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Cholesterol Overview

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January 2008 saw some surprising news in the mainstream press. It may be that 2008 will be remembered as the year the high cholesterol tune began to change and the old mantras began to give way to a more accurate understanding of heart disease.

In January, 2008, the New York Times reported: [1]

“For decades, the theory that lowering cholesterol is always beneficial has been a core principle of cardiology. It has been accepted by doctors and used by drug makers to win quick approval for new medicines to reduce cholesterol.

“But now some prominent cardiologists say the results of two recent clinical trials have raised serious questions about that theory… “Because the link between excessive LDL cholesterol and cardiovascular disease has been so widely accepted, the FDA generally has not required drug companies to prove that cholesterol medicines actually reduce heart attacks before approval….”

The January 17th, 2008 cover story of Business Week also openly questioned the high cholesterol issue: [2]

“People like to have a metric, such as cholesterol levels, that can be monitored and altered. ‘Once you tell people a number, they will be fixated on the number and try to get it better,’ says University of Texas’ Dr. Howard Brody. Moreover, ‘the American cultural norm is that doing something makes us feel better than just watching and waiting,’ says Brody. That applies to doctors as well. They are being pushed by the national guidelines, by patients’ own requests, and by pay-for- performance rules that reward physicians for checking and reducing cholesterol. ‘I bought into it,’ Brody says. Not to do so is almost impossible, he adds. ‘If a physician suggested not checking a cholesterol level, many patients would stomp out of the office claiming the guy was a quack.’

“Yet Brody changed his mind. ‘I now see it as myth that everyone should have their cholesterol checked,” he says. ‘In hindsight it was obvious. Duh! Why didn’t I see it before?’ “

IT STARTED WITH RABBITS

The idea that cholesterol causes coronary heart disease started in the early 1900’s when extremely high amounts of dietary cholesterol were fed to rabbits. Their blood cholesterol rose twenty-fold and a soft plaque like substance formed on the coronary arteries. Cholesterol levels returned to normal and the plaque disappeared when the feeding was stopped.

In the early 1950s autopsies were done on heart attack victims and their arteries were found clogged with plaques containing high concentrations of cholesterol. And among servicemen who died in battle in Korea and Vietnam, more than 75 percent were found to have hardening and narrowing of the arteries. More evidence that cholesterol causes atherosclerosis. [3]

In the late 1950’s, Ancel Keys proposed that the more saturated fat you ate, the higher your cholesterol. This gave birth to the “lipid theory” that dietary cholesterol is downright dangerous because it directly causes atherosclerosis. Based on this idea, people were told for decades to eat a low fat diet and to embrace “heart-healthy” vegetables oils, despite the fact most were hydrogenated. A time-honored breakfast of steak and eggs, biscuits and gravy was now described as “a heart attack on a plate.”

Yet despite increased sales of margarine and corn oil, rates of heart disease continued to climb. The death rate from heart disease in the United States began increasing early in the twentieth century, and it reached its peak about 1975

Look again at those rabbits. They were given a synthetic form of cholesterol that easily oxidized when exposed to air. Oxidation makes cholesterol toxic to the body. Rabbits also do not metabolize cholesterol as do humans.

What might have accounted for atherosclerosis in American servicemen? The water given to servicemen was so heavily chlorinated it was virtually undrinkable. Chlorine is a powerful oxidizing agent that is capable of causing severe damage to blood vessels. There are few, if any communities around the world with chlorinated drinking water that have a low incidence of atherosclerosis. In animal studies, chlorine has been found to promote the development of atherosclerosis.

What of Ancel Keyes’ findings? His data was seriously flawed. Probably the most painstaking analyses of the Keyes data was published in 2001 in a book entitled The Cholesterol Myth by Dr. Uffe Ravnskov.

“People with high cholesterol live the longest. This statement seems so incredible that it takes a long time to clear one´s brainwashed mind to fully understand its importance. Yet the fact that people with high cholesterol live the longest emerges clearly from many scientific papers.” [4]

For many years, researchers uncovered - and published - evidence that ran contrary to the “saturated fat and high cholesterol will kill you” mantra. For example, in 1994, Dr. Harlan Krumholz of the Department of Cardiovascular Medicine at Yale University reported that old people with low cholesterol died twice as often from a heart attack as did old people with high cholesterol. [5]

THE HERD MENTALITY

But that kind of finding didn’t make the evening news. Instead, the high cholesterol myth kept going and going and going like the Energizer bunny. Why?

Here’s an inside look at how things sounded in the 1980s from Mary Enig, a world renowned expert on fats (lipids) and oils who researches and lectures extensively: [6]

“The 1984 Cholesterol Consensus Conference final report [contained] no mention of the large body of evidence that conflicted with the lipid hypothesis. One of the blanks was filled with the number 200. The document defined all those with cholesterol levels above 200 mg/dL as ‘at risk’ and called for mass cholesterol screening, even though the most ardent supporters of the lipid hypothesis had surmised in print that 240 should be the magic cutoff point. Such screening would, in fact, need to be carried out on a massive scale [because] the federal medical bureaucracy, by picking the number 200, had defined the vast majority of the American adult population as ‘at risk.’

