Friday, April 22, 2016

Re-evaluation of the Traditional Diet-Heart Hypothesis

This study examined previously unpublished data from the Minnesota Coronary Experiment (MCE) and put those findings in the context of existing diet-heart randomized controlled trials.

Design: The MCE (1968-73) is a double blind randomized controlled trial designed to test whether replacement of saturated fat with vegetable oil rich in linoleic acid reduces coronary heart disease and death by lowering serum cholesterol. Recovered MCE unpublished documents and raw data were analyzed according to hypotheses prespecified by the original investigators. Further, a systematic review and meta-analysis of randomized controlled trials that lowered serum cholesterol by providing vegetable oil rich in linoleic acid in place of saturated fatty without confounding by concomitant interventions was conducted.

Interventions: Serum cholesterol lowing diet that replaced saturated fat with linoleic acid (from corn oil and corn oil polyunsaturated margarine). The control diet was high in saturated fat from animal fats, common margarines, and shortenings.

Results: The intervention group had significant reduction in serum cholesterol compared with controls. However, no mortality benefit for the intervention group was found or for any prespecified subgroup. There was a 22% higher risk of death for each 30 mg/dL reduction in serum cholesterol. There was no evidence of benefit in the intervention group for coronary atherosclerosis or myocardial infarcts. In meta-analyses, these cholesterol lowering interventions showed no evidence of benefit on mortality from coronary heart disease or all-cause mortality.

My Take:
This one was skipped over by the National Institutes of Health. It has far reaching conclusions that fly in the face of the existing dogma on cholesterol and heart disease.

First, the fact that “unpublished data” exists from the MCE study raises concerns over the validity of the original study. Too often, researchers discard data that doesn’t fit their premise. This has been the case in many of the studies on high cholesterol and heart disease over the past forty years.

Second, a decrease in cholesterol levels increased the risk of heart attack and death. That’s just the opposite of what you have been told for most of your life.

Third, the myth that animal fat (in moderation) increases mortality is exposed in this study.

Finally, the use of margarine and corn oil as healthy alternatives is laughable. Margarine is full of trans-fats and so is corn oil if it has been partially hydrogenated. Trans-fats are by far the most dangerous of all fats. The half-life of a trans-fat is 53 days and it takes five half-lives to eliminate a substance. So when you eat those French fries from a fast food joint, it takes your body nine months to get rid of the trans-fats.

The Bottom Line:
High cholesterol does not cause heart disease, but the use of trans-fats in the diet does increase heart disease risks. Get your healthy omega 6 fatty acids from olive oil, not corn oil or soybean oil (margarine). However, if you are pre-diabetic or diabetic (and that’s over half of all Americans) even healthy omega 6 fatty acids can be pro-inflammatory.

Source: April 12, 2016 British Medical Journal

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