk for coronary heart disease. Most interesting of all, is a study of people who have genetically caused reduced levels HDL do not have a higher risk of coronary heart disease. [4] Studies across several countries with similar HDL-LDL levels resulted in very different incident rates of heart disease. If the theory that HDL-LDL leads to heart disease is to be true, then a more consistent death rate from the disease would have been evident in these countries. It has also been shown that cholesterol level in the blood stream has no correlation with heart disease. In fact, over 80% of people who suffer heart attacks, do not have elevated cholesterol levels. [5] In addition, only 30-40% of people with artherosclerosis have elevated cholesterol levels. [6] It seems that cholesterol is neither a good indicator nor a risk factor for heart disease. (Note: A very small percentage of people have a genetic illness called hypercholesterolemia which interferes with their ability to matabolize cholesterol. People with this genetic condition do have to watch blood cholesterol levels.) [7]

So, what is the next most likely candidate for leading to heart disease? Lipoprotein (a) or Lp(a) has been pointed to as a coronary heart disease risk factor. [8] Although research is incomplete, early findings have been strongly suggesting that Lp(a) contributes to and promotes atherosclerosis. Evidence currently points to trans fatty acids as a major increaser of Lp(a) levels. What's ironic is that saturated fats have been linked to lowering Lp(a) levels! [9]

So, what are trans fatty acids? In unsaturated fatty acids, the carbon double bonds cause bends because the two bonded hydrogens are next to each other (cis). If the hydrogens alternate, then the carbon chain is once again straight. This is referred to as trans.
     H H H H H H H   H H   H H   H H H

COOH-C-C-C-C-C-C-C-C=C-C-C=C-C-C=C-C-C-H
H H H H H H H H H H H H H H
(trans-9,trans-12,trans-15-octadecatrienoic acid)
Trans fatty acids are created through partial hydrogenation of fats (natural or chemical). In nature this occurs rarely and results in very small amounts of trans fatty acids. In our supermarkets, this is a common place fatty acid. It was discovered that if you partially hydrogenated a fatty acid, about half of the fats would have bends going the other way (not in the same direction: cis), thus straightening out the chain. This causes the fatty acid to have a higher melting point, allowing the public to enjoy solid fats without the saturated fat (which was thought to be bad at the time). Margarine replaced butter, shortening replaced palm oil and lard, and partially hydrogenated soybean oil replaced coconut oil. During the last ten years, a great deal of research has been performed on trans fatty acids and the conclusions are not good. Trans fats (fats made of trans fatty acids) promote artherosclerosis and other cardiovascular dieases and increase the risk factor for cancer. In addition, trans fats have been found to replace necessary saturated fats in fat cells resulting in an unusable substance taking the place where a fuel and nutrient source should have been. This leads to the body increasing capacity of fat cells in order to maintain fuel and nutrient storage levels. Trans fats are also unstable and may lead to promotion of free radicals in the human body (for the same reasons that polyunsaturated fats do). It should be noted that fully hydrogenated fats are the same as saturated fats and do not exist in cis or trans formations (as there is no bend).

So, now we have discussed how saturated fats do not cause directly or indirectly heart disease, cholesterol is not an indicator or risk factor of heart disease, polyunsaturated fats should be reduced in the diet, and trans fats are to be avoided completely. (Pretty much the opposite of what the media and food oil producing companies tell us.) But, I haven't discussed any benefits of saturated fats.

Before I get into that, I want to mention that although a reduced polyunsaturated fat intake is recommended, there are two families of essential fatty acids that we should intake: omega-3 and omega-6. These are polyunsaturated fatty acids where the double bond is three or six carbons from the methyl group. About 1-2% of the calories you intake in a day should be omega-3 and about 2-3% should be omega-6. Too much omega-6, however, can limit your body's ability to use omega-3 fatty acids. Omega-3 fatty acids can be found in fish, flaxseed, walnut, and unprocessed soybean oil (the processing that removes color and oil from soybean oil pretty much destroys all the linolenic acid in it).

In a past article, I've mentioned that I cook predominantly with olive oils and butter. Here's why: olive oil is high in monounsaturated fat. In fact it is less than 10% polyunsaturated. Butter is less than 4% polyunsaturated and contains a large amount of heathful substances. These include naturally occuring vitamins (A, D, E, and K), small amounts of linoleic (omega-6) and linolenic (omega-3) acids, butyric acid (demonstrated anti-tumerigenic properties and a major fuel source for intestines), lauric acid (anti-microbial and anti-viral), glycosphingolipids (protects against intestinal infections), conjugated linoleic acid (strong anti-cancer properties and helps prevent weight gain; found only in butter and milk from grass-fed cows), lecithin (assists in metabolising cholesterol and fat components), selenium (aids vitamin E as an antioxidant; butter is one of the richest selenium food sources available), and cholesterol. It might seem weird to list cholesterol as a benefit, but cholesterol is a precursor to vitamin D and many hormones as well as an antioxidant and the body's primary repair substance. Consuming cholesterol also contributes to intestinal wall health. Ingesting cholesterol on a regular basis has been shown to not increase blood cholesterol levels because the body reduces its natural production and increases cholesterol metabolism to compensate.

