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Debunking the Cholesterol Myth
The website linked link immediately below provides an up-to-date summary of the statin drug fraud.
When Framingham Risk Data using cholesterol levels were applied to
British men over a period of ten years, it was found that 84% of heart disease
occurred in men classified as low risk!
Furthermore, 75% of the men classified as high risk using the Framingham Risk
data were still free of heart disease ten years later. It seems the equation is
still missing a few important variables. What are we missing here?
Department of Social Medicine, University of Bristol, Bristol BS8 2PR.
OBJECTIVE: To establish the predictive accuracy of the Framingham risk score for
coronary heart disease in a representative British population.
DESIGN: Prospective cohort study.
SETTING: 24 towns in the United Kingdom.
PARTICIPANTS: 6643 British men aged 40-59 years and free from cardiovascular
disease at entry into the British regional heart study.
MAIN OUTCOME MEASURES: Comparison of observed 10 year coronary heart disease
mortality and event rates with predicted rates for each individual, using the
relevant Framingham risk equation.
RESULTS: Of 6643 men, 2.8% (95% confidence interval 2.4% to 3.2%) died from
coronary heart disease compared with 4.1% predicted (relative overestimation
47%, P < 0.0001). A fatal or non-fatal coronary heart disease event occurred in
10.2% (9.5% to 10.9%) of the men compared with 16.0% predicted (relative
overestimation 57%, P < 0.0001). These relative degrees of overestimation were
similar at all levels of coronary heart disease risk, so that overestimation of
absolute risk was greatest for those at highest risk. A simple adjustment
provided an improved level of accuracy. In a "high risk score" approach, most
cases occur in the low risk group. In this case, 84% of the deaths from coronary
heart disease and non-fatal events occurred in the 93% of men classified at low
risk (< 30% in 10 years) by the Framingham score.
CONCLUSION: Currently recommended risk scoring methods derived
from the Framingham study greatly overestimate the absolute coronary risk
assigned to individuals in the United Kingdom.
PMID: 14644971 [PubMed - indexed for MEDLINE]
Further Comment in:
BMJ. 2003 Nov 29;327(7426):1238-9.
Emerging Science to Explain the Cause of Cardiovascular Disease
Little Known Scientific facts about Cholesterol the discredit its role as a cause of cardiovascular disease
C-Reactive Protein and
Homocysteine as Causal Indicators being tested in the
laboratory to evaluate for risk of atherosclerosis and cardiovascular disease.
Vitamin D deficiency as a cause of cardiovascular disease: Dr. Armin Zittermann,
Ruhr University in Germany, has reviewed mounting evidence that vitamin D
deficiency is a major cause of heart disease.
Br J Nutr. 2005 Oct;94(4):483-92.
Paradigms and Paradoxes.
A paradigm is a set of assumptions, concepts, and practices that constitutes
a way of viewing reality. The current paradigm is that heart disease is caused
by a combination of genetics, hypertension, diabetes, cholesterol, smoking,
obesity, inactivity, and diet. A paradox is a fact that contradicts the
paradigm.
There are several interesting heart disease paradoxes. How well do you know
them? Good time for another quiz.
1. The French Paradox is the observation that cardiovascular disease is
relatively low in France, despite high intakes of cholesterol and saturated
fats.
A. True
B. False
True. Perhaps the best known of the cardiovascular disease
paradoxes, the most common explanation is that the French love red wine and the
flavonoid, resveritol family of antioxidants it contains. It was first described
in 1987, before the dermatologists scared the French out of their bikinis. The
rates of cardiovascular mortality in France are much lower in the South and West
than in the North. One of the world’s best vitamin D researchers, Dr. Marie
Chapuy, found that vitamin D levels of healthy adults in France follow that same
pattern, with a mean level of 38 ngs/ml in the sunnier and drier South and West,
but less than half that (17ngs/ml) in the colder, rainier, and more polluted,
North.
Arch Mal Coeur Vaiss. 1987 Apr;80 Spec No:17-21.
Hypertension. 2005 Oct;46(4):645-6. Epub 2005 Sep 12.
Hypertension. 2005 Oct;46(4):645-6. Epub 2005 Sep 12.
Osteoporos Int. 1997;7(5):439-43.
