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21 June 2021

Is High Cholesterol Deleterious? An Alternative Point of View. Comment on Burén et al. A Ketogenic Low-Carbohydrate High-Fat Diet Increases LDL Cholesterol in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial. Nutrients 2021, 13, 814

Independent Researcher, Magle Stora Kyrkogata 9, 22350 Lund, Sweden
In their study of the effect of an LCHF-diet on blood lipids, Burén et al. became worried because, after a few weeks, the participants’ LDL-cholesterol (LDL-C) increased significantly [1]. However, they need not worry. It is correct that many studies have found an association between LDL-C and cardiovascular disease, but association is not the same as causation. In a recent study, we have documented that the cholesterol hypothesis is unable to satisfy any of the Bradford Hill criteria for causality [2]. Accordingly, we have identified 38 studies where the authors have followed more than six million people of all ages for several years after having measured their LDL-C. In three of the studies, mortality was a little higher among those with the highest LDL-C, but mortality was highest among those with the lowest LDL-C. In the other 35 studies, those with the highest LDL-C lived just as long or, in most cases, longer than those with normal or low LDL-C [3,4].
The reason why high LDL-C is beneficial is most likely that LDL participates in our immune system by adhering to and inactivating all types of microorganisms and their toxic products, a little-known fact that has been documented in many ways by more than a dozen research groups [5,6].

Funding

This research received no external funding.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Burén, J.; Ericsson, M.; Damasceno, N.R.T.; Sjödin, A. A Ketogenic Low-Carbohydrate High-Fat Diet Increases LDL Cholesterol in Healthy, Young, Normal-Weight Women: A Randomized Controlled Feeding Trial. Nutrients 2021, 13, 814. [Google Scholar] [CrossRef] [PubMed]
  2. Ravnskov, U.; De Lorgeril, M.; Diamond, D.M.; Hama, R.; Hamazaki, T.; Hammarskjöld, B.; Hynes, N.; Kendrick, M.; Langsjoen, P.H.; Mascitelli, L.; et al. LDL-C does not cause cardiovascular disease: A comprehensive review of the current literature. Expert Rev. Clin. Pharmacol. 2018, 11, 959–970. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  3. Ravnskov, U.; Diamond, D.M.; Hama, R.; Hamazaki, T.; Hammarskjöld, B.; Hynes, N.; Kendrick, M.; Langsjoen, P.H.; Malhotra, A.; Mascitelli, L.; et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: A systematic review. BMJ Open 2016, 6, e010401. [Google Scholar] [CrossRef] [PubMed]
  4. Ravnskov, U.; de Lorgeril, M.; Diamond, D.M.; Hama, R.; Hamazaki, T.; Hammarskjöld, B.; Harcombe, Z.; Kendrick, M.; Langsjoen, P.H.; McCully, K.S.; et al. The LDL paradox: Higher LDL-cholesterol is associated with greater longevity. Ann. Epidemiol. Public Health 2020, 3, 1040–1047. [Google Scholar]
  5. Ravnskov, U.; McCully, K.S. Vulnerable plaque formation from obstruction of Vasa vasorum by homocysteinylated and oxidized lipoprotein aggregates complexed with microbial remnants and LDL autoantibodies. Ann. Clin. Lab. Sci. 2009, 39, 3–16. [Google Scholar]
  6. Ravnskov, U.; McCully, K.S. Infections May be Causal in the Pathogenesis of Atherosclerosis. Am. J. Med. Sci. 2012, 344, 391–394. [Google Scholar] [CrossRef] [Green Version]
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