It should also be noted that the small amount of ingested cholesterol can hardly be noticed in the large amounts of cholesterol flowing in your blood stream. For example, if you are capable of intake half of the cholesterol you consume daily (let's say 150 milligrams of 300 milligrams consumed) and you compare that to the amount of cholesterol in the blood (150 mg/dL), then you'll find that of the 7500 mg of cholesterol in your blood (150 mg/dL * 10 dL/L * 5 L/human) you've added only another 150 milligrams (assuming your body is even capable of intaking 50% of the cholesterol you've ingested). A healthy body can easily throttle back cholesterol production and increase metabolism to absorb the additional cholesterol intake.[3]

1. Felton CV, et al; Dietary Polyunsaturated Fatty Acids and Composition of Human Aortic Plaques. Lancet, 1994.

2. Cranton EM and Frackelton J; Free Radical Pathology in Age-Associated Diseases. Journal of Holistic Medicine, 1984.

3. Enig M; Know Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils and Cholesterol; Bethesda Press, 2000.

4. Smith R and Pinckney E; Diet, Blood Cholesterol, and Coronary Heart
Disease: A Critical Review of the Literature. Vector Enterprises, 1991.

5. Rowland D; The Nutritional Bypass. Heath Naturally Publications, 1995.

6. Reiser R; The Three Weak Links in the Diet-Heart Disease Connection. Nutrition Today, 1979.

7. Byrnes S; Diet and Heart Disease: It Is Not What You Think. Whitman Publications, 2001.

8. Garrison J and Somer E; The Nutrition Desk Reference; Keats Publishing, 1995.

9. Enig M; Fat Facts; Price-Pottenger Nutrition Foundation Journal, Winter 1998.

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Written by Michael Chu
Published on June 28, 2004 at 07:30 PM
54 comments on Saturated Fats, Cholesterol, and Heart Disease:(Post a comment)

On January 06, 2006 at 10:15 PM, an anonymous reader said...
Interesting - may I ask, if cholesterol in the blood in not a "risk factor of heart disease," why is anti-cholesterol medicine commonly prescribed to those with a risk of heart disease?


On January 06, 2006 at 10:16 PM, an anonymous reader said...
It's to make drug companies money.
I used to be required to take lipitor, but since i lost my job 8 mos. ago
due to the failing economy, (due to the bad decisions of an inbred, retarded texan), I had to get on indigent health care.For some strange reason they say I don't need it anymore? I've only been taking it for one month.


On January 06, 2006 at 10:16 PM, Michael Chu said...
I like to think it's the same reason why most professional chefs still put oil in the water that they boil pasta in. Habit, tradition, makes them feel better because that's what their mother (doctor) told them.


On January 06, 2006 at 10:17 PM, an anonymous reader said...
I was told putting a little bit of oil in the water keeps the pasta apart...ie not stick together.


On January 06, 2006 at 10:17 PM, an anonymous reader said...
A Tablespoon of butter will help a pot of boiling pasta not boil over.


On January 06, 2006 at 10:17 PM, an anonymous reader said...
Yes, oiling your pasta keeps the noodles from sticking to each other, but it also makes it harder for sauces to cling to the noodles. I find if I stir the pasta immediately after adding it to the boiling water, and once or twice while cooking, they don't stick together.


On January 06, 2006 at 10:18 PM, an anonymous reader said...
regarding taking lipitor/anticholesterol meds:

People make practically all the cholesterol in their bodies. Some people make too much, such as type2 diabetics. The lipitor helps these people to drive those levels down. It may come as surprising to some, but the liver generates cholesterol in response to sugar, and not to fat.


On January 06, 2006 at 10:19 PM, an anonymous reader said...
Michael, I think you are in danger of repeating the mistakes of the past (which you recognise) by being two quick to implicate trans fat and too quick to (completely) exhonorate saturated fat.

As you no doubt know, most dietary studies are short-term observational studies that, even when not flawed in methodology, are statistically very weak.

As University of Maryland researches pointed out (in a cautionary note to their 1997 study where the data suggsted that total fat, monosaturated fat, and monounsaturated fat all reduced stroke risk -- the first study to indicate this in caucasians): "Large-scale experimental studies that would provide more compelling data (such as the Women's Health Initiative) cost hundreds of millions of dollars and take decades to complete. Each study can only address the effects of a single nutritional change. Thus, it is still necessary to base advice to patients on dietary information that is less than certain and incomplete."