2. The Israeli Paradox is the observation that cardiovascular disease is
high in Israel despite a high consumption of polyunsaturated omega-6 fats.
A. True
B. False
True. According to the current paradigm, polyunsaturated fats
contained in vegetable seed oils are supposed to lower the risk of heart
disease. However, high consumption of these oils doesn’t appear to prevent the
Israelis from dying from heart attacks. Israel does, despite its sunny weather,
have a high incidence of vitamin D deficiency. Average vitamin D levels among
healthy adults in Lebanon, right next door, are only 9.7 ngs/ml - dangerously
low. Healthy Jewish mothers, especially orthodox ones, have low vitamin D
levels. (If you are wondering how the pro-inflammatory omega-6 oils could ever
help heart disease, one possibility is these oils dissociate vitamin D from its
binding protein, making more free vitamin D available. Apparently, the Israelis
don’t have enough vitamin D in their blood to dissociate).
Isr J Med Sci. 1996 Nov;32(11):1134-43.
Isr Med Assoc J. 2004 Feb;6(2):82-7.
J Bone Miner Res. 2000 Sep;15(9):1856-62.
Isr Med Assoc J. 2001 Jun;3(6):419-21.
J Steroid Biochem Mol Biol. 1992 Sep;42(8):855-61.
3 The Italian Paradox is the observation that a population of heavy
smokers has a low incidence of cardiovascular disease.
A. True
B. False
True. The overall death rate from cardiovascular disease in
Italy, a country of heavy smokers, is relatively low. Before you say it is the
olive oil and wine, ask yourself where olive trees and grapevines grow―in
the sun. However, at least two good studies show vitamin D levels in Europe are
a paradox, the closer a European lives to the equator, the lower their vitamin D
level. Nevertheless, an Italian study showed healthy Italian blood donors had
robust vitamin D levels of 48 ngs/ml in the summer. Even average postmenopausal
Italian women reached 36 ng/ml in the summer. Anyone who has traveled in Italy,
know that most Italians love the sun. As the old Italian proverb points out:
“Where the sun does not go, the doctor does.”
QJM. 2000 Jun;93(6):375-83.
Br J Nutr. 1999 Feb;81(2):133-7.
4. The Northern Ireland Paradox is the observation that a population with a very
high incidence of coronary heart disease does not have high rates of the
expected risk factors.
A. True
B. False
True. In fact, the age adjusted mortality for coronary artery
disease was more than four times higher in Belfast than in Toulouse, France,
despite almost identical coronary risk factors. There were 761 deaths per
100,000 in Belfast compared to 175 in Toulouse. This is hard to explain, given
the current paradigm of heart disease. Of interest, Belfast is at 54 degrees
latitude, at sea level, and has 257 rainy days per year. Toulouse is eleven
degrees closer to the equator, its altitude is 500 feet closer to the sun, and
Toulouse only has 74 rainy days per year. Lots more vitamin D in Toulouse!
QJM. 1995 Jul;88(7):469-77.
QJM. 1998 Oct;91(10):667-76.
5. The Indian Paradox is the observation that a high prevalence of
coronary artery disease in urban Indians in India is associated with low
cholesterol and saturated fat intake.
A. True
B. False
True. Researchers found that a low saturated fat diet did not
prevent heart disease in the citizens of the brass-works-polluted city of
Moradabad in northern India. The authors did not mention that air pollution
dramatically lowers vitamin D levels.
J Am Coll Nutr. 1998 Aug;17(4):342-50.
Arch Dis Child. 2002 Aug;87(2):111-3.
6. The Swedish Paradox is the observation that the strong association
between cold weather and heart disease in Sweden is not explained by the usual
risk factors.
A. True
B. False
True. Researchers tried to explain why higher annual cardiac
mortality is associated with residence in colder regions of Sweden. Try as they
might, the authors could not support the current paradigm for heart disease.
They failed to mention that cold weather is a marker for low vitamin D levels,
as outdoor activity in cold weather is both curtailed and requires extensive
clothing.
Scott Med J. 1991 Dec;36(6):165-8.
The point of these six paradoxes is simple. Our current paradigm for
understanding heart disease is incomplete. One or more major causes of heart
disease remain unknown. The theory that vitamin D deficiency is a major cause of
heart disease can explain these paradoxes.
