Heart of the Matter – ABC Catalyst

The Australian Broadcasting Corporation Catalyst program series produced a 2 part program collectively titled Heart of the Matter. The programs are titled Dietary Villains and Cholesterol Drug War. These programs were aired in October 2013.

The presenter and co-producer is Dr Marianne Demasi. The medical “experts” interviewed include Dr Michael Eades, Dr Jonny Bowden and Dr Stephen Sinatra. Science and medical writer Gary Taubes was also interviewed.

Eades is a medical doctor specialising in obesity. Bowden a PhD in nutrition from a non-accredited university. Sinatra is a medical doctor and cardiologist.

All sell supplements to support their nutritional programs and they have not published papers in peer-reviewed journals.

Demasi opens the program with the assertion:

I will follow the road which led us to believe that saturated fat and cholesterol causes heart disease and reveal why it is being touted as the biggest myth in medical history.

The program claims that evidence linking saturated fats, cholesterol, and heart disease is based on “bad science”. The program declares that the idea that saturated fat raises cholesterol arose in the 1950s by Ancel Keys. The myths surrounding Ancel Keys have been addressed in other chapters.

Lyon Diet Heart Study

The Catalyst program Heart of the Matter references the Lyon Diet Heart Study as evidence that cholesterol is not implicated in heart disease.  If you actually read the Final Report of the Lyon Diet Heart Study [1] , it clearly states that cholesterol is indeed implicated in heart disease.

The Lyon Diet Heart Study is a “randomized, single-blind secondary prevention trial aimed at testing whether a Mediterranean-type diet, compared with a prudent Western- type diet, may reduce recurrence after a first myocardial infarction.”

The Final Report of the Lyon Diet Heart Study shows that “the data confirm the impressive protective effect of the Mediterranean diet.”  It also states, “major traditional risk factors, such as high blood cholesterol and blood pressure, were shown to be independent and joint predictors of recurrence.”

This report concludes, that “for each increase of 1 mmol/L of total cholesterol increased the risk of recurrence by 20% to 30%.  Epidemiological studies have consistently shown a positive correlation between plasma cholesterol levels and the incidence of (and mortality from) CHD in various populations.  Thus, our population does not appear to be different from other low-risk populations.”

This is not the conclusion that Catalyst managed to derive from the Lyon Diet Heart Study.

This report also states that an increased leukocyte count increased the risk of heart disease.

George McGovern

Catalyst showed recordings of the U.S. Senate Select Committee on Nutrition hearings, chaired by Senator George McGovern. It showed an unnamed, heroic scientist passionately imploring that the guidelines be deferred—“ that’s why I have pleaded in my report and will plead again orally here for more research on the problem before we make announcements to the American public.” The scientist was Robert (Bob) Olson, professor of medicine and chairman of biochemistry at St. Louis University and a consultant to the American Egg Board.[2]

As a member of the National Academy of Science, Olson co-authored a report Toward Healthful Diets[3] that extolled the virtues of the high-fat, high-meat American diet.[4]

McGovern was born in 1922 in small farming community in the south of South Dakota. His father was a Methodist minister, who served the impoverished and hungry communities of South Dakota during the extreme hardships of the depression of the 1930s. McGovern served as a bomber pilot in Europe during the Second World War, earning an Air Force medal with three Oak Clusters and the Distinguished Flying Cross. McGovern was a skilled pilot and leader, who managed to landed his badly damaged bomber on several occasions— once with his co-pilot friend dead next to him. He was a senator of South Dakota from 1963 to 1980. He was the first director of the Food for Peace program in 1961 and was involved in the creation of the United Nations’ World Food Programme. McGovern was the chairman of the Senate Select Committee on Nutrition and Human Needs from 1968 to 1977.[5]

In 1998, McGovern served a three-year term as United States’ ambassador to the United Nations’ Agencies for Food and Agriculture during President Clinton’s administration. He worked with Bob Dole (U.S. Congressman from Kansas, 1961– 1996) to create the McGovern-Dole International Food for Education and Child Nutrition Program in 2000. In 2000, Clinton presented McGovern with the Presidential Medal of Freedom, the nation’s highest civilian honor, in recognition of McGovern’s service in the effort to eradicate world hunger. In October 2001, McGovern was appointed as the UN Global Ambassador on World Hunger and remained in that position until his death in October 2012, at the age of 90.

The first draft of the McGovern Report (1977), linking heart disease and food, caused such a tumult that major revisions were required before it was released for publication. In the Catalyst program, Eades claims that “McGovern himself was from a big wheat-growing state, so it didn’t hurt him politically that people moved away from foods of animal origin into breads and pastas.” As well is being a large wheat producing state, South Dakota also produces livestock. Much of the grain produced is used to raise livestock. McGovern believed that he and five other senators from agricultural states lost seats in November 1980, partly as a result of this report.[6] McGovern was not re-elected to office— any office — after the November 1980 senate elections. The notion that McGovern was driven by political motives cannot be substantiated and collapse with a little scrutiny.

Six Countries Study

Ancel Keys’ paper Atherosclerosis: A Problem in Newer Public Health paper was presented in New York in January 1953.  This paper is commonly referred to as the Six Countries Study.   He stated that the present high rate of death from degenerative heart disease is not inevitable by showing comparisons with other countries. [7]

J Yerushalmy and H Hillboe criticised the paper Atherosclerosis: A Problem in Newer Public Health in the publication Fat In The Diet and Mortality From Heart Disease [8] , claiming that Keys only choose 6 countries that supported his hypothesis.  They state Keys did not give reasons for his selection.  This is clearly incorrect.  If you read Keys’ paper, Keys did give the reasons for choices.

