Cholesterol and hypertension, one of the longest lasting hoaxes?

Each era creates its food myths, also its hoaxes, and spreads them inexorably even though for decades no one has fed them. Who does not remember when years ago everyone was invited to consume two liters of water? Or when the consumption of chicken was avoided because the hormones used for the growth of the animal suposedly increased the size of the breasts among men?

Years later we know that consuming so much water can cause serious health problems and that hormone treatment in chickens is so expensive that it is economically unfeasible, but these are not myths that have disappeared from the collective imagination. In fact, every year, without burying hoaxes from the past, new ones are added that are again based on partial studies promoted by the industry or mere pseudo-scientific anecdotes. If they are lucky and soak people minds, they are likely to have a very long life. Let us remember that today it is about demonizing gluten, milk with lactose, palm oil, etc. when many still feel guilty for not having ingested the "recommended" amount of water or from eating chicken without remember the effect on their chest. 

One of the longest-running hoaxes has been that of cholesterol.

Cholesterol is necessary for the human being. It is a lipid - a fat - found in the tissue and blood plasma of vertebrates whose mission is varied. For instance it t forms part of the structure of plasma membranes, transports fat-soluble vitamins, is a precursor of sex hormones such as progesterone, estrogen and testosterone etc etc. In short, if cholesterol was removed from our body, we would literally die without remedy. But more than half a century ago someone drew a parallel between the amount of cholesterol in the blood and cardiovascular disease. And that "someone" has a name: Ancel Keys.

Ancel Keys was an American biologist who in the late 1940s began researching cholesterol. His investigations were carried out without great diffusion until an event occurred that placed them in the foreground. In 1955 then President Eisenhower suffered a myocardial infarction which brought the issue of coronary heart disease to the forefront of today. 

Ancel Keys secured funding to conduct a major seven-country study to see if there was a correlation between diet and cardiovascular disease. The result was spectacular. In a graph that has become famous, it was clearly shown that mortality due to cardiovascular diseases was much higher in those countries with a high consumption of saturated fats and therefore with large amounts of cholesterol in the blood. 

Ancel himself hit on both the problem and the solution. It was clear that the fastest way was to reduce the consumption of saturated fats and switch to what he called the "Mediterranean diet" which was basically the one followed by the countries of southern Europe: lots of vegetables and fruit, oily fish, olive oil etc. In other words, the concept of the Mediterranean diet was also born with Mr. Keys. 

From the first moment critical voices arose with the study of Keys. Although there were data from some 22 countries, only 7 of them had been chosen and the reason was obvious: if countries like France were included, with a very high intake of saturated fats and a minimum incidence of coronary diseases, the Keys graph was distorted . The same thing happened if Norway was compared with the United States: in the former, with the same intake of saturated fat, only a third of people died of heart problems. But by then the all-powerful North American Society of Cardiology had positioned itself on the side of Keys' postulates and it was no longer a question of whether these studies were correct or had been deliberately distorted to support a hypothesis, but how to make that the  message penetrate the mind of  the people. 

The worst was yet to come. When the food and pharmaceutical industries began to launch low-fat products - the former - and new medical products - the latter -, the matter became very complicated. All the marketing of both almighty industries, the investments made in the launch of new products and the education of customers and health professionals made it almost unfeasible to go back on an initial approach that, due to its ease of understanding, had penetrated deeply. Who has not had problems at home with a pipe clogged by dirt? Explaining that the accumulation of fat in the arteries impeded blood circulation was so easy to understand that it required little pedagogy in this regard.

Of course, reality sometimes forced us to patch up the theory. Many people circulated with very high cholesterol levels without suffering any kind of problem. At that time the discovery of "good" cholesterol or HDL and "bad" or LDL came to solve the problem. According to this theory, the LDL would be in charge of transporting the elements necessary for the cell and the HDL of collecting the surplus for its elimination. Anyone could have a high cholesterol level as long as it was "good" while it was the "bad" that had to be watched. Some values ​​were set and since then - the 70s of the last century - more than one  have lived mortified by periodic blood tests. Not to mention some foods such as eggs that many avoid due to their high cholesterol content.

While all this was happening, an interesting experiment was taking place that has come to be called the Framingham Heart Study. Framingham is a city in Massachusetts that, due to its "average" characteristics, was chosen in 1948 by the National Heart Institute to study whether lifestyle habits were determining factors in coronary heart disease. The study, which is still ongoing, did not provide conclusive results: people with high cholesterol levels never developed any coronary heart disease, while others died of heart attacks with unblemished blood tests.

At this time we find fervent supporters of Ancel Keys and other "dissidents" such as Dr. Ravnskov who suggest that all the blame thrown on cholesterol is nothing more than the result of partial and in most cases erroneous studies. Is there any complete and rigorous study about it? Actually there isn't a single one. There are complete ones, but they are all backed by some member of the pharmaceutical or food industry, so the bias is at least suspicious. Other studies suggest that cardiovascular diseases are more related to tobacco consumption -something beyond any doubt-, sedentary lifestyle and even excessive intake of carbohydrates such as refined flours and sugar.

If this is so, why does no one rectify it? The answer is simple. The fight against smoking was led by governments that were horrified at how spending on Social Security for this large risk group increased. So, by dint of taxes, laws and social awareness, it was possible to reduce consumption, which led to a drastic drop in the rate of coronary diseases. The same can be said of sedentary lifestyle. Government campaigns to eradicate it are essentially a fight to reduce Social Security spending. And what about carbohydrates, sugars and medications? The excess of carbohydrates is harmful to health but in this case it is not the Governments that lead the fight against them, but the food industries that have seen in the alternatives to them - sweeteners, gluten-free etc - a source of income additional, what is usually called giving an "added value" to a product whose benefits could not be squeezed any further. But isn't it true that no one tells you that that bun you eat with so much pleasure is capable of causing a heart attack? Or that the stamina you take to lower cholesterol causes cancer in lab mice?

Behind every supposed truth regarding food or medicine, there is a series of half-truths or half-lies, depending on whether you see the glass as half full or half empty. Because that's not going to make anyone money. What is sure is that pharmaceutical and food industries will see the glass full, whatever you behave well or you misbehave.