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Summary.


The myth that the low fat “heart healthy” diet will prevent all forms of severe arterial disease is based on four popular deceptions.

The first is that the secular trend in (falling) heart attack rates in many countries is due solely to the 1977 dietary change that promoted a reduction in saturated fat intake in those countries.


But the scientists who actually performed those studies and who have no personal stake in the findings, come to quite different conclusions. Namely that many factors explain this trend and that of these factors, smoking is the most, and diet, probably the least important. These authors also note that the incidence of obesity is rising at the same time that the rate of heart attack is falling. The same applies to diabetes. So they must at least consider that the change to a low fat “heart healthy” diet is driving the obesity/diabetes epidemic.


The second deception is that heart attack is a marker of all atherosclerotic arterial diseases so that if heart attack rates are falling, then so must be the rates of all arterial diseases including those caused by diabetes.

But this is clearly false since the rate of occlusive atherosclerotic arterial disease in diabetes is increasing exponentially as shown by increasing rates of blindness, renal failure and limb amputations in diabetic patients. But our professional obsession with heart attacks, so skilfully manipulated by the pharmaceutical industry’s greedy interest in selling cholesterol-lowering drugs, obscures this reality.

So what has really happened since 1977 is the following:

The reduction in smoking rates that began in the US some time before the release of the 1977 dietary guidelines immediately and dramatically reduced rates of acute heart attacks because smoking reduction reduced the incidence of acute plaque rupture – the immediate pathological process that causes sudden heart attacks. Because of the close temporal relationship, the promoters of the low fat “heart healthy” diet jumped on this as definitive proof that their diet is obviously preventing all forms of arterial disease.

Instead what these dietary guidelines actually did was to create a global epidemic in obesity and diabetes and, as a result, in occlusive diabetic arterial disease. By describing diabetes as a metabolic disorder of glucose metabolism rather than a deadly arterial disease, this truth was conveniently hidden.

The third deception is that there is absolute scientific evidence that the low fat diet prevents heart attacks and insures our long-term health. But the evidence from the 3 multi-billion dollar studies using the most sophisticated experimental methodology – the randomized controlled trial (RCT) (see next column) and which includes the WHI study to which Professor Rossouw contributed – have not shown any benefits for this diet. Instead they have identified potential for harm.

The fourth deception is the unproven teaching that dietary fat causes blood cholesterol concentrations to rise and that these high levels are then the direct cause of arterial disease. I address this in the next column by showing that arterial disease is initiated by metabolic changes in the liver produced by high carbohydrate/fructose/sugar diets that cause continuously elevated blood glucose and insulin concentrations, and non-alcoholic liver disease (NAFLD) in those with insulin resistance. These changes then produce the abnormal blood fat and glucose changes – the atherogenic dyslipidaemia – that leads directly to the development of arterial plaque, at the same time promoting acute plaque rupture.

In the next column I also explain why all these outcomes were entirely predictable when we encouraged persons with insulin resistance – the most prevalent medical condition across the globe – to eat highly addictive, carbohydrate-based, sugar-enriched processed foods.


I will also address what all this means for the future of the medical profession if it truly wishes to prevent the 5 chronic diseases that are now killing us in increasing numbers and at progressively younger ages.

We have all the evidence. What we lack is the leadership to act.

Why can’t South African scientists and politicians lead the way out of this sad impasse? And so save the health of our nation

Monet lääkärit ovat ulkoistaneet ajattelemisen lääketeollisuudelle, professori Noakes sanoo. Hän ei kunnioita lääkäreitä, jotka torjuvat sairauksien ehkäisemisen ruokavaliolla ilman, että olisivat edes perehtyneet asiaan lukemalla sitä koskevaa kirjallisuutta. Sama koskee ravitsemustieteilijöitä ja -terapeutteja.