To the extent that the lipid model many be true, it is true in very complicated ways. The only answer we have is to do statistical analysis on the study results themselves and see what the proponderance of them say. Dietary advice should change very slowly. It is amazing to me how we have can go from one extreme to another. Pritican and Atkens are two examples of (contradictory) extremes; the only thing being more extreme than their advice is the extremism of their proponents!

In many of the recent studies, olive oil was used as a "control" group against trans fat. Olive oil is a poor control because it is known to be healthy. The high trans fat group was forced by definition a low monounsaturated group, although this was unrealistic due to trans fat being a small portion of total fat calories consumed. However, the results of these studies are primarilly being applied to the "Butter vs. Margarine" question. In this case, the trade off in the study should have been trans vs. saturated, but (as you have pointed out) there is such a bias agaist saturated fat that this was not done.

The FDAs recent advisories against trans fat are all based on a number of studies, but nearly every one of them is authored or co-authored by one researcher: Harvard University’s Walter Willett, a member of the radical Center for Science in the Public Interest (which was the group that petitioed the FSA for a trans fat labeling requirement). The CSPI is known for using scare tactics and singling out individual foods as "dangerous" (something no respectable dietician does).

The majority of studies that Willet is not involved in fail to find such a link. Also, the studies that did find "issue" with trans fat linked them to LDL, not disease risk. Not a one found increased corinary artery disease. You pointed out above that you are suspicious of blood lipids as isolated risk factors, but you seem willing to indite trans fat using the same indicators.

Specific studies:

The "Boston" study or 239 patients that linked trans fat with LDL/HDL ratio dis not correct for smoking, excercise, medical history, and familly medical history,

The Bolton-Smith study found no statistically significant result.

The most conclusive of Willett's studies found a link only with the highest trans fat consumption group and the relative risk index of 1.53 was well short of what one would accepet as statistically sound (ie 2.0 or more)

I'd like to see some independant confirmation (ie. not just Willett and Ascherio) of these numbers and a link to disease (not just serum lipid levels) before making any conclution differentiating between trans fat and other polyunsaturates.


On January 06, 2006 at 10:19 PM, Michael Chu said...
re: Pasta and oil

What causes the pasta to not stick together is a large quantity of water to cook in (at least 4 quarts). This allows the starches to disperse into the water so the pasta does not clump in the pot. Oil simply floats at the top of the water (which may or may not keep the water from boiling over - I'll have to look into that).

It's best to apply a bit of oil (or the sauce) directly to the pasta after draining (with perhaps a bit of reserved water). This will insure the pasta doesn't stick and the sauce will still stick.


On January 06, 2006 at 10:20 PM, Manang (guest) said...
Wow! It's my first time to visit your blog and I love it, Michael!
I once posted in my blog about coconut oil ( http://manangkusinera.blogspot.com/2004/06/coconut-milk-and-coconut-oil-is-it.html#comments ), with some similar issues tackled in your post re the marketing strategies of food oil companies and the uses of fats and oil in our body, also another post about cholesterol and triglycerides in http://manangkusinera.blogspot.com/2004/07/cholesterol-and-triglycerides.html#comments.
I do not get swayed easily by so-called recent studies, because before I believe that something that has been traditionally used is bad, I like arriving at empirically derived conclusions subjected to logical assessment.
Recently there was an update on the guideline in cholesterol management, which has lower values to be considered normal. The studies "supporting" the guideline were sponsored by the pharmaceutical industries, with the end-result of prescribing anti-cholesterol agents to more patients (with the addition of previously normal-cholesterol-level patients).
Yeah, fat is too maligned and misunderstood. I am glad to have found another ally in this fight against anti-fat fads (the same is true with anti-carb fads). Why don't the people just use their common sense? Oh, I almost forgot, common sense is not so common nowadays.
I commend you for sharing your valuable knowledge. I added your blog as a link to mine. Thanks for sharing.


On January 06, 2006 at 10:20 PM, an anonymous reader said...
How wonderful to see someone commenting on he cholesterol myth in such a popular forum (love the recipes and the format). The drug company inspired crusade against cholesterol and the subsequent ignoring of other aetiologies for heart attacks ignores the obvious: mammals have eveolved in an environment where saturated animal fat was in plentiful supply, whereas transfats and polyunsaturated fats/oils were not.
Cholesterol and lipoprotein A are checmicals formed as the result of inflammation in the body. While lipoprotein A blood levels have a near 1:1 correlation with heart attack risk and can be used as an absolute indicator of heart attack risk, cholesterol has a far far lower correlation. Lipoprotein is not affected by fat intake, which strongly implies that the cholesterol model is wrong.
The cholesterol model also ignores findings that around 70% of people with recent heart attacks have antibodies against a chlamydia, and that anti-chlamydial antibiotics have a dramatic effect in reducing post-CVA relapse/recurrance. It also ignores other epidemiological studies that heart attacks run in groups that would suggest an infectious agent.
Bt we live in a world where medical research is funded by large corporations who are interested in funding and disseminating research findings that will support increased sale of their products. Antibiotics are past their patent periods, so are too competitively priced to make money for the companies.


