by Dr. Will Cole
When you hear the word “cholesterol,” chances are the first thing that comes to mind is the idea of clogged arteries and heart attacks. This is what we’ve been taught, and as a nation, we’ve spent trillions of dollars spreading this belief. We have The War on Terror, The War on Drugs, and The War on Cholesterol. Of course, in the U.S., whenever we have a war on something, it will be accompanied by plenty of propaganda, whether true or not, and this has unintended consequences. But is this particular war justified? Is it based on real science?
The idea that eating cholesterol will raise blood cholesterol, clog the arteries, and cause heart disease, has its roots in the 1950s’ diet-heart hypothesis, which basically states that cholesterol and saturated fat in the diet cause high levels of cholesterol in the blood, and that polyunsaturated fatty acids (PUFAS) like those found in soybean, corn, canola, and vegetable oils, in their liquid-at-room-temperature state, will not clog the arteries and can help prevent heart disease.
Along with these so-called facts is the notion that an above-normal level of total cholesterol and especially LDL “bad” cholesterol will most certainly increase your chance of having a heart attack or a stroke. But what if I told you that all these things so many people believe are not only incorrect, but incredibly oversimplified? In fact, these beliefs have actually contributed to the chronic disease epidemic happening right now in this country. I know this because science says so.
First of all, let’s think about this logically. If high blood cholesterol causes heart disease, then it should be a risk factor in all populations, for all ages and both sexes. Conversely, lowering blood cholesterol should reduce heart disease. In reality, though, we see the opposite. The rate of heart disease in 65-year-old men is 10 times higher than that of 45-year-old men, regardless of blood cholesterol levels.
Additionally, a study in the Journal of American Medical Association found that high LDL cholesterol is not actually a risk factor in heart disease or a cause in any deaths in the elderly. Therefore, it’s highly unlikely and illogical that the risk factor of the disease would cease to be important for certain age groups, for the disease that is the leading cause of death. That’s like saying smoking is a risk factor for lung cancer for people in their 40s, but not when they’re 80.
Furthermore, high blood cholesterol isn’t a risk factor for women at all! Women have 300% lower rates of heart disease despite higher cholesterol levels than men on average. Approximately 125,000 women have been researched in 11 different studies, with no relationship being found between cholesterol and heart disease. Heart disease is the number one killer of women as well as men, but the closer we look at the research, the more it appears that cholesterol has nothing to do with this.
There’s more. The World Health Organization’s MONICA Study looked at a wide range of populations and their cholesterol and heart disease rates in an attempt to find a directly proportional correlation. What they found was quite the opposite. Australian Aboriginals have the lowest cholesterol and the highest rate of heart disease. They have 30 times that of people in France and 15 times higher than those in the UK. Conversely, the Swiss have some of the highest cholesterol levels, and 1/3 the heart disease rate of the UK. Dr. Malcom Kendrick, author of The Great Cholesterol Con, stated, “It is unbelievable to me that you can look at this data and sustain your belief in the cholesterol hypothesis.”
If the diet-heart hypothesis was accurate, we should be see a lower risk of heart disease once cholesterol is lowered. We see the opposite in the literature. Over 40 trials on the subject showed that lowering cholesterol had the same or in some cases a surprisingly higher risk of heart attack than the control groups.
As for LDL being “bad,” this idea is also oversimplified. There are actually two types of LDL: small dense LDL and large buoyant LDL. Small dense LDL particles are like little darts that tear holes in the lining of blood vessels, but large buoyant LDL particles are like large fluffy balls. They can’t do any damage and may actually prevent the small dense LDL from causing damage. For this reason, a simplistic cholesterol test that does not separate out these two types of LDL cholesterol cannot predict your risk. So what does predict heart attack and stroke? We know the answer to this question – these are the bio-markers that actually predict heart attack and stroke:
- Low HDL “good” cholesterol
- High triglycerides, which can reflect a diet high in sugar and refined carbohydrates.
- High levels of small dense LDL
So as you can see, cholesterol is involved – just not at all in the way we thought, and the only way to truly assess risk is to run different, more comprehensive tests. I run a blood test on my patients called the NMR (Nuclear Magnetic Resonance) that tells me if they have more small dense LDL or large buoyant LDL. We also look at inflammation which is an underlying cause of heart disease that has nothing to do with cholesterol, and we look at chronic disease as a whole, which is a measure of general health and vitality.
There are two other significant predictors of heart attack and stroke related to inflammation:
- High homocysteine
- High C-Reactive protein
I run these two blood tests on my patients to determine the patient’s level of inflammation. When inflammation is high, that is when I know we need to intervene to reduce the risk of heart disease. But as for that grass-fed steak or those scrambled eggs you thought you couldn’t have for breakfast, go ahead and dig in. You are much better off skipping the donuts.
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