
US government to withdraw longstanding warnings about cholesterol (2015) - winteriscoming
https://www.washingtonpost.com/news/wonk/wp/2015/02/10/feds-poised-to-withdraw-longstanding-warnings-about-dietary-cholesterol/
======
petilon
This doesn't go far enough. That there is a link between high cholesterol and
heart disease is only a hypotheses, not a scientifically proven fact. Lowering
cholesterol does not necessarily lower heart disease. Read more here:
[http://www.nytimes.com/2008/01/27/opinion/27taubes.html](http://www.nytimes.com/2008/01/27/opinion/27taubes.html)

Because the link between excessive LDL cholesterol and cardiovascular disease
has been so widely accepted, the Food and Drug Administration generally has
not required drug companies to prove that cholesterol medicines actually
reduce heart attacks before approval. See:
[http://www.nytimes.com/2008/01/17/business/17drug.html](http://www.nytimes.com/2008/01/17/business/17drug.html)

Meanwhile drug companies are making billions selling cholesterol lowering
medicines called statins. But lowering cholesterol using drugs is not useful.
Read more about that here:
[https://www.bloomberg.com/news/articles/2008-04-15/heart-
dis...](https://www.bloomberg.com/news/articles/2008-04-15/heart-disease-not-
about-cholesterol-businessweek-business-news-stock-market-and-financial-
advice)

Not only that, these statins are dangerous drugs. Its side effects include
loss of short term memory, for example. Read more about that here:
[https://www.scientificamerican.com/article/its-not-
dementia-...](https://www.scientificamerican.com/article/its-not-dementia-its-
your-heart-medication/)

~~~
djsumdog
I agree with you. This article also mentions they're focusing on
fats/saturated fats; which is also a terrible focus.

The real danger is not fat, even saturated/trans-fats, but starches and sugar.
The increase in these types of carbohydrates in products like baby formula is
actually leading to obesity in infants!

Excess sugar can stress arteries and damage them. Cholesterol is carried to
these artier by lipids (LDLs and HDLs, which are not actually cholesterol, but
proteins that carry it through your bloodstream). If you eat a lot of sugar,
cholesterol can build up between the walls of arteries as they fix the damage.
They can eventually break down the wall, releasing plaque into the bloodstream
and potentially causing heart complications.

I highly recommend Dr. Lustig's video (UCTV) to learn more:

[https://www.youtube.com/watch?v=dBnniua6-oM](https://www.youtube.com/watch?v=dBnniua6-oM)

A few years back I switched to a keto normal fat/very low carb (excluding
fiber) diet. I've lost weight, gained energy and have felt a lot better. Of
course this isn't for everyone. Some people have a body type that lends itself
to higher carb intake (I knew a runner who'd eat 30 bananas a week) and as
always do your research, consult with your doctor, dietitian, etc. before
drastic changes in your diet.

It's a common myth that Adkins died of his own diet. He didn't, and Reuters
rededicated their column implying that he did. I honestly wonder if the
obesity epidemic would have gone down today if the world didn't dismiss his
ideas, or the ideas of many nutritionist for decades before him that made
similar claims about the dangers of sugar.

~~~
baron816
It's also a myth that runners need a high carb diet. I was a competitive
distance runner for many years with a high carb diet and I'm confident that my
performance suffered because of it. You're cells become much more efficient at
using energy as you train, so you really don't need to eat that many calories
at all. I was running 80+ miles per week, with a not above average calorie
intake (for Americans), and my weight was stable.

~~~
argonaut
There's a certain irony in calling something a myth based on your personal
anecdote.

~~~
ageofwant
Personal anecdotes are considerably more valuable to the individual that
generalized truths. Every human body is unique and while trends and
generalizations matter, they do not matter as much as empirical observed
facts. Much more so in the context of personal health.

~~~
Fnoord
You're forgetting all the biases (& fallacies) which may or may not have
affected the experience or the memory leading to the anecdote. These biases (&
fallacies) are detectable or the lack of them is verifiable, with the
scientific method.

I'm not denying an anecdote is not valuable to the individual. It is, for the
individual who _made_ the anecdote; not the rest of us, not the readers.

I'm also will admit I, too, use anecdotal evidence. But that does not mean one
has strong evidence when they do; they don't, and neither do I.

