Heart Disease

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Today I will summarize the approach to preventing heart disease I’ve been writing about for the past couple of years. If you’re new to the blog and haven’t seen those articles, there’s an index of them here.

After today’s post I’m going to move on to some new topics. There are so many mainstream health myths out there it’s hard to cover them all! In the next few months we’re going to shift our attention to the digestive system. We’ll talk about the real cause of acid reflux (GERD), the high rates of gluten intolerance in the US and its consequences when undiagnosed and untreated, the hidden problem underlying Irritable Bowel Syndrome (IBS), and more.

As you know if you’ve been following this blog, heart disease is primarily caused by inflammation and oxidative damage. This is now well-accepted amongst medical researchers, though many physicians and medical professionals are still unfortunately focused on cholesterol.

It follows, then, that to prevent heart disease our primary goal should be to reduce inflammation and oxidative damage. How do we do that? Follow these nine steps:

1. Don’t eat industrial vegetable oils.

Industrial vegetable oils like corn, soy, cottonseed, sunflower, and safflower are high in omega-6 polyunsaturated fatty acids (n-6 PUFA). Countless studies show that n-6 PUFA promote both oxidative damage and inflammation, and significantly raise the risk of heart disease. Industrial vegetable oils are found in nearly all processed and packaged foods, and in most foods cooked in restaurants. My rule here is simple: if it comes in a package, don’t eat it. And make eating out a special occasion, not a daily ritual.

For more on the danger of vegetable oils, see How to Increase Your Risk of Heart Disease.

2. Eat traditional, saturated fats.

For more than five decades we’ve been brainwashed to believe that saturated fat causes heart disease. It’s such a deeply ingrained belief that few people even question it. It’s just part of our culture now.

But several recent studies have confirmed what many researchers have known all along: that eating saturated fat doesn’t cause heart disease. Saturated fats are protected against oxidative damage – one of the primary causes of heart disease. What’s more, saturated fats have numerous health benefits.

For more on this, see New Study Puts Final Nail in the “Saturated Fat Causes Heart Disease” Coffin, and The Most Important Thing You Probably Don’t Know About Cholesterol, and Have Some Butter with your Veggies!

3. Eat less sugar (including simple carbs).

Most people know that eating sugar wreaks havoc on their health. But what many don’t understand is that all carbohydrates eventually break down into sugar in the body. Simple carbohydrates such as rice, potatoes, pasta and bread can cause spikes in blood sugar and insulin, both of which contribute to oxidative damage and inflammation – and consequently increase the risk of heart disease.

For decades the American Heart Association and American Diabetes Association have been promoting a low-fat, high-carb diet. Research has shown that this diet actually increases the risk of both heart disease and diabetes! If you want to steer clear of these conditions, a high-fat, low-carb diet is your best choice.

The average American gets 57% of his/her calories from highly refined cereal grains and polyunsaturated (PUFA) oils. The #3 source of calories, behind grains and PUFA, is sugar and high-fructose corn syrup. Refined grains, polyunsaturated oils and sugar are all major contributors to both inflammation and oxidative damage. Clearly the low-fat, high-carb diet has been a failure.

For more on this, see The Most Important Thing You Probably Don’t Know About Cholesterol and, Low-Carb Diet Best for Weight Loss.

4. Eat nutrient dense foods (especially organ meats and egg yolks!)

The key to proper nutrition is eating nutrient-dense foods. Most people think about vegetables when they think of vitamins and minerals. However, a serving of beef liver has between 10-100 times the amount of key vitamins and minerals than those found in carrots or apples.

Egg yolks are another of nature’s superfoods. One egg provides 13 essential nutrients, all in the yolk (contrary to popular belief, the yolk is far higher in nutrients than the white). And despite conventional wisdom, it’s entirely safe to eat three eggs a day. In fact, studies show that egg consumption actually increases large, buoyant LDL cholesterol – which is the type that doesn’t cause heart disease!

