This article was published in the February/March 2006 Wedge newsletter. The following information may be outdated.

As the Studies Turn...

Dietary Fat, Disease and Death

Editor's note: Below is a summary directly from the study. For details, go to the link.

Most current dietary guidelines encourage limiting relative fat intake to less than 30% of total daily energy (calories), with saturated and trans fatty acids contributing no more than 10%. We examined whether total fat intake, saturated fat, monounsaturated, or polyunsaturated fat intake are independent risk factors for prospective all-cause, cardiovascular and cancer mortality.

This was a population-based, prospective cohort study - a five year study of 28,098 middle-aged individuals in the city of Malmo, Sweden.

Results: No deteriorating effects of high saturated fat intake were observed for either sex for any cause of death. Beneficial effects of a relatively high intake of unsaturated fats were not uniform. With the exception of cancer mortality for women (women in the fourth quartile of total fat intake had a significantly higher relative risk of cancer mortality, Ed. note: the overall risk is still very low) individuals receiving more than 30% of their total daily energy from fat and more than 10% from saturated fat, did not have increased mortality. Current dietary guidelines concerning fat intake are thus generally not supported by our observational results.

Wedge says: Research keeps affirming that the anti-saturated-fat campaign is not based on science.

Journal of Internal Medicine Volume 258, Issue 2, Page 153 - August 2005.

LDL Cholesterol and Heart Disease

In the IDEAL study (Incremental Decrease in End Points through Aggressive Lipid Lowering), published in the Journal of the American Medical Association, patients with a history of heart disease did not do better with daily high-dose Lipitor therapy (80 milligrams) than they did with 20 milligrams of Zocor, which costs a lot less than 80 milligrams of Lipitor.

The finding was a surprise to cardiologists because it was generally accepted that high-dose Lipitor, which can lower LDL (bad) cholesterol to targets well below 100 milligrams/deciliters, is the best way to prevent recurrent heart attacks, strokes and heart-related death.

It was so surprising that even the authors of the study treated the finding as a statistical blip on the Lipitor radar screen. Adopting an "it's only one study" line, the researchers recommended that physicians continue to use "whatever is needed" to achieve superlow LDL levels.

Wedge says: This is not the first study that failed to show a benefit from aggressive lowering of LDL cholesterol. It is interesting that the authors continue to recommend a treatment that has never been proved to help patients. For an interesting review of the studies on LDL cholesterol, read: "LDL: Bad Cholesterol or Bad Science?"(pdf) recently published in the Journal of American Physicians and Surgeons.

It may surprise you to learn that the role of cholesterol in heart disease is not settled. Debate rages in scientific journals. For more on the heart disease and cholesterol debate, check out: www.thincs.org/news.htm

Vitamin D More Important for Bones Than Dietary Calcium

REYKJAVIK, Iceland, Nov. 9 - If you don't get enough vitamin D it doesn't seem to matter to your bones how much calcium you get. So concluded an Icelandic study of nearly 1,000 healthy adults that found higher 25-hydroxyvitamin D levels more closely associated with normal levels of serum intact parathyroid hormone (PTH) than were high levels of calcium.

In short, otherwise healthy people with adequate 25-hydroxyvitamin D levels may need no more than 800 mg of calcium per day in order to have calcium homeostasis and maintain normal levels of PTH, investigators here suggested in the Nov. 9 issue of the Journal of the American Medical Association. The recommended RDA is 400 IU to 800 IU of vitamin D.

Wedge says: The evidence has been mounting for a number of years that adequate Vitamin D is far more important for bone health than a high calcium intake. This is one more study confirming it. It is especially important to get Vitamin D from supplements or food during northern winters. It's recommended that people in northern latitudes need up to 700 Units per day (or more, depending on the study) during winter. According to this study, as long as vitamin D status is sufficient, it may not be necessary to get more than 800 mg of calcium per day.

www.medpagetoday.com/Endocrinolog y/Osteoporosis/tb/2102

Coffee does not cause high blood pressure in middle-aged women.

Multi-year study of almost 30,000 nurses indicates no relation between long-term coffee consumption and the development of high blood pressure. Cola drinks, however, were associated with a significantly increased risk of developing high blood pressure.

The study did not look at the impact of coffee on people who already have high blood pressure, but seems to be off the hook for causing the condition.

Journal of the American Medical Association, November 9, 2005.