The Cholesterol Myth: The Biggest Medical Conspiracy of The Last 50 Years
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That was just a marker. Their vitamin D levels were high because they were getting plenty of exposure to the thing that was really responsible for their good health—that big orange ball shining down from above. One of the leaders of this rebellion is a mild-mannered dermatologist at the University of Edinburgh named Richard Weller. This pathway is one which came from following the data rather than a desire to overturn apple carts. He discovered a previously unknown biological pathway by which the skin uses sunlight to make nitric oxide.
Sure enough, when he exposed volunteers to the equivalent of 30 minutes of summer sunlight without sunscreen, their nitric oxide levels went up and their blood pressure went down. Because of its connection to heart disease and strokes, blood pressure is the leading cause of premature death and disease in the world, and the reduction was of a magnitude large enough to prevent millions of deaths on a global level. For every person who dies of skin cancer, more than die from cardiovascular diseases.
Melanoma, the deadly type of skin cancer, is much rarer, accounting for only 1 to 3 percent of new skin cancers. And perplexingly, outdoor workers have half the melanoma rate of indoor workers. Tanned people have lower rates in general. These are pretty radical words in the established dermatological community.
So certainly people need to be cautious. Lindqvist tracked the sunbathing habits of nearly 30, women in Sweden over 20 years. Lindqvist looked at diabetes next. Sure enough, the sun worshippers had much lower rates. True, the sun worshippers had a higher incidence of it—but they were eight times less likely to die from it. So Lindqvist decided to look at overall mortality rates, and the results were shocking.
Over the 20 years of the study, sun avoiders were twice as likely to die as sun worshippers. There are not many daily lifestyle choices that double your risk of dying. Some doctors, in fact, found it quite dangerous. For three years, his team tracked the blood pressure of , people in 2, spots around the U. The results clearly showed that the reason people in sunnier climes have lower blood pressure is as simple as light hitting skin.
When I spoke with Weller, I made the mistake of characterizing this notion as counterintuitive. Until the industrial revolution, we lived outside.
How did we get through the Neolithic Era without sunscreen? Actually, perfectly well. Meanwhile, that big picture just keeps getting more interesting.
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Vitamin D now looks like the tip of the solar iceberg. Sunlight triggers the release of a number of other important compounds in the body, not only nitric oxide but also serotonin and endorphins. It reduces the risk of prostate, breast, colorectal, and pancreatic cancers. It improves circadian rhythms.
It reduces inflammation and dampens autoimmune responses. It improves virtually every mental condition you can think of. These seem like benefits everyone should be able to take advantage of. But not all people process sunlight the same way.
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And the current U. Not only is Addis Ababa near the equator, it also sits above 7, feet, so it receives massive UV radiation. And yet Africans in Britain and America are told to avoid the sun. All early humans evolved outdoors beneath a tropical sun. Like air, water, and food, sunlight was one of our key inputs. Humans also evolved a way to protect our skin from receiving too much radiation—melanin, a natural sunscreen. Our dark-skinned African ancestors produced so much melanin that they never had to worry about the sun. As humans migrated farther from the tropics and faced months of light shortages each winter, they evolved to produce less melanin when the sun was weak, absorbing all the sun they could possibly get.
They also began producing much more of a protein that stores vitamin D for later use. Sunburn was probably a rarity until modern times, when we began spending most of our time indoors. Suddenly, pasty office workers were hitting the beach in summer and getting zapped. One reason is it was difficult to measure the molecule and basically like VHS and Betamax video formats, glucose plowed ahead, cholesterol was measured and easy to measure, plowed ahead, and insulin got left behind.
Ivor: I had a conversation with one very accomplished medical doctor, and when I explained some of the basics to him, he was confused. Specialized teams realized this. Lee: Can I quote you here? You need to use insulin measures to properly test for this disease to check that you have insulin signaling issues.
Joseph Kraft, who in the 70s and 80s, with 15, people, validated that the earliest laboratory tests for diabetes Type 2 was a post-meal insulin.
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And Chinese teams more recently have shown the same thing, that the pattern of insulin after a meal or after drinking glucose, can predict future full-blown diabetes to an incredible extent. The reason is, it is type 2 diabetes, just much earlier than when your glucose goes out of control. Lee: So if you really want to do prediction and catch yourself moving into higher and higher risk category, you should be measuring insulin.
I pay I think 12 euros. Where do you get access to measuring your insulin? So, insulin kinda you get for free along with all the other measures [inaudible ]. But you ask for insulin at the same time? In the UK no one will do it, and I believe they will refuse an insulin test. Hyperinsulinemia has causal mechanisms into increasing your chances of disease, and hyperinsulinemia also reflects other causes of disease.
It acts as a marker for other issues. So for instance, if you get very poor sleep over a period, your insulin will rise. Having high insulin has many causal pathways into dyslipidemia and into disease risk, but also hyperinsulinemia and insulin resistance, if you measure it, can reflect many other issues, because insulin rises in response to inflammatory and immune response. By introducing lipopolysaccharides into human, they rapidly rise their insulin and their insulin resistance.
It acts as an incredibly good gauge for some other problem, because it reacts to bad things by rising. You put in your fasting glucose, put in your fasting insulin, and it puts the two together into an even better measure than just looking at insulin or glucose alone. The HOMA is very, very good for a quickie cheap test. So, fasting blood glucose, to make clear, is missing the great majority of people who are pre-diabetic or diabetic.
We could be getting huge number of people much earlier. So, what do you mean by … can you introduce the concept that cholesterol is a distraction?
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Cholesterol and the various measures are risk factors. Ivor: So, there was total cholesterol decades ago, [it] was believed to be a risk factor. Guess what? It got dropped. It got dropped when it became apparent it was ambiguous, misleading, kind of a joke almost. We talked about the risk calculators earlier. Ivor: Well, the new risk calculators are not based on it.
They are based on lifetime risk and overall risk. They use ratios and non-HDL and smoking and blood pressure and all these other things. They should be looking at all the risk factors and making a decision based on much more. One particular one was the cancer. Ivor: But one guy did a study, it was in the BMJ, and he showed that the low cholesterol link to cancer was unchanged and went back 20 years, right, when he looked at the data.
So he said this is not reverse causality. The low cholesterol is genuinely, and decades in advance, consistently linked with more cancer.
So, put that in your pipe and smoke it. Ivor: So, long story short, the higher cholesterol is much better as a risk factor in younger people , and I believe a lot of that is relating to higher cholesterol-indicating issues, often ones with insulin and metabolic syndrome. In many ways, LDL is hitching a ride in much more important processes going on under the hood-.