1

votes

Have we finally achieved Cholesterol Clarity?

Answered on August 19, 2014
Created September 01, 2013 at 12:52 AM

Thoughts, opinions, reactions to Paleo author/blogger Jimmy Moore and his provocative new book?

56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 02, 2013
at 03:23 PM

nice comment. I totally agree. The French paradox is one example. You can't get into a bistro without your clothes getting impregnated with smoke. They drink a lot of wine. Yet they live to be 80+, with little heart disease.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 02, 2013
at 12:18 AM

What people don't understand is that in the U.S., smoking reflects not just the act of smoking but a bad diet, obesity, alcoholism, reckless driving, gambling & a whole host of self-destructive behaviors. Abroad, smoking is regarded as hip and is not accompanied by the same ills. You can smoke but still eat a decent diet, exercise, drink in moderation, and not act in a hellbent manner to destroy your health. That's why American doctors are completely confounded when they occasionally see smokers in perfect health. Smoking is a general proxy for ill health in the U.S.. But not abroad.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 01, 2013
at 07:19 PM

Provocative? I'm not sure. It's a rehash of his past guest interviews with a focus on cholesterol components. I thought he was going in another direction. As it happened, these are basically all his past guests and some are not even experts. Many are GPs with their own, peculiar views on cholesterol. Some I do not believe are experts on cholesterol at all. And some are obesitologists who're used to seeing T2 diabetics or morbidly obese patients whose lipids may indeed be very peculiar. He will not influence any mainstream thinkers based on the views he's collected.

56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 01, 2013
at 03:30 PM

Then you are saying that there are other, comparable or worse, sources of disease. I am fine with that. Indeed data based models of mortality versus cholesterol predict higher heart attacks at high cholesterol, but lower strokes and cancer. So let me redact my comment by replacing "causation" with "main causation". More in the next answer.

A2f6a1fba0452e96f7f97325c8da3934

(60)

on September 01, 2013
at 04:01 AM

If smoking rates went down a bit during a period of ramped pollution and use of asbestos in homes and lung cancer rates increased would that show smoking has nothing to do with lung cancer? No it wouldn't, it just shows population trends aren't indepedent of others. Not that I think dietary cholesterol matters much in cvd risk but that logic is wonk.com

A2f6a1fba0452e96f7f97325c8da3934

(60)

on September 01, 2013
at 03:53 AM

Uhhhh wait whut?

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2 Answers

3
56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 01, 2013
at 02:08 AM

I have not read the book, but here are some uncontroversial facts:

1) in the last 60 years cholesterol consumption (per person) has decreased in the US. Heart attacks have increased.

2) Nation-by-nation studies by the WHO show that the lowest mortality versus cholesterol is at a value of 220 (total). Studies in the US and Europe peg that value a bit lower, around 200.

The first point tells you that dietary cholesterol has nothing to do with heart disease. Correlation does not imply causation, but anti-correlation rules out causation. The second tells you that, study after study, dietary cholesterol has the U shape that many other essential nutrients have. too little (like 150) is not good. Too high is also not good. Note that 200 may trigger some uninformed doctors into prescribing statins or other drugs.

56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 01, 2013
at 03:30 PM

Then you are saying that there are other, comparable or worse, sources of disease. I am fine with that. Indeed data based models of mortality versus cholesterol predict higher heart attacks at high cholesterol, but lower strokes and cancer. So let me redact my comment by replacing "causation" with "main causation". More in the next answer.

A2f6a1fba0452e96f7f97325c8da3934

(60)

on September 01, 2013
at 04:01 AM

If smoking rates went down a bit during a period of ramped pollution and use of asbestos in homes and lung cancer rates increased would that show smoking has nothing to do with lung cancer? No it wouldn't, it just shows population trends aren't indepedent of others. Not that I think dietary cholesterol matters much in cvd risk but that logic is wonk.com

A2f6a1fba0452e96f7f97325c8da3934

(60)

on September 01, 2013
at 03:53 AM

Uhhhh wait whut?

1
56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 01, 2013
at 03:37 PM

Let me add

3) The Kitava studies have shown zero heart disease associated with high cholesterol.

In Kitava, nothing much has changed since millennia. There is a modest influx of western foods, and 77% of the population now smokes. This is just an aside, but the smoking example above is flawed. You can smoke and be free of heart disease. Smoking alone does not induce cancer, diabetes or heart disease.

The simplest explanation is no inflammation = no heart disease. Without inflamed artery walls there will be no cholesterol accumulation. The answer above stands, with the redaction "causation" = "sole or main causation".

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on September 02, 2013
at 12:18 AM

What people don't understand is that in the U.S., smoking reflects not just the act of smoking but a bad diet, obesity, alcoholism, reckless driving, gambling & a whole host of self-destructive behaviors. Abroad, smoking is regarded as hip and is not accompanied by the same ills. You can smoke but still eat a decent diet, exercise, drink in moderation, and not act in a hellbent manner to destroy your health. That's why American doctors are completely confounded when they occasionally see smokers in perfect health. Smoking is a general proxy for ill health in the U.S.. But not abroad.

56c28e3654d4dd8a8abdb2c1f525202e

(1822)

on September 02, 2013
at 03:23 PM

nice comment. I totally agree. The French paradox is one example. You can't get into a bistro without your clothes getting impregnated with smoke. They drink a lot of wine. Yet they live to be 80+, with little heart disease.

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