Butter Battle 2.0

The Guardian enters “The Butter Battle 2.0”.  More heat than light.

Here are the 10 things everyone need to know to navigate this minefield.

1. LDL-Cholesterol (LDL-C) levels (from dietary fat) correlate (but poorly) with CV mortality.
2. Triglyceride levels (from dietary sugar) correlate (much better) with CV mortality.
3. LDL particle number (LDL-P) is the right measure for CVD, and higher is worse. But a standard lipid profile measures LDL-C, not LDL-P. Wrong test.
4. Dietary fat raises LDL-C, but not necessarily LDL-P, while sugar raises triglyceride levels.
5. Red meat is associated with increased CVD. But maybe not because of its saturated fat. In fact, dairy saturated fat is protective against CVD.
6. If you have a super high LDL-C (over 200), then you probably also have a high LDL-P, and you might need a statin.
7. If your LDL-C is between 70 and 200, maybe your LDL-P is high, but maybe it is not. Statins are not prescribed based on LDL-P; they are prescribed based on LDL-C. This is a bad idea, yet doctors do it all the time.
8. 4/5 of the people taking statins were prescribed for high LDL-C. But this is the wrong reason. And 20% of statin takers get side-effects.
9. That doesn’t mean you should stop your statin. But it also doesn’t mean you can eat butter without abandon. 
10. A doctor who knows what they are doing can figure your situation out. But most don’t know what they are doing; they do as they’re told.

Reference:

• Butter nonsense: the rise of the cholesterol deniers. -The Guardian
• The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance. -The Pharmaceutical Journal