Wednesday, March 11, 2015

The Nutrition Debate #295: Cholesterol: no longer “…considered a nutrient of concern…”

“NBC’s ‘Today Show’ had a story about dietary cholesterol,” my wife said at breakfast yesterday. Later we both heard a similar story on PBS’s “All Things Considered” as we drove to our separate engagements. So, today I did a Google News search on “dietary cholesterol” (the cholesterol in food, like eggs and shrimp, that we eat). The first story that came up was from Fox News. It wasn’t very good. The author puffed it up with off-message “contributions” from the AP and Reuters.
Still, the essence was that Marian Neuhouser, chair of the relevant subcommittee of the 2015 Dietary Guidelines Advisory Committee, announced a decision to the full DGAC committee at its final meeting in December 2014. She said it is their recommendation that dietary cholesterol no longer be ‘considered a nutrient of concern for overconsumption,’ according to the Fox News Report. A 6hr. 57min. indexed video of the full meeting, #7 (December 15), is online and can be seen here.
The final report, “2015 Dietary Guidelines for Americans,” will be published by the USDA/HHS later this year. “While those agencies could ignore the committee’s recommendations, major deviations are not common,” The Washington Post said.
“Five years ago, I don’t think the Dietary Guidelines diverged from the committee’s report,” Naomi K. Fukagawa, the 2010 vice chair, told The Washington Post. Fukagawa says she supports the change on cholesterol. “Walter Willett, chair of the nutrition department at the Harvard School of Public Health, also called the turnaround a ‘reasonable move,’” The Post reported. “There’s been a shift of thinking,” he said. (“…a shift of thinking”? Incredible that he said that!)
Well, la-di-da, the Titanic IS really changing course. (See: The Nutrition Debate #12: “Turning the Titanic,” also #162, #189, #202, and #292). And this is MAJOR, except that, with this report, saturated fat is left behind; it is still one of the bad guys. But it’s good news for people who long for shrimp. I actually know a few, including medical doctors, who have passed up shrimp being passed as h’ordeuvres at a cocktail party, and others who eat egg whites instead of whole eggs for breakfast. (See: The Nutrition Debate #176, “Eggs, Cholesterol and Choline,” #211, “Eggs and Satiety,” and #225, #228 and #265.
The danger, of course, with the Titanic changing course, is whether it is turning to port or to starboard. If it turns to starboard, it will run into a sea of ice flows and eventually solid sea ice. Think eroded endothelial layers, advanced glycation end products (AGEs), and clogged arteries from the rancid and oxidized LDLs (oxLDL) in overused and overheated vegetable and seed oils. (See: The Nutrition Debate #21, “The Dangers of Polyunsaturated Fats,” also #20, #22, #23, #24, and #49.)
That’s the outcome that can be expected 1) from the 2013 AHA/ACC recommendation that the target for total dietary fat consumption be omitted to allow fat to replace the formerly much too high Dietary Guidelines recommendation for carbohydrates, both simple sugars and highly processed carbs; and 2) that saturated fat consumption be further reduced from the previous 7% - 10% of total calories to 5% - 6%. With this 1-2 punch the resultant recommendation will be that we consume more Mono and Polyunsaturated fats. But, while monounsaturated fats are good, most PUFAs are BAD.
That’s exactly where the Titanic is headed, with the blessing of Robert Eckel, current co-chair of the ACC/AHA guidelines committee and past president of the American Heart Association. While he conceded that there is “insufficient evidence” to make a recommendation to support dietary restrictions of cholesterol, he said “a three-to four-egg omelet isn’t something I’d ever recommend to a patient at risk for cardiovascular disease.” Some myths die hard. 
The Post story recalls the origins of the cholesterol myth. A Russian scientist at the Czar’s Medical Institute in St. Petersburg fed cholesterol to rabbits for four to eight weeks in 1913 and saw that the cholesterol harmed them. Then in the 1960s an American graduate student, Lawrence Rudel, noted that when the Russian fed cholesterol to white rats, it had no effect. Later, Ancel Keys acknowledged the difference between obligate herbivores (rabbits) and mammals (rats and humans). In 1997, Ancel Keys, father of the diet/heart hypothesis (saturated fat + cholesterol → heart disease), infamously said:
“There’s no connection whatsoever between the cholesterol in food and cholesterol in the blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.”
Then there’s this: Updated findings of the famous Framingham Study, published in Archives of Internal Medicine (2009):
“In Framingham, Massachusetts, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower people’s serum cholesterol. . . we found that the people who ate the most cholesterol, ate the most saturated fat, ate the most calories weighed the least and were the most physically active.” Quote from Dr. William Castelli, Director.

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