~~~
TheSpiceIsLife
I feel like waving my hands around in the air while running around screaming.

The bullshit that's been pushed on us for decades about cholesterol isn't
science.

And to add to that, I've never heard any anecdotal evidence that goes "I went
on a low cholesterol diet and my symptoms improved".

The scientific method is valuable. _Science_ as it is practiced...? Let's just
say it's reputation has been tarnished.

~~~
evidence_first
What is this 'bullshit'? There are studies that show correlations between LDL
cholesterol and risk of heart attacks (happy to show you some if you're
curious).

It's true that we're still making sense of how to operationalize those
observations (restrictive diet, exercise, statin therapy, etc). This doesn't
make the science worthless; it's just an intermediate step in this particular
area of research.

~~~
pessimizer
> There are studies that show correlations between LDL cholesterol and risk of
> heart attacks (happy to show you some if you're curious).

Why wouldn't you? It seems like it would be unambiguously helpful both in
general for the thread, and specifically for your argument.

For evidence that the lowering of LDL cholesterol lowers the risk of heart
attacks, though, the evidence can't just be an association between heart
attacks and naturally high cholesterol, which could obviously both spring from
the same cause. An association between low cholesterol diets and heart attack
rates, or good evidence that statins lowered mortality would both be
interesting.

------
clarkmoody
Wouldn't it be nice if there were more government warnings and less
restrictions / regulations?

Imagine if the FDA, instead of blocking new drugs for 10 years and $1B, it
simply withheld its endorsement until satisfied by the clinical trials.
Consumers could then take the government's recommendations into consideration
when making a decision and drugs could get to market much faster.

The history of medical reversals -- and in this case, nutrition reversal --
shows that the government isn't magic.

A whole raft of restrictions could be converted to warnings and
recommendations, freeing up industry to innovate and consumers to take a
little more responsibility for themselves.

Imagine the history of the past few decades if the state had outlawed any
foods with more than X% cholesterol. Or trans-fats. Or any of the other food
fads over that time. It would have been terrible, especially now that the
recommendation is reversed. The whole time, consumers were allowed to factor
government warnings into their decisions, but food producers weren't breaking
the law by selling foods with (X+1)% cholesterol.

~~~
badsock
Just as an example: 9% of the cases of Idiosyncratic Drug-induced Liver Injury
is self-harm caused by people taking non-regulated dietary supplements:

[https://www.ncbi.nlm.nih.gov/pubmed/18955056](https://www.ncbi.nlm.nih.gov/pubmed/18955056)

You have a theory that the average person will wisely assume the
responsibility to vet the health effects of what they consume, but empirical
reality disagrees with your theory. Right now people are injuring themselves
with products at the margin of regulation.

There's a societal cost for lots of people injuring themselves, and offloading
the responsibility of researching safety to the average consumer will cause
fear and superstition, limiting people's willingness to try new products, and
I would argue that that reduces innovation. Regulation in this area has been a
net societal benefit.

~~~
azinman2
Don't forget that marketing budgets for pharmaceuticals are also huge. The
average person has no chance. The constant bombardment already means people go
to their doctor asking for Rx by name even without understanding the medical
need or if they're right for it. Now remove regulation... the warnings
basically just blur into the background. Already we get so many warnings on
prescriptions that they just turn into nothing because people become so
habituated to them. It's identical to the paradox that is windows/browser
security -- the more you warn, the more people just click through and ignore.

~~~
RangerScience
Hmm. Could you then disallow any advertising of drug while you're still
without FDA endorsement? Like how you're not allowed to advertise cigarettes.

I suspect this line of thinking just leads to too many problems, however.