On January 06, 2006 at 10:21 PM, rsub8 (guest) said...
I used to add oil to pasta water until being voiciferously told it's a major no-no (the sauce won't coat / penetrate the pasta properly).

4 quarts and half a handful of kosher salt is appropriate for one pound of pasta (it takes awhile to boil, so plan accordingly). Use a big pot and cook uncovered, and it won't boil over or stick (just stir very well when you add the pasta to the already boiling water). The salt improves the cooking and also raises the boiling point of the water a bit, while somewhat taming boilovers.

When al dente (with practice, can tell this just by stirring the pasta; otherwise, sample a piece), drain in colander (don't rinse) and then put in bowl, add sauce, stir to coat.


On January 06, 2006 at 10:21 PM, an anonymous reader said...
I found the comment, "In fact, over 80% of people who suffer heart attacks, do not have elevated cholesterol levels.[5]" very interesting. I may be true, based upon the originating research. I would be hesitant to quote David Rowland after reading this article on Quack Watch.

http://www.quackwatch.org/11Ind/rowland.html


On January 06, 2006 at 10:21 PM, an anonymous reader said...
>if you are capable of intake half of the cholesterol you consume daily (let's say 150 milligrams of 300 milligrams consumed) and you compare that to the amount of cholesterol in the blood (150 mg/dL), then you'll find that of the 7500 mg of cholesterol in your blood (150 mg/dL * 10 dL/L * 5 L/human) you've added only another 150 milligrams (assuming your body is even capable of intaking 50% of the cholesterol you've ingested). <

So, hmm, they always make fun of the old practice of bloodletting. But it's kind of one way to cut cholesterol... (leaving aside for the moment the issue of whether it's bad to have x amount of cholesterol in your blood) :)


On January 06, 2006 at 10:22 PM, an anonymous reader said...
Love the site, but unfortunately you have some facts serious wrong. With respect to cholesterol's role in cardiovascular disease, numerous randomized, placebo-controlled studies show that cholesterol-lowering drugs signicantly reduce the risk of cardiovascular mortality. The implication that cholesterol is a an "innocent bystander" rather than a causal factor is simply incorrect, and could only be made by someone who has very little knowledge on the subject.


On January 06, 2006 at 10:23 PM, an anonymous reader said...
Your description of the chemical stucture of trans-fatty acids differs slightly from what I
learned in organic chemistry.

The Hydrogen atoms appear on opposite sides of the same double carbon bond.

H H H
-C-C=C-C-
H H H

Chemical Structure of Fats and Fatty Acids
Wikipedia article


On January 06, 2006 at 10:23 PM, Michael Chu said...
Whoops, you are correct. I have updated the article.


On January 06, 2006 at 10:23 PM, an anonymous reader said...
In regards to previous anonymous comment that your thoughts on cholesterol "could only be made by someone who has very little knowledge on the subject. " - there are plenty of exceptionally knowledgeable biochemists around the world that support the ideas put forward on this blog. I would suggest that you have very little knowledge on the subject if you are not aware of this fact.


On January 06, 2006 at 10:24 PM, an anonymous reader said...
To the couple of posters saying that you are making a mistake -- pay not attention to these dullards. I have been studying the issue for over ten years now. The fats you have to watch out for are the kind that are over heated and changed in structure. For example, french fries. On the other hand, one can eat as much coconut oil as he likes, this is a good oil with all sorts of great properties.

Butter is not only harmless, its good for us. Same thing with eggs. Although unpasteurized butter and range free eggs are many times better than the other.

Avocados are good for us too. And don't forget Kefir. This along with raw, unheated, unpasteurized honey will make a person strong and healthy..

Perry

perrypierce@gmail.com


On January 06, 2006 at 10:24 PM, an anonymous reader said...
After cooking the pasta, I serve the portions, then rinse the remaining pasta in cold water. It stores well this way- leftovers don't turn into one big glob of pasta and the sauce sticks better than when coated in oil.


On January 07, 2006 at 09:25 AM, High School Chemistry (guest) said...
Subject: Minor factual errors
In your discussion of monounsaturated fatty acids, you misstate the shape of the bend around the double bond -- it would bend towards the missing hydrogens, not away.

Also, metabolize is misspelled as matabolize


On January 07, 2006 at 09:40 AM, The Warren Commission (guest) said...
Subject: Big bad pharmaceutical companies
While I'd like to avoid the name-calling and intelligence-questioning that some posters have been engaging in, there are certain points being made in the comments section that coudn't be honestly made by an intelligent informed person of science ...

Suffice it to say that we know that the big heart drugs work. Anyone who says otherwise is ignorant or anti-science. We know that, for example, the statins (brand names: Lipitor, Zocor, Pravachol, etc) reduce the incidence of heart disease among people who take them.