Grass-fed, organic animal products and raw dairy (butter, milk) are also high in health promoting nutrients, and should be eaten liberally.

For more on this, see Three Eggs a Day Keeps the Doctor Away, Cholesterol Doesn’t Cause Heart Disease and Liver: Nature’s Most Potent Superfood.

5. Eat fermented foods.

Almost all healthy, traditional cultures that have been studied regularly consume fermented foods like yogurt, kefir, sauerkraut, kim chi and kombucha. These foods have numerous health benefits, but in the context of heart disease one of the most important reasons to include them in the diet is that they are one of the few dietary sources of vitamin K2.

Unfortunately, many people are not aware of the health benefits of vitamin K2. The K vitamins have been underrated and misunderstood up until very recently in both the scientific community and the general public. While K1 is preferentially used by the liver to activate blood clotting proteins, K2 is preferentially used by other tissues to deposit calcium in appropriate locations, such as in the bones and teeth, and prevent it from depositing in locations where it does not belong, such as the soft tissues.

A 1993 study showed that those in the highest third of vitamin K2 intake were 52 percent less likely to develop severe calcification of the arteries, 41 percent less likely to develop heart disease, and 57 percent less likely to die from it.

For more on this, see Vitamin K2: The Missing Nutrient.

6. Take your high-vitamin cod liver oil.

Cod liver oil is one of the only supplements I recommend to people. It’s a great source of long chain omega-3 fatty acids (EPA and DHA), which protect against inflammation. But even more importantly, cod liver oil is one of the few dietary sources of vitamin D. Low vitamin D levels associate with nearly every common non-communicable disorder, including obesity, diabetes, cardiovascular disease, autoimmune disease, osteoporosis and cancer.

But not all cod liver oils (CLOs) are created equal. Most commercially available CLOs are processed with heat and chemicals. Because heat and chemicals destroy the naturally occurring vitamins, synthetic vitamins are then added back in. Synthetic vitamins don’t have the same benefits as naturally occurring vitamins, and in fact they can be toxic at high doses (hence the hysteria of vitamin A toxicity from taking too much cod liver oil).

The only brand I know of that is cold-processed and contains the naturally occurring vitamins A & D in high amounts is Green Pastures Fermented Cod Liver Oil. Even better, because it’s fermented you’ll also get vitamin K2, which we know from step #5 protects against heart disease.

For more on this, see Separating Fact from Fiction on Cod Liver Oil, and Vitamin D: The New Super-Nutrient?.

7. Be active & go outside.

Physical inactivity is likely a major causative factor in the explosive rise of coronary heart disease in the 20th century. During the vast majority of evolutionary history, humans have had to exert themselves to obtain food and water. Even at the turn of the 20th century in the U.S., a majority of people had jobs that required physical activity (farmers, laborers, etc.) Now the majority of the workforce has sedentary occupations with little to no physical activity at all.

Currently more than 60% of American adults are not regularly active, and 25% of the adult population is completely sedentary. People that are physically inactive have between 1.5x and 2.4x the risk of developing heart disease.

On the other hand, regular exercise reduces both inflammation and oxidative damage. Even relatively low levels of activity are protective – as long as they are consistent. A public review at Harvard University showed that 30-minutes of moderate physical activity on most days of the week decreases deaths from heart disease by 20-30%.

It’s also important to spend time outdoors and get some sun. In addition to the obvious psychological and even spiritual benefits, sunlight exposure will boost your vitamin D levels. Just remember that sunscreen blocks your body from making vitamin D from sunlight.

For more on this, see Throw Away the Sunscreen!

8. Maintain a healthy weight (not too fat or thin)

Countless studies show that obesity causes both inflammation and oxidative damage, and significantly raises the risk of heart disease. For those who are obese, losing weight is perhaps the most important first step to take to reduce their risk profile.

However, most people aren’t aware that being too skinny can also increase the risk of heart disease.

