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Thursday, February 18, 2016

Cholesterol risk

The AMICOR Maria Inês Reinart Azambuja reaction to the article of NYT was published:


Maria Azambuja

 Brazil 2 hours ago

This should be very old news by now...The fact that it is not says a lot about the resistance we have to review our knowledge. In 1994 I first suggested that the rise and fall in CHD mortality seen worldwide during the 20th Century had something to do with Influenza, and that serum cholesterol was probably just a marker of infection/autoimmunity. My idea of an effect of the influenza recycling on the constitution of the human population has evolved during the last decades to dispute causation not just of the CHD epidemic, but also of trends in other diseases' occurrence and mortality, including the AIDS epidemic. But we need a major shift regarding how we model diseases causation to be able to even consider these ideas. During the late 19th and the whole 20th century we have been thought that diseases and their manifestations can be completely explained by our exposure to some external cause like an infectious agent (HIV, or Ebola, or the Zica virus) or a dietary factor. We abandoned more complex conceptions that disputed this view and modeled diseases as the individual response to the environmental challenges. We need to look for determinants of variation in individuals' vulnerability (besides genetic traits) and go back to the 19th Century to rebuild, upon those foundations and our current knowledge of immunoinflammatory phenotypes, a more comprehensive model of causality.

 

A new study provides more evidence that eating high-cholesterol food does not increase the risk for heart disease.
The Finnish study, in The American Journal of Clinical Nutrition, followed 1,032 initially healthy men ages 42 to 60. About a third were carriers of ApoE4, a gene variant known to increase the risk for heart disease (and Alzheimer’s). The researchers assessed their diets with questionnaires and followed them for an average of 21 years, during which 230 men developed coronary artery disease.
The men consumed an average of about 2,800 milligrams of cholesterol a week, more than a quarter of it from eating an average of four eggs weekly. (An egg contains about 180 milligrams of cholesterol.)
After controlling for age, education, smoking, B.M.I., diabetes, hypertension and other characteristics, the researchers found no association between cardiovascular disease and total cholesterol or egg consumption in either carriers or noncarriers of ApoE4.
The researchers also examined carotid artery thickness, a measure of atherosclerosis. They found no association between cholesterol consumption and artery thickness, either.
The lead author, Jyrki K. Virtanen, an adjunct professor of epidemiology at the University of Eastern Finland, said that for healthy people, “Moderate intake of cholesterol,” including up to one egg a day, “doesn’t seem to increase the risk of heart disease, even among those people at higher risk.”

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