Plant sterols lower cholesterol but increase risk of heart disease

The diet heart hypothesis (and yes – it is only a hypothesis!) can be boiled down to the claim that “fat raises cholesterol and cholesterol causes heart disease.” Like so many hypotheses that don’t work, it has been mutating to try to work for decades. It was originally thought that dietary cholesterol raised blood cholesterol (we covered that last week) and then it was thought that total fat raised blood cholesterol (which it doesn’t). Then it was thought that saturated fat raised total cholesterol (good luck with that one). The latest (and quite long standing) hypothesis is that saturated fat raises LDL (low density lipoprotein) cholesterol.

For those of you who have read Dr Malcolm Kendrick’s brilliant “The Great Cholesterol Con”, he lobs out a challenge on p35: “How can eating saturated fat raise LDL levels? It is not merely biologically implausible, it is biologically impossible. (Boy does that statement make me a hostage to fortune!)” Over 10 years later, Malcolm still does not have an answer to this question.

Last week I shared some of the unexpected findings from my PhD – one of the most interesting ones being what happened to cholesterol levels in the original dietary fat trials. The men (and they were only men) involved in the diet trials in the 1960s and 1970s experienced falls in their cholesterol levels during the trials. The men in the diet groups experienced bigger falls than the men in the ‘leave alone’ (control) groups.  I shared my hypothesis for this that plant sterols – plant cholesterol in effect – could be lowering cholesterol rather than saturated fat raising cholesterol.


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