“The Consensus Conference also provided a launching pad for the nationwide National Cholesterol Education Program, which had the stated goal of “changing physicians’ attitudes.” NHLBI-funded studies had determined that while the general population had bought into the lipid hypotheses, and was dutifully using margarine and buying low-cholesterol foods, the medical profession remained skeptical. A large “Physicians Kit” was sent to all doctors in America, compiled in part by the American Pharmaceutical Association, whose representatives served on the NCEP coordinating committee. Doctors were taught the importance of cholesterol screening, the advantages of cholesterol-lowering drugs and the unique benefits of the Prudent Diet. NCEP materials told every doctor in America to recommend the use of margarine rather than butter.”

In 1988, the American Medical Association’s Executive Vice-President, Dr. James Sammons, promised physicians of their financial rewards stating,

“The AMA’s campaign against cholesterol will bring both old and new patients to you for necessary testing, counseling and care.” [7]

And many doctors took it to heart.

“… the current cholesterol campaign represents a rare concordance of interests on the part of many constituencies. … Physicians will benefit because they will be providing better medical care to their patients and incidentally will have a new and expanded market of patients for preventive medical care. The pharmaceutical industry will benefit from the greatly expanded market for cholesterol lowering drugs that will result from even the most careful application of the guidelines on a national scale. The public will benefit from reductions in coronary risk…” [8]

Ah, the silver bullet theory of medicine. A simple, convenient pill will fix everything.

Dr. Uffe Ravnskov put that in perspective: [9]DrRavnskov“Proponents claim that if we had a drug that could lower blood cholesterol sufficiently without any serious side effects, we could prevent or at least delay all disease caused by atherosclerosis.

This is a dream come true for doctors. All that’s necessary to prevent heart disease is a prescription pad and a gadget for measuring cholesterol–and no time-consuming fuss with diet counseling.

And what a bonanza for the drug producers! A lifetime lowering of cholesterol with expensive drugs in a substantial proportion of the population.”

Dr. Daniel Steinberg, a cholesterol researcher at the University of California in San Diego who headed a federally sponsored panel that recommended lowering cholesterol for the nation, wondered what critics expected policy planners to do. In 1989 he told the New York Times: [10]

“We could have said, ‘We don’t have the data, so don’t do anything about cholesterol’. Meanwhile people are dying of heart attacks at the rate of 500,000 a year. We would have felt derelict if we had not made the recommendation.”

In 2004, the National Cholesterol Education Program recommended that those “at risk” of cardiovascular events decrease their LDL levels to between 70 and 100 mg/dl.

The following year, sales of statin drugs ballooned 46% to over $22 billion.

“But besides real diseases, we are subject to many that are only imaginary, for which the physicians have invented imaginary cures; these have several names, and so have the drugs that are proper for them.” – Jonathan Swift (1667-1745)

CAUGHT AT THE SCENE OF THE CRIME

Imagine your home security alarm system goes off, police respond. You arrive, determine you have been robbed - and blame the police officers still at the scene.

That is basically what happened to cholesterol.

Cholesterol is used by the body as a raw material for the healing process. When lesions are formed in arterial walls, LDL is dispatched to the site carrying cholesterol to mend the lesion and restore the waterproof feature to prevent clotting within the blood vessel. Serious damage to arteries can cause high amounts of cholesterol in a blockage due to the amount of cholesterol necessary to heal the lesions. This is why cholesterol has been associated with blockage of arteries. Cholesterol buildup may be part of the mechanism of blockages, but it is not the cause of the coronary disease resulting in blockages. High cholesterol is not necessarily the direct cause but may only be a marker of inflammation.

So, if you have a lot of arterial plaque, a lot of lesions - if you have high cholesterol, why might that be?

FREE RADICALS COMMITTED THE CRIME

Free radicals are unpaired electrons looking for a mate. They roam your body like a burglar looking to steal electrons from tissues. They are part of the body’s immune mechanism that kills viruses and bacteria, and detroys toxins. An excess of them can cause tears and irritation in the artery walls. Excess free radicals are generated by the detoxification of environmental toxins like cigarette smoke, vehicle exhaust, and insecticides. Free radicals are also generated by what we eat like sugar, preservatives, aspartame, and trans-fats.

We ingest free radicals when we eat foods prepared with processed vegetable oils - French fries, fried food, non-fat dried milk and homogenized milk [11], powdered or liquid coffee creamer, most salad dressings, crackers, cookies, chips, and a plethora of other processed and convenience foods. Margarine, heavily promoted since the 1940s, is a tub of lethal trans fats. As some put it, we’ve been poisoning ourselves with vegetable oils, which mankind never ate in great quantity before.

Processed vegetable oils have an unstable chemical structure. They are a free radical waiting to happen. When free radicals come in contact with the blood vessel, they cause lesions and that triggers inflammation. LDL cholesterol molecules are dispatched to the scene to repair the lesion and stop the inflammation.