~~~
teddyh
Yes, it’s possible to do this. You may be surprised to hear that the USA is
one of only two countries _on the entire planet_ which it’s even _legal_ to
advertise drugs. All others outlaw it completely.

~~~
Sacho
Indeed, that was surprising to hear, and a quick google search found me many
countries in Europe where advertising drugs is legal, within some restrictive
framework.

Examples:

Spain
[http://uk.practicallaw.com/0-618-5403#a202338](http://uk.practicallaw.com/0-618-5403#a202338)

France
[http://uk.practicallaw.com/2-618-6699](http://uk.practicallaw.com/2-618-6699)
)

~~~
comex
Both of those links say that there's a total ban on advertising _prescription_
drugs to consumers, which is more specific than what the parent said but still
very broad.

~~~
teddyh
I’m sorry, yes, I should have specified prescription drugs, as that is what I
meant. In context, though, this was what was discussed by the grandparent
post: “[…] _people go to their doctor asking for Rx by name_ […]”.

------
d0mdo0ss
The sugar industry has a history of lobbying public attention away from sugar
and towards cholesterol. It has even enlisted places like Harvard School of
Public Health on this task:

[http://time.com/4485710/sugar-industry-heart-disease-
researc...](http://time.com/4485710/sugar-industry-heart-disease-research/)

[https://www.theguardian.com/society/2016/apr/07/the-sugar-
co...](https://www.theguardian.com/society/2016/apr/07/the-sugar-conspiracy-
robert-lustig-john-yudkin)

------
pdq
Let me know when the government wakes up and inverts the food pyramid, so that
breads and grains and carbs are scarce, rather than fats.

~~~
mkautzm
Carbohydrates are not a bad thing and are indeed an important part of health.
The current suggested diet doesn't say, 'bread'. It specifically calls out
Whole Grains, which a great deal of evidence suggests are a Good Thing.
Suggesting that grains, or even carbs, are somehow worse than literal fat is
misleading at best, and delusional at it's worst.

~~~
pdq
I'm referring to the original 1992 food pyramid:
[https://en.wikipedia.org/wiki/Food_pyramid_(nutrition)#/medi...](https://en.wikipedia.org/wiki/Food_pyramid_\(nutrition\)#/media/File:USDA_Food_Pyramid.gif)

> Fats, oils, sweets: sparingly

> Bread, cereal, rice & pasta: 6-11 servings

Yes I am in the camp that believe fats and proteins are both much healthier
than carbs, and especially refined sugars. The latest nutrition supports low
carb diets, as can be seen with Atkins and Keto diets.

~~~
teach
> The latest nutrition supports low carb diets

The "latest nutrition" supports nothing of the sort. Dietitians still
recommend you get roughly 50% of your calories from healthy carbs.

Source: my wife is a registered dietitian and has a PhD in nutrition.

~~~
bobdole1234
The latest research shows exactly that.

In 15 years or so, what gets taught will reflect that.

------
mtw
For those who are curious, the 2015-2020 Dietary Guidelines is available here
[https://health.gov/dietaryguidelines/2015/resources/2015-202...](https://health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf)
(PDF)

Unfortunately it does not highlight the danger of sugar & processed food.
Someone can follows these dietary guidelines and still be able to have a high
intake of sugar, HCFS, processed food and all sorts of food chemicals
(emulsifiers etc.), all prevalent in the american food industry, and get
cardiovascular disease.

We are not going to reverse the obesity epidemic anytime soon!

