I watched the video John. I attended a top-ten medical school for 2.5 years and left in good standing. I later went back to graduate school in another field of science and earned my Ph.D. It would be easy to write a 2000-word critique of this video and the points presented pro and con. The video attacks early subjective “science” and opinions. However, I heard a lot of “opinions” from the con side. I noted that the word cholestrol was used generally and did not always correlate with saturated fats.
The problem with medical science is that when it comes to disease etiology (cause) medicine must often rely on meta-analyses which correlate observations with complex outcomes. Meta-analyses are not replicated research trials with controlled variables (which is needed for statistical validation). To do credible research, medicine would have to do replicated studies from birth to death with large population samples, controlling all variables associated with arterial disease, varying either saturated fats **“or” **cholesterol only.
There is a line I have used several times at Sways, correlation does not imply causation. Malaria outbreaks are highest in the summer months. Ice cream consumption is highest in the summer months. Therefore, ice cream causes malaria, 100% correlation.
This video is very generalized from both points of view. I heard many unsubstantiated opinions from the con side. First and foremost, heart disease is multifactorial – genetics, blood pressure, stress, salt, diet, obesity, exercise …
Dr. Goldstein was one of my professors in medical school. He discovered the mechanism for familial hypercholesterolemia – caused by the lack of or a reduced number of receptors for regulating cholesterol metabolism. Blood cholesterol levels were exceptionally high. These people developed severe arterial disease. Yes, this study became highly generalized by the medical community and the lay press.
Some people can eat lots of cholesterol because they can metabolize it, some cannot. The body (liver) most certainly synthesizes cholesterol to generate what it needs – sometimes more than it needs.
Yes inflammation (damaged arterial tissue) innitiates plaque formation. Inflammation is caused by many processes. High blood pressure is a hydraulic stressor to arterial walls – higher force and turbulent flow. Salt (sodium) is a factor causing higher blood pressure. Arteries have musclular walls to cope with and adjust the pulsing pressure. It is believed that high blood pressure causes them to thicken and harden (more muscle?)… It is theorized that salt causes fluid retention in the body (thickening arterial walls with fluid and reducing elasticity?). As the body ages, arteries get harder (a bit like an old garden hose) and thicker, blood pressure and turbulence rise. If I recall correctly, lipids (fats – arterial walls and blood levels) can trigger the clotting mechanisms.
(I have not even addressed the mechanisms of kidney involvement with blood pressure and electrolyte regulation.)
Hyperlipedemia (high blood fat concentrations) increases blood viscosity. Higher fluid viscosity creates more resistence to flow (more damage?). Saturated fats are more viscous at any given temperatures than unsaturated fats. That is, butter (and other saturated fat) is solid in the refrigerator, vegetable oil (unsaturated fat) remains liquid – why coldwater fish have lots of omega-3 unsaturated fat rather than saturated fat. Yes unsaturated fats oxidize easily. Oxidized compounds cause free radical formation. Free radical formation can cause tissue damage. Omega-6 and omega-3 fats (lipids/fatty acids) are both unsaturated fats. Yet, these doctors suggest, (I agree) based on Mediterranean and Asian “meta-analyses,” that omega-3 fats, “unsaturated”, are good for heart/arterial health.
The liver must synthesize cholesterol to form bile salts. Bile salts are needed to absorb saturated fats. Increased saturated fat intake causes increased cholesterol production and increased blood cholesterol levels. High cholesterol or high saturated fat intake?
Several years ago, I was on the road for a professional conference eating classic road foods – I forgot I was due for my first cholesterol test the Monday after I got back. For two weeks, I ate cheeseburgers, fries, poorboys/hoagies, mufaletta, Mexican, Quiznos Classic Italian sub – high saturated fat intake. I came home to eat steak and coconut cream pie the weekend before my cholesterol test. My cholesterol was 220 (total), HDL marginal. I decided to test my grasp of medical science learned, reading labels and doing my best to keep my saturated fat intake to no more than 100% of the RDA (did not eliminate it). I also avoided eggs – love them with bacon. My cholesterol dropped 50 to 170. I also alternated daily taking 1000 mg of Fish Oil or Flaxseed oil in combination with an anti-oxidant (Vit E, CoQ and green tea). My HDL climbed to the levels recommended for those with arterial plaque problems (not an issue for me but I do have other heart problems and high blood pressure). However, I alos do a variety of diligent daily exercise workouts.
Bottom line, moderate intake of saturated fats (no more than 100% RDA), salt and refined carbohydrates. Get good vitamin and mineral intake. Eliminate all trans fat. Exercise regularly. Get plenty of sleep. Reduce/eliminate stress (still working on this one, seems retirement may be my only hope).
The potential side effects of many of the cholesterol drugs are disturbing.
What I have written here is just a drop in the bucket towards explaining and deciphering the complexities of heart/arterial disease.
BTW I did not have time to edit this for proper grammar etc …