The Framingham Heart Study

The Framingham Heart Study first identified high cholesterol as a risk factor for cardio-vascular disease. But 30 years later they reversed that idea. "Total Cholesterol" was NOT a good marker of heart disease.

However, by now the science had improved, and they were measuring HDL-Cholesterol and LDL-Cholesterol. HDL-Cholesterol was definitely protective of your life. So maybe, LDL-Cholesterol is "bad". For the last 25 years, statins have been issued to millions of people on the assumption, LDL-Cholesterol was "bad". That assumption is (most probably) wrong. The LDL-Cholesterol itself is harmless, and essential to your good health, but maybe the small dense particles it contains are harmful. Case not proven either way at the moment. (2016)

So after 40 years the Framingham study is producing lots of results, many of them highly confusing, and not what researchers expected. So they decided to design another study, a "Rolls Royce" study, with good controls, that would give better and more definite results than they could get from Framingham. They called it The Women's Health Initiative, and almost 50,000 post menopausal women were chosen to take part. The study was initially funded for 10 years, starting in 1991.

There were two groups, those on the recommended diet (low-fat high-carbohydrate, and low cholesterol), and those who could do what they liked. After eight years the study was stopped. Women on the recommended diet were dying earlier than those who were not. They also had more heart attacks. This result astounded researchers. They couldn't believe their own results, and so in 1998 the study was stopped. (The researchers had a duty of care to the participants.) Prior to this study, it had always been assumed the "everybody knew what a healthy diet was." Since the 1950's reducing saturated fat in the diet to protect against heart disease had been recommended. Researchers Nathan Pritikin, Dean Ornish and Caldwell Esselstyn all recommended some form of vegetarian diet. What was or wasn't a healthy diet was supposed to be self evident. The Standard American Diet Guidelines, reinforced that understanding.

The Women's Health Initiative, was supposed to prove the SAD was healthy, and protective against obesity, cancer and cardio-vascular disease. But the researchers careful and well controlled study, didn't show that. Apparently, what "everybody knows about diet" isn't self-evident after all. Confusion and controversy about how to report the results followed. Their results were delayed and not published until 2006. At that time they said, "The recommended diet has no health benefits," that is surprise number two.

After 1998, there was for the first time in 40 years and incentive for dietary research of a different nature. Key researchers were Dr Stephen Phinney, Dr Jeff Volek, and Dr Eric Westman, who together wrote the book giving "The New Atkins Diet" it's scientific backbone. To those three I add the name Dr Tim Noakes, a very well known expert in sports medicine and physiology in South Africa. Noakes, with Jonno Proudfoot (chef) and Sally-Ann Creed (Dietician) developed in South Africa, The Real Meal Revolution, and the Banting Diet, based on the latest dietary science.

John Stephen Veitch
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