Uffe Ravnskov

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Dr Uffe Ravnskov (circa 2005).

Uffe Ravnskov (born 1934) is a Danish independent researcher, a member of various international scientific organisations, and a former private medical practitioner in Sweden. In recent years he has gained international recognition for his research into numerous scientific studies, leading to the publication of a book which stated that the widely popularised Lipid Hypothesis is scientifically invalid.

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[edit] Early career

He was born in Copenhagen, Denmark, and received his medical doctorate from the University of Copenhagen in 1961. Over the following seven years, he worked at various surgical, roentgenological, neurological, paediatric and medical departments in Denmark and Sweden. He then began scientific studies at the Departments of Nephrology and Clinical Chemistry at the Lund University Hospital in Lund, Sweden. He was awarded his doctorate of philosophy (specialising in internal medicine and nephrology) there in 1973, and was assistant professor at the university's Department of Nephrology from 1975 to 1979.[1][2][3]

An encounter with scientific fraud committed by a colleague ended up changing Dr Ravnskov's career:

“ In 1977 I discovered that one of my co-workers had falsified part of his PhD thesis. Whistle blowers are not welcome in the academic world. So, instead of excluding the fraudulent researcher it was my research that was questioned. Finally I found the resistance from my superiors intolerable and decided to go into private practice.[4] ”


Dr Ravnskov entered private medical practice as a specialist in internal medicine and nephrology in 1979, and worked in Lund in this capacity and as a family doctor until retiring in 2000. Since 1979 he has worked as an independent scientific researcher and since 2000 continues to do so on a full-time basis.[3]

[edit] Research in Nephrology

In his 1973 PhD. thesis, On Renal Handling of Serum Proteins, Dr Ravnskov introduced the albumin/creatinine clearance ratio, a more accurate way to measure proteinuria.[5] He was also the first to describe the peritubular uptake of low-molecular-weight proteins.[3][6][7][8]

He also proposed a theory that glomerulonephritis is primarily a tubulointerstitial disease, supported by his earlier findings that most patients with glomerulonephritis excrete large amounts of tubular proteins[9] and tubulospecific enzymes.[10]

In experimental studies he demonstrated that the handling of proteins by the kidneys differs in man and other mammals,[11][12] implying that knowledge from animal studies cannot be applied to humans.

Dr Ravnskov also conducted work on urinary tract infections; in one study of urinary tract infections in women he found that the major cause of dysuria was soap, not bacteria.[13][14][15][16]

His major research interest concerns the association between hydrocarbon exposure and glomerulonephritis; this interest was sparked by a 1975 paper in The Lancet by Stephen W. Zimmerman, K. Groehler, and G.J. Beirne,[17] who found that the large majority of their patients with glomerulonephritis on dialysis treatment had prior heavy exposure to industrial solvents. In his subsequent work in this area, he was the first to demonstrate that a discontinuation of hydrocarbon exposure may improve the course of glomerulonephritis,[18] a finding confirmed by follow-up studies made by British researchers.

[edit] Investigation of the Lipid Hypothesis, or "Diet-Heart" Idea

While not the first scientific researcher to question the validity of the Lipid Hypothesis (which has become increasingly fashionable in corporate, media and certain medical circles in many countries due to the work of doctors such as Ancel Keys in the 1950s), when this came to be promoted strongly in Sweden Dr Ravnskov felt there was an incongruity between the Diet-Heart Idea and scientific literature he could recall. In Dr Ravnskov's words,

“ When the cholesterol campaign was introduced in Sweden in 1989, I was very surprised. Having followed the scientific literature about cholesterol and cardiovascular disease superficially for a number of years, I could not recall any study showing that high cholesterol was dangerous to the heart or the blood vessels, or that any type of dietary fat was more beneficial or harmful than another one. I became curious and started to read more systematically.[19] ”


He began to collect and examine the data from past scientific studies, and discovered sufficient evidence to enable him to assert that the scientific foundations of the Diet-Heart Idea were scientifically flawed, and thus the Lipid Hypothesis had no validity. The amount of conflicting statements he had assembled on the topic made him realise an entire book was necessary to publicly question all the "inaccuracies, misinterpretations, exaggerations and misleading quotations in this research area."[20] His book Kolesterolmyten ("The Cholesterol Myths") was subsequently published in Sweden in 1991 and in Finland in 1992. It received adverse attention from the local media when they consulted the researchers and health authorities that it criticised; in the 2003 edition of the book, Ravnskov recalls how it was belittled in a television programme on Finland's Channel 2 television station and a copy of the book literally set on fire. Suppression of the work by media-generated ridicule and hysteria, rather than by scientifically valid refutation proved to be generally effective, and distribution of the book languished.