What we may not know is why they work -- we know that they reduce "bad" cholesterol and since that is the prevailing model of heart disease right now, they are often described as working BY lowering cholesterol, but, in fact, we don't know how they work. Recent evidence indicates that they might instead work by reducing inflammation in the lining of blood vessels. However, none of this changes the fact that THEY WORK.

For the most part, in order to get approved for use in this country, drugs have to meet mortality or morbidity endpoints in their trials, not biochemical ones. That means that people taking the drug have to die less frequently or regain body functions more frequently than people not taking a drug. Simply changing body chemistry (e.g. lowering a blood chemcial like LDL compared to people not on a drug) is not good enough to get approval.

This post makes some interesting points, but the author never claims (and I hope didn't mean to imply) that, if he's correct, you should stop taking your drugs. They work. It's not a big pharma conspracy; it's science.[/i]


On January 07, 2006 at 09:54 AM, General Lee Supportive (guest) said...
Subject: Don't overreach
I was really enjoying your post until I came across this doozy:

"It seems that cholesterol is neither a good indicator nor a risk factor for heart disease"

Why make this silly statement? You're making the same mistake that you've just nailed the medical orthodoxy for: overreaching.

You've done a good job of poking holes in their extreme overemphasis on cholesterol as a cause for heart disease by pointing out times where it didn't hold, but then you totally overshoot the mark by claiming that it doesn't ever hold. That's crazy talk!

I think that it's a commonly accepted fact that people with higher cholesterol have heart disease at a higher rate than people with lower cholesterol. Just because people with lower cholesterol also have heart disease doesn't mean that cholesterol isn't a risk factor, it just means that it's not the only risk factor.

Other than that, I'm generally supportive


On January 07, 2006 at 10:01 AM, High School Chemistry (guest) said...
Subject: One more thing on pasta
I think that chefs add oil to pasta water as a surfactant.

The starch released from the pasta increases the surface tension of the water so bubbles can form more easily and grow larger. This can quickly cause a pot to boil over. To counteract this, chefs just add oil to reduce the surface tension and shrink the bubles back down.

This really deserves its own post on Cooking for Engineers


On January 07, 2006 at 12:07 PM, Ray Smillie - OzFire - said...
Subject: Re: Don't overreach
General Lee Supportive wrote:
I think that it's a commonly accepted fact that people with higher cholesterol have heart disease at a higher rate than people with lower cholesterol


The key words are "commonly accepted" not many scientists wold say it though, generally it is dietitian's that make the statement.

The fat around the heart is cholesterol but it is a symptom of heart disease rather than a cause, this has been known for many years by the scientists.

hence we have cultures eating almost pure cholesterol with almost no heart disease - The Inuit, they eat blubber.

the cholesterol we eat we digest... Cows eat grass where do you think they get their cholesterol from .... Like us they manufacture their own


On January 07, 2006 at 05:34 PM, General Lee Supportive (guest) said...
Subject: Don't overreach
Dude, the key word is "fact"

No scientist, dietician or otherwise, would dispute that higher levels of cholesterol in the blood are correlated with higher rates of heart disease. As Smilin' Jack Ross would say, any attempt to prove otherwise is futile because it just ain't true

You seem to be basically ignoring the amount of cholesterol in the blood, and instead talk about the amount of cholesterol in the diet. That's not really relevant to my point, but it's OK -- there are important points to be made regarding the distinctions between the two. However, you seem to be saying that the amount of cholesterol in the diet has no effect on the amount of cholesterol in the blood. If that's what you meant, that, once again, is crazy talk.

I'll deal with the Inuit in a separate post


On January 13, 2006 at 01:15 AM, Ray Smillie - OzFire - said...
Subject: Re: Don't overreach
General Lee Supportive wrote:
No scientist, dietician or otherwise, would dispute that higher levels of cholesterol


Around here it is commonly believed
that science is a good substitute to common belief.

here are some facts from a real scientist- about cholesterol
http://www.ravnskov.nu/myth2.htm

dietitians and nutritionists are not scientists.
Just business people who make money out of having an opinion, and the fat debate is one of their biggest money spinners. They have a vested interest in the fat myths. Now trans fat and hey you have science right with you.... margarine is a serious health risk


On February 14, 2006 at 08:00 AM, jeanthibca said...
Subject: what is your problem?
Sorry for the offensive subject title. It is just to introduce my point that people should worry more on what cause their disease than trying to have all the types of fats possible just to have the whole collection of the omega something fats.. By exemple, even is olive oil might be good for the heart, an overweight person should avoid it because it will make them even more overweight, since any type of fat is full on energy. This leads to diabetes melitus and metabolic syndrome. Thin people having homozygote HDL recaption defect should avoid animal products, but should use olive oil liberatly. [/i]


On March 13, 2006 at 12:50 PM, lance (guest) said...
Subject: melting point of lipids
So, what is the melting point of arterial plaque?