7. Robert Scragg, Associate Professor in Epidemiology at the
University of Auckland, New Zealand, first proposed that vitamin D deficiency
plays a role in cardiovascular disease.
A. True
B. False
True. For the last 25 years, Dr. Scragg has been trying to
convince anyone who would listen that vitamin D explains many of observations
about heart disease. These include the facts that heart disease is higher at
higher latitudes with less sunlight, lower altitudes, in the winter, in African
Americans, in older, inactive, and in more obese patients. Remember, vitamin D
blood levels are lower at higher latitudes, lower altitudes, in the winter, in
African Americans, in older, inactive, and in more obese patients. Altitude is
the least known of these associations. The age adjusted mortality for heart
disease in the USA showed a striking inverse correlation with altitude in 1979,
before the sun scare. American populations at the highest altitude had about
half the heart disease of sea level populations. Thirty-five years ago, Leaf
observed that most of the long-lived populations in the world reside at high
altitude.
Int J Epidemiol. 1981 Dec;10(4):337-41.
J Chronic Dis. 1979;32(1-2):157-62.
Sci Am. 1973 Sep;229(3):44-52.
8. Dr. Scragg showed that higher vitamin D levels are associated with
lower risk for heart attack.
A. True
B. False
True. In 1979, the Tromso Heart Study found corrected vitamin D
levels showed the same thing.
Int
J Epidemiol. 1990 Sep;19(3):559-63.
Br Med J. 1979 Jul 21;2(6183):176.
9. Dr. Scragg is such a good scientist, he then published a study
which seemed to disprove his theory.
A. True
B. False
True. He discovered that a single oral dose of 100,000 units of
vitamin D had no effect on risk factors (serum cholesterol or blood pressure)
five weeks later. This seemed to disprove his theory, but he published the data
anyway, always a mark of a good scientist. We now know that 100,000 units are a
small dose and that such “stoss” therapy is not physiological. Such a small
single dose will raise vitamin D levels for a month or two, but then they
rapidly fall towards baseline and would have little physiological effect five
weeks later.
Eur J Clin Nutr. 1995 Sep;49(9):640-6.
10. Zittermann points out that vitamin D reduces vascular smooth muscle
proliferation, reduces vascular calcification, decreases parathormone levels,
reduces C reactive protein (CRP) and other markers of inflammation, and
decreases renin, all of which should prevent or treat heart disease.
A. True
B. False
True. He discusses most of the evidence that exists, tying
heart disease to vitamin D deficiency. A vitamin D theory of heart disease
explains the excess cardiovascular deaths at high latitude, low altitude and
during the winter. Furthermore, it explains the higher incidence of heart
disease in African Americans, older, inactive, and obese individuals as these
groups have significantly lower vitamin D blood levels.
Br J Nutr. 2005 Oct;94(4):483-92.
11. In 2003, Zittermann discovered that patients with congestive heart failure
(CHF) have very low levels of vitamin D.
A. True
B. False
True. Furthermore, he found that a protein (NT-proANP), which
is a predictor of CHF severity, was inversely associated with vitamin D levels.
J Am Coll Cardiol. 2003 Jan 1;41(1):105-12.
12. Blood cholesterol measurements are worse at higher latitudes, lower
altitudes and in the winter.
A. True
B. False
True. The effects of latitude on cholesterol seen in the first
study are quite remarkable. In the Greek study, total serum cholesterol for both
men and women were significantly lower at higher altitude in spite of similar
diets. The seasonal variations in cholesterol are well known and not explained
by seasonal dietary changes.
QJM. 1996 Aug;89(8):579-89.
J Epidemiol Community Health. 2005 Apr;59(4):274-8.
J Clin Epidemiol. 1988;41(7):679-89.
Chronobiol Int. 2001 May;18(3):541-57.
13. Blood pressure is higher at higher latitudes, lower altitudes, in
the winter, in African Americans, in the aged, and in the obese.
A. True
B. False
True. High blood pressure is one of the strongest predictors of
heart disease. Here, six facts about hypertension can be explained by one
theory: vitamin D. The lower the vitamin D the higher the blood pressure.
Hypertension. 1997 Aug;30(2 Pt 1):150-6.
Ann Hum Biol. 2000 Jan-Feb;27(1):19-28.