Jacob Yerushalmy and Herman Hilleboe examined the data from 22 countries (out of a possible 33) in the WHO Epidemiological and Vital Statistics 1951-1953 publication.  The results were published in their paper Fat in the diet and mortality from heart disease.

Note that Keys’ paper was presented in Amsterdam in late 1952 and later in New York in January 1953.  Yerushalmy and Hilleboe used World Health Organisation data from the years 1951-1953, which was published in 1956.

Even if data from all the 22 countries are included, it still shows:

  • positive correlations between heart disease and calories consumed, fat consumption, animal fat consumption, animal protein consumption and
  • negative correlations with heart disease and carbohydrate consumption, vegetable protein consumption, vegetable fat consumption.

Hillboe later co-authored a paper Risk Factors in Ischemic Heart Disease in Vol 53 No 3 American Journal of Public Health showing that “high cholesterol was the greatest risk factor of any single variable in ischemic heart disease”.

In the conclusion of this paper, Keys states that there is sufficient evidence to “warrant a large extension of this type of epidemiological research”.  His views were refined with later studies including the Seven Countries Study.

Ancel Keys, the “Six Countries Study” and Seven Countries Study are examined in more detail in the following articles.

Cholesterol Recommendations

Dr Bill Roberts (previous long-time editor of the medical journal Cardiology), Dr Bill Castelli (director of the Framingham Heart Study), Dr Caldwell Esselstyn  (surgeon at the Cleveland Clinic) have stated that they have never seen a heart disease fatality when cholesterol levels are below 150 mg/dL (3.9 mmol/L). [9]

Dr John Mcdougall recommends the same guidelines and recommends oat bran, garlic, vitamin C, vitamin E and niacin if there is difficulty in reaching this level.  [10]

He also states that HDL “Good” Cholesterol is Not Worth Your Attention because HDL cholesterol will fall as total and LDL cholesterol falls. [10] [11]

The Catalyst conclusion that a low-fat high carbohydrate Mediterranean style diet is the best way to avoid heart disease is consistent with Ancel Keys’ conclusion. The producers are apparently unaware that it was Ancel Keys who devised the concept of the Mediterranean Diet based on the  He based his version of the Mediterranean Diet on the diets of Greece, southern Italy and the Mediterranean regions of France and Spain of the 1960s. He and his wife Margaret wrote three popular books [12] [13] [14] espousing the virtues of this diet.

It is in stark contrast with the high fat, high protein diet advocated by Gary Taubes. [15]. Even more effective than a Mediterranean-style diet is a whole-food, plant-based diet as advocated by Professor Colin Campbell, Dr Caldwell Esselstyn, Dr Dean Ornish, Dr Neal Barnard, Dr John McDougall and Dr Michael Greger.

Other related articles are:

Footnotes

  1. de Lorgeril, M. et al. (1999) Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 99 (6), 779–785.
  2. Mills, B. K. (1980) The Nutritionist Who Prepared the Pro-Cholesterol Report Defends It Against Critics. People Magazine [online]. Available from: http://www.people.com/people/archive/article/0,,20076734,00.html (Accessed 21 November 2015). [online]. (Accessed 21 November 2015).
  3. National Research Council Food and Nutrition Board (1980) Toward Healthful Diets. [online]. Available from: http://onlinebooks.library.upenn.edu/webbin/book/lookupid?key=olbp24852.
  4. Campbell, T. C. & Campbell, T. M. (2006) The China Study. Dallas USA: BenBella Books.
  5. Armstrong, J. (2014) If Only: George McGovern and the America That Might Have Been. North Berwick ME USA: PSA Communications.
  6. Campbell, T. C. & Campbell, T. M. (2006) The China Study. Dallas USA: Benbella Books, p252.
  7. Keys, A. (1953) Atherosclerosis: a problem in newer public health. Journal of Mt Sinai Hospital. July-Aug; 20 (2), 118–139.
  8. Yerushalmy, J. & Hilleboe, H. E. (1957) Fat in the Diet and Mortality from Heart Disease.
  9. Campbell, T. C. & Campbell, T. M. (2006) The China Study. Dallas USA: Benbella Books.
  10. McDougall, J. (2002) Cholesterol - When and How to Treat [online]. Available from: http://www.nealhendrickson.com/mcdougall/020900pucholesterol.htm.
  11. McDougall, J. (2004) HDL ‘Good’ Cholesterol is Not Worth Your Attention [online]. Available from: https://www.drmcdougall.com/misc/2004nl/apr/040400pufav5.htm.
  12. Keys, A. & Keys, M. (1959) Eat Well and Stay Well. Doubleday, Garden City, NY.
  13. Keys, A. & Keys, M. (1967) The Benevolent Bean. New York: Doubleday, Garden City, NY.
  14. Keys, A. & Keys, M. (1975) How to eat well and stay well the Mediterranean way. Doubleday, Garden City, NY.
  15. Greger, M. (2005) Carbophobia: The Scary Truth about America’s Low-Carb Craze. New York: Lantern Books.

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