~~~
yellowgatorade
Are there any studies showing that "processed food" is, on its own, dangerous?
Or is the inherent danger largely due to the HFCS, sugar, and other items that
are usually added in the process?

~~~
mtw
A few studies
[https://www.ncbi.nlm.nih.gov/pubmed/26514947](https://www.ncbi.nlm.nih.gov/pubmed/26514947)
[http://thorax.bmj.com/content/early/2016/11/25/thoraxjnl-201...](http://thorax.bmj.com/content/early/2016/11/25/thoraxjnl-2016-208375.short?g=w_thorax_ahead_tab)
[http://cancerres.aacrjournals.org/content/early/2016/11/05/0...](http://cancerres.aacrjournals.org/content/early/2016/11/05/0008-5472.CAN-16-1359)
[http://cebp.aacrjournals.org/content/4/8/895.short](http://cebp.aacrjournals.org/content/4/8/895.short)
[https://www.ncbi.nlm.nih.gov/pubmed/20479151](https://www.ncbi.nlm.nih.gov/pubmed/20479151)

I am sure there is a meta-analysis somewhere but this would take a bit of time
to find

------
empath75
There is so much that 'everybody knows' about nutrition that is pure bullshit
peddled by farmers, agribusiness and processed food companies.

Just one example-- that fat causes heart disease. Pure nonsense pushed by the
soda and sugar industry.

[https://www.theguardian.com/society/2016/apr/07/the-sugar-
co...](https://www.theguardian.com/society/2016/apr/07/the-sugar-conspiracy-
robert-lustig-john-yudkin)

Just eat a balanced diet, don't overeat, and don't eat too much processed food
and red meat, and you'll probably be fine.

~~~
delinka
"Balanced diet" is the terminology that's honestly hard to define. Until we
have that definition, "a variety of types of food" seems better to me. Here,
let me offer a correction:

"Eat a variety of foods, avoiding large amounts of any one thing, and don't
overeat; you'll probably be fine."

~~~
andy_ppp
"Eat food. Not too much. Mostly plants."

\- Michael Pollan

~~~
credit_guy
Right. And what do you do if you are hungry after you eat "not too much" ?

~~~
lkbm
Use different food.

If your diet is complex carbs with lots of fiber, you probably won't be hungry
after ingesting a decent amount of calories. Most people don't do that (myself
included), so instead I add in a lot of protein, which also fills me up
reasonably quickly on a per-calorie basis.

It's not simply calories that fill you up, so choose the right calories. I can
eat a thousand Calories of chocolate chip cookies and still be hungry, but a
thousand calories of protein bars or broccoli will usually fill me up
reasonably well.

(Actually, I've never managed a couple thousand Calories of just broccoli. I
usually do 200-300 Calories of broccoli, but that alone does as much as all
those cookies for satiety, so I can then eat a filling-but-sane second dinner
and be full+healthy.)

------
rcavezza
<<< The new view on cholesterol in food does not reverse warnings about high
levels of “bad” cholesterol in the blood, which have been linked to heart
disease. Moreover, some experts warned that people with particular health
problems, such as diabetes, should continue to avoid cholesterol-rich diets.

<<<The greater danger in this regard, these experts believe, lies not in
products such as eggs, shrimp or lobster, which are high in cholesterol, but
in too many servings of foods heavy with saturated fats, such as fatty meats,
whole milk, and butter.

Here is my paraphrased takeaway:

Cholesterol you see in your blood results is still bad. Whole milk, butter,
and fatty meats is still bad. Foods like eggs, shrimp, and lobster might be
good.

I don't think this changes any of my mental models. The foods that I always
thought of as "probably not great" are still classified as such, according to
this article.

~~~
nether
> Whole milk, butter, and fatty meats is still bad

You're sure of that?

[http://www.npr.org/sections/thesalt/2014/02/12/275376259/the...](http://www.npr.org/sections/thesalt/2014/02/12/275376259/the-
full-fat-paradox-whole-milk-may-keep-us-lean)

My main takeaway:

> "Almost every single nutrient imaginable has peer reviewed publications
> associating it with almost any outcome," John P.A. Ioannidis, a professor of
> medicine and statistics at Stanford and one of the harshest critics of
> nutritional science, has written.

~~~
ubercore
Even in that article, they say it's just associated with reduced obesity, and
saturated fats in dairy are still associated with heart disease.

~~~
sandGorgon
This is inaccurate.