It is also important to keep in mind that where you store body fat is probably more important than how much body fat you have. For example, body fat stored in the legs has consistently been shown to protect against metabolic risk in longitudinal studies. In contrast, abdominal fat, and in particular visceral fat, is independently associated with increased risk of morbidity and mortality.

For more on this, see this excellent offsite article: Get Fat, Live Longer.

9. Don’t smoke and minimize exposure to other toxins

Smoking promotes both oxidative damage and inflammation. Smoking as few as one cigarette a day can increase the risk of heart disease by 40 percent, while smoking 40 cigarettes a day increases the risk by 900 percent.

Over 70,000 synthetic chemicals are used commercially and approximately 1,000 new chemicals are introduced into our environment each year. These include insecticides, herbicides, gasoline, dry cleaning chemicals, personal care products, and more.

Environmental toxins cause both inflammation and oxidative damage, which as you certainly know by now, cause heart disease. Avoid exposure to these toxins as much as possible. Using environmentally friendly cleaning and personal care products in your home is a great start.

10. Manage stress & enjoy life

In the famous INTERHEART study, stress tripled the risk of heart disease. This was true across all countries and cultured that were studies. The primary mechanism by which stress causes heart disease is by dysregulating the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is directly intertwined with the autonomic nervous system, and it governs the “fight-or-flight” response we experience in reaction to a stressor.

Continued activation of this “fight-or-flight” response leads to hyper-arousal of the sympathetic nervous system, which in turn leads to chronically elevated levels of cortisol. And elevated levels of cortisol can cause both inflammation and oxidative damage.

Stress management, then, should be a vital part of any heart disease prevention program. In fact, some researchers today believe that stress may be the single most significant factor in the cause and prevention of heart disease. There are several proven methods of stress reduction, including mindfulness-based stress reduction (MBSR), acupuncture and biofeedback. It doesn’t matter which method you choose. It just matters that you do it, and do it regularly.

If you follow these ten steps, you will dramatically reduce your risk of not only heart disease, but also diabetes, metabolic syndrome and almost every non-communicable modern disease. You’ll also have more energy, sleep better and improve your quality of life. So what do you have to lose? Sure beats taking dangerous statin drugs.

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important

Summary:

  • The simplified view of cholesterol as “good” (HDL) or “bad” (LDL) has contributed to the continuing heart disease epidemic
  • Not all LDL cholesterol is created equal. Only small, dense LDL particles are associated with heart disease, whereas large, buoyant LDL are either benign or may protect against heart disease.
  • Replacing saturated fats with carbohydrates – which has been recommended by the American Heart Association for decades – reduces HDL and increases small, dense LDL, both of which are associated with increased risk of heart disease.
  • Dietary cholesterol has a negligible effect on total blood LDL cholesterol levels. However, eating eggs every day reduces small, dense LDL, which in turn reduces risk of heart disease.
  • The best way to lower small, dense LDL and protect yourself from heart disease is to eat fewer carbs (not fat and cholesterol), exercise and lose weight.

Not all cholesterol is created equal

By now most people have been exposed to the idea of “good” and “bad” cholesterol. It’s yet another deeply ingrained cultural belief, such as the one I wrote about last week, that has been relentlessly driven into our heads for several decades.

But once we’ve put on our Healthy Skeptic goggles, which I know all of you fair readers have, we no longer simply believe what we’re told by the medical establishment or mainstream media. Nor are we impressed or in any way swayed by the number of people that tell us something is true. After all, as Anatole France said, “Even if fifty million people say a foolish thing, it is still a foolish thing.”

Words to live by.

The oversimplified view of HDL cholesterol as “good” and LDL cholesterol as “bad” is not only incomplete, it has also directly contributed to the continuing heart disease epidemic worldwide.

But before we discover why, we first have to address another common misconception. LDL and HDL are not cholesterol. We refer to them as cholesterol, but they aren’t. LDL (low density lipoprotein) and HDL (high density lipoprotein) are proteins that transport cholesterol through the blood. Cholesterol, like all fats, doesn’t dissolve in water (or blood) so it must be transported through the blood by these lipoproteins. The names LDL and HDL refer to the different types of lipoproteins that transport cholesterol.

