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Diamond DM, Alabdulgader AA, de Lorgeril M, et al. Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone. BMJ Evid Based Med. 2020;26(6):295-301doi: 10.1136/bmjebm-2020-111412.
Diamond, D. M., Alabdulgader, A. A., de Lorgeril, M., Harcombe, Z., Kendrick, M., Malhotra, A., O'Neill, B., Ravnskov, U., Sultan, S., & Volek, J. S. (2021). Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone. BMJ evidence-based medicine, 26(6), 295-301. https://doi.org/10.1136/bmjebm-2020-111412
Diamond, David M, et al. "Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone." BMJ evidence-based medicine vol. 26,6 (2021): 295-301. doi: https://doi.org/10.1136/bmjebm-2020-111412
Diamond DM, Alabdulgader AA, de Lorgeril M, Harcombe Z, Kendrick M, Malhotra A, O'Neill B, Ravnskov U, Sultan S, Volek JS. Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone. BMJ Evid Based Med. 2021 Dec;26(6):295-301. doi: 10.1136/bmjebm-2020-111412. Epub 2020 Jul 05. PMID: 32631832.
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BMJ Evid Based Med. 2021 Dec;26(6):295-301. doi: 10.1136/bmjebm-2020-111412. Epub 2020 Jul 05.

Dietary Recommendations for Familial Hypercholesterolaemia: an Evidence-Free Zone.

BMJ evidence-based medicine

David M Diamond, Abdullah A Alabdulgader, Michel de Lorgeril, Zoe Harcombe, Malcolm Kendrick, Aseem Malhotra, Blair O'Neill, Uffe Ravnskov, Sherif Sultan, Jeff S Volek

Affiliations

  1. Psychology, Molecular Pharmacology & Physiology, University of South Florida, Tampa, Florida, USA [email protected].
  2. Prince Sultan Cardiac Center, Al Ahsa, Saudi Arabia.
  3. Department of Equipe Coeur & Nutrition, University of Grenoble, Grenoble, France.
  4. Independent Researcher, Cardiff, UK.
  5. Macclesfield District General Hospital, Macclesfield, Cheshire East, UK.
  6. Department of Cardiology, Bahiana School of Medicine and Public Health, Salvador, Brazil.
  7. Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
  8. Independent Researcher, Lund, Sweden.
  9. National University of Ireland, Western Vascular Institute, University Hospital Galway & The Galway Clinic, Galway, Ireland.
  10. Department of Human Sciences, The Ohio State University, Columbus, Ohio, USA.

PMID: 32631832 DOI: 10.1136/bmjebm-2020-111412

Abstract

We have evaluated dietary recommendations for people diagnosed with familial hypercholesterolaemia (FH), a genetic condition in which increased low-density lipoprotein cholesterol (LDL-C) is associated with an increased risk for coronary heart disease (CHD). Recommendations for FH individuals have emphasised a low saturated fat, low cholesterol diet to reduce their LDL-C levels. The basis of this recommendation is the 'diet-heart hypothesis', which postulates that consumption of food rich in saturated fat increases serum cholesterol levels, which increases risk of CHD. We have challenged the rationale for FH dietary recommendations based on the absence of support for the diet-heart hypothesis, and the lack of evidence that a low saturated fat, low cholesterol diet reduces coronary events in FH individuals. As an alternative approach, we have summarised research which has shown that the subset of FH individuals that develop CHD exhibit risk factors associated with an insulin-resistant phenotype (elevated triglycerides, blood glucose,

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: cardiovascular diseases; disease management; evidence-based practice; integrative medicine; nutritional sciences

Conflict of interest statement

Competing interests: DMD is a member of the science advisory board for Anutra and has received honoraria from Pruvit. ZH receives royalties for books/content on diet and health. MK receives royalties

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