An important task for a scientific journal is to host debate which scrutinizes established scientific “truths”. In the current issue of the Scandinavian Cardiovascular Journal the validity of the low fat diet/low cholesterol hypothesis in cardiovascular disease is challenged by invited researchers within this field. As the reader will find out, the purpose of publishing this issue has not been to give a balanced review. Instead, the intention has been to provoke scientific debate of a topic which has had a great impact on medical practice and society during the last decades.
In addition to the speakers at the symposium mentioned by Tore Scherstén in the “Introductory remarks” below, the two legendary cardiovascular researchers Björn Folkow and Lars Werkö give their views, and Dag Thelle, with a vast knowledge in cardiovascular epidemiology, has taken on the defence of the lipid cholesterol theory. Finally, Arne Svilaas and co-authors have addressed one important aspect in a review article.
The chief editor, with only superficial knowledge in this research field, takes no stance in the debate. It is difficult, however, not to reflect on the coinciding low fat/cholesterol era and (ensuing?) epidemic obesity.
Hopefully, the readers will respond to the series of provocations, preferably by participating in scientific debate in subsequent issues of the Scandinavian Cardiovascular Journal.
Rolf Ekroth, Editor-in-Chief
Introductory remarks
“Discovery consists of seeing what everybody has seen and thinking what nobody has thought” Alberth Szent-Györgyi
This special feature issue of Scandinavian Cardiovascular Journal is based on the presentations at the international conference “Dietary Fats and Cholesterol – facts and myths” held in Gothenburg, Sweden, April 24, 2007.
The conference was organized in association with the Leo Prize Ceremony.
The “Leo Prize for Independent Thinking” was established 2006 by Professor Emeritus Gösta Walin. It rewards independent research in the natural sciences and medicine, particularly when the results are in conflict with conventional wisdom. Independent thinking and challenging the established “truth” has a historical perspective of being two of the most important driving forces for advancement in science, which may ultimately lead to scientific revolution (Karl Popper). Therefore, the research community welcomes the prize.
The second “Leo Prize for Independent Thinking” was awarded to Uffe Ravnskov for his sharp scientific criticism of the assumed relationships between cholesterol and cardiovascular diseases. He has previously received the 1999 Skrabanek Award from Trinity College of Dublin for innovative contributions to medical skepticism and the 2003 Integrity in Science Award from the Weston A. Price Foundation.
Atherosclerotic and coronary heart diseases have afflicted man since antiquity, but only in the past 5 to 6 decades have they been recognized as major health problems and been the subject of intense research. As reported here, the results of these studies have been largely contradictory and the strength of the scientific evidence has been highly varied. Conventional wisdom implies that high consumption of saturated fat and cholesterol leads to increased blood cholesterol, especially the low-density lipoproteins (LDL), which in turn increases the risk for coronary heart disease and cardiac death. Most of the studies supporting this hypothesis are epidemiological with conclusions based on statistical correlations. It is easy to be fooled into believing that a statistical correlation is proof of a causal relationship.
Uffe Ravnskov has analyzed the scientific background and the evidence for the cholesterol hypothesis since the early nineties, and has become one of the main critics of the “cholesterolization” of coronary heart diseases.
He is receiving an ever-increasing extent of support for his criticism through scientifically well conducted both experimental and epidemiological studies. This support is particularly evident from the steady growth of the International Network of Cholesterol Skeptics (THINCS) drawn from the realm of science, physicians and academia at large. Ravnskov is chairman of this network and a well deserving recipient of the Leo Prize for Independent Thinking. Tore Scherstén, Professor Emeritus, member of the Royal Swedish Academy of Sciences