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        Response to Ravnskov et al. on saturated fat and CHD
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        Response to Ravnskov et al. on saturated fat and CHD
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We thank Dr Ravnskov and colleagues(1) for their interest in our editorial. Ravnskov et al. appear to ignore the large number of controlled metabolic studies relating fatty acid intake to plasma total and LDL-cholesterol as well as the overwhelming evidence that LDL is causally related to the atherosclerotic process.

The issues that Ravnskov et al. raise were raised earlier in sixty-two Letters to the Editor, which Dr Ravnskov has published about lipids and heart disease in the past 20 years(263). His letters have appeared in JAMA, the New England Journal of Medicine, the British Medical Journal, the Lancet, Science, the American Journal of Clinical Nutrition, Annals of Internal Medicine, the Journal of Clinical Epidemiology, the International Journal of Cardiology, Circulation, the Quarterly Journal of Medicine, the Journal of the National Cancer Institute, Nutrition Metabolism and Cardiovascular diseases, several Scandinavian medical journals, and now in the British Journal of Nutrition.

All these letters argue essentially the same point, namely that lowering blood cholesterol levels is of unproven value. We refer readers to the responses of dozens of reputable scientists set out in each journal's Letters section, where they have carefully responded to Dr Ravnskov's letters and shown that, by and large, Ravnskov's arguments are faulty.


