Heart of the Matter—How We Got So Far Down the Wrong Track in Our Efforts to Prevent Heart Disease

Story at-a-glance -

  • Over the past 60 years, research has repeatedly demonstrated that there’s NO correlation between high cholesterol and plaque formation that leads to heart disease. Despite that, the saturated fat/cholesterol myth has persisted
  • The cholesterol hypothesis turned into a boon for the processed food industry, and gave birth to the “low-fat” craze. In the process, healthful saturated fats were swapped for harmful trans fats, and ever increasing amounts of sugar
  • The cholesterol theory also resulted in a massive boon for the drug industry. Cholesterol-lowering statins are now among the most widely prescribed drugs on the market with one in four Americans over 45 taking them
  • Sugar is a primary dietary culprit in the development of heart disease. To protect your heart health, you need to address your insulin and leptin resistance, which is the result of eating a diet too high in sugars and grains

By Dr. Mercola

The video above is a special edition of Catalyst,1 aired on ABC News in Australia. In it, Dr. Maryanne Demasi investigates the science behind the persistent claim that saturated fat causes heart disease by raising cholesterol.

I highly recommend setting aside an hour to watch it, as it does an excellent job describing how we got so far down the wrong track.

The idea that high cholesterol causes heart disease can be traced back to Rudolph Virchow (1821-1902), a German pathologist who found thickening in the arteries in people he autopsied, which he ascribed to a collection of cholesterol.

He was followed by Ancel Keys (1904-2004), a well-known physiologist who published his seminal paper known as the "Seven Countries Study"2 in 1963. This first major report linking saturated animal fat consumption to heart disease served as the basis for nearly all of the initial scientific support for the Cholesterol Theory.

What many don't know is that data was actually available from 22 countries, but Keys selectively analyzed information from only seven of them. The seven countries chosen held true to his initial theory.

Upon later analysis, other researchers discovered that when all 22 countries are included, there's no correlation at all between saturated fat consumption and coronary heart disease. In fact, the full data set suggests the opposite—that those eating the most saturated animal fat tend to have a lower incidence of heart disease.

The Propagation of Flawed Science

Over the past 60 years, research has repeatedly demonstrated that there's NO correlation between high cholesterol and plaque formation that leads to heart disease. Despite that, the saturated fat/cholesterol myth has been an extremely persistent one.

As of 2010, recommendations from the US Department of Agriculture3 (USDA) call for reducing your saturated fat intake to a mere 10 percent of your total calories or less. Fat is abhorred to the point it was virtually removed entirely from the latest USDA "food pyramid," now called "MyPlate". Except for a small portion of dairy, which is advised to be fat-free or low-fat, fats are missing entirely.

How could this be?

This is the precise converse of what your body needs!  Many health experts now believe that, for optimal health, you likely need anywhere from 50 to 85 percent of your daily calories in the form of healthful fats.

My Plate Preview

In the 1960s, British physician John Yudkin was among the first to challenge Ancel Keys' hypothesis, stating that SUGAR is the culprit in heart disease—not saturated fat.

Alas, as described in the featured video, Keys was a politically powerful figure. He publicly discredited and ridiculed Yudkin, whose sugar hypothesis ended up fading into oblivion. By the 1970s, supporting the sugar hypothesis made you a quack in the eyes of the medical establishment.

So rather than following the science, or at least having an open mind to investigate multiple hypotheses, public health recommendations simply followed the trail of the loudest, most politically astute bully...

Just to give you a couple of recent examples, here are two 2010 studies—both of which negate Keys' selectively biased findings and the cholesterol hypothesis as a whole, while supporting the sugar hypothesis in the development of heart disease:

  • A meta-analysis4 that pooled data from 21 studies and included nearly 348,000 adults found no difference in the risks of heart disease and stroke between people with the lowest and highest intakes of saturated fat.
  • Another 2010 study published in the American Journal of Clinical Nutrition5 found that a reduction in saturated fat intake must be evaluated in the context of replacement by other macronutrients, such as carbohydrates.

    When you replace saturated fat with a higher carbohydrate intake, particularly refined carbohydrate, you exacerbate insulin resistance and obesity, increase triglycerides and small LDL particles, and reduce beneficial HDL cholesterol.

    The authors state that dietary efforts to improve your cardiovascular disease risk should primarily emphasize the limitation of refined carbohydrate intake, and weight reduction.

'Low-Fat' and Trans Fat—Two 'Healthier' Alternatives That Turned Out to Be Disastrous for Public Health

The cholesterol hypothesis turned into a boon for the processed food industry, which began creating all manner of "low-fat" and "low cholesterol" foods. Healthful saturated fats were also swapped for harmful trans fats, and ever increasing amounts of sugar.