On March 26, 2006 at 01:54 AM, !Anaka said...
Yeah, you are right man! :(


On April 11, 2006 at 03:30 AM, farmer joe (guest) said...
Subject: read the lipitor label
It is interesting to note that the fine print on Lipitor labels and ads says something like "has not been shown to reduce risk of heart disease" or something like that.

Check out westonaprice.org to find out much more about the cholesterol myth.


On May 05, 2006 at 07:05 PM, katrina (guest) said...
Subject: interesting article
Time and again lot of things have been said regarding the blood pressure and th ways by which a check can be put to it, whatever the ways maybe fact is the number of people dealing in this problem is rising, now I encountered a rather interesting blog related to the cause of high blood pressure I am sure all of you will find it rather interesting.


On June 04, 2006 at 11:35 PM, an anonymous reader said...
I got a bit lost in the long and informative article.
Which types of fat are not bad to consume, saturated or unsaturated -OR- are they both ok, and it is mainly the trans-fats that are harmful.


On June 05, 2006 at 04:39 AM, Michael Chu said...
Anonymous wrote:
I got a bit lost in the long and informative article.
Which types of fat are not bad to consume, saturated or unsaturated -OR- are they both ok, and it is mainly the trans-fats that are harmful.

This is still a much debated topic. It is widely believed that saturated fats are bad for you because they are thought to be a contributor to heightened cholesterol levels. The research this is based on has recently (during the last decade) been brought into question because many of the studies didn't differentiate between saturated fats and those solidified through hydrogenation. In addition, there are scientists who believe that increased cholesterol may not actually be a cause for heart disease but merely a symptom of a stressed body. You'll notice that cholesterol is usually referred to as an indicator of increased risk of heart disease. Reducing an indicator could work, or it may be simply turning back the odometer of a car - the engine itself hasn't changed.

Another aspect to consider is that even if you avoid saturated fats, polyunsaturated fats are inherently less stable and might contribute to some forms of cancer and heart disease.

However, not consuming fats at all cuts out a lot of vital amino acids that we cannot make ourselves. So, we can't stop eating fats and fats may kill us.

So, everyone needs to make a decision for themselves how much this fat thing is going to keep us from enjoying our lives. We make similar decisions everyday when we get in our cars and drive to work - but we do it anyway because the risk isn't worth the inconvenience of not being able to go to work (or the risk of taking the bus or walking may be higher depending on where you live). In the same way, we should consider the amount and types of fat that we consume and make an informed decision as to whether or not we are willing to put it into our mouths.

That's not quite the answer you're looking for, so I'll provide what I've currently decided for myself (and my wife agrees, for now). I try to avoid foods with trans fatty acids whenever it makes sense to. (If I'm at a friend's house and the food has trans fats, then I'll go ahead and eat, but I don't eat trans fats on a regular basis.) I eat saturated fats regularly (but in small quantities - probably an ounce or two a day) as well as oils high in monounsaturated (olive oil, canola oil). Because generally the American diet is high in n-6 but not in n-3, I'll occassionally seek out sources of n-3 polyunsaturates but usually I try to get it through foods that I'd consume anyway (use of canola oil, eating wild salmon every few weeks). That's it. I don't actually think about it too much - it's one thing to know, be aware, and make conscious choices, it's another thing to worry and stress. In the long run, worry and stress is probably a bigger contributor to poor health than the types of food you consume.


On June 21, 2006 at 11:57 PM, Rosaline said...
Subject: Butter from Grass-fed cows
Quote:
conjugated linoleic acid (strong anti-cancer properties and helps prevent weight gain; found only in butter and milk from grass-fed cows)


Do you know of a national brand of butter that is from grass-fed cows? Maybe a Trader Joe's brand? I will keep an eye out for this - great article!


On June 27, 2006 at 02:38 AM, mrafal said...
Subject: HD and Dietary Fats
I only recently stumbled on this site and the thread on fats. Great tutorial !

The fat wars have always seemed a bit like trying to forecast the lifecycle cost of a car by focusing on the replacement cost of the sparkplugs - it's at best a second order effect. What seems to be lost in these discussions is that the [u:3e6f936db0]biggest [/u:3e6f936db0]change in our diet over the past few decades is not the ingredients but the quantity of food that we eat. When coupled with a simultaneous decrease in exercise, the number of excess calories consumed has exploded (along with our waistlines).

My parents ran a restaurant in the 50s and 60s. A typical lunch back then was a 2 oz hamburger, 1 oz fries and a 6.5oz Coke. Today our expectation is 4 to 6 oz hamburgers, 3 to 4 oz fries and 24 to 32 oz Coke. Does anyone really believe that the effect of which type of fat is used in the fryer has a bigger impact on health than the sheer volume of food consumed?