Free radicals, however, are not the only reason for arterial plaque and lesions. There likely were lots of other “accomplices to the crime.” Here are a few:

(1) Chlorine

During the 1960s Dr. Joseph Price wanted to know why cardiovascular heart disease, such as heart attacks, strokes, and atherosclerosis, had become so prevalent when prior to 1900 it was virtually non-existent. His search led him to chlorine. [12]

Dr. Price reported that the Japanese people, who have a heart attack rate one-sixth that of the United States, develop atherosclerosis when they move to Hawaii and drink chlorinated water. When the Japanese were rebuilding their cities after WWI, they installed water purification systems using chlorine recommended by American engineers. Prior to this time they had never used it. Shortly thereafter, the Japanese medical community began to notice that the Japanese people were starting to have a lot of heart attacks. Their investigation led them to chlorine as the source of the causative factor. They discontinued the use of chlorine.

Chlorination of water supplies first began in 1908 in the United States, but it wasn’t until 10 to 20 years later that heart attacks first began to increase. That’s because unlike the soldiers in the Korean and Vietnam Wars who drank very high concentrations of chlorinated water, causing a faster rate of developing plaques on the blood vessel walls within a year or less, the public water supplies had much lower amounts which produced a slower rate of developing plaques over a 10 to 20 year period.

(It is also interesting to note that women with breast cancer have been found to have 50 to 60% more organochlorines in their breast tissue than women without breast cancer. [13] Does this reflect absorption of pesticides? Creation of organochlorine compound within the breast tissue itself because of high chlorine levels in the water? We can only speculate.)

(2) Vegetable oils

The dietary use of vegetable oils became widespread in America in the 1930s, about the same time atherosclerotic heart disease began to climb.

Butter consumption was declining while the use of vegetable oils, especially oils that had been hardened to resemble butter by a process called hydrogenation, was dramatically increasing. By 1950 butter consumption had dropped from eighteen pounds per person per year to just over ten. Margarine filled in the gap, rising from about two pounds per person at the turn of the century to about eight. Vegetable oil consumption had more than tripled - from just less than three pounds per person per year to more than ten. [14]

By 1950, coronary heart disease was the leading source of mortality in the United States, causing more than 30% of all deaths. What’s wrong with vegetable oils? This summary is from renowned researchers Russell Smith and Edward Pinckney: [15]

Diets high in polyunsaturates:

  • Are highly subject to rancidity, and so they increase the body’s need for vitamin E and other antioxidants.
  • Are damaging to the reproductive organs and the lungs - both of which are sites for huge increases in cancer in the US.
  • In test animals, inhibit the ability to learn, especially under conditions of stress.
  • Are toxic to the liver.
  • Compromise the integrity of the immune system.
  • Depress the mental and physical growth of infants.
  • Increase levels of uric acid in the blood.
  • Cause abnormal fatty acid profiles in the adipose tissues.
  • Are linked to mental decline and chromosomal damage.
  • Will accelerate aging.
  • Are associated with increasing rates of cancer, heart disease and weight gain.
  • Interferes with the production of prostaglandins leading to an array of complaints ranging from autoimmune disease to PMS. Disruption of prostaglandin production leads to an increased tendency to form blood clots, and hence myocardial infarction, which has reached epidemic levels in America.

Not only do corn and soy oils provide the oxidized fats that cause heart disease, they raise cholesterol levels in the process. [16]

(3) Low thyroid

Since the 1930’s, it has been clearly established that suppression of the thyroid raises serum cholesterol while increasing mortality from infections, cancer, and heart disease. Restoring thyroid function brings cholesterol down to normal.[17] When thyroid function is poor, usually due to a diet high in sugar and low in usable iodine, fat-soluble vitamins and other nutrients, the body floods the blood with cholesterol as an adaptive and protective mechanism, providing a superabundance of materials needed to heal tissues and produce protective steroids. It is thought that the majority of Americans now have low thyroid levels.[18] Part of that is because so much non-organic commercially produced bread since the 1980s contains bromide as a dough conditioner; bromide is a chemical cousin to chlorine. Bromide and chlorine suppress the uptake of iodine, an essential nutrient for optimal thyroid function. Corn oil and soybean oil also suppress thyroid function.

(4) Lack of Sunshine

Sunlight lowers cholesterol levels. Since the 1980s, we’ve been subject to an erroneous public relations campaign to stay out of the sun for fear of skin cancer. Sunlight converts the cholesterol on your skin to hormone precursors which are used to make steroid hormones like vitamin D. The cholesterol in your bloodstream then migrates to the surface of the skin, to replace the cholesterol that was converted. Staying out of the sun and routine use of sunscreens is an invitation to increased cholesterol levels. [19]

