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Frank Cooper and I share a common interest in the cholesterol theory; we both have sky high cholesterol levels. As younger men we were taught this put us at high risk of sudden death. Then we investigated the theory and found it lacking. There is no clear cause/effect relationship between cholesterol levels and heart attacks. Actually the theory has leaked like a sieve from the very beginning.

In Cholesterol & The French Paradox Frank has done a fine job of putting the cholesterol theory to rest. Frank's stated purpose in writing this book is to simplify the subject for non-health professionals. He has done a good job.

Heart attacks kill more people in developing and industrialized nations than anything else. The cholesterol theory has dominated thinking on the subject for decades and is still promoted by commercial interests. However, in scientific publications the theory is eroding in favor of newer concepts such as the oxidation theory, arterial damage from high Homocysteine levels, rupture of fatty plaques and the role of inflammation. Articles on these topics make interesting reading. They begin by bowing down in praise of the cholesterol theory, then move on to present something more useful. Authors seem to know the cholesterol theory is so entrenched that if they attacked it, their paper would never see the light of day.

My personal introduction to another way of looking at the cholesterol theory began when I had dinner with Linus Pauling 30 years ago. Dr. Pauling told me there wasn't much evidence to support the theory and that cholesterol would take care of itself provided a person was well nourished in all of the materials the body needs. He conveyed this to me while eating a large juicy steak and I ate a less tasty fish dish. Pauling, the only person to be awarded two individual Nobel Prizes, lived an active life right up to his death at 93.

I discovered books by Dr. Paul Dudley White, founder of the specialty of cardiology. Dr. White wrote he once was asked his opinion of the cholesterol theory. He responded he couldn't believe in the theory because it was not consistent with the history of the disease. Nobody asked for his opinion again.

What White was referring to was that the very first heart attack in the world proven by autopsy was in England in 1878 (a time when nearly everyone who died was autopsied in the name of medical science). White graduated from medical school in 1910 but didn't see a heart attack victim until 1921. By 1950 the heart attack had become the leading cause of death, apparently coming out of nowhere. Dr. White knew that during all of this time (and later) dietary intake of cholesterol and saturated fats remained the same.

Inspired by these giants in science I searched the medical library for studies on cholesterol. I found the theory was based on a very weak association between blood cholesterol levels and heart attacks that was seen only in middle aged men with genetically high levels. A few years later I asked a cholesterol researcher from Stanford University what he thought about exceptions to the cholesterol theory. He replied he didn't know of any.

Well, here are a few:

• Cholesterol intake has been constant for over 100 years, as the death rate from coronary heart disease has risen and fallen sharply.
• There is no association between blood cholesterol levels and heart deaths in women despite TV ads for statin drugs showing women keeling over because of high cholesterol levels.
• No heart attacks were seen in more than 15 primitive life style cultures that consumed high fat diets.
• Scientific studies failed to show that lowering blood cholesterol levels lowered overall death rates which, after all, should be the ultimate goal of any preventive effort.
• Half of people dying of a heart attack have cholesterols in the "normal" range.
  Eating less cholesterol does not drop blood levels of cholesterol significantly.
• It should be obvious we are omnivores. We have the biochemistry to handle carbohydrates, proteins, and fats.
• And of course there is the French Paradox discussed in this book.

How current low-fat dietary guidelines came into being deserves comment. The Consensus Development Conference on cholesterol was held at the National Institutes of Health in Washington, DC, in 1984. Attendance was by invitation only. Most attendees made their living researching cholesterol, hardly an unbiased and open minded group.

By that time over 15 studies had been completed with the goal of proving that reducing cholesterol levels would reduce heart attack deaths. However, the presenter who reviewed this work apologized at the beginning saying that in every study something "ridiculous" happened that prevented expected results from being observed. After two days of less than convincing presentations the chairman announced a consensus had been reached. He called a press conference and recommended low fat, low cholesterol diets for everyone.

Belief in the cholesterol theory has led to illogical actions through the years as large commercial interests became involved. Manufacturers of margarines and vegetable oils launched advertising campaigns pointing out that their products don't contain cholesterol or saturated fats (little was known at the time about harmful trans fats these products contain and only animal products contain cholesterol or saturated fats). Pharmaceutical companies launched a huge educational program encouraging physicians to prescribe a series of what turned out to be ineffective cholesterol-lowering drugs.

Cholesterol phobia caused sales of beef to fall in half but only temporarily because Americans really love beef. Egg sales fell a devastating 40% and stayed there for years. When egg producers advertised the truth that eggs had never been shown to be harmful to anyone they were taken to court and convicted of false advertising by a judge who believed the testimony of cholesterol researchers.

In 1995 the first statin study was presented. Researchers proudly proclaimed this was the first study in which heart attack deaths dropped without seeing a counterbalancing increase in deaths from other causes. To me this only served to expose lies the public was told for 40 years that cholesterol-lowering drugs were of benefit.