My guess is that any health impact (positive or negative) of consuming various types of fats is lost in the noise compared to the impact of excess calories. Put another way, I suspect that even a small reduction in calories will have a greater health benefit than optimizing the balance of fats consumed (even if we knew how to do that).

Just my $0.02


On July 05, 2006 at 12:15 AM, an anonymous reader said...
I don’t post much, but since some of those dissenting the idea that saturated fats, and butter might actually be more healthful than commonly believed were using scientific studies and some very good evidence, I thought I would add a slightly different slant:

Scientific studies are wonderful things, but they can also be a irritating nuisance after being mulled over, verified, then debunked, then re-introduced, then used by the media…It makes me want to pull out my hair by the roots. Which side is the right side? At what point does begin thinking for themselves and doing a little personal dietary experimentation?

Now about fats: I suffer from any number of ailments, eczema, asthma, and hypoglycemia. Yada, yada…I could go on and on. I’m not overweight. I have always had a good diet. I avoid sugar, refined carbs, eat a ton of veggies, a modest amount of meat, and whole grains. No Soda! And I have always avoided too much fat on the advice of my doctor, which is common.

Now my father, who suffers from heart disease and unfortunately narrow arteries which prohibits any possible surgery, is a doctor himself. No, not MD…he’s an oral surgeon. Still, he needs a bit of knowledge to practice, and as such is very familiar with medicine. After struggling with the statin drugs, he began fooling around with adding copious amounts of flax seed and olive oil with a few other thisis and thats to his diet. Lots of fish and eggs (literally, he goes fishing up at Big Lake every weekend…trout and bagpipe playing enough to distress anyone who knows him... :D ) His cholesterol dropped nicely at the same time. By the way, an ex marine and retired officer, my father also, is not overweight, has never been, and has always exercised properly. (I come from a nutritionally gung-ho family. My mother was even an amateur body builder…heh, heh..)

Because I suffered from a variety of medical ailments, my dad sat me down one visit and heartily suggested that if nothing else, I add coconut oil, olive oil and butter to my diet with each meal, and drop all other fats. Also in addition to take the omega 3’s and 6’s.

Why not? Couldn’t hurt…at least not much. So I did. It’s been awhile since then, and I am eczema free, my inhaler is sitting idle in the cupboard, and even after adding what would be considered a gruesome amount of fat to my diet, I haven’t gained any weight despite not changing my very mild excersise regimen. Last time I checked, my cholesterol was fine.

I’ve gone back and forth with the whole fat/no fat/cholesterol thing for awhile now. The debate rages on….and I know that a single anecdotal story about fats doesn’t count for much, but hey, I feel good. And my gp has declared me healthy, even though I went against his advice…

Go figure...


On August 18, 2006 at 04:35 PM, cheater (guest) said...
Subject: cholesterol
Hi!
First of all - I must say this is one of the best websites on the Internet for me. I've always, ALWAYS dreamt of figuring out how cooking *works* - understanding what's happening, instead of "just boiling the egg for 3 minutes". Add the great atmosphere of the website, no nags/banners and really nice web design - and you have a winner.

This article (and subsequent posts) have given me some interesting insight to the whole butter/margarine "war" waged since I ever remember.

I talked about this article with my mother - with the impression that cholesterol is in fact good, not bad. My mom is a caretaker of older people. She brought up an example of an older lady which she was taking care of lately - the lady had two of the arteries supplying blood to brain completely clogged up with cholesterol.

Let's suppose cholesterol is not bad and it's good. This "bad" behaviour is then caused not by cholesterol itself, but by some abnormal reactions or functioning of the body. What to do to prevent such an ill mechanism from activating? I'm not saying cholesterol is bad - but lowering cholesterol is the only way I know of right now to prevent such problems.

P.S. sorry about the lack of real medical descriptions and wording - English isn't my first language.

cheers!


On October 04, 2006 at 02:59 AM, Tweeter (guest) said...
Subject: my thoughts
Hi there, just a few thoughts and comments.

Back when I was 25-30, I started gaining weight and went to the quack doctor for diet pills. He ran some bloodwork and my cholesterol was around 175. At that time I was running rampant thru the dairy aisle, usually 3 meals a day included butter and cheese. Grilled cheese sandwich anyone? I would eat them for breakfast lunch and dinner if I could. Unfortunately the diet pills ended up just making me eat faster.. :(

Fast forward 15-20 years. Never did lose the weight. Actually put more on. I started donating blood last year, and as a perk, they give you your cholesterol readings - after 4 donations you get the complete breakdown. Dec - 165 April - 188 June - 231...

June freaked me out. I started eating yogurt,mini wheats and fruit for breakfast, salad or subway for lunch, regular dinner usually. I also re-started taking supplements that I used to take - green tea, grapeseed extract, multivitamin with a gazillion ingredients, and gugulipid. Granted, it wasn't always subway or salad for lunch, and more often than not the dinner was...not...low calorie in any shape or form.