Pubmed studies show that butter is not related to heart disease
[https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines...](https://www.ncbi.nlm.nih.gov/pubmedhealth/behindtheheadlines/news/2016-06-30-stop-
demonising-butter-say-researchers/)

~~~
ubercore
I'm just relating what's in the article. Thanks for sharing that, though.

------
conistonwater
The full dietary guidelines being discussed appear to be here:
[https://health.gov/dietaryguidelines/2015/guidelines/](https://health.gov/dietaryguidelines/2015/guidelines/)

------
test_pilot
Youtube is where most people get their dietary advice now. The most
influential diet advice is coming from young attractive healthy looking
people. Whatever they're eating seems to be working. Obviously most of these
people won the genetic lottery, but they've also nurtured their body correctly
with food and exercise.

This seems like a much better approach in convincing people what to eat
anyway. Look at the results and imitate healthy people if you want to look and
stay healthy.

------
kazinator
> _The greater danger in this regard, these experts believe, lies not in
> products such as eggs, shrimp or lobster, which are high in cholesterol, but
> in too many servings of foods heavy with saturated fats, such as fatty
> meats, whole milk, and butter._

Translation: the lobbyists for various polyunsaturated "edible plastics" are
currently in the lead.

------
mescalito
Interesting, for those who enjoy reading (which I guess are probably quite a
lot) I'd recommend the big fat surprise[1], a very interesting book about
this, which goes way beyond this article.

[1]: [http://thebigfatsurprise.com/](http://thebigfatsurprise.com/)

------
blatherard
This needs a (2015) added to it.

~~~
Perceptes
February 2015, nonetheless. It's almost two years later. I'd like to hear what
developments there have been on the topic since this was published.

------
galfarragem
I use to look around in a _naive_ way and take my conclusions:

\- Grandfather, 89, ate everything _moderately_ during his life, mostly
organic. He evites fat and bread and walks every day. Low energy person.

\- Grandmother, passed at 82, cancer. Same diet as my grandfather. Much less
exercise though.

\- Grandmother, 92, ate _a lot_ until 50's, mostly organic, obese. Since then
barely eats, mostly vegetables and yogurt. Right weight and good health. No
exercise.

\- Grandfather, passed at 71. Ate more fat than anyone I know. Death by heart
attack or stroke. Very energetic person with a lot of exercise.

Can you see a pattern? I can't.

~~~
singularity2001
The minimum sample size for any meaningful statistic is 7

------
thomasvarney723
I recommend Peter Attia's (currently unfinished) series, "The straight dope on
cholesterol". He's a surgeon interested in health and fitness.
[http://eatingacademy.com/?s=cholesterol](http://eatingacademy.com/?s=cholesterol)

------
known
Current reference intake is 300 mg
[https://en.wikipedia.org/wiki/Dietary_Reference_Intake#Macro...](https://en.wikipedia.org/wiki/Dietary_Reference_Intake#Macronutrients)

------
kelukelugames
My surgeon friend told me medical studies are like the bible. You can find a
paper that says something is bad for you and another that says it is good for
you. So just believe the one that makes you happier.

~~~
lkbm
You can definitely find contradictory studies. The solution is not to abandon
research, but to recognize that _A_ study means very little, unless it's a
systematic review or meta-analysis (in which case it's a study of many
studies).

