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Omega-6 vegetable oils as a driver of coronary heart disease: the oxidized linoleic acid hypothesis
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    The effect of linoleic acid on coronary heart disease may be increased coagulation rather than oxidation
    • Uffe Ravnskov, MD, PhD, independent researcher Not affiliated to any institution

    We agree with DiNicolantonio´s and O´Keefe´s hypothesis that a high intake of omega-6 vegetable oils may promote coronary heart disease (CHD).1 However, we think that the mechanism is not oxidation of LDL-cholesterol (LDL-C). It is a solidly documented but little-known fact that LDL partake in the immune system by adhering to and inactivating almost all types of microorganisms.2 As the LDL-covered microorganisms are oxidized after having been taken up by macrophages, we think that the oxidation of LDL is a secondary phenomenon. The crucial event is most likely, as explained in our papers,2,3 that complexes of LDL-covered microorganisms may aggregate, in particular in the presence of
    hyperhomocysteinemia, because homocysteine thiolactone causes aggregation and precipitation of thiolated LDL. Because of the high extra-capillary tissue pressure, aggregates of such complexes may be trapped in vasa vasorum of the major arteries and result in ischemia of the arterial wall. The reason why omega-6 oils promote CHD may be that these oils may result in increased coagulation,4 which is a well-known risk factor for CHD, even among individuals with familial hypercholesterolemia.5

    1. DiNicolantonio JJ, O’Keefe JH. Omega-6 vegetable oils as a driver of coronary heart
    disease: the oxidized linoleic acid hypothesis. Open Heart 2018;5:e000898. doi:10.1136/openhrt-2018-000898
    2. Ravnskov U, McCully KS. Vulnerable plaque formation from obstruction of...

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    Conflict of Interest:
    None declared.