(5) Lack of Vitamin C

Dr. Linus Pauling met Dr. Matthias Rath, a German cardiologist, in July of 1983 at a Nobel Laureates meeting in Germany. Dr. Rath shared with Dr. Pauling his hunch that if you were low in vitamin C you produced more LDL cholesterol. The reverse is also true; if you have more vitamin C, you produce less LDL cholesterol. Atherosclerosis appears to be a defensive mechanism so we don’t bleed to death from scurvy - scurvy weakens blood vessels. Instead, we die later from heart disease. The formation of cholesterol plaques is the body’s way of “patching” the vessel walls, weakened by a deficiency of vitamin C, zinc, copper and magnesium. [20]

Vitamin C is also the recycler of vitamin E which shields cells, fats, cholesterol and LDL from oxidation. Vitamin E is also a potent stimulant for production of prostanoids which dilate the arteries. Long-term or periodically low vitamin C weakens the connective tissue (made of collagen, elastin and ‘cartilage proteo-glycans’) which then allows blood to enter the artery walls, thickening and hardening them with repair and clotting materials, with calcium and with cholesterol crystals. Muscle cells then multiply inside the connective tissue to strengthen the wall. Such thickened artery walls increase the risk for stroke and heart disease. [21]

(6) Stress

Some of those hormones made by cholesterol are the ones that help you handle stress. The more stress you have, the more corticosteroid hormones you need. When you lower cholesterol with drugs, you get more stress-related problems. High cholesterol in young and middle-aged men could, for instance, reflect the body’s need for more cholesterol because cholesterol is the building material of many stress hormones. Any possible protective effect of high cholesterol may therefore be counteracted by the negative influence of the artificially lowered levels of cholesterol on the vascular system.

(7) Infection

For many years scientists have suspected that viruses and bacteria, in particular cytomegalovirus and Chlamydia pneumonia (also named TWAR bacteria, Taiwan Acute Respiratory Agent) participate in the development of atherosclerosis.

The role of infections in chronic heart failure has been studied by Dr. Mathias Rauchhaus of Martin-Luther-University in Halle, Germany. His research team found that the strongest predictor of death for patients with chronic heart failure was the concentration of cytokines in the blood, in particular in patients with heart failure due to coronary heart disease.[22] To explain their finding they suggested that bacteria from the gut may more easily penetrate into the tissues when the pressure in the abdominal veins is increased because of heart failure. In accordance with this theory, they found more endotoxin in the blood of patients with congestive heart failure and edema than in patients with non-congestive heart failure without edema, and endotoxin concentrations decreased significantly when the heart’s function was improved by medical treatment. [23]

“Saturated fat and cholesterol in the diet are not the cause of coronary heart disease. That myth is the greatest scientific deception of this century, perhaps of any century.” – George V. Mann, M.D., professor of Medicine and Biochemistry at Vanderbilt University

“Both the public and clinical physicians have simultaneously been swamped by an ever-growing tidal wave of exaggerations, distortions and even fabrications of the facts.” – Russell L. Smith, PhD, author of “The Cholesterol Conspiracy”

STATIN DRUGS - BRING ‘EM ON

Statin drugs, which promise to lower cholesterol, are the best selling drugs on the market.

It looks more and more as though the anti-inflammatory effects of statins may be the main source of their cardiac benefits, rather than their ability to lower cholesterol. Atheroscleosis is fundamentally an inflammatory disease.

“What the shrewd marketing people at Pfizer and the other companies did was spin it to make everyone with high cholesterol think they really need to reduce it,” says Dr. Bryan A. Liang, director of the Institute of Health Law Studies at the California Western School of Law and co-director of the San Diego Center for Patient Safety. “It was pseudo-science, never telling you the bottom-line truth, [which is] that the drugs don’t help unless you have pre-existing cardiovascular disease.” The marketing worked, Liang says, “even in the face of studies and people screaming and yelling, myself included, that it is not based on evidence.” [24]

An estimated 25 million Americans take Lipitor, Crestor, Zocor, Pravachol, Mevacor and other statin drugs at the constant urging and heavy pressure of the mainstream medical establishment. Crestor, which is not available as a generic drug, costs about $3.45 per day, for example.

Muscle pain and weakness are common side effects of statin drugs. The JUPITER clinical trials first linked an increase in diabetes to Crestor; a 2010 analysis of statin clinical trials suggests that increased diabetes risk is linked to all statins.

Additionally, we have conclusive evidence of statins’ profoundly destructive impact on the brain. A U.C. San Diego study found statins can provoke symptoms similar to Alzheimer’s. [25] And no wonder. Cholesterol is crucial to brain function. It protects nerve cells and literally speeds up your brain’s operation in all areas, including your thought processes, recall, and speech. It’s also the building block for synapses, the areas between nerve cells that transmit messages.

Some of the study’s subjects reported memory loss to the point where they couldn’t recognize people they’d known for decades. Others found that statins had stripped them of their ability to concentrate, work, think clearly or even talk.

A February, 2008 column in the Wall Street Journal underscores the concern:

“Cognitive side effects like memory loss and fuzzy thinking aren’t listed on the patient information sheet for Lipitor … [but] some doctors theorize that lowering cholesterol would slow the connections that facilitate thought and memory. … ‘This drug makes women stupid,’ Oril Etingin, vice-chairman of medicine at New York Presbyterian Hospital, declared … Anecdotes linking statins to memory problems have been rampant for years.” [26]

Yet, the makers of Lipitor initiated an aggressive campaign to get doctors to prescribe the maximum dose.

