Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
More Than Dietary Fat
- Bill D. Misner Ph.D. (5 December 2003)
-
The diet-heart idea is kept alive by selective citation
- Uffe Ravnskov (8 December 2003)
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Bill D. Misner Ph.D., Director R & D, E-CAPS Inc. Elk, Washington USA 99009
Send response to journal:
|
Greetings Editors, I agree with the author's original statement that the types of fat are more important than total fat in predicting risk of coronary heart disease. In fact, total fat intake may not be the major risk factor in coronary heart disease. W.B. Grant [1], reviewed dietary links to Ischemic Heart Disease {IHD} and Cardiovascular Heart Disease {CHD} using a multi-country statistical approach involving 32 countries. In age groups aged 35+, IHD, milk carbohydrates were found to have the highest statistical association for males aged 35+ and females aged 65+, while for females aged 35-64, sugar was found to have the highest association. In the case of CHD, non- fat milk was found to have the highest association for males aged 45+ and females aged 75+, while for females 65-74, milk carbohydrates and sugar had the highest associations, and for females aged 45-64, sugar had the highest association. Most physicians are alarmed when first hearing but are convinced after reviewing the full text version. Several mechanisms are proposed may explain the milk carbohydrate or non-fat milk association with IHD & CHD. One of the most prominent theories is that animal protein contributes to homocysteine (Hcy) production; however, milk more than meat lacks adequate B-vitamins (methylation activity of B-12/Folate, B-6) to convert Hcy to useful metabolites. Lactose and calcium in conjunction with Hcy from consumption of non-fat milk may also contribute to calcification of the arteries. Dietary fat intake needs to be further explained and potentially exonerated. Current meal habits including processed milk proteins, dairy byproducts, and refined carbohydrates continue to impose cardiovascular health-inhibiting results in the general population. [1] W.B. Grants Free Full Text review paper in Altern Med Rev 1998;3(4):281-294: http://www.thorne.com/altmedrev/fulltext/milk3-4.html) Competing interests: None declared |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Uffe Ravnskov, Independent researcher Magle Stora Kyrkogata 9, S-22350 Lund, Sweden
Send response to journal:
|
He
et al maintain that saturated fat is bad and polyunsaturated fat is good for the
cardiovascular system.1 They reject a large number of contradictory
epidemiologic and experimental studies2 by the argument that they are
inconsistent and inadequate. Instead they refer to a previous study from their
group.3 In that study the authors had calculated that a replacement
of 5% of energy from saturated fat with the same amount of
polyunsaturated fat should be followed by a 50% lower risk of coronary heart
disease. They claimed that this calculation was supported by Sacks and Katan’s
review4 of four allegedly successful dietary trials.5-8
However, these authors had ignored four similar trials with a less favourable
outcome.9-12 Relevant data from all eight trials are shown in the table (see below). As seen, the accumulated relative risk of death in the four trials cited by Sacks and Katan decreased by eight percent, but in the four trials that they had ignored, it increased by nine percent, and the figures for coronary mortality was not much better.2,13 Another contradictory finding was that complicated atherosclerosis was significantly more pronounced in the treatment group of the only trial that included a post-mortem.8 This way of reviewing the literature is not unique. In a meta-analysis of all controlled, randomised cholesterol lowering trials I found that trials considered supportive were cited on average 40 times, but unsupportive trials only seven times per year.14 Also, in three of the most influential American reviews of the diet-heart idea, half of a large selection of contradictory studies were ignored; the rest were quoted irrelevantly; or insignificant findings in favour of the hypothesis were inflated; or unsupportive results were quoted as if they were supportive.15 And in a recent letter in Science Scott Grundy, one of the main figures in the cholesterol campaign, claimed that saturated fatty acids are the main dietary cause of coronary heart disease, but the many studies he used as support either had not addressed this question, or they were inconclusive, or directly contradictory.16 No
statistical operations are able to explain away the fact that an exchange of
saturated with polyunsaturated fats has no effect on mortality. This is also in
accordance with the findings of He et al. that intake of dietary fats are not
associated with the risk of stroke,17 and this is also what we should
expect because the idea that atherosclerosis in the coronary arteries should
have a different cause than atherosclerosis in the cerebral ones are highly
unlikely. References
Table.
Total
mortality in eight cholesterol-lowering, controlled and randomised dietary
trials, where the only intervention was an exchange of saturated fats with
polyunsaturated fats.
Competing interests: None declared |
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||