A Functional Medicine Perspective On Heart Disease + Cholesterol

Heart Disease + Cholesterol 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?

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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.

While cholesterol is not the heart disease culprit, there are some dietary demons that likely do contribute significantly to heart disease risk. Populations with diets high in saturated fats and low in what Weston A. Price referred to as the “displacing foods of modern commerce” – like white flour, white sugar, white rice, and vegetable oil – don’t have the rates of chronic disease that we see in the United States. The legitimate, randomized, double-blind, placebo-controlled studies are clear: A low-fat, low-cholesterol diet is not the answer to decreasing heart disease. In fact, this diet has been shown to increase triglycerides, decrease HDL, and increase small dense LDL and inflammation – all of the factors for a heart attack or stroke!

Avoiding processed foods and focusing on whole natural foods means giving yourself a better chance of avoiding heart disease. Here are three dietary changes to make today, in service of a stronger and healthier heart.

1. Remove inflammatory fats and replace them with heart-healthy fats

Certain fats really do harm your health, but they may not be the fats you think they are. “Bad” fats include hydrogenated and partially hydrogenated oils, trans fats, and polyunsaturated industrial seed oils such as corn, vegetable, soy, and canola oil. These are all linked to cellular congestion and inflammation, which can lead to chronic diseases like heart disease.

Science bears this out. A 2009 study from Harvard School of Public Health showed that the more vegetable oils the women in the study ate, the worse their atherosclerosis became. The Sydney Diet Heart study found that diet rich in polyunsaturated fatty acids (PUFAs) increases mortality by 39 percent. The top three sources of calories for Americans today are refined carbs, vegetable oils (PUFAs), and corn syrup – three things our healthy ancestors never even heard of. Is there any question as to why heart disease is an epidemic?

By contrast, diets high in saturated fats and cholesterol don’t raise blood cholesterol levels in most people, and even when they do, they tend to raise the levels of the large buoyant “fluffy” type of LDL cholesterol, which we learned in my last article are protective, not harmful! A University of Connecticut study showed that eating three eggs a day decreased small dense LDL by almost 20 percent. Sources of good fats essential to hormone production, cancer prevention, brain function, weight loss, and heart disease prevention come from coconut oil, avocados, local farmed eggs, kefir, ghee, organic butter, grass-fed raw milk, and raw nuts and seeds. Enjoy!

2. Choose better meat

Not all meat is bad. What separates good meat from bad meat is quality. There are hundreds of studies that link commercial meat (i.e., industrial farm lot meat) to heart disease. Surprisingly, this could be due to grain (many of them genetically modified) fed to these animals, who are made to eat grass. This sub-standard cattle diet changes the fatty acid ratios in the meat, denaturing good fats and making the meat more inflammatory. This leads to chronic disease like heart disease.

These factory farmed cattle are also typically pumped full of hormones and antibiotics. The inflammatory toxins accumulate in the fat. This is how to make a nutritious food into a food that raises disease risk. But it isn’t the animal fat per se that is the problem. It’s what we’ve done to it. When you choose grass-fed beef and organic chicken, you avoid this problem. Fat from these animals is benign. If you can’t find these products, choose the leanest meat possible, to avoid the accumulation of toxins and other inflammatory properties in the animal fat.

3. Remove all processed grains and refined sugars

Now for the final and significant culprit! What we’ve done as a society to our grain supply is contributing to the deaths of millions. The genetic modification, refining, hybridization for more starch and sugar content, and all-around defiling of most grains with pesticides and desiccants, makes it difficult to get a good source of this once healthy food (which, by the way, our ancestors ate in extremely small quantities compared to the way we eat grains in our world today). As alternatives to products made with industrial wheat and corn, try organic quinoa and wild rice, both good grain options thanks to their high nutrient density and the fact that they don’t typically trigger the inflammatory response that most grains cause.

And what about sugar? This anti-nutrient offers insignificant amounts of vitamins and minerals, but simultaneously robs your body of nutrient stores. This can lead to chronic diseases such as heart disease. High glycemic or refined sugar cause elevated glucose levels result in insulin spikes that can lead to premature aging and degenerative diseases such as heart disease, diabetes, and cancer.

Dr. Sylvan Lee Weinburg, former president of the American College of Cardiology, warned, “The low-fat, high carbohydrate diet may well have played an unintended role in the current epidemics of obesity, lipid abnormalities, type II diabetes, and metabolic syndromes.” Weinburg went on to say, “This diet can no longer be defended by appeal to the authority of prestigious medical organizations.”

The Inevitable Demise of the Lie

How have all the myths and lies surrounding cholesterol survived, despite all the evidence to the contrary? Sadly, eight out of nine doctors who write the National Cholesterol Guidelines receive money from the pharmaceutical industry, I’d say that was a conflict of interest. Also, two-thirds of all medical research is funded by those pharmaceutical companies. The market for statin drugs is over $25 billion per year and is the largest drug company in the world! There is money and power in keeping the population in a direct battle with heart disease, and while it would be a daunting task to try and change the entire billion-dollar cholesterol drug racket and government-subsidized junk food monopoly, you can change your own destiny.

It’s my goal to impact people’s health on an individual basis. Elevating people’s minds and health (and hearts) is my passion and I believe this prioritizing of health over profit must be a part of the future of evidence-based natural health.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe. 

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Dr. Will Cole, IFMCP, DNM, DC, leading functional medicine expert, consults people around the world via webcam and locally in Pittsburgh. He received his doctorate from Southern California University of Health Sciences and post doctorate education and training in functional medicine and clinical nutrition. He specializes in clinically researching underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Dr. Cole was named one of the top 50 functional medicine and integrative doctors in the nation and is the best selling author of Ketotarian and The Inflammation Spectrum.