In addition to cholesterol, lipoproteins carry three fat molecules (polyunsaturated, monounsaturated, saturated – otherwise known as a triglyceride). Cholesterol is a waxy fat particle that almost every cell in the body synthesizes, which should give you some clue about its importance for physiological function.

You do not have a cholesterol level in your blood, because there is no cholesterol in the blood. When we speak of our “cholesterol levels”, what is actually being measured is the level of various lipoproteins (like LDL and HDL).

Which brings us back to the subject at hand. The consensus belief, as I’m sure you’re aware, is that LDL is “bad” cholesterol and HDL is “good” cholesterol. High levels of LDL put us at risk for heart disease, and low levels of LDL protect us from it. Likewise, low levels of HDL are a risk factor for heart disease, and high levels are protective.

It such a simple explanation, and it helps drug companies to sell more than $14 billion dollars worth of “bad” cholesterol-lowering medications to more than 24 million American each year.

The only problem (for people who actually take the drugs, rather than sell them, that is) is the idea that all LDL cholesterol is “bad” is simply not true.

In order for cholesterol-carrying lipoproteins to cause disease, they have to damage the wall of an artery. The smaller an LDL particle is, the more likely it is to do this. In fact, a 1988 study showed that small, dense LDL are three times more likely to cause heart disease than normal LDL.

On the other hand, large LDL are buoyant and easily move through the circulatory system without damaging the arteries.

Think of it this way. Small, dense LDL are like BBs. Large, buoyant LDL are like beach balls. If you throw a beach ball at a window, nothing happens. But if you shoot that window with a BB gun, it breaks.

Another problem with small LDL is that they are more susceptible to oxidation. Oxidized LDL, or oxLDL, is formed when the fats in LDL particles react with oxidation and break down.

Researchers have shown that the smaller and denser LDL gets, the more quickly it oxidizes when they subject it to oxidants in a test tube.

Why does this matter? oxLDL is a far greater risk factor for heart disease than normal LDL. A large prospective study by Meisinger et al. showed that participants with high oxLDL had more than four times the risk of a heart attack than patients with lower oxLDL.

I hope it’s clear by now that the notion of “good” and “bad” cholesterol is misleading and incomplete. Not all LDL cholesterol is the same. Large, buoyant LDL are benign or protect against heart disease, whereas small, dense LDL are a significant risk factor. If there is truly a “bad” cholesterol, it is small LDL. But calling all LDL “bad” is a dangerous mistake.

Low-fat, high-carb diets raise “bad” cholesterol and lower “good” cholesterol

Here’s where the story gets even more interesting. And tragic.

Researchers working in this area have defined what they call Pattern A and Pattern B. Pattern A is when small, dense LDL is low, large, buoyant LDL is high, and HDL is high. Pattern B is when small, dense LDL is high, HDL is low, and triglycerides are high. Pattern B is strongly associated with increased risk of heart disease, whereas Pattern A is not.

It is not saturated fat or cholesterol that increases the amount of small, dense LDL we have in our blood. It’s carbohydrate.

Dr. Ronald Krauss has shown that reducing saturated fat and increasing carbohydrate intake shifts Pattern A to Pattern B – and in the process significantly increases your risk of heart disease. Ironically, this is exactly what the American Heart Association and other similar organizations have been recommending for decades.

In Dr. Krauss’s study, participants who ate the most saturated fat had the largest LDL, and vice versa.

Krauss also tested the effect of his dietary intervention on HDL (so-called “good” cholesterol). Studies have found that the largest HDL particles, HDL2b, provide the greatest protective effect against heart disease.

Guess what? Compared to diets high in both total and saturated fat, low-fat, high-carbohydrate diets decreased HDL2b levels. In yet another blow to the American Heart Association’s recommendations, Berglund et al. showed that using their suggested low-fat diet reduced HDL2b in men and women of diverse racial backgrounds.

