I’d love to see some objective, skeptical discussion of NMR particle size and it’s meaning.

Thanks!

Olive oil is natural and has been used by humans for thousands of years. The Romans have used it and have many in the area for millenium. Yes, your family may have eaten animal fats and lived long but this does not mean that olive oil is an industrial product. Corn oil and canola oil are.

Dr. Uffe Ravnskov, one of the most outspoken and published voices against the lipid hypothesis, often claims that the few studies that support it do so because of the inclusion of participants with familial hypercholesterolemia. I don’t think there’s any doubt that this disorder is associated with a greater risk of cardiovascular disease, but similar to your perspective, I think this may merely indicate an increased susceptibility rather than a direct cause. This is supported by the inconsistencies in mortality found when comparing populations with familial hypercholesterolemia to normal populations.¹

In my opinion, a much greater concern than a high serum LDL level is oxidized LDL, and perhaps the inability to properly metabolize LDL makes those with familial hypercholesterolemia more susceptible to the effects of oxidation. In addition, the vascular changes associated with familial hypercholesterolemia are said to be different than those of conventional atherosclerosis² which I think further justifies your suspicion of the lipid hypothesis and its relevance to FH.

I don’t blame you for not wanting to take statins. Although they’ve been shown to be more effective than diet at lowering cholesterol and have even reduced mortality in some cases, evidence indicates that it’s not a result of cholesterol lowering and that it’s instead due to other effects relating to inflammation.^3,4 This brings into question whether or not the undesirable side effects of statins are justified and if there are safer alternatives. It’s also another indication that the lipid hypothesis is flawed.

It’s great that you’ve overcome your stress and depression. This may be more relevant than you think since stress has been shown to be a much greater risk for heart disease (as well as cancer) than the typical risk factors.^b,c It’s unfortunate that our medical system tends to promote additional stress for patients with these diseases.

Thanks again for sharing your story. I wish you the best of luck with your continued health!

1. Sijbrands EJG, Westendorp RGJ, Defesche JC, de Meier PHEM, Smelt AHM, Kastelein JJP. “Mortality over two centuries in large pedigree with familial hypercholesterolaemia: family tree mortality study.” British Medical Journal. 2001. 322:1019-1023.

2. Stehbens WE. “Coronary heart disease, hypercholesterolemia, and atherosclerosis I. False premises.” Experimental and Molecular Pathology. 2001. 70(2):103-119.

3. Ravnskov U. “Is atherosclerosis caused by high cholesterol?” QJM. 2002. 95(6):397-403.

4. Ravnskov U. “Conclusions from the heart protection study were premature. British Medical Journal. 2002. 324:789.

5. Eysenck HJ. “Personality, Stress, and Disease: An Interactionist Perspective.” Psychological Inquiry. 1991. 2(3):221-232.

6. Allison TG, Williams DE, Miller TD, Patten CA, Bailey KR, Squires RW, Gau GT. “Medical and Economic Costs of Psychologic Distress in Patients With Coronary Artery Disease.” Mayo Clinic Proceedings. 1995. 70(8):734-742.

I read the commentary on this issue with particular interest. I have familial hypercholesterolemia. I am 40 years old. I have known of my “condition “since I was 18. I have never had a coronary event, nor a stroke. I have waivered between taking and not taking statins to bring my total cholesterol down to ” acceptable” limits. In my case, we are talking about high dosages of medication. For period of time in the last 10 years I have taken cholesterol medications on and off. The longest period was 2 years. The secondary effects were unpleasant to say the least. I took the medication out of fear because of the scare I was given by the doctors when I was first diagnosed. For many years, and as a young man, I was stressed about my mortality. It contributed to an episode of depression. I became a compulsive exerciser. I felt I was not in control of my own life or destiny. In my 30′s I became a father and we now have 3 beautiful children. I am in control of my life and I have made a decision that I am not convinced that the presence of cholesterol in itself is a cause of heart attack and stroke. I do believe that it is the combination of a number of factors, perhaps some of which we are not yet aware, which together contribute to heart disease and stroke. I realized that everything else in my lifestyle was NOT contributing to the known risk factors – I do not smoke, I do not drink excessive amounts of alcohol,I do not have high blood pressure, I exercise 5 days per week, I have healthy and fulfilling relationships, I enjoy my work life, I balance my diet.

I meet with the cardiologist every year – They scan my heart, do ECGs, measure my CRP levels ( extremely low). I have my major arteries scanned by ultrasound – No presence of arteriosclerosis AT ALL.

I am sure that I don’t have all the answers. One day I may fall victim to a stroke or heart attack. But I am at peace with my decision. It is a decision made after reading widely on the subject and taking every pro-active step I can to keep myself healthy without taking medication. I am sure that science has a long way to go to explain the genetics of my particular circumstances. I believe that we are all different and statistics are an approximation. One day medicine will be able to individually profile our genetic code to understand how each of us works. In the meantime I am listening to, and looking after my own body. I am just not going to make any more decisions out of fear, and not least when there are real doubts in my mind about what popular medical theory says on Cholesterol.

I completely agree that the selective use of data by Ancel Keys presents a much different picture. Dr. Ravnskov discusses this in detail in his book.

I also agree that it’s a shame that research can be so influenced by business and politics. In regard to saturated fat, cholesterol, and heart disease, it makes me wonder how much this has set us back in terms of nutritional knowledge, how much it is costing in terms of health care, and how many lives it has negatively effected.