I admit to bias in this book review, having written one of the four Forwards in it. Dr. Ravnskov's earlier book, The Cholesterol Myths, 2000, has become quite famous. When it went out-of-print around 2007 used copies had asking prices of $300. I read it in 2002 and referred to it frequently. As in the new book (FCGY), the complete lack of correlation between serum cholesterol, LDL-C, and HDL-C and chance of atherosclerosis leading to heart attack was shown. Also, in both books, the lack of harm from eating animal fat (saturated) was shown from published trials. Some trials claimed the opposite, the still common myths that you hear frequently, but Ravnskov would look at the data in the medical papers and see whether those data matched the Abstract and Conclusions, finding often a disconnect. He is one of the few who would search the references of a paper to see whether the purpose the paper cited was actually supported by the content of the paper; often it was not. He also showed that reduction of cholesterol or LDL-C by old or new drugs such as the statins (Zocor, Lipitor) was of no benefit whatever, that the side effects of these drugs were more common and severe than claimed, and that their accidental benefits of being anti-inflammatory, like aspirin, were exaggerated by perversion of clinical trials by a level of patient selection far beyond what your physician would ever achieve.In addition to all this, in FCGY, newer data from the nine recent years is woven into the original narrative. Some of the new data were whimsical, such as the correlation between heart attacks and animal fat, yellow fingers and the local tax rate. Hunh? Well, real studies show animal fat intake to be a benefit, opposite to the common dogma; yellow fingers is correct because it is from smoking tobacco; and the rate of heart attacks in the municipal districts of Stockholm, Sweden vs. the local tax rates has an excellent correlation; but could it be a cause?
A new sidebar revealed the storm of protest in Finland over a campaign by a dairy products producer to show the healthfulness of its products. As Finland is even more consumed by anti-fat campaigns than the USA, the manufacturer finally backed down. Another sidebar and a new chapter near the end explained why high-carb diets (even complex whole grain carbs) are disaster for diabetics. Another sidebar explained the lack of evidence for the term "bad cholesterol" for LDL-C, including a deep literature search that showed nothing in support of the claim. Another showed the uselessness of serum triglycerides (TG) to show good health, the lack of accuracy in the assay being one reason. Another showed the cheating in the huge (and expensive US taxpayers) MRFIT Study on about 360,000 subjects. Another showed the claims of Dr. Dean Ornish (and by implication, Pritikin, McDougall, Esselsteyn, etc.) of great results from a 6-factor lifestyle change were not backed by evidence. Another showed that the members of the committee of the National Cholesterol Education Program, pretending to be a government organization, all had multiple financial ties to the Big Pharma producers of the cholesterol lowering drugs.
New topics were introduced not in the older book. One was an honest attempt to explain what causes arterial lesions, atherosclerosis, then blockages leading to heart attacks, including the amazing finding that vaccination for influenza prevents heart attacks. Ravnskov showed that an arterial plaque that could break open was similar to a boil, and why veins do not become atherosclerotic. A final chapter answers another topic the earlier book did not address: how to avoid premature death from a heart attack.
There is a good index, and hundreds of citations, mostly to medical journals. The writing is easy to read, if "accented". There are no wild claims. The only technical item I question is the term "cholesterol droplets" (p197) and the appearance of crystalline cholesterol, because the melting point of cholesterol is 149°C, far higher than body temperature of 37°C. Most cholesterol is present as esters such as the oleate and palmitate, which melt much lower and are more soluble in any fatty material.
The publisher did no favors in proof reading. Dozens of words are hyphenated as though they were on two lines, and sometimes even the location of the hyphen was odd. Loose was used at least twice when lose was meant.
Because of its exceptional honesty, depth of literature searching, logical correlations and connections, and even some humor, FCGY is strongly recommended. It should become a classic in its own right.
Product Description
Do you know
...what REALLY causes heart disease?
...that heart patients haven't eaten more saturated fat than other people and stroke patients have eaten less?
...that diabetics may be cured if they replace carbohydrates with saturated fat?
...that people with low cholesterol become just as atherosclerotic as people with high?
...that high cholesterol is not a risk factor for women or diabetics?
...that high cholesterol is not a risk factor for old people although by far most heart attacks occur after age 65?
...that old people with high cholesterol live longer than old people with low?
...that the lipoproteins protect us against infectious diseases and probably also against cancer?
The author is a scientist himself and has published more than 80 papers and letters in the scientific press critical to the cholesterol campaign, for which he has won two international awards. In his new book, which includes updated and simplified sections from his previous one (The Cholesterol Myths), Ravnskov also presents his own idea about the cause of heart disease, an idea that explains all the findings that do not fit with the present view.
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