26 de Setembro, 2009
Hipótese lipídica moderna cada vez mais contestada e colocada em causa em face aos novos estudos e dados epidemiológicos que vão surgindo diariamente
Foto: Campanha "Não brinque com o seu colesterol".
Correcção: na realidade o comentário não é do Dr. Parker, mas de Steve. Eu não percebi bem quem assinava o comentário. Fica a correcção.
O artigo Diet-Heart Hypothesis: R.I.P., que agora li, tem um comentário do Dr. Steve Parker que cita o meu artigo de epidemiologia sobre colesterol e mortalidade, mas não é (só) por isso que estou aqui a destacá-lo. É porque em dois parágrafos, de facto este médico, adepto da dieta mediterrânica e que já passou pelo Low Carb Show, consegue sintetizar as razões mais filosóficas do movimento que actualmente contesta a Hipótese Lipídica clássica:
"The question asked by cholesterol skeptics is one of root cause: does high cholesterol play an independent role in the development of heart disease (making it a treatment target) or is it a symptom of some other cause? There is certainly an association between high LDL/low HDL and heart disease, as there is with many other metabolic markers. The key question is one of causality, i.e. if I lower LDL independent of other metabolic factors, does that significantly reduce disease? Or is high LDL a symptom of a deeper metabolic problem? And there’s the closely related question of whether lowering cholesterol has a beneficial effect on total disease incidence and mortality, see e.g.
https://canibaisereis.com/2009/09/19/low-cholesterol-certainly-not-healthy/
The issue with LDL in particular may be deeper than just total amount, because the inflammatory reaction now believed to be at the root of formation of atherosclerotic plaques is driven by oxidized or sugar-damaged (glycated) LDL. This links several observations, i.e. if your LDL is chronically high, it’s probably hanging around longer in the blood which gives it a better chance of being damaged. If your LDL particles are small, they have greater surface area, again increasing the potential for damage. Uncontrolled blood sugar increases the potential for glycation.
I would guess the keys to avoiding heart disease lay in maintaining metabolic normality (e.g. glucose tolerance) and keeping inflammatory reactions in check via appropriate omega-6/3 ratio and Vitamin D repletion.
Steve."
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