Statin use may lead to cancer. Cholesterol-lowering drugs cause cancer in rodents at the equivalent doses used by man.[26A] The extrapolation of evidence of cancer from rodent to human is very uncertain. This is the argument of those in favor of using cholesterol-lowering drugs. However, evidence from the cholesterol-lowering drug trial known as CARE (Cholesterol And Recurrent Events) showed that Pravachol (a cholesterol-lowering drug made by Bristol-Myers Squibb) caused a 1500% increase in breast cancer among women taking it. An increase in cancer rates among Pravachol users was also shown in the drug trial known as PROSPER. Many feel this side effect continues to fly below the radar because cancer typically takes a long time to develop and most of the statin trials do not go on longer than two or three years.

A 2008 paper published in the American Journal of Cardiovascular Drugs cites nearly 900 studies on the adverse effects of statins.[26B]

In 2010, a research paper in the British Medical Journal warned doctors to think more carefully about prescribing cholesterol-lowering drugs because of their wide range of “unintended” side effects that include liver problems, kidney failure, muscle failure, and cataracts. [26C]

Also in 2010, researchers re-examined the extremely influential JUPITER trial and found it was both flawed and biased - nine of 14 authors of the JUPITER trial had financial relationships with AstraZeneca, which sponsored the trial. The JUPITER trial basically said that if you give people who have not yet had heart trouble 20 mg of a statin drug, you will see a 44% reduction in nonfatal heart attacks and strokes, and confirmed death from cardiovascular causes. But when researchers re-examined the JUPITER data, they found no evidence of the “striking decrease in coronary heart disease complications” reported in the trial. “The results of the trial do not support the use of statin treatment for primary prevention of cardiovascular diseases and raise troubling questions concerning the role of commercial sponsors,” the authors wrote.

But most of all, why lower cholesterol by force when it is not the cause of heart disease?

CAN’T LIVE WITHOUT IT

Cholesterol is something humans simply need – a lot.

Mother’s milk contains a high ratio of cholesterol. It is critical for proper brain development of fetuses and growing children. Women in China have a tradition of eating perhaps 30 eggs a day when they are pregnant so they will have healthy, smart babies.

During puberty, the brain sprouts all sorts of new nerve cells. These cells have to make connections with each other, and the body needs the right kind of fats and cholesterol to do this.

Cholesterol is “the mother of all hormones.” It is the precursor to all steroid hormones, including mineralcorticoids, glucocorticoids, and sex hormones. Thus cholesterol is a major player in athletic performance, regulating blood sugar, controlling blood pressure, regulating mineral balance, maintaining libido, building muscle mass, and more.

It is also the raw material from which vitamin D and CoQ-10 are made. Vitamin D boosts the immune system and protects us from cancer; CoQ-10 acts like the catalytic converter in the mitochondria, removing excessive free electrons (the cellular) from the energy factory line.

All living creatures use cholesterol to make cells waterproof, a mechanism vital for proper function. The fact that cells are waterproof is especially critical for normal functioning of nerves and nerve cells. Thus, the highest concentration of cholesterol in the body is found in the brain and other parts of the nervous system.

Cholesterol forms 50 percent of the nervous system. A deficiency of cholesterol results in fatigue, obesity, nervous and emotional disturbances, digestive difficulties, impotence or inability to conceive and/or complete a pregnancy, menstrual syndromes and masculine traits in women, effeminate traits in men, blood pressure irregularities, fluid imbalances, nutritional deficits and imbalances, and more. [27]

In addition to acting like the body’s ever-ready band aid for arterial lesions, cholesterol is a potent antioxidant. It scavenges free radicals. It is flooded into the bloodstream when we take in too many harmful free-radicals – usually from damaged and rancid fats in margarine and highly processed vegetable oils. This is the likely explanation for the fact that cholesterol levels go up with age. As an antioxidant, cholesterol protects us against free radical damage that leads to heart disease and cancer. [28]

Researchers at Texas A&M University find that lower cholesterol levels result in reduced muscle mass among older adults engaging in resistance exercise. Cholesterol serves as an essential building block for repair of the “micro-tears” that occur in muscle membranes stressed by exercise. [29]

Those who have very low levels of cholesterol had a greater incidence of cancer while those with very high cholesterol suffered more heart attacks. [30]

You’ll find about 5 ounces of cholesterol in the average person. Approximately 7 percent of that, or one tablespoon, circulates in the blood. The less cholesterol comes from food, the more the body produces. Adults probably absorb only about 25 percent of the cholesterol they consume.

Cholesterol is not water-soluble so it needs to travel through the bloodstream in little round orbs made of protein and fats called lipoproteins. These lipoproteins are categorized according to their density.

HDL means a High Density Lipoprotein and LDL means a Low Density Lipoprotein. HDL carries cholesterol to the liver from body tissues. LDL carries cholesterol away from the liver, where it is produced, to tissues including blood vessel walls.

