TMMI (Too Much Mis-Information)-Conclusion

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Here’s the conclusion:

View the slides: Cholesterol: Fact & Fiction

  1. Cholesterol levels are determined by what is consumed
    1. False: Diet and physical activity contribute to overall blood cholesterol levels as well as the cholesterol that is made naturally by the body.  However, there are wide genetic variations in both the amount of cholesterol produced as well as the types of lipoproteins produced. The body compensates for cholesterol intake by reducing the amount synthesized. Limiting food high in saturated fat and trans fat may help lower your LDL (bad) cholesterol. The Food and Drug Administration now requires foods to be labeled for trans fats. Trans fats are found in variable amounts in most foods made with partially hydrogenated oils such as baked goods, cakes, cookies, crackers, pastries, pies, muffins, doughnuts, fried foods, shortening and some margarines and dairy products
  2. Cholesterol level is the best measure of cardiovascular risk
    1. False: Cholesterol is used because it can be measured easily and cheaply, lipoprotein measurements are much more expensive
  3. Cholesterol can be reduced by diet and exercise
    1. True: Cholesterol can be reduced with diet. In many studies the amount achievable by diet was 10-15%, which often does not reach the targeted levels. We have seen many patients who can get their levels to guideline recommendations through diet alone, but they often had a very poor diet to start. Likewise, many people who do not have a terrible diet to start cannot reach target levels without medication due to genetic predisposition. As a chef, I abhor a lot of those diets because it’s like eating cardboard (I tried one and it was gastronomic water boarding) Exercise, as mentioned, is an excellent way to increase HDL. Niacin is used to help with low HDL and heart disease, and is of course a naturally occurring vitamin.)
  4. Diabetics with no history of heart disease and normal cholesterol levels are at the same risk for cardiovascular events as the general public
    1. False: Diabetics (type II) with no history of myocardial infarction have approximately the same risk (~20%) of having a myocardial infarction as those who have already had a myocardial infarction ( 17.5%).
  5. Consumption of unprocessed red meat increases your risk of heart attack
    1. False: A recent meta-analysis from the Harvard School of Public Health published in Circulation (May 2010) suggests that the cardiovascular risk associated with red meats comes primarily from the highly processed and chemically treated varieties such as bacon, sausage, hot dogs and other processed lunch and deli meats. The non-processed meats examined were beef, lamb and pork (not poultry). While both contain fat, cholesterol and saturated fat, the processed choices are much higher in salt, preservatives and additives. The analysis combined data from 20 different studies involving more than 1.2 million people worldwide.  The findings revealed that daily consumption of about two ounces of processed meat was associated with a 42% increased risk of heart disease and a 19% increased risk of diabetes. Conversely, a four-ounce daily serving of red meat from beef, hamburger, pork, lamb or game did not increase the risk of heart disease, nor did it significantly increase the risk of diabetes. The rates of smoking, exercise and other risk factors were similar between the two groups.