Television news the last couple of days has been showing ‘year in review’ montages. These montages seem to focus almost exclusively on three things: the presidential election, terrorism, and celebrity deaths. While the presidential election was pretty remarkable, I want to argue that perhaps the most significant development of 2016 was the mainstreaming of skepticism regarding the lipid hypothesis: the idea that saturated fat and cholesterol cause heart disease.
The lipid hypothesis has been dominant for 60 years, and has profoundly influenced modern medicine and the American diet. It’s really hard to overstate its impact. As a response to the fear of fat, the food industry has developed a ‘low-fat’ or ‘non-fat’ version of seemingly every traditional food product: cookies, ice cream, yogurt–you name it. For a couple of generations now, everybody has been avoiding fat and/or taking statins to reduce cholesterol. After my uncle had by-pass surgery, he spent the last 20 years of his life scrupulously avoiding saturated fat. He even got the chef at his favorite restaurant to remove the chicken skin before cooking (even though every chef in the world knows that chicken is properly cooked in the skin and on the bone). Just before Christmas I found myself in a supermarket in Massachusetts where I overheard two elderly ladies discussing how drinking eggnog must be particularly unhealthy. “I’m OK,” said one of them, “as long as I take my cholesterol pill.” Statins have indeed become the most profitable drug in history.
And yet, the lipid hypothesis never was supported by very much scientific evidence, and the best and most recent evidence refutes it. The Massachusetts lady with the cholesterol pill is operating on multiple levels of delusion. There is in fact little or no connection between diet and serum cholesterol. It’s not like the cholesterol in the eggnog goes straight to your bloodstream; the body itself produces and regulates cholesterol. Second, the best and latest evidence contradicts the idea that high cholesterol causes heart disease. Patients with heart problems admitted to hospitals do not, on average, have cholesterol levels higher than the population as a whole. High cholesterol, in fact, is associated with longer lifespan.
If heart disease has a dietary culprit, it would seem not to be fat, but rather sugar and other refined carbohydrates.
In 2016, the truth about fat and cholesterol was finally reported by major publications, including the Boston Globe, New York Times, and Washington Post. Some of these stories appeared in previous years, but I believe I saw more this year than ever before. The word at last is getting out.
Maybe in another five years or so, your doctor will catch up with the Huffington Post and stop focusing on cholesterol numbers. Anyway, we can hope.
It’s really an amazing thing if you think about it. Heart disease is the leading cause of death for both men and women worldwide. And yet the medical establishment has been completely wrong about it for 60 years. Because they cured so many other diseases, everybody believed they must be right about heart disease too. But they were wrong, and they issued dietary advice that was particularly harmful. They told us to substitute toxic transfats for healthy butter.
Over two generations, how many people died prematurely by trying to follow the awful dietary recommendations, or by putting their faith in statins? Millions? The lipid hypothesis might be the second most deadly idea after collectivized agriculture.