Dr. Raphael,

You cite Uffe Ravnskov in an argument against the unbalanced attacks on
saturated fats and cholesterol - an argument that I support, by the way.  I
do feel that the issue with saturated fat and cholesterol should focus on
the issue that the body through poor food choices is ill prepared to handle
to handle the fats and oils it consumes.   It is essential to provide needed
nutrients, beneficial phytochemicals, and other beneficial lifestyle
factors.  These are the issue more than the fat and oils themselves.  It's
all balance, and health ultimately depends on what we don't do, as well as
what we do and eat.

BUT - if you were to read Ravnskov's book, "The Cholesterol Myths," you
would see that he also comes down hard on trans fats.  I do believe that
once you read the evidence you will change your mind.  I realize that you
are out there with your "Relax, It's all a fraud" statement, but I trust
that as a scientist you will realize that exposure to new evidence requires
appropriate adjustments.


Regards,

EB





-_____________________________
Ed Blonz, Ph.D.
001 510-525-6925 (phone/fax)
[log in to unmask]
Website:   http://blonz.com











-----Original Message-----
From: Health Promotion on the Internet [mailto:[log in to unmask]] On Behalf
Of Dennis Raphael
Sent: Friday, December 12, 2003 4:40 AM
To: [log in to unmask]
Subject: Toronto Star Story...


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Dec. 12, 2003. Toronto Star

On matters of the heart, cholesterol and Oreos

JUDY GERSTEL

Last week I wrote about spouses cheating on-line and a Toronto agency that
facilitates adultery. Enough people e-mailed me with personal experiences
that I began to feel like a voyeur.
I also heard from "attached" men, including one who said his best asset is
honesty, wanting to interact in ways ranging from sublime to ridiculous with
my middle-aged body.

I confess to being tempted by a 21-year old eager to give me a foot massage
(my new boots are killing me); he's experienced at this kind of thing, he
says, because he regularly massages the feet of his 55-year old mother.

But life is not all fun and games.

So let's turn to heart and body matters of a different nature: cholesterol,
Oreo cookies, trans fats. Also, poverty, childhood deprivation and what it
takes to have a healthy society.

More and more, trans fats are regarded as public enemy number one. What
people don't realize is that the real front in the war against heart disease
is not the food we eat, says York University professor Dennis Raphael.

It's the food people don't get to eat.

"The excessive concern with trans fats is a joke," says Raphael. "For the
average, healthy person going to Loblaws, the health effects, if any, are
going to be negligible.

"But having close to 800,000 Canadians using food banks on a monthly basis,
with not enough money to spend on basic needs, experiencing stress and
insecurity, that's really sowing the seeds for poor cardiovascular health."

Raphael is a tireless proselytizer for acting on the proven link between
health and socioeconomic status.

And he thinks it's too bad we're getting sidetracked by the likes of Oreo
cookies: "Cholesterol by itself is not really that much of a risk factor."

Take that ubiquitous advertisement showing a body on a gurney, accompanied
by the query, "Would you rather have a cholesterol test or a final exam?"

Yes, cholesterol-busting statins do help reduce heart attacks, but the
impact is not all that dramatic, notes Raphael.

"Of people who take statins, 95 per cent don't have heart attacks over a
five-year period. Of people who don't take statins, 92 per cent don't have
heart attacks." And possible adverse long-term effects of these drugs are
largely unknown.

While cholesterol may be a good predictor of heart disease as a selective
variable, if you put it in context with other variables, such as childhood
infections and deprivation, it seems that cholesterol may be a byproduct of
other processes.

In other words, levels of cholesterol associated with heart disease may
occur simultaneously with heart disease, but may not be the causal agent.

Causation is a tricky concept. We're tempted to attribute cause to
adjacency.

For example, the best minds used to believe that noxious odours and foul air
called miasma caused disease.

As it turns out, the bad smells were associated with the true cause of
disease: infection agents in the unsanitary water and environment.

Some researchers now caution that cholesterol may fit into the "miasma
theory" of disease.

In a letter published in the British Medical Journal last year about the
link between dietary fat, cholesterol concentration and coronary heart
disease (CHD), Swedish physician and scientist Uffe Ravnskov wrote,
"accumulated epidemiology actually strongly contradicts such a link."

He cited a study of Japanese migrants in the U.S. showing that cultural
upbringing was the strongest predictor of CHD.

"Those who were brought up in a non-Japanese fashion but preferred lean
Japanese food had a heart attack almost twice as often as those brought up
in the Japanese way but preferred fatty American food."

Also, Masai people probably have the highest intake of animal fat in the
world, notes Ravnskov. And yet, abnormalities on electrocardiography were
far less frequent than in Americans. In southern India, mortality was seven
times higher than in the north (and age at death was 44 years compared with
52), even though people in the north ate 19 times more fat, mostly animal
fat, and smoked more.

Canada's Fraser Mustard, in a book titled Why Are Some People Healthy And
Others Not? states, "since the main cause of heart attacks is a
thromboembolic event, it is difficult to see how changes in cholesterol
levels in adult males will dramatically change outcomes since there is no
evidence cholesterol has a major effect on the thromboembolic process.

"This may be one of the reasons why ... trying to lower cholesterol levels
has not had a dramatic effect on the incidence of heart attacks."

Referring to Mustard's observations that two processes are at work in
cardiovascular disease ? those that cause thickening of blood vessels and
those that cause narrowing and blood clotting ? York University's Raphael
argues that the presence of environmental stressors may be related to the
second process, the main cause of heart disease.

"Whether the second process occurs appears to be related to whether the
person experiences stress," Raphael says.

He makes the point to emphasize his findings that low income and social
exclusion are major causes of heart disease in Canada.

But in questioning the focus on cholesterol ? a focus which serves the
pharmaceutical industry by making statins the best-selling drugs ? Raphael
is challenging us to think critically about it. You can find out more about
how cholesterol may be more of a red herring than a cause of cardiovascular
disease on-line at http://www.ravnskov.nu/cholesterol and at
http://www.thincs. org. Thincs stands for The International Network of
Cholesterol Skeptics.

Of course, this doesn't mean you should run right out to buy Oreos. But it
doesn't hurt to question received wisdom, especially when it results in a
handsome profit.

And it doesn't hurt to be reminded that the people around us who are living
in poverty and finding sustenance at food banks aren't just hungry and
stressed, they're the ones who are most at risk for heart disease and heart
attacks.

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