Sugar was later replaced by processed high fructose corn syrup, which is far cheaper to produce. Then, in 1995, the first genetically engineered corn was approved in the US, and today, most of the corn syrup used in processed foods is made from genetically engineered corn. This has its own set of potential hazards, over and above those associated with fructose.

This chain of events offers even more support for the notion that it is the processed sugar (and grains if you are insulin and leptin resistant) in your diet—not saturated fat—that causes heart disease. Because despite the low-fat craze, rates of heart disease have stayed on a steady incline.

While saturated fat consumption was dramatically reduced in most people's diet, what didn't decrease was sugar. On the contrary, fructose consumption has skyrocketed, courtesy of it being added to virtually every imaginable kind of processed food and beverage. (One of the reasons for all this added sugar is because when you remove fat, you remove flavor. Sugar and added flavorings are used to add flavor back in.)

Consumption of trans fat, which for decades was touted as a healthier alternative to saturated animal fat, also radically increased, starting in the mid-1950s. Fortunately, the science showing trans fats to be FAR more harmful than saturated fat is now being officially acknowledged.  

On November 7, 2013, the US Food and Drug Administration (FDA) announced it is now considering removing partially hydrogenated oils—the primary source of trans fats—from the list of "generally recognized as safe" (GRAS) ingredients.6 This is the first step toward getting trans fats out of the American diet altogether. The World Health Organization (WHO) has also called for the elimination of trans fats from the global food supply.7

Your Body Needs Saturated Fat and Cholesterol

Unfortunately, the FDA is still holding fast to its ignorant view on saturated animal fats, urging people to "choose products that have the lowest combined amount of saturated fat, cholesterol and trans fat."8 The fact of the matter is, saturated fats from animal and vegetable sources provide a number of important health benefits, and your body requires them for the proper function of your:

Cell membranes Heart Bones (to assimilate calcium)
Liver Lungs Hormones
Immune system Satiety (reducing hunger) Genetic regulation


One of the most important fats your body needs for optimal health is animal-based omega-3. Again demonstrating the abject failure of government guidelines to promote health, the 2011 "food pyramid" (My Plate) doesn't mention omega-3 at all. In an effort to remedy this atrocious situation, I've created my own Food Pyramid for Optimal Health, which you can print out and share with your friends and family.

Dr. Mercola's Food Pyramid for Optimal Health Preview

Omega-3 deficiency can cause or contribute to very serious health problems, both mental and physical, and may be a significant underlying factor of up to 96,000 premature deaths each year. For more information about omega-3s and the best sources of this fat, please review this previous article. Besides animal-based omega-3 fats, other sources of healthful fats to add to your diet include:

Avocados Butter made from raw grass-fed organic milk Raw dairy Organic pastured egg yolks
Coconuts and coconut oil Unheated organic nut oils Raw nuts such as, almonds, pecans, macadamia, and seeds Grass-fed meats

Sugar Is a Primary Driver of Heart Disease

As initially postulated by Dr. Yudkin in the 1960s, SUGAR is a primary dietary culprit in the development of heart disease. To protect your heart health you need to address your insulin and leptin resistance, which is the result of eating a diet too high in sugars and grains—again, not fat (with the exception of trans fats from partially hydrogenated vegetable oils, which have been linked to increased heart disease risk, even in small amounts). To safely and effectively reverse insulin and leptin resistance, thereby lowering your heart disease risk, you need to:

  • Avoid sugar, processed fructose, grains if you are insulin and leptin resistant, and processed foods
  • Eat a healthful diet of whole foods, ideally organic, and replace the grain carbs with:
    • Large amounts of vegetables
    • Low-to-moderate amount of high-quality protein (think organically raised, pastured animals)
    • As much high quality healthful fat as you want (saturated and monosaturated from animal and tropical oil sources). Most people actually need upwards of 50-85 percent fats in their diet for optimal health—a far cry from the 10 percent currently recommended.

Inaccurate Science Still Dictating Medical Treatment...

Besides spawning an entire food revolution of low-fat, low-cholesterol products devoid of healthful fats, the cholesterol theory has also resulted in a massive boon for the drug industry. Cholesterol-lowering statins are now among the most widely prescribed drugs on the market with one in four Americans over 45 taking them. Statins are already the number one profit-maker for the pharmaceutical industry, and they're about to get yet another major boost in sales, courtesy of updated treatment guidelines laid out in the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.9, 10

The revised guidelines—issued by the American Heart Association and the American College of Cardiology on November 1211—will likely DOUBLE the number of Americans being prescribed these dangerous drugs, bringing the estimated total to a staggering 72 million people. The reason for this dramatic jump is because the guidelines now focus on risk factors rather than cholesterol levels. If you answer "yes" to ANY of the following four questions, the treatment protocol calls for a statin drug:

  • Do you have heart disease?
  • Do you have diabetes? (either type 1 or type 2)
  • Is your LDL cholesterol above 190?
  • Is your 10-year risk of a heart attack12 greater than 7.5 percent?