With the popularisation of the internet in the late 1990s, Dr Ravnskov saw the opportunity to inform the general public of his findings and, in 1997, published selected sections of The Cholesterol Myths on the world wide web. According to the search engine Direct Hit (since acquired by Ask.com in 1999),[21] Ravnskov's website soon became ranked as one of the top ten most popular websites about cholesterol. As a result of this worldwide interest, his book was translated into English and published in the United States as The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol cause Heart Disease in September 2000 by a publishing house established by the head of the Weston A. Price Foundation, Sally Fallon. It was later published in Germany in 2002 under the title Mythos Cholesterin. Die zehn größten Irrtümer ("Cholesterol Myth: The Ten Biggest Errors").

Since 1990, Dr Ravnskov has published over 80 scientific papers critical of the Diet-Heart Idea, proposing new hypotheses and also showing[22][23][24] that "the successful dissemination of the diet-heart idea is due to authors systematically ignoring or misquoting discordant (contradictory) studies".[3] He was the first to suggest that the positive effect of the statins may be due to other effects than cholesterol-lowering (a view which Ravnskov notes has gained widespread acceptance). In a meta-analysis of cholesterol-lowering trials published in the British Medical Journal in 1992, he demonstrated that coronary mortality was not lowered by cholesterol lowering, but total mortality was increased.[25]

In 2003 he published a review[26] of the many studies that have shown low density lipoprotein (LDL) to be protective against infections, and put forward the hypothesis that high cholesterol, rather than promoting atherosclerosis, in fact may protect against it.[3]

Dr Ravnskov continues to actively investigate scientific communications on cholesterol and heart disease for misinformation, and in the British Medical Journal in October 2005[27] refuted statements contained in a July 2005 paper on coronary heart disease in Poland, printed in the same journal.[28]

In a 2005 interview with a representative from Health Myths Publishing, Dr Ravnskov was asked for his viewpoint on what causes heart disease, and remarked

“ Most researchers to-day in this field agree that inflammation of the arterial wall is the start. The crucial question is, what starts the inflammation? As cholesterol has been demonized for so many years we have not been able to clear the blackboard and rethink... all studies of dead people have failed to show an association between their intake of saturated fat, or their serum cholesterol, and the degree of atherosclerosis. People who avoid all saturated fat and who have low cholesterol become just as atherosclerotic as people who gorge in animal food and whose cholesterol is high.

Another misconception is that atherosclerosis is a disease. When arteries become inflamed the body immediately starts a repair process to strengthen the vascular wall. Smooth muscle cells proliferate, fibrosis follows, and later, if necessary for further strength, cholesterol and calcium are used for reinforcement. This is in particular important in the coronary arteries because due to the steady movements of the heart and the negative pressure at their outside they have to be stronger than for instance arteries running to the intestines or inside bony channels. Inflammatory processes go on now and then already from childhood; it is a natural defence mechanism and atherosclerosis should therefore be considered as scars, remnants from a long life's combat with noxious chemicals or microorganisms....I think that the final attack is caused by microorganisms, but this is not the only answer. Any factor that weakens our immune defense may facilitate the growth of microorganisms, also at the inside of our vessels. These factors may be environmental (toxic compounds) or nutritional. There is much evidence that microorganisms may play a role. I published a review about this issue a few years ago. This paper[29] has since long been one of the most-frequently read article in that journal.[4]

 ”


[edit] Awards and Organisations

Dr Ravnskov has received the Skrabanek Award in 1999 from Trinity College, Dublin, Ireland, for original contributions in the field of medical scepticism. He was also honoured with the Integrity In Science Award 2003 given by The Weston A. Price Foundation, an organisation which shares Ravnskov's skepticism about the lipid hypothesis.

He is a member of the free panel of the Journal of the Swedish Medical Association (the medical journal Läkartidningen), the International Science Oversight Board, the International Society for the Study of Fatty Acids and Lipids, and is the spokesman for THINCS, The International Network of Cholesterol Skeptics.

He resides in Lund, Sweden.

