G'day G'day Folks,

 It is fascinating to follow the personal trials and tribulations of
someone who boldly goes where others don't dare.  In this instance
Kilmer McKully dared to think outside the established beliefs as to
the cause of coronary heart disease, CHD.  The widely accepted
hypothesis is that high levels of blood cholesterol especially LDL
leads to CHD.   Unfortunately, his determination to explore an
alternative hypothesis lead to him losing funding and becoming
unemployable in some 50+ universities.  This level of persecution had
the unfortunate effect of encouraging even greater belief in his
original hypothesis and delayed proper exploration of its validity.

Here in a nutshell is McKully's hypothesis.  

Modern overly-refined diets were leading to the accumulation of
homocysteine in the blood. Homocysteine is toxic and destroys arterial
integrity.  With a wholesome diet homocysteine is produced only in
small amounts so does no damage. When the diet is made up of overly
processed foods, certain vitamins and minerals are lacking in the
amounts demanded by the macronutrients in the foods.  For example if
the diet is high in refined carbohydrates then the B group vitamins eg
B6 and folic acid were proportionately deficient and so the demand for
them exceeded the supply.  If one ate meat, then the supply of
methionine, an amino acid found in abundance in protein from meat,
encouraged the formation of more homocysteine.  His solution was not
to obtain protein from vegetarian sources which is deficient in
methionine but instead to combine meat eating with eating vegetables
that provided some hundred different folates that converted the
homocysteine safely back into methionine.  

McKully did account for the correlation between the high LDL and CHD.
LDL carried homocysteine. After all LDL does have one of the best
correlations to CHD though not the best. The higher LDL, the more
homocysteine could be carried through the arteries to do damage.

What he proposed as a diet made a lot of sense that many of us could
take on board or find that we already have taken on board for other
reasons.  By in large, avoid supermarket food and "take away" food.
Convenience food may contain eggs which many find healthy but if they
come in a packeted premix then they are dried and the B group vitamins
needed to convert homocysteine would be depleted.  Avoid refined
carbohydrates eg white rice, white bread etc for the same reasons. He
did encourage fortified products where Vit B6, Vit B12, folic acid and
minerals such as magnesium were added.  Unlike many here he didn't
discourage eating of potatoes except canned potato and dried potato
powder where the B group vitamins were depleted.

All in all he offered a 6 week program that would lower the risk of
CHD.

It all seems very plausible.  He had found some youngsters who had
died of CHD yet had not built up cholesterol laden plaque. They had
died of high homocysteine.  Half of the people who died of CHD have
normal levels of LDL.  His bold hypothesis, though it obviously
annoyed the conventional thinkers, appeared to hold merit.

What then was the snag?

Well it came when scientist performed INTERVENTION trials.  As so
often happens the intervention trials were not carried out using
wholesale dietary change as McKully had done.  They were carried out
without dietary change but with the addition of supplements. The first
that I am aware of used large amounts of folic acid, one form of
folate that is readily available in standard form. It reduced
homocysteine to normal levels wonderfully.  What it didn't do was
reduce CHD rates.  Some later studies used a combination of folate
with Vit B6 and Vit B12. They seem to have suffered the same fate.
They reduced homocysteine but didn't reduce CHD.  Clearly something
other than homocysteine reduction was at work in the success of
McKully's "Proven 6 week program"  and McKully was overstating his
case when he published, the "EXTRAORDINARY DISCOVERY that finally laid
the cholesterol myth to rest"

In later threads I would like to tackle some other bold hypotheses
because there is much to be learnt from them. Some of the learning is
in the accepting and some in the rejection of novel ideas.

Best wishes,