New Cholesterol Treatment Guidelines Likely to Do Far More Harm Than Good

Two fundamental flaws render these guidelines highly suspect. First of all, 12 of the 16 panel members who created these guidelines are affiliated with more than 50 different drug companies, many of which manufacture cholesterol-lowering drugs. Secondly, the calculator created to ascertain your 10-year heart attack risk has been programmed in such a way as to make patients out of virtually everyone—health status or cholesterol levels be damned.

How convenient!

As it stands, the guideline committee has vowed to examine the flaws to determine if and what changes are needed to make it more accurate. Until then, please be aware that the cardiovascular risk calculator13 appears to overestimate your risk by anywhere from 75 to 150 percent!

Also, beware that the new guideline14 does away with the previous recommendation to use the lowest drug dose possible—a strategy that typically meant you'd end up being prescribed a low-dose statin along with one or more other cholesterol-lowering medications. Instead, it focuses on statin-only treatment, and at higher dosages, ostensibly to eliminate the need for additional drugs. But if you don't need ANY drug to begin with, why take a much higher dose of a drug that is well-known for having potentially serious side effects?

There are over 900 studies proving their adverse effects, which run the gamut from muscle problems to increased cancer risk, and the list just keeps getting longer. Prescribing statins as "preventive medicine" to cut heart disease risk is just as insanely counterproductive as the low-fat craze with its preponderance of trans fats and sugars.

Consider this: As of 2011, Americans over the age of 65 numbered 41.4 million,15 and according to estimates, the new statin treatment guidelines will raise the number of American statin users to an estimated 72 million! I do not foresee the end result of medicating virtually every adult American being a good one... It is obvious to anyone that understands natural health that this is a disaster in the works, as the evidence of harm from statins is overwhelming.

Better Alternatives to Cholesterol-Lowering Drugs

Meanwhile, studies largely support the notion of using exercise as a cholesterol-lowering strategy. This makes sense, as being of a healthy weight and exercising regularly creates a healthy feedback loop that optimizes and helps maintain appropriate glucose and insulin levels through optimization of insulin receptor sensitivity. And, as I've mentioned before, insulin resistance—primarily driven by excessive consumption of refined sugars and grains along with lack of exercise—is the underlying factor of not only heart disease, but nearly all chronic disease that can take years off your life.

One recent meta-review16 compared the effectiveness of exercise versus drug interventions on mortality outcomes for four common conditions, including heart disease. After reviewing 305 randomized controlled trials, which included nearly 339,300 people, they found "no statistically detectable differences" between physical activity and cholesterol lowering medications for heart disease.

The two drugs included in the evaluation were statins and beta blockers. The only time drugs beat exercise was for the recovery from heart failure, in which case diuretic medicines produced a better outcome.

Exercise was in fact found to be so potent a strategy that the researchers suggested drug companies ought to be required to include it for comparison when conducting clinical trials for new drugs! Previous research has also shown that exercise alone can reduce your risk of cardiovascular disease by a factor of three.17 You'd be wise to pay attention to how you exercise, though.

Most people still think that in order to improve your cardiovascular fitness, endurance training is a must. But this is actually not true. Quite the contrary. High-intensity interval training, which requires but a fraction of the time compared to conventional cardio, has been shown to be FAR more efficient, and more effective.

This type of physical activity mimics the movements of our hunter-gatherer ancestors, which included short bursts of high-intensity activities, but not long-distance running. This, researchers say, is what your body is hard-wired for. Basically, by exercising in short bursts, followed by periods of recovery, you recreate exactly what your body needs for optimum health. In the case of high intensity exercises, less really is more. You can get all the benefits you need in just a 20-minute session performed twice to three times a week.

Take-Home Message

We've covered a lot of ground here, but the take home message can be summarized as follows. If you want to prevent heart disease, you basically need to do the converse of what conventional medicine tells you. So, to prevent heart disease:

  • DO eat unprocessed saturated animal fats, and don't listen to the media, as you will benefit from these fats. Many may also benefit from increasing the healthful fat in their diet to 50-85 percent of daily calories
  • AVOID all sugars, including processed fructose and grains if you are insulin and leptin resistant. It doesn't matter if they are conventional or organic, as a high-sugar diet promotes insulin and leptin resistance, which is a primary driver of heart disease
  • DO exercise regularly, as physical activity along with a healthy diet of whole, preferably organic, foods may be just as potent—if not more potent—than cholesterol-lowering drugs
  • AVOID statins, as the side effects of these drugs are numerous, while the benefits are debatable. In my view, the only group of people who may benefit from a cholesterol-lowering medication are those with genetic familial hypercholesterolemia. This is a condition characterized by abnormally high cholesterol, which tend to be resistant to lifestyle strategies like diet and exercise