Cholesterol and Beyond

by Truswell, A. Stewart

• ISBN13: 9789048188741
• ISBN10: 9048188741
• Edition: 1st
• Format: Hardcover
• Copyright: 2010-07-01
• Publisher: Springer Nature

Summary

Only once in a great while does a book come along that really does the job in addressing a major medical issue. When this happens, all can be joyful… Readers will find ALL their favorite dietary puzzlements dealt with… With consummate scholarship, clarity and brevity, Truswell sifts out the chaff and identifies the critical questions, the responsible investigators, and the key studies.”So says Emeritus Professor Henry Blackburn from the University of Minnesota in the foreword to this remarkable concise book on the history of research on diet and heart disease. This was a theme of scientific, medical and public interest in the 20th Century, a century marked by the rise and fall of coronary heart disease as the major cause of death in the first world, followed by the rise of this cause of death in the developing world.There is obviously much to learn, and this book is an excellent starting point, tracing dietary factors and their role in heart disease one by one: fats, sugar, salt, alcohol, coffee, trans-fats, etc. Without an understanding of the role of diet and the changes that have been seen in the North American and NW European diet, the story of the decline in the heart disease death rate may have been very different.

Table of Contents

Emergence of Coronary Heart Disease as a Diagnosis	p. 1
In Osler's Textbook (1904)	p. 1
First Reports of Coronary Thrombosis with Survival	p. 2
Papers Appear in British Journals	p. 3
Added to International List of Causes of Death (1930)	p. 4
Experimental Pathology in St. Petersburg	p. 5
Atherosclerosis Introduced as a Pathological Term	p. 5
Pioneering Experimental Work 1908-1913 Feeding Cholesterol to Rabbits in St. Petersburg	p. 5
Anitschkow Described His Work Further in 1933 American Monograph	p. 6
Anitschkow's Early Rabbit Work Confirmed in Other Countries	p. 7
Rabbits' Arterial Lesions Compared with Human Atherosclerosis	p. 7
Is Plasma Cholesterol Raised with Human Atherosclerosis?	p. 9
Cholesterol Characteristic in Human Atherosclerosis	p. 9
At First not Clear if Plasma Cholesterol Raised with Human Atherosclerosis	p. 9
Improved Statistical Design Shows Average Plasma Cholesterol Higher with CHD	p. 10
It is Low-Density Lipoproteins that are Associated with CHD	p. 10
"Normal" Cholesterol Level in Affluent Countries May not be Healthy Cholesterol	p. 11
Serum Cholesterols Lower in Naples and Madrid and Hunter Gatherers	p. 11
Diet can have Worth while Effects on Human Plasma Cholesterol	p. 13
Dietary Cholesterol	p. 13
Dietary Fat has more Effect than Dietary Cholesterol	p. 14
And the Type of Dietary Fat	p. 14
Saturated and Polyunsaturated Fats, Rather than Animal or Vegetable Fats	p. 14
Repeated Tests by Keys' Group with Different Fats and Oils	p. 16
Not all Saturated Fatty Acids have the same Effect on Serum Cholesterol	p. 17
How does it Work? Could it be by Changing Cholesterol Excretion?	p. 18
Discovery of the Low Density Lipoprotein Receptor	p. 18
A New Type of Observational Epidemiology	p. 21
Invention of Prospective, Cohort Studies	p. 21
The Framingham Study, Started 1949	p. 21
Results Emerge from Framingham and Subsequent Cohort Studies	p. 22
Big Three Risk Factors: Serum Cholesterol, Smoking and Blood Pressure	p. 22