Cholesterol is just one of the risk factors for heart disease. Dr. Ronald M. Krauss, director of atherosclerosis research at the Oakland Research Institute, explained that higher LDL levels do help set the stage for heart disease by contributing to the buildup of plaque in arteries. But something else has to happen before people get heart disease. “When you look at patients with heart disease, their cholesterol levels are not that [much] higher than those without heart disease,” he says. Compare countries, for example. Spaniards have LDL levels similar to Americans’, but less than half the rate of heart disease. The Swiss have even higher cholesterol levels, but their rates of heart disease are also lower. Australian aborigines have low cholesterol but high rates of heart disease. [31]

SATURATED FAT

Along with cholesterol, saturated fat has also been wrongly blamed for heart disease. The “lipid hypothesis” said saturated fat and cholesterol from animal sources raise cholesterol levels in the blood, leading to deposition of cholesterol and fatty material as pathogenic plaques in the arteries.

Saturated fat was a mainstay of mankind’s diet for tens of thousands of years; atherosclerosis was not a problem until just recently. This part of the story has been well documented with research over the years, but still has not broken through the mainstream news barrier. Heart disease is unknown today among the Eskimos who eat their traditional diet, primarily blubber. Heart disease is unknown today among the Masai of Africa who eat their traditional diet, primarily milk and meat, a diet rich in cholesterol and saturated fat. George Mann’s independent studies of the Masai in Africa,[32] had convinced him that the lipid hypothesis was “the public health diversion of this century … hundreds of millions of tax dollars are wasted by the bureaucracy and the self-interested Heart Association.” [33]

In the early 1900s, half of all Americans lived on farms and ate lots of meats, raw whole milk, cream, butter, and eggs. Heart attacks were rare.

But the nature of saturated fat has been changed by modern farming methods into a form which is unhealthy for the structure of the cell wall. Saturated fat has no strong links with disease, while industrially produced trans fats do.

Read Salmon and Red Meat in our library to see what is different about the saturated fat we find in the modern grocery store and the role that plays in human health.

ASKING THE WRONG QUESTION?

Millions of people have had their cholesterol levels tested, but only a tiny fraction ask about their triglycerides or understand why high triglycerides levels warrant more attention than high cholesterol levels. Why are most people - and many doctors - in the dark about triglycerides? Perhaps because there is no drug that effectively lowers triglycerides, the amount of fat circulating in the bloodstream.

When you eat, your body uses the calories it needs for quick energy. Excess calories are stored as fat regardless of what kind of food you eat - fat, carbohydrate, or protein. If you regularly eat more calories than you burn, you may have high triglycerides.

Also, kidney disease, obesity, and an underactive thyroid (hypothyroidism) may cause high triglycerides. Alcohol and sugar have a particularly strong effect on triglycerides.

In normal amounts, triglycerides are important to good health. When triglyceride levels are high, it is not clear whether these high levels directly increase your risk for heart disease. But high triglycerides are often part of a group of conditions called metabolic syndrome.

An elevated triglyceride blood level in and of itself is a strong and independent risk factor for heart attack among middle-aged and elderly men. In fact, studies have shown that blood triglyceride level was a stronger risk factor than total cholesterol alone. It is not known why women appear to be immune to this other than postulations that the high level of estrogen acts as a protective factor.

Triglycerides 101:

  • There are two main lipids found in the blood, cholesterol and triglycerides.
  • A normal triglyceride level is less than 150 milligrams per deciliter (mg/dL) according to the National Cholesterol Education Program guidelines.
  • When triglyceride levels reach 200 mg/dL, coronary artery disease risk doubles
  • Heart disease risk is considerably higher among women than men when triglyceride levels top 200 mg/dL
  • Individuals with high triglyceride levels (hypertriglyceridemia) may develop numerous pimple-like lesions across their body. Extremely high levels of triglycerides may also result in kidney disease and pancreatitis - a severe inflammation of the pancreas that may be life-threatening.
  • Sepsis, a life-threatening condition caused by bacterial growth in the blood, is associated with a high level of triglycerides. The high level of triglycerides seen in sepsis is a normal immune response to infection. [34]

Triglyceride levels are strongly influenced by diet. While cholesterol levels remain pretty constant over a month or so and aren’t terribly affected by meals, triglycerides respond quickly to a meal, particularly one with a lot of fat, sugar, or alcohol.

There are two ways to control triglycerides: 1) Exercise regularly, and 2) eat a balanced diet that’s low in sugar, simple carbohydrates, and processed foods.

PREVENTION IS THE BEST MEDICINE

Drugs induce a false sense of security. You might force the body to stop making cholesterol, but, do you really want to? When you stop the manufacture of cholesterol, you also stop the manufacture of Coenzyme Q-10 (CoQ-10) which is crucial for function of the cell’s energy factories known as mitochondria. This is one explanation for the muscle fatigue, muscle pain and congestive heart failure which can develop as a “side effect” of lipid-lowering drugs.