[edit] References

  1. ^ Uffe Ravnskov, The Cholesterol Myths, (Washington DC, 2003), p. 307. ISBN 0-96708-970-0.
  2. ^ "The Cholesterol Myths: About the Author". www.ravnskov.nu Website. http://www.ravnskov.nu/uffe.htm. Retrieved 2006-12-20. 
  3. ^ a b c d e "Uffe Ravnskov: My life and my work". www.ravnskov.nu Website. http://www.ravnskov.nu/lifeandwork.htm. Retrieved 2006-12-20. 
  4. ^ a b "Uffe Ravnskov MD, PhD (2005 Interview)". Health Myths Publishing Website. http://www.healthmyths.net/uffe.html. Retrieved 2006-12-20. 
  5. ^ Ravnskov U., "On renal handling of plasma proteins", Scandinavian Journal of Urology and Nephrology 1973; 7 (suppl 20) (Thesis).
  6. ^ Ravnskov U., Johansson B.G., Göthlin J., "Renal extraction of β2-microglobulin", Scandinavian Journal of Clinical and Laboratory Investigation 1972; 30: 71-75.
  7. ^ Ravnskov U., and Karatson A., "Renal handling of human β2-microglobulin in the rat: The importance of sham-operation", Acta Physiologica Scandinavica 1975; 94: 467-471.
  8. ^ Ravnskov U., "Serum β2-microglobulin and glomerular function", New England Journal of Medicine 1976;294:611.
  9. ^ Johansson B.G., Ravnskov U., "The serum level and urinary excretion of a 2-microglobulin, β2-microglobulin and lysozyme in renal disease", Scandinavian Journal of Urology and Nephrology 1972; 6: 249-56.
  10. ^ Hultberg B., Ravnskov U., "The excretion of N-acetyl-β-glucosaminidase in glomerulonephritis", Clinical Nephrology 1981; 15: 33-8.
  11. ^ Ravnskov U., Johansson B.G., Ljunger L., "Proteinuria in pigs with experimentally induced renal damage", Contributions to Nephrology 1975; 1: 50-61.
  12. ^ Ravnskov U., Johansson B.G., "Isolation and partial characterization of a porcine low molecular weight protein occurring in plasma and urine", International Journal of Biochemistry 1976; 7: 579-583.
  13. ^ Ravnskov U., "Soap is the major cause of dysuria", The Lancet 1983; 1: 1027-8.
  14. ^ Ravnskov U., "Dysuri kan orsakas av tvål", Läkartidningen 1985; 82: 836.
  15. ^ Ravnskov U., "Dysuri skyldes som regel sæbe", Ugeskrift for Læger 1985; 147: 1493-94.
  16. ^ Ravnskov U., "Sæbe og dysuri", Ugeskrift for Læger 1985; 147: 2093.
  17. ^ Zimmerman S.W., Groehler K., Beirne G.J., "Hydrocarbon exposure and chronic glomerulonephritis", The Lancet 1975 Aug 2;2(7927):199-201.
  18. ^ Ravnskov U., "Influence of hydrocarbon exposure on the course of glomerulonephritis", Nephron 1986; 42: 156-160.
  19. ^ Uffe Ravnskov, The Cholesterol Myths, (Washington DC, 2003), p. xv (Author's Forward).
  20. ^ Uffe Ravnskov, The Cholesterol Myths, (Washington DC, 2003), p. xv. (Author's Forward).
  21. ^ "About Ask.com: Webmasters". Ask.com Website. http://sp.ask.com/en/docs/about/webmasters.shtml. Retrieved 2006-12-20. 
  22. ^ Ravnskov U., "Quotation bias in reviews of the diet-heart idea", Journal of Clinical Epidemiology 1995; 48: 713-9.
  23. ^ Ravnskov U., "Debatt i Science: Kostråd mot hjärtinfarkt försvaras med felcitat", Läkartidningen 2002; 99: 2673.
  24. ^ Ravnskov U., Allan C., Atrens D., Enig M.G., Groves B., Kaufman J., Kroneld R., Rosch P.J., Rosenman R., Werkö L., Nielsen J.V., Wilske J., Worm N., "Studies of dietary fat and heart disease", Science 2002; 295: 1464-5.
  25. ^ Uffe Ravnskov, "Cholesterol lowering trials in coronary heart disease: frequency of citation and outcome", British Medical Journal 1992; 305: 15-19. Letters: BMJ 1992; 305: 420-422, and 717.
  26. ^ Ravnskov U., "High cholesterol may protect against infections and atherosclerosis", QJM 2003; 96: 927-34.
  27. ^ Ravnskov U., "Dietary fat is not the villain", British Medical Journal 2005; 331: 906-7.
  28. ^ Zatonski W.A., Willett W., "Changes in dietary fat and declining coronary heart disease in Poland: population based study", British Medical Journal 2005;331: 187-8.
  29. ^ Ravnskov U., "High cholesterol may protect against infections and atherosclerosis", QJM 2003;96:927-34. url=http://qjmed.oxfordjournals.org/content/96/12/927.long pmid=14631060

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