Tentative Recommendations to High Risk Patients Start in 1960s	p. 23
Serum Triglycerides? Another Risk Factor	p. 25
Endogenous and Exogenous Serum Triglycerides	p. 25
Early Claims that Serum Triglycerides Predict Risk of CHD	p. 25
Fasting Serum Triglycerides not a Strong Independent Risk Factor	p. 26
Fredrickson's Classification of the Hyperlipoproteinaemias	p. 29
Five Types of Hyperlipidaemia, and Three Types of Low Serum Lipoproteins	p. 29
Further Developments of Fredrickson's Types	p. 31
The Seven Countries Study (7CS)	p. 33
Setting Up	p. 33
Methods	p. 35
Results	p. 35
Dietary Results	p. 36
Implications from the 7CS	p. 37
Longer Follow Up	p. 38
Sucrose - An Alternative Dietary Hypothesis	p. 39
Yudkin's Proposal	p. 39
Reactions	p. 40
HDL-Cholesterol is Protective	p. 41
Early Observations	p. 41
The Millers' Hypothesis	p. 42
It Ran Against the Grain	p. 42
Epidemiological Support	p. 42
HDL2 or HDL3?	p. 43
In Developing Countries?	p. 43
In Women	p. 43
Diet Affects HDL-Cholesterol Quite Differently	p. 44
Critics and Sceptics	p. 45
Sir John McMichael, London	p. 45
Dr George Mann, USA	p. 46
Thrombosis on and in Atheroma	p. 49
Thrombosis a Separate, Acute Process	p. 49
Tests for Liability to Thrombosis are Indirect	p. 49
Or can Mural Thrombosis Become Atheroma?	p. 50
Dietary Cholesterol May Affect Plasma Cholesterol	p. 51
Keys had Asserted Dietary Cholesterol does not Raise Plasma Cholesterol	p. 51
Other Early Studies Inconclusive	p. 51
Keys' Group and Hegsted's Group Re-examine	p. 52
Metabolism of Labelled Cholesterol	p. 52
Many Human Experiments with Dietary Cholesterol 1960s and 1970s	p. 53
Are some Individuals Responsive to Dietary Cholesterol, not Others?	p. 54
Effect of Basal Cholesterol Intake	p. 55
Different Recommendations by Advisory Committes	p. 56
First Controlled Trials	p. 57
First Two Randomised Dietary Trials, 1965	p. 57
Two more Dietary Trials	p. 58
The Los Angeles VA Trial, Reported 1969	p. 59
Helsinkin Mental Hospitals	p. 59
Drugs Trials	p. 61
Early Trials with Cholesterol-Lowering Drugs	p. 61
More Promising Drugs Followed	p. 61
"Atromid" or Clofibrate	p. 62
Cholestyramine Resin	p. 62
Dietary Fibre	p. 63
Obesity	p. 65
Desirable Weight for Height	p. 65
Body Mass Index	p. 66
Waist Circumference - Visceral Adiposity	p. 69
At the End of the Century the Cardiac Risk of Overweight Remained Variable for Moderate Overweight	p. 70
Thrombosis Treated Early	p. 71
Acute Phase Coronary Angiography	p. 71
Clotting Factors in a Prospective Study	p. 72
Platelet Function	p. 73
What's a Normal Plasma Cholesterol?	p. 74
Fish Oil	p. 77
Traditional Eskimos: High Fat Diet but CHD Uncommon	p. 77
Eicosapentaenoic Acid Reduces Platelet Aggregation	p. 78
Epidemiological Studies: Fish Consumption and CHD	p. 79
Polyunsaturated Oils Prevent Dangerous Arrhythmias in Rats	p. 80
Human Prevention Trials with Fish Oil	p. 81
Alcohol	p. 83
Impressions at Post-mortem Examination	p. 83
Negative Association with CHD in 1974 Case-Control Study	p. 84
Epidemiological Studies Build Up the Case	p. 84
Alcohol Only Benefits Health of Older People in Developed Countries	p. 86
Which Type of Alcoholic Drink?	p. 87
How does Alcohol Reduce the Risk of CHD?	p. 88
Serum HDL-Cholesterol (HDL-c)	p. 88
Haemostatic Effects	p. 89
Polyphenolic Antioxidants in the Beverage	p. 89
The French Paradox	p. 89
Coffee	p. 91
Coffee and Caffeine	p. 91