And drugs don’t address the ongoing “poisoning” of the system by bad foods and environmental toxins.

How to prevent arterial lesions and the resulting inflammation? Here is our Top Ten List:

  1. Come to terms with the sugar habit. Sugar increases triglyceride storage and cellular oxidative damage. This assaults the vascular wall, leading to micro-leakages in the endothelial wall of blood vessels, leading to the self-repair mechanism of cholesterol. In medical lingo, sugar is a significant contributory factor of oxidative stress. Cuba for example has one of the highest levels of sugar use, and has a higher death rate from heart attacks in men between ages 55 and 64 than the U.S. [35]
  2. Think in terms of what causes free radicals. The short list of what to avoid includes trans fats, refined and synthetic sugars, food additives and preservatives, cigarette smoke, chlorine, and pesticides.
  3. If you feel the need to lower serum cholesterol, bypass fruit juices. Eat the whole fruit with its pectin and fiber.
  4. Increase your intake of vitamins B12, B6, and folic acid which can reduce levels of homocysteine, which damages the arteries and set the stage for disease. Fish oil helps curb inflammation, a most significant risk factor for heart attack. Increase your intake of vitamins C and E which neutralize free radicals that oxidize LDL cholesterol.
  5. Stick with unrefined olive oil, unrefined coconut oil, and butter. Avoid margarine and trans fats like the plague.
  6. Feed your thyroid. Coconut oil has wonderful antimicrobial properties, and it stimulates your metabolism and increases thyroid function. Buy organic breads that do not use bromide. Use honest-to-goodness sea salt for its mineral content, including absorbable iodine; minerals influence thyroid activity.
  7. Increase your exposure to sunlight. Your body needs about 15 minutes a day (without sunscreen and in a bikini bathing suit) to make enough vitamin D.
  8. Bypass “low-fat” milks” because non-fat dried milk is added to 1% and 2% milk. Unlike the cholesterol in fresh milk, which plays a variety of health promoting roles, the cholesterol in non-fat dried milk is oxidized and it is this rancid cholesterol that promotes heart disease.
  9. Reduce systemic inflammation by searching out the triggers - allergies, leaky gut, and toxicities like chemicals and heavy metals.
  10. Laugh more, stress less.

At the Arizona Center for Advanced Medicine, we find the majority of people are deficient in iodine and Vitamin D. We recommend measurement of these substances, as well as lipid profiles, thyroid function and several blood chemistries at our initial evaluation.

Many people come to us with stated goals to lower cholesterol levels. There are indeed supplements which can be given in large, so-called pharmacologic doses, which will lower serum cholesterol. However, we take the issue a step farther. Rather than simply lowering the cholesterol levels, we evaluate the whole person, to determine the source of their high inflammatory state - whether dietary, environmental allergies, toxicities, heavy metals… Once the source is identified, we utilize the appropriate therapies to treat the cause of the inflammation.

Our nutritional program, called FirstLine Therapy™, is essential, to help people kick the sugar habit and migrate toward a diet that lessens inflammation overall in the body.

We utilize IV nutritional therapies if the person is unable to absorb what they need because of an unhealthy gut. Intravenous vitamin C is excellent for reducing free radicals. We treat heavy metal toxicity with chelation if indicated. We determine allergies (food, pollen, chemical, etc) and treat those, to lessen the overall burden of inflammation and toxicity in the body.

Yes, treating abnormalities of blood chemistry requires effort and takes time. But the end result is worth it - a healthy lifestyle, a longer and healthier life… healthy old age… what could be better?

INQUIRING MINDS WANT TO READ MORECholesterolFactsCholesterol Facts & Fantasies
by Judith A. DeCava, CNC, LNC
2005
CoconutOilMiracleCoconut Oil Miracle by Bruce Fife
2004, revised edition
EatFatLookThinEat Fat, Look Thin
By Bruce fife, ND
2002
Know Your FatsKnow Your Fats: The Complete Primer for Understanding the Nutrition of Fats, Oils and Cholesterol
by Mary G. Enig
2000


The Cholesterol ConspiracyThe Cholesterol Conspiracy
by Russell L. Smith, Edward R. Pinckney
1991

These references are available online:


[1] Alex Berenson, New Questions on Treating Cholesterol, New York Times, Business Section, January 17, 2008

[2] John Carey, Do Cholesterol Drugs Do any Good? Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated. Business Week, January 17, 2008

[3] Joseph G. Hattersley, The negative health effects of chlorine, Townsend Letter for Doctors and Patients, May 2003

[4] Uffe Ravnskov, The Benefits of High Cholesterol, The Quarterly Journal of the Weston Price Association

[5] H.M. Krumholz HM, et al; Lack of association between cholesterol and coronary heart disease mortality and morbidity and all-cause mortality in persons older than 70 years. Journal of the American Medical Association 272, 1335-1340, 1990.

