I’ve never actually met Jimmy Moore, so I can’t say for sure he’s real. Sure, I read his Livin’ La Vida Low-Carb blog every day, we exchange emails regularly, we’ve spoken on the phone, and he’s threatened to drop by for a visit in October, when he’ll be in Nashville for a wedding. Still, he may be a pod person, created by the meat and dairy industries to fool us into thinking their products won’t kill us. (His shows, after all, are called “podcasts” … coincidence?)
I’m suspicious because Jimmy’s total cholesterol is well over 300, which puts him in the category I sang about in the closing song for Fat Head: “I’m shopping for my coffin, but don’t shed me any tears … ‘cuz according to the experts, I’ve been dead for several years.”
Score that high on a cholesterol test, and your doctor will break into an impression of the scarecrow from the Wizard of Oz, arms flying in opposite directions as he lurches for a bottle of Lipitor and a defibrillator at the same time.
To make matters worse, Jimmy has a family history of heart disease. His father had a quintuple bypass a year ago. His brother Kevin died of heart failure at age 41. And Jimmy was morbidly obese for much of his life.
Worst of all, Jimmy lives on a diet that’s around 70% fat (much of it saturated), and he has committed the cardinal sin of refusing to accept the sacrament of statin drugs, despite many warnings from his doctor. In other words, according to the Holy Church of Accepted Advice For Living a Long and Healthy Life, Jimmy is a condemned man, a heart attack waiting to happen.
And yet when he had a heart scan recently, the amount of plaque build-up in his arteries was measured at …(drum roll, please) … Zero. None. Nada. No plaque. Despite being a walking bundle of supposed risk factors, he has no signs of heart disease whatsoever.
This goes against everything we’ve been told about heart disease for the past 40-plus years. (Or, as his doctor put it when reading the test results, “That’s not possible.”) If Jimmy does visit in October, I may have to serve him a drink in a cracked glass so I can send a blood sample to a lab. There’s a good chance it will come back labeled “Not human, unable to identify.”
But let’s assume Jimmy is human, and is also alive and well. Perhaps he’s just an outlier. Surely, if we compare cholesterol levels and heart disease across large populations, we’ll see a pattern, right?
Check out this video by Dr. Malcolm Kendrick, author of the very enlightening and very funny book The Great Cholesterol Con, speaking about the world-wide MONICA study:
Dr. Kendrick arranged his data to demonstrate a crazy up-and-down pattern in the heart-disease death rate as you go up the cholesterol scale. I was curious what the data would look like on a scatter chart. (Yes, I’m that big of a dweeb.)
So I went prospecting for MONICA data on the internet and ended up finding two useful nuggets: 1) average cholesterol levels for men in various countries, and 2) heart-disease death rates for men aged 35 to 75 in those same countries – in other words, men who died prematurely due to heart disease. (If I die of a heart attack at age 95, I’ll consider it a victory.)
I plotted the results for 40 of the most populous countries. But before we get to those, take a look at these charts, courtesy of Tony at Emotions for Engineers, demonstrating what different degrees of correlation look like:
A perfect correlation equals 1.0, which produces a trendline starting in the lower left and rising to the upper right. If x (horizontal axis) causes y (vertical axis), the data from studies comparing them should be strongly correlated. Researchers rarely get excited about a correlation of less than 0.8, unless their grants are running out.
With that in mind, take a look at the average cholesterol levels for men in 40 countries plotted against the annual heart-attack death rates per 100,000 men in those same countries:
Do you see a meaningful pattern there? If so, you probably also see secret messages from the CIA in crossword puzzles and college baseball scores – published solely for your benefit, of course.
Or perhaps you just work for one of the organizations that’s been promoting the Lipid Hypothesis for the past 50 years. I found and downloaded the MONICA data from the official website of the British Heart Foundation, the U.K. equivalent of the American Heart Association. The same site includes (of course) recommendations for reducing your risk of a heart attack:
It is now universally recognised that a diet which is high in fat, particularly saturated fat, sodium and sugar and which is low in complex carbohydrates, fruit and vegetables increases the risk of chronic diseases – particularly cardiovascular disease (CVD) and cancer … The dietary changes which would help to reduce rates of coronary heart disease (CHD) in the UK population were detailed in the 1994 report of the Government’s Committee on the Medical Aspects of Food and Nutrition Policy (COMA). This recommended a reduction in fat intake, particularly saturated fat intake, a reduction in sodium intake and an increase in fruit and vegetable and complex carbohydrate intake.
I ran the CORREL function on the data in Excel, and the result was -0.25 … a negative correlation. In other words, there is no meaningful correlation at all, but the tiny correlation that does exist would point towards heart disease rates going down as cholesterol levels go up.
I can only imagine the conversations that go on in organizations like this when they look at the results of large studies like MONICA:
“Did you finish analyzing the cholesterol data?”
“Yes, Doctor Higginbotham, all done.”
“A careful analysis of the data from 40 of the largest countries shows no relationship between cholesterol levels and heart disease whatsoever.”
“Hmm … that’s it, then. We’d better keep telling people to cut back on saturated fat.”
“Because it raises cholesterol.”
“But … uh … I’m afraid I don’t understand.”
“Well, it’s complicated, so let me explain it this way: Shut up.”
Yes, Jimmy has high cholesterol – very high, by most standards. But he also has very low triglycerides and high HDL, and only 2 percent of his “too high” LDL is the small, dense type that can penetrate the walls of an artery and lead to heart disease. He achieved those numbers by ignoring the experts and cutting the sugars and starches from his diet, not the fats. He’s not an outlier, any more than the hundreds of thousands of people who die from heart disease every year despite having low cholesterol.
As for whether or not Jimmy Moore really exists …I’ll let you know in October.