This is but a small part of the cholesterol issue. What remains at the end of the day is a tale of false hopes, biases, and manipulation by commercial interests. This book explores the cholesterol/coronary heart disease connection from several angles. Frank does a good job presenting information on how basic science research can be exploited by financial interests. I especially agree with him that people are going to be the healthiest when they consume fresh whole foods and shun refined and processed foods. That advice is far more useful than current recommendations to cut down on cholesterol and saturated fats which reduces intake of some of our most highly nutritious foods.

Contents
ACKNOWLEDGEMENTS
PREFACE BY CHARLES T. MCGEE, MD
PART 1: EXPLORING THE MYTH
CHAPTER 1 THE FRENCH PARADOX
CHAPTER 2 THE MEDICAL WORLDS

Research Doctors
Practicing Doctors
Pharmaceutical Industry Doctors

CHAPTER 3 LET’S TALK CHOLESTEROL

Is Cholesterol Clogging Your Arteries?
New Research into Cholesterol

CHAPTER 4 WHAT LEVEL OF CHOLESTEROL IS NORMAL?

Recommended Cholesterol Guidelines
Do You Have Coronary Heart Disease, or High Cholesterol?
Cholesterol Tests are Inaccurate
Scanning & Imaging Your Arteries

CHAPTER 5 CHOLESTEROL LOWERING DRUGS – ARE THEY SAFE?

Naturally Derived Statins
Synthetic Statins
Statin Side Effects
Muscle Inflammation / Deterioration
Kidney Damage (Rhabdomyolysis)
Nerve Damage (Polyneuropathy)
Memory & Cognitive Damage

CHAPTER 6 STATIN USERS, CASE EXAMPLES

Medical Case – Chief Executive Officer, Serious Muscle & Memory Problems, USA
Medical Case – Business Executive, Serious Muscle Breakdown, Australia
Medical Case – Company Director, Cognitive Memory Damage, USA

CHAPTER 7 ALTERNATIVES TO STATIN DRUGS

Summary of Statin Side Effects
Policosanol / Sugar Cane Wax Alcohols
Red Yeast Rice
Ayurvedic Medicine for Cholesterol-Lowering
Plant Sterols
Naturopathic Physicians

CHAPTER 8 WHO DETERMINES CHOLESTEROL GUIDELINES
CHAPTER 9 DOES HEART DISEASE RUN IN THE FAMILY
CHAPTER 10 WOMEN AND CHOLESTEROL

Older Women with Elevated Cholesterol Live Longer
Pregnant Women - Special Alert
Research Data for Women

CHAPTER 11 CLINICAL TESTS FOR YOUR HEART

C-Reactive Protein
Homocysteine
Lipoprotein(a)

CHAPTER 12 BLOOD PRESSURE / HYPERTENSION

Risks of High Blood Pressure
Salt Formulations
Magnesium – An Essential Nutrient
L-Arginine, Nitric Oxide and Vasodilation

CHAPTER 13 SMOKING

Free Radical Damage / Inflamed Arteries
Collagen Damage and Haemorrhage Stroke
Surgical Risks for Smokers

PART 2: A HEALTHY HEART
CHAPTER 14 WHY HEART DISEASE IS DECLINING

Heart Attack Epidemic 1920 - 1968
Vitamin and Mineral Deficiencies 1920 - 1968

CHAPTER 15 IMPROVED MEDICAL & SURGICAL TECHNIQUES

Angioplasty
Coronary Stents
Chelation Therapy

CHAPTER 16 IRREGULAR HEARTBEAT / ARRHYTHMIAS

Artificial Sweeteners and Irregular Heartbeat
Bread Preservatives - Calcium Propionate #282

CHAPTER 17 FRENCH CUISINE

French Cuisine - Eating Food in Season

CHAPTER 18 WINE & PHYTONUTRIENTS

The French Paradox Is Born
The Copenhagen Heart Study
LDL Cholesterol
Phytonutrients in Foods – Powerful Antioxidants
Microwave Cooking Destroys Phytonutrients

CHAPTER 19 WINE ALLERGIES

Sulphur Dioxide, Sulphites, Preservative #220
Low Preservative and Organic Wine

CHAPTER 20 INFLAMMATION IN THE ARTERIES

Foods That Heal
Foods Causing Inflammation
Eating Out / Travelling

CHAPTER 21 OILS & FATS (LIPIDS)

Trans Fats / Hydrogenated Vegetable Oils
Interesterification / Interesterfied Fats
Palm & Coconut Tropical Oils

CHAPTER 22 MEDIA REPORTS
CHAPTER 23 THE FRENCH PARADOX UNRAVELLED
CHAPTER 24 ACTION PLAN - YOU AND YOUR PHYSICIAN

Action Plan & Recordkeeping
Reminder Checklist

CHAPTER 25 READER COMMENTS

Before We Finish

APPENDIX 1 MY LIFE JOURNEY WITH CHOLESTEROL
APPENDIX 2 CHOLESTEROL: HOW IT BECAME A DISEASE
APPENDIX 3 THE HISTORY OF FATS & OILS (1900 TO 2000)

Interesterfied vegetable oils

REFERENCES
INDEX
ABOUT THE AUTHOR
CHOLESTEROL& THE FRENCH PARADOX– BACKCOVER

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