[6] Mary Enig, PhD, and Sally Fallon; Oiling of America, 1999. Accessed at http://www.westonaprice.org/knowyourfats/oiling.html

[7] Ray Gebauer, MD; The Cholesterol Myth, accessed February 2008 at http://freehealthcontent.com/article_1722.shtml

[8] D.S. Goodman, Cholesterol Revisited: Molecule, Medicine and Media, Arteriosclerosis, 9, 430-438, 1989

[9] Uffe Ravnskov, The Cholesterol Myth, p. 166

[10] Gina Kolata, Major Study Aims to Learn Who Should Lower Cholesterol, New York Times, September 26, 1989

[11] Weston A. Price Foundation

[12] Dr. Joseph M. Price, Coronaries/Cholesterol/Chlorine, NY, Pyramid, 1969.

[13] Charlie Skeen, Chlorine – A Crippler and Killer, Live Well Naturally Newsletter, September 24, 2006

[14] Mary Enig, PhD; Trans Fatty Acids in the Food Supply: A Comprehensive Report Covering 60 Years of Research, 2nd Edition, 1995, Enig Associates, Inc., Silver Spring, MD, pp 4-8

[15] A general review of citations for problems with polyunsaturate consumption is found in E R Pinckney, and C Pinckney, The Cholesterol Controversy, 1973, Sherbourne Press, Los Angeles, pp127-131

[16] Bruce Fife, ND, CN; The Coconut Oil Miracle, 2004

[17] Raymond Peat, Ph.D.; Coconut Oil, newsletter of 1996, accessed February 2008 at http://www.efn.org/~raypeat/coconut.rtf

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[21] Daniel H. O’Leary, MD, et al; Carotid-Artery Intima and Media Thickness as a Risk Factor for Myocardial Infarction and Stroke in Older Adults, New England Journal of Medicine, Volume 340:14-22, January 7, 1999

[22] Rauchhaus M and others. Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation 102, 3060-3067, 2000.

[23] Niebauer J and others. Endotoxin and immune activation in chronic heart failure. Lancet 353, 1838-1842, 1999.[24] Carey, John. Do Cholesterol Drugs Do Any Good? Business Week, January 17, 2008

[25] B.A. Golomb, Impact of statin adverse events in the elderly. Expert Opinion on Drug Safety. 2005;4(3):389-397.

[26] Melinda Beck, Can a Drug That Helps Hearts Be Harmful to the Brain? Wall Street Journal, Health Journal, February 12, 2008

[26A] Thomas B. Newman, et al; Carcinogenicity of Lipid-Lowering Drugs, JAMA, January 3, 1996-Vol 275, No. 1

[26B] Golomb BA, Evans MA. Statin adverse effects : a review of the literature and evidence for a mitochondrial mechanism. Am J Cardiovasc Drugs. 2008;8(6):373-418. doi: 10.2165/0129784-200808060-00004.

[26C] Hippisley-Cox J, Coupland C. Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. British Medical Journal, 2010 May 20;340:c2197. doi: 10.1136/bmj.c2197.

[27] Judith A. DeCava, CNC, Cholesterol Facts and Fantasies, Selene River Press, 2005

[28] Mary Enig, PhD, and Sally Fallon; The Truth About Saturated Fat, Weston A. Price Foundation

[29] Riechman SE, Andrews RD, MacLean DA, Sheather S. Statins and dietary and serum cholesterol are associated with increased lean mass following resistance training. J Gerontol A Biol Sci Med Sci. 2007 62: 1164-1171.

[30] G.N. Stemmermann et al; Sereum cholesterol and colon cancer indidence in Hawaiin-Japanese men. Journal of the national Cancer Institute, 67, 1179-1182, 1982

D.L. Morris et al; Serum cholesterol and cancer in the hypertension detection and follow-up program, Cancer, 52, 1754-1759, 1983

R. W. Sherwin et al; Serum cholesterol level and cancer mortality in 361,662 men screened for the multiple risk factor intervention trial, Journal of the American Medical Association, 257, 943-948, 1987

C.G. Isles et al; Plasma cholesterol, coronary heart disease, and cancer in the Renfew and Paisley survey, British Medical Journal, 298, 920-924, 1989

S.J. Winawer et al; Declining serum cholesterol levels prior to diagnosis of colon cancer. A time-trend, case control study. Journal of the American medical Association, 263, 2083-2085, 1990

L.D. Cowen et al; Cancer mortality and lipid and lipoprotein levels. The Lipid research Clinics’ program mortality follow up study. American Journal of Epidemiology, 131, 468-482, 1990

[31] John Carey, Do Cholesterol Drugs Do any Good? Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated. Business Week, January 17, 2008[32] Mann, G V, et al, “Atherosclerosis in the Maasai,” Am J Epidemiol, 1972, 95:26-37[33] Coronary Heart Disease, The Dietary Sense and Nonsense, George V Mann, ed, 1993, Veritas Society, London[34] Harris HW, Gosnell JE, Kumwenda ZL. The lipemia of sepsis: triglyceride-rich lipoproteins as agents of innate immunity. Journal of Endotoxin Research 6, 421-430, 2001.[35] Judith DeCava, Cholesterol, Facts and Fantasies, Selene River Press, 2005

Cholesterol Overview

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