1 Ravnskov, U, Diamond, D, Karatay, MCE, et al. (2011) No Scientific support for linking dietary saturated fat to CHD. Br J Nutr 107, 455457.
2 Ravnskov, U (1991) Are polyunsaturated fats useful? Läkartidningen 88, 1058, 1060.
3 Ravnskov, U (1992) What is the correct answer in the cholesterol debate? Ugeskr Laeg 154, 17161718.
4 Ravnskov, U (1992) Frequency of citation and outcome of cholesterol lowering trials. BMJ 305, 717.
5 Ravnskov, U (1993) Cardiovascular disease in developing countries. BMJ 306, 145146.
6 Ravnskov, U (1993) Doubtful advices on cholesterol screening in children. Ugeskr Laeg 155, 18861887.
7 Ravnskov, U (1993) Reducing serum cholesterol. Lower cholesterol of doubtful benefit to anyone. BMJ 307, 125.
8 Ravnskov, U (1993) New trends from the USA. The cholesterol campaign is questioned. Läkartidningen 90, 25282529.
9 Ravnskov, U (1993) Coronary atherosclerosis on angiography–progress or regress, and why? Circulation 88, 13581360; author reply 1356–1357.
10 Ravnskov, U (1993) Decreased cholesterol level shortens life. Ugeskr Laeg 155, 36793680.
11 Ravnskov, U (1993) Stop the cholesterol campaign!. Läkartidningen 90, 45874588; discussion 4589–4590.
12 Ravnskov, U (1994) Ischaemic heart disease and cholesterol. Optimism about drug treatment is unjustified. BMJ 308, 1038, 1041.
13 Ravnskov, U (1994) Do polyunsaturated fats cause male sterility? Läkartidningen 91, 2308.
14 Ravnskov, U (1994) Uncritical review of articles on cholesterol. Ugeskr Laeg 156, 44794480.
15 Ravnskov, U (1994) Doing the right thing: stop worrying about cholesterol. Circulation 90, 25722573; author reply 2573–2577.
16 Ravnskov, U (1994) Is intake of trans-fatty acids and saturated fat causal in coronary heart disease? Circulation 90, 25682569; author reply 2573–2577.
17 Ravnskov, U (1994) What do angiographic changes after cholesterol lowering mean? Lancet 344, 1297.
18 Ravnskov, U (1995) Fatty acids and confusing signals. Ugeskr Laeg 157, 15341535.
19 Ravnskov, U (1995) The Scandinavian Simvastatin Survival Study (4S): hasty conclusions. Ugeskr Laeg 157, 21652166.
20 Ravnskov, U (1995) Implications of 4S evidence on baseline lipid levels. Lancet 346, 181.
21 Ravnskov, U (1995) Beneficial effects of simvastatin may be due to non-lipid actions. BMJ 311, 14361437.
22 Ravnskov, U (1996) Do cholesterol-lowering drugs cause cancer? Läkartidningen 93, 2040.
23 Ravnskov, U (1996) American College of Physicians guidelines on cholesterol screening. Ann Intern Med 125, 10101011.
24 Ravnskov, U (1998) Experts ask for priorities when it comes to interpretation. Ravnskov answers in the debate on dietary fats. Läkartidningen 95, 10221023.
25 Ravnskov, U (1998) On honesty and monounsaturated fat. Läkartidningen 95, 4966.
26 Ravnskov, U (1999) Misleading cholesterol statistics. Läkartidningen 96, 1947, 1949.
27 Ravnskov, U (1999) Why heart disease mortality is low in France. Authors' hypothesis is wrong. BMJ 319, 255256.
28 Ravnskov, U (2000) Prevention of atherosclerosis in children. Lancet 355, 69.
29 Ravnskov, U (2000) VAT and fat. Evidence is contradictory. BMJ 320, 1470.
30 Ravnskov, U (2001) Too optimistic view in mass media on statin treatment in acute myocardial infarction. Läkartidningen 98, 2370.
31 Ravnskov, U (2001) Lipid lowering doesn't affect the development of atherosclerosis in peripheral artery disease. Läkartidningen 98, 48974898.
32 Ravnskov, U (2001) Cholesterol and all-cause mortality in Honolulu. Lancet 358, 1907.
33 Ravnskov, U (2002) Diet–heart disease hypothesis is wishful thinking. BMJ 324, 238.
34 Ravnskov, U, Allen, C, Atrens, D, et al. (2002) Studies of dietary fat and heart disease. Science 295, 14641466.
35 Ravnskov, U (2002) A too optimistic report of a new study on statins. Läkartidningen 99, 949951.
36 Ravnskov, U (2002) Surrogate research on heart disease and risk factors. Läkartidningen 99, 1507.
37 Ravnskov, U (2002) Statins as the new aspirin. Conclusions from the heart protection study were premature. BMJ 324, 789.
38 Ravnskov, U (2002) The debate in Science: dietary guidelines against myocardial infarction are defended by wrong citations. Läkartidningen 99, 2673.
39 Ravnskov, U (2003) Statins increase the risk of cancer among the elderly. Läkartidningen 100, 974.
40 Ravnskov, U (2003) Lipoproteins and cardiovascular risk. Lancet 361, 19881989; author reply 1989.
41 Ravnskov, U (2003) ASCOT-LLA: questions about the benefits of atorvastatin. Lancet 361, 1986; author reply 1986–1987.
42 Ravnskov, U (2003) Too many calories and too little exercise cause obesity not intake of fat. Läkartidningen 100, 32553256; author reply 3256.
43 Ravnskov, U (2003) Dietary fat intake and risk of stroke: allegations about dietary fat are unfounded. BMJ 327, 1348; author reply 1348–1349.
44 Ravnskov, U (2004) Inflammation, cholesterol levels, and risk of mortality among patients receiving dialysis. JAMA 291, 18331834; author reply 1834–1835.
45 Ravnskov, U & Sutter, MC (2004) Aggressive lipid-lowering therapy and regression of coronary atheroma. JAMA 292, 38; author reply 39–40.
46 Ravnskov, U (2004) Hasty conclusions on cardiac mortality in Norway. Tidsskr Nor Laegeforen 124, 2153; author reply 2153.
47 Ravnskov, U (2004) Karl Popper and the cholesterol hypothesis. Tidsskr Nor Laegeforen 124, 2517.
48 Ravnskov, U, Rosch, PJ & Sutter, MC (2005) Intensive lipid lowering with atorvastatin in coronary disease. N Engl J Med 353, 9396; author reply 93–96.
49 Ravnskov, U (2005) Should cholesterol levels be reduced more aggressively? Läkartidningen 102, 25832584; discussion 2584.
50 Ravnskov, U (2005) Europe in transition: dietary fat is not the villain. BMJ 331, 906907; discussion 907.
51 Ravnskov, U (2006) Misleading advice on cholesterol reduction. Läkartidningen 103, 568; discussion 569.
52 Ravnskov, U (2006) Treatment of hypercholesterolemia-lower is not better. Ugeskr Laeg 168, 1665.
53 Ravnskov, U, Rosch, PJ & Sutter, MC (2006) High-dose statins and the IDEAL study. JAMA 295, 2476; author reply 2478–2479.
54 Ravnskov, U (2006) Low carbohydrate diets reduce the need of statin treatment. Läkartidningen 103, 3017; author reply 3017–3018.
55 Ravnskov, U (2006) Saturated fat does not affect blood cholesterol. Am J Clin Nutr 84, 15501551; author reply 1551–1552.
56 Ravnskov, U (2007) Lack of evidence for recommended low-density lipoprotein cholesterol treatment targets. Ann Intern Med 146, 614; author reply 614–615.
57 Ravnskov, U (2007) Reply to “Cholesterol lowering and mortality: a sea of contradictions”. Nutr Metab Cardiovasc Dis 17, e25e27; author reply e21–23.
58 Ravnskov, U (2008) Hypercholesterolaemia. Should medical science ignore the past? BMJ 337, a1681.
59 Ravnskov, U (2008) Re: the association between statins and cancer incidence in a veterans population. J Natl Cancer Inst 100, 972973; author reply 973–974.
60 Ravnskov, U (2008) Should medical science ignore the past? BMJ 337, a1681a1681.
61 Ravnskov, U (2009) Is there a reason to take the cholesterol campaign seriously? Läkartidningen 106, 4748; discussion 48.
62 Ravnskov, U (2010) Statin-induced muscular problems are underestimated. Ugeskr Laeg 172, 1235; author reply 1235.
63 Ravnskov, U (2011) The doubtful association between blood lipid changes and progression of atherosclerosis. Int J Cardiol 153, 95.