Coffee and CHD (Direct) Epidemiology	p. 92
Coffee and Serum Cholesterol: Human Experiments	p. 93
It's Cafestol and Kahweol in Coffee that Raise Serum Cholesterol	p. 94
And Tea?	p. 95
Trans-Fatty Acids	p. 97
Hydrogenation of Liquid Oils to make Solid Margarines	p. 97
Human Experiments: Trans Fatty Acids and Serum Cholesterol	p. 98
Epidemiological Studies	p. 101
Conclusion	p. 102
Antioxidants	p. 103
LDL Oxidation and Atherosclerosis - Hypothesis	p. 103
¿-Tocopherol the Major Antioxidant Inside LDL	p. 104
Vitamin E and CHD in Cohort Studies	p. 104
Randomised Controlled Prevention Trials with Vitamin E	p. 105
Trials with Beta-Carotene	p. 105
Why didn't Alpha Tocopherol or Beta Carotene Work?	p. 106
Fruit and Vegetables - Part of Favourable Dietary Patterns	p. 106
More Controlled Dietary Trials	p. 109
Further Dietary Trials in Table 23.1	p. 109
Two Large Multi-Factorial Trials	p. 112
Four Dietary Trials Assessed by Coronary Angiography	p. 113
The Lyon Diet Heart Study	p. 114
Trials of Better Drugs	p. 115
Cholestyramine (1984)	p. 115
Gemfibrozil (1987)	p. 116
Statins Arrive	p. 116
Implications of Statins	p. 118
Linoleic Acid is Protective	p. 121
Cohort Studies Accumulate	p. 121
Mechanism(s) of Action	p. 123
Linoleic (18:2) not the Usual Source of Arachidonic Acid (20:4)	p. 123
Recommendations	p. 123
Plant Sterols Fade and Return	p. 125
Phytosterols not Absorbed	p. 125
The Pharmaceutical Phase	p. 126
Sitosterolaemia	p. 127
The Food Additive Phase	p. 127
Soy Proteins Versus Casein	p. 129
An Animal Protein Effect on Serum Cholesterol in Rabbits	p. 129
In Humans Soy Protein Compared Against Casein: Variable Results	p. 130
Isoflavones may Contribute	p. 131
High Homocysteine Associated with Cardiovascular Diseases	p. 133
Homocystinuria and Arterial Disease	p. 133
Raised Plasma Homocysteine and Arterial Disease	p. 134
Environmental Influences on Plasma Homocysteine	p. 135
Plasma Homocysteine Lowered by Folic Acid and/or Vitamin B-12	p. 136
And Salt should be Included	p. 139
Discovery of Essential Hypertension	p. 139
Early Diets for Hypertension	p. 140
Is Salt a Cause of Essential Hypertension?	p. 142
Thiazides and Sceptics	p. 144
Potassium and Blood Pressure	p. 144
Answers to the Sceptics; the Salt Case Develops	p. 145
Moderate Sodium Restriction	p. 145
Remote Communities	p. 146
Regression Dilution Bias	p. 147
Intersalt	p. 147
Chimpanzee Experiments	p. 148
Cardiac Effects of Salt Reduction	p. 149
Higher Blood Pressures in African Americans	p. 149
Baby Food Manufacturers take the Lead	p. 150
And for Adults	p. 151
Dietary Goals for the US	p. 151
Subsequent Official Recommendations	p. 152
Most Salt we Eat was Put in by Food Processors	p. 152
How does BP Increase in Salt-Sensitive Individuals	p. 153
Kidneys	p. 153
Arterioles	p. 153
Humoral Inhibitor of the Sodium Pump	p. 154
Into the Next Century	p. 155
How it Adds Up	p. 157
American Heart Association, 2000	p. 157
In "ABC of Nutrition", 1999	p. 158
The Big Picture	p. 161
USA and Canada	p. 161
Australia and New Zealand (Fig. 31.4)	p. 164
Nordic Countries	p. 166
British Isles (Fig. 31.6)	p. 167
Western Europe	p. 168
East European Countries	p. 169
End Notes	p. 173
What Happened	p. 173
On the Research Front	p. 174
Inertia and Opposition	p. 175
In the Public Arena	p. 176
What Happened Further	p. 177
Hypothesis and Variations	p. 178
References	p. 181
Index	p. 221
Table of Contents provided by Ingram. All Rights Reserved.