Harvard strikes again.

The February 2008 issue of the Harvard Heart Letter (subscription only) contains an article titled Triglycerides: A Big Fat Problem. The article discusses the correlation of elevated triglyceride levels with the development of coronary artery disease, then lists eight methods for reducing elevated triglyceride levels. It’s this list I want to discuss, but first let’s consider what triglycerides are and what they do.

Triglycerides are storage fats composed of three fatty acid chains hooked onto a glycerol (a 3-carbon carbohydrate) molecule. Fats travel in the blood as triglycerides and are stored in the cells as triglycerides. Each time a triglyceride moves into or out of a cell, the three fatty acids must first be removed from the glycerol backbone. After the fatty acids move across the cell membrane into or out of the cell, the fatty acids are then reattached in a process called esterification. (The particular bond between the fatty acids and the glycerol molecule is called an ester bond.)

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After the Enhance study came out Katie Couric interviewed Dr. Steve Nissen, a statinator of renown.

Although Dr. Nissen, who is the Chairman of Cardiology at the Cleveland Clinic, is upset over the findings of the Enhance study, it hasn’t dimmed his enthusiasm for statin drugs a whit. As you watch the video, note the quotes I’ve excerpted. They demonstrate how a famous cardiologist is firmly in the grip of the lipid hypothesis despite considerable evidence that the hypothesis has been built on a very shaky foundation.

Here is the video.

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I just ran across a video of Dr. Malcolm Kendrick discussing the lack of correlation between cholesterol levels in the blood and heart disease. As you may remember I reviewed Dr. Kendrick’s book The Great Cholesterol Con in a previous post. His book is by far and away the better of the two books out there with the same title. Dr. Kendrick has a wealth of experience from which to draw and writes in a clever, witty and easily readable style. If you’re still worried that cholesterol may be the cause of heart disease, you need to read this book.

When I reviewed this book earlier, it took several weeks to get. Now the books are available from Amazon.com and can be had quickly. Add it to your low-carb library.

One caveat about the video. Despite how compelling the data are, they still come from observational studies, and, as such, can’t really be used to prove causation or lack thereof. The reason for this video is that so many people have tried to prove that cholesterol causes heart disease with the use of observational studies, it’s nice to see one that clearly shows the opposite.

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Just read through the August issue of the American Journal of Clinical Nutrition, which was chocked full of good articles. I’ll be kept in blogging fodder for several days just from the contents of this one issue.

The paper I want to discuss today is one that I find hilarious. It’s a report of the Hamburg Burger Trial and I find it hilarious because the results were so different than what the researchers expected. In fact, they mention how surprised they were to get these results. The only reason they should have been surprised is that they are either ignorant or stupid – or both.

If I gave most readers of this blog the same data the authors of the study had, the blog readers would not have been surprised. They would have expected exactly the outcome that resulted. Which makes the readers of this blog a whole lot smarter than the long list of scientists who authored this paper.

Here’s the setup.

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On the flight from London to Rome I read an article on the immune system and cancer. It got me to thinking about the immune system and a whole lot of other health problems.

It’s sunrise in The Eternal City right now. I’ve been up early watching the dawn break over St. Peters, which is a couple of miles below the hotel. I figured everyone was getting tired of travel disaster stories, so I thought this would be a good time to sketch out my views on the inflammatory basis of heart disease.

If you read enough in the medical literature you will perceive a change in outlook on the underlying cause of many of the so-called diseases of civilization, especially heart disease. Most authors – mainly, I suspect, out of desire to keep their academic positions and reputation with their peers – throw a bone to the lipid hypothesis before admitting that it probably isn’t the only cause of coronary artery disease. Over the last decade or so the progression has been thus: elevated cholesterol causes heart disease – elevated cholesterol and maybe a little inflammation cause heart disease – elevated cholesterol and inflammation cause heart disease – inflammation along with elevated cholesterol cause heart disease – and now, among the more enlightened – inflammation causes heart disease. In my opinion, it probably is inflammation by itself that is the driving force behind the development and progression of most cardiovascular disease.

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