So, next donation in August... 195. Don't know what lowered it. But it did. Next donation is beginning of November with the breakdown.

But. I try to eat less processed food, and I consider butter to be a LOT more natural than whatever and however they actually make margerine. Just as I'd rather bake a cake from scratch than a mix, and once I figure out cream-of-*.* soups, that will be a plus. Hah...guess I should be drinking red wine and green tea instead of supplements. But, I *do* try!! lol

Gugulipid is made by Natrol, for those interested. Natrol also does the green tea and grapeseed stuff. All are at drugstore.com and no, I'm not affiliated with them in any way. Just want to pass on probably a cheaper way to those that are taking expensive prescription drugs.

Oh, and I also took Milk Thistle, which is for liver support, and if liver processes or makes cholesterol, maybe that had something to do with it??

Anyhoo, I guess that's my 2 cents... my vote is FOR butter and olive oil.


On October 09, 2006 at 10:39 PM, an anonymous reader said...
Subject: "Arthersclerosis"
I noticed in the original post, you mentioned "arthersclerosis". This is not a word but, rather, a jumble of two actual words: arteriosclerosis and atherosclerosis. The former refers to the hardening and thickening of the arteries, and the latter is a type of arteriosclerosis that involves atheromas--fatty deposits on the inner walls of the arteries. These fatty deposits are actually beneath the inner lining of cells (the endothelium), so they result from transport of lipoproteins across the endothelium.

I'm not so sure about your ideas on saturated fat. I've seen data comparing unsaturated, cis-unsaturated, and trans fat with trans fat coming out the worst, sat. fat being bad--but not nearly as bad at trans--and natural unsaturated fats actually being beneficial to health. There's just too much data collected over decades implicating high saturated fat diets in cardiovascular disease. It would be nice if I didn't have to watch my sat. fat consumption. I could eat all the butter, lard, and cheese I wanted. But I have to go with the facts rather than what I want to believe.

I think this is a really great blog; I just don't agree with you on this point.


On October 11, 2006 at 05:44 PM, an anonymous reader said...
Cook with Coconut Oil, its loaded with medium chain fatty acids and won't break down like Olive Oil.


On November 05, 2006 at 01:33 AM, an anonymous reader said...
gr8 suggestions dude


On November 05, 2006 at 01:35 AM, Geregry (guest) said...
Hi, in my recent blood test I have found high level of cholesterol. My friend told me that Lipitor is a well known medicine for reducing cholesterol level in blood. Before I went to buy Lipitor I want to know all about it. If you have any personal experience about this drug then plz share it with me.


On February 08, 2007 at 09:23 PM, Theresa (guest) said...
Subject: Statin Studies and Heart Disease
I agree with the original article. I have read every available study on drugs used to lower cholesterol. My meta-analysis found that while statins like Lipitor lower cholesterol, there is no reduction in death rate for patients using statins. Statins stop your liver from producing lots of things (not just cholesterol.) One of the things not produced in statin users is Coenzyme Q10, which is required for transfer of energy to the heart (and other muscles.) Patients on statins still die; they die at about the same age, but they die from heart failure instead of heart attack.

If you are taking a statin, please read all of the available studies. You'll be shocked.

I also agree with using natural oils. I'm a big fan of ghee and olive oil.


On March 27, 2007 at 02:04 PM, david.mihola said...
Subject: A summary and some questions...
Hello,

after reading this thread as well as the discussion about the smoking points of various fats I think I have arrived at some answers, but some questions remain as well:

Answers:
- for all "cold" applications (salad dressings, etc.) olive oil will remain my first choice
- to ensure a sufficient supply of omega-3-fats I will regularly consume walnuts, fish (salmon) and canola oil (according to the manufacturer's website, Rapso, the most popular brand of canola oil in Austria, contains as much as 10% alpha-linolenic acid)
- for frying: don't heat your oil beyond smoking point
- apart from that: try to avoid trans-fats

Questions:
- regarding the omega-3-fats: are flaxseeds (whole or ground) also a significant source of omega-3, i.e. if you add a tablespoon to your breakfast muesli, or would you have to go for the oil to get significant amounts?
- for frying: I read that even at temperatures well below the smoking point polyunsaturated fats will be transformed to trans-fats. Does that happen to an extent that will make olive oil or canola oil unhealthy to use for frying? If so, which would be the better alternative? Does that significantly reduce the amount of omega-3-fat in canola oil, thereby reducing it's benefits?
- and: what is extra-light olive oil? I couldn't find such a thing in Austria - is it some kind of refined olive oil? What about (extra-)virgin olive oil for frying?

Any comments, answers and clarifications would be greatly appreciated,

greetings, David


On March 27, 2007 at 04:55 PM, Michael Chu said...
Subject: Re: A summary an