Don't pick the one study that shows what you want. Pick _all_ the studies and
go with whatever the preponderance of evidence suggests. _That 's_ science,
and it's by far our most effective and reliable way of learning useful and
non-obvious truths about the world.

~~~
singularity2001
that good insight needs to be put in a quotable format

------
known
Sounds like US is endorsing
[https://en.wikipedia.org/wiki/French_Paradox](https://en.wikipedia.org/wiki/French_Paradox)

------
overgard
The USG is frankly incompetent when it comes to this matter. I guess it's
happy news that they're not creating more chaos but yay? Hollow victory

------
fulldecent
This is a link to a non-authoritative source. Could someone please provide a
link to the authoritative source so that I may investigate by myself?

------
jordache
oh so now butter is bad again? WTF. Can't believe anything the nutritionists
put out.

------
mistermann
Interesting, why now I wonder?

------
pombrand
For those of you who still believe it's OK or even good to eat a lot of
saturated fats, if you look at the studies it's not much of a controversy:"
Whether saturated fat is a risk factor for cardiovascular disease (CVD) is a
question with numerous controversial views.[1] Although most in the mainstream
heart-health, government, and medical communities hold that saturated fat is a
risk factor for CVD, some hold contrary beliefs."
[https://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascul...](https://en.wikipedia.org/wiki/Saturated_fat_and_cardiovascular_disease_controversy)

Anecdotally, I've read 50% of people who go on Keto see a huge 2-3x increase
in triglycerides and LDL-P (Particle count as measured by NMR) - the #1 risk
factor for cardiovascular disease. More LDL particles bouncing around in your
arteries = bad. People with a condition that makes them break down more LDL
have much less artheroscleriosis:
[http://www.nejm.org/doi/pdf/10.1056/NEJMoa054013](http://www.nejm.org/doi/pdf/10.1056/NEJMoa054013)
People with a condition that makes them have more LDL particles get more
artheroscleriosis:
[https://en.wikipedia.org/wiki/Familial_hypercholesterolemia](https://en.wikipedia.org/wiki/Familial_hypercholesterolemia)
Read Peter Attila's exposition that goes in detail (eating cholesterol is fine
though): [http://eatingacademy.com/nutrition/the-straight-dope-on-
chol...](http://eatingacademy.com/nutrition/the-straight-dope-on-cholesterol-
part-i) Keto could work, but it's a hyper-pro level high-risk diet requiring
frequent blood work and still avoiding saturated fats keeping them primarily
monounsaturated which makes it very hard to follow. Plus it sucks for
weightlifting..

Surprisingly, very low fat diets might be great for you, it might not be the
absolute macronutrient composition that matters, but rather the specifics of
the nutrients (GI, fiber, other nutrients etc) and your genetic makeup:
[https://deniseminger.com/2015/10/06/in-defense-of-low-
fat-a-...](https://deniseminger.com/2015/10/06/in-defense-of-low-fat-a-call-
for-some-evolution-of-thought-part-1/) Scary correlations about saturated fats
and neurodegenerative disease therein too.

Personally I'm sticking with a "balanced" ~10/45/45 carbs from protein, low GI
carb/monounsaturated fat vegan diet - not wanting to risk side effects of any
extreme (although I'm having to ensure adequate calcium, K2, D, B12 and DHA
and EPA intake - If I didn't find it unethical to eat fish a pescetarian
variety would likely be easier/healthier/less gassy). Tip for you
vegetarians/vegans: look up low FODMAP foods; foodstuffs low in carbs
indigestible in the small intestine which tend to produce more gas.

------
LargeCompanies
Hmmm this was just on the homepage then quickly removed.. top of the page then
boom gone? Any reason why this is?

Also I've been on statins since 37 after feeling my heart race and not being
able to catch my breathe after being with girlfriend at the time. That was
some scary stuff and after the statin and change of diet I no longer have
those type of bouts anymore. So maybe it's my change in diet (cut out 75%
fried food and sugar intake is 50% less) and the statin combined and or maybe
the statin is just a placebo and my change is diet helped eliminate those
heart racing attacks?

I had a lot of those attacks from 37 to about 39...im now 41 and haven't dealt
with any such attacks unless I eat a say Five Guys or In and Out.

------
jljljl
"Eat food, not too much, mostly plants."

\- Michael Pollan

~~~
jdminhbg
The oft-cited and never-defined Tautology Diet.

~~~
SwellJoe
There is a whole book defining the quote above. It's a very enjoyable read,
and reasonably well-cited.

------
pcurve
Just eat in moderation and try to maintain healthy weight.

The last time I checked, average woman in the U.S. is 5'4" but weighs 165lbs;
average man clocks in at nearly 200lbs. We can do better.

~~~
sjg007
Sweet I'm above average!! ;)

