What Actually Causes Heart Disease & High Blood Pressure?

If you’re confused and frustrated because you followed the guidelines to eat less salt and saturated fat, and still ended up sick and overweight, this paper is for you. Maybe eating that way helped lower your cholesterol, but other markers are off. Your triglycerides, glucose, blood pressure, and insulin are high, your HDL is low, and you have excess weight and have little energy. You tried to fix the cholesterol problem by following the low-fat, low-salt, low calorie recommendations but it made everything else worse. Sound familiar? You're about to learn what actually causes high blood pressure and heart disease. And spoiler alert, it's not saturated fat, or cholesterol.

When you ask Dr. Google, "What causes heart disease?" you get a list of risk factors like high blood pressure, smoking, poor diet, high LDL cholesterol, or inactivity. Not a cause. Risk factors are important, but they are a downstream effect. We need to know what causes these risk factors in the first place. Because when you treat the cause, you can prevent the effect of high blood pressure and heart disease. Mainstream advice to prevent heart disease is to eat less saturated fat and cholesterol. The thinking is that this will reduce the “bad” LDL cholesterol that "clogs" your arteries. Right? Wrong. Just because something is repeated over and over doesn’t make it true.

2+2 = 5 all day, but it’s still not correct. You’ve likely heard this myth about saturated fat and cholesterol for so long from trusted sources you don’t even question if it’s true. high LDL cholesterol does not mean you have an increased risk of heart disease. Although, drug companies selling you statins would love you to believe this. Worldwide, sales of statins are running at about $19 billion a year and growing. Let’s break down this coverup.

The hypothesis that saturated fats cause cardiovascular disease emerged in the late 1950s. It's called the Diet-Heart Hypothesis. Ancel Keys was the magnanimous physiologist who created it. The evidence supporting this hypothesis consisted primarily of one observational study. According to levels of evidence, an observational study is 3 out of 5. You cannot determine causation with an observational study. The Seven Countries Study compared the level of saturated fat intake with heart disease outcomes. It involved over 12,000 men in Europe, the US, and Japan. There were several major flaws outlined in an article linked in the description. I'll cover two here. First, the study recorded dietary data in less than 5% of the participants. This was about 500 individuals, or fewer than 100 participants per country. So, the entire low-fat movement started with this sample of 500 men. And the problems don't stop there. The second flaw was the non-random selection of data for the study. Keys cherry-picked only the areas that showed a relationship between saturated fat and cardiovascular disease.

He ignored the data that didn't fit into his original hypothesis. And any scientist will tell you, you're not supposed to ignore the data. Despite the shaky evidence, the Diet Heart Hypothesis became the majority opinion, and remains so to this day. Look at the American Heart Association's website. They recommend about 13 grams of saturated fat a day. That's the amount found in 2 tablespoons of heavy cream plus one ounce of cheese. They also say: "Decades of sound science has proven it can raise your "bad" cholesterol and put you at a higher risk for heart disease." But how sound is the science?

The most recent review of the literature by the US Dietary Guidelines Advisory Committee in 2020 concluded that: "There is “strong” evidence for continuing caps on saturated fat intake to 10% of calories or less. And to replace saturated fat with poly-unsaturated fat." A 2021 article called Dietary Saturated Fats and Health: Are the U.S. Guidelines Evidence-Based reveals otherwise. One of the lead investigators, Nina Teicholz wrote the book the Big Fat Surprise. I’ll link to her interview for our podcast in the description. It’s a fascinating read. Her team revealed the evidence is not strong, and was in fact cherry-picked once again. The researchers independently analyzed the same studies used by the Advisory Committee. They found that 88% of the findings did not support the committee’s conclusion on saturated fats and heart disease. 94% of the studies that observed dairy foods showed a higher dairy intake was associated with lower heart disease risk. So why did they recommend we limit saturated fat if 88% of the evidence says otherwise?

The Committee’s conclusion relied on data from a randomized control trial. This data showed eating polyunsaturated fats, instead of saturated fats, lowered total and LDL-cholesterol. And this is 100% true. Replacing butter with canola oil will lower your LDL and total cholesterol. What they don’t mention is that lowering total cholesterol and LDL-cholesterol do not correlate with a reduced risk of cardiovascular disease. That’s where the Diet-Heart Hypothesis breaks down. Eating more saturated fat does raise LDL cholesterol. But this rise in LDL cholesterol does not mean a higher cardiovascular risk. LDL particle number, and some would argue size, is what matters for risk of cardiovascular risk. Not total cholesterol or LDL-cholesterol.

In fact, this study showed that those with the lowest LDL cholesterol, and highest LDL particle number, had the highest risk for cardiovascular events. And this study found similar results that a high LDL-P, or particle number is what matters for heart disease. We've been trying to lower the wrong thing all along. The 2020 US Dietary Guidelines Advisory Committee did not talk about LDL-particle size or number. They only discussed LDL-cholesterol. Thanks to people like Nina Teicholz, Dr. Peter Attia, and many more who risk their careers to expose the truth, the Diet-Heart Hypothesis is experiencing a slow death. But why are things so slow to change? Because it would make the American Heart Association, among other institutions, look really bad to reverse over 50 years of recommendations to limit saturated fat. They would lose the public’s trust and funding.

Food companies would have to reengineer food products and marketing. Big pharma would lose lots of money. And what does this mean for you? If saturated fat and elevated cholesterol isn't causing heart disease, what is? It's time to shift the conversation to the real cause of heart disease. And that's insulin resistance and inflammation. This is a complete paradigm shift for most people. But understanding this root cause completely changes your strategy to prevent heart disease. To get help with preventing or reversing insulin resistance, click below to check out our coaching services. We help streamline the learning process for you. You’ll get evidence-based, personalized information that works to lower insulin resistance for long-term weight loss and better health. And be sure to subscribe for more information each week about insulin resistance, weight loss, and disease prevention.