Harv Health Lett. 2005 Sep;30(11):8.
14. Diabetes is more common at higher latitudes, at lower altitudes, in
African Americans, in the aged and the obese. Both blood sugar and hemoglobin
A1C are higher in the winter.
A. True
B. False
True. Six final facts that can be explained with one theory:
vitamin D.
Eur J Epidemiol. 1991 Jan;7(1):55-63.
Nutrition. 2001 Apr;17(4):305-9.
Diabetes Res Clin Pract. 2005 Aug;69(2):169-74. Epub 2005 Jan 12.
Diabetologia. 1982 Apr;22(4):250-3.
Am J Epidemiol. 2005 Mar 15;161(6):565-74.
15. Two studies show vitamin D significantly reduces C reactive protein
(CRP), which may be a better predictor of heart disease than LDL cholesterol.
A. True
B. False
True. The Belgian study found a significant effect on CRP even
though their high-dose vitamin D group only got 500 units a day.
QJM. 2002 Dec;95(12):787-96.
J Clin Endocrinol Metab. 2003 Oct;88(10):4623-32.
16. The risk for total mortality is significantly lower in subjects with
high vitamin D levels.
A. True
B. False
True. However, the study is in Finnish and has not been
translated into English (author communication).
Seppanen R, Marniemi J, Alanen E, Impivaara O, Jarvislo J, Ronnemaa T, et al.
Ravinnon ja seerumin vitamiinit ja kivennaisaineet vanhusten kuolleisuuden
ennustajina. Suom Laakaril 2000;42:4255-60 [Finnish].
Reported in Nutr Metab Cardiovasc Dis. 2005 Jun;15(3):188-97.
17. It is now a proven scientific fact that vitamin D both prevents and treats
heart disease.
A. True
B. False
False. The epidemiological evidence is very strong, but like so
may other fields of vitamin D research, we lack the definitive prospective
interventional trials that would settle the point. It would be simple for the
National Institutes of Health to fund a study giving physiological doses of real
vitamin D (5,000 units of cholecalciferol) to heart disease patients for a year
and see if CRP, proinsulin, blood pressure, cholesterol, body weight, heart
attacks, or death rate decreases over time. Like EDTA, there is no patent on
vitamin D, so there is no profit potential in such research for the
pharmaceutical industry.
We will have to wait years for science to find out if vitamin D prevents and/or
treats heart disease. While you are waiting, you have a choice. You can treat
with vitamin D (especially for deficient levels less than 40 ngs/ml) or
you can wait vitamin D research (which may not occur in your lifetime). This
time you may be betting your heart.
Also, remember that vitamin D should be taken daily, not monthly or weekly. It
should be obtained physiologically, not in an all-then-none manner, as would
happen if you took 100,000 units one day a month and nothing the other 29 days.
It even appears likely that high blood levels followed by low blood levels may
do harm. The reason is that falling blood levels reset the enzymes maintaining
intracellular levels of activated vitamin D, resulting in low intracellular
levels.
Int J Cancer. 2004 Sep 1;111(3):468; author reply 469.
Vitamin D should be consumed the way the human genome wants it, a steady
amount every day. If you live down south, you can go in the sun for a few
minutes every day. If you live up north you can sun in the warmer months and use
a sunlamp or take real vitamin D (cholecalciferol) in the winter. AS a minimum,
adults in the north could take one 5,000 unit capsule a day in late fall,
winter, and early spring, less in the late spring and early fall, and none in
the summer months - depending on your sunning habits. Children over 50 pounds
need two of the 1,000 unit capsules every day in the colder months while
children under 50 pounds need about 1,000 units in the colder months. Few people
really need to take oral vitamin D in the summer unless you are sun
phobic, but there is no evidence for harm in supplementing these doses. Get
enough vitamin D every day to maintain stable vitamin D blood levels
(25-hydroxy-vitamin D) around 50 ngs/ml, year-around.
Last question: should patients dying from heart disease be allowed to die with
vitamin D deficiency? According to the current paradigm and clinical practices,
the answer is yes. At least, none of the cardiologists I know even bother to
check a vitamin D level. Given the scientific literature, that’s a bit
paradoxical.
The Vitamin D Council
Copyright © 2007 MedTech Consulting. Inc., all rights reserved
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