Here’s what the authors said about their results:

The results indicate that dietary changes suggested to be prudent for a large segment of the population will primarily affect [i.e., reduce] the concentrations of the most prominent antiatherogenic [anti-heart attack] HDL subpopulation.

Translation: following the advice of the American Heart Association is hazardous to your health.

Eating cholesterol reduces small LDL

The amount of cholesterol in the diet is only weakly correlated with blood cholesterol levels. A recent review of the scientific literature published in Current Opinion in Clinical Nutrition and Metabolic Care clearly indicates that egg consumption has no discernible impact on blood cholesterol levels in 70% of the population. In the other 30% of the population (termed “hyperresponders”), eggs do increase both circulating LDL and HDL cholesterol.

Why is this? Cholesterol is such an important substance that its production is tightly regulated by the body. When you eat more, the body produces less, and vice versa. This is why the amount of cholesterol you eat has little – if any – impact on the cholesterol levels in your blood.

Eating cholesterol is not only harmless, it’s beneficial. In fact, one of the best ways to lower small, dense LDL is to eat eggs every day! Yes, you read that correctly. University of Connecticut researchers recently found that people who ate three whole eggs a day for 12 weeks dropped their small-LDL levels by an average of 18 percent.

If you’re confused right now I certainly don’t blame you.

Let’s review what we’ve been told for more than 50 years:

  1. Eating saturated fat and cholesterol in the diet raises “bad” cholesterol in the blood and increases the risk of heart disease.
  2. Reducing intake or saturated fat and cholesterol protects us against heart disease.

Now, let’s examine what credible scientific research published in major peer-reviewed journals in the last decade tells us:

  1. Eating saturated fat and cholesterol reduces the type of cholesterol associated with heart disease.
  2. Replacing saturated fat and cholesterol with carbohydrates lowers “good” (HDL) cholesterol, raises triglyceride levels, and increases our risk of heart disease.

Dr. Krauss, the author of one of the studies I mentioned above, recently said in an interview published in Men’s Health, “Everybody I know in the field — everybody — recognized that a simple low-fat message was a mistake.”

In other words, the advice we’ve been given by medical “authorities” over the past half century on how to prevent heart disease is actually causing it.

I don’t know about you, but that makes me very angry. Heart disease is the #1 cause of death in the US. Almost 4 in 10 people who die each year die of heart disease. It directly affects over 80 million Americans each year, and indirectly affects millions more.

We spend almost half a trillion dollars treating heart disease each year. To put this in perspective, the United Nations has estimated that ending world hunger would cost just $195 billion.

Yet in spite of all this money spent, the best medical authorities can do is tell us the exact opposite of what we should be doing? And they continue to give us the wrong information even though researchers have known that it’s wrong for at least the past fifteen years?

Really?

Sometimes it seems like everything is backwards.

How to reduce small LDL

Eating fewer carbs is perhaps the best place to start. Reducing carbs has several cardio-protective effects. It reduces levels of small, dense LDL, reduces triglycerides, and increases HDL levels. A triple whammy.

Exercise and losing weight also reduce small, dense LDL. In fact, weight loss has been shown to reverse the evil Pattern B all by itself.

As we saw above, eating three eggs a day can reduce our small LDL by almost 20%. Interestingly, alcohol has also been shown to reduce small LDL by 20%.

In other words, if you want to reduce your risk of heart disease, do the opposite of the American Heart Association (and probably your doctor) tells you to do. Eat butter. Eat eggs. Eat traditional animal fats. Reduce your intake of carbs, vegetable oils and processed foods, and stay active and within a healthy weight range.

Testing your small LDL level

I’m not a fan of arbitrary testing. Our medical system is obsessed with testing. But where has testing has brought us with cholesterol and heart disease? Has it improved outcomes? On the contrary, we test for a number (total LDL) that tells us very little, and then medicate it downwards recklessly and expensively.

If you’re worried about your small LDL level, my advice would be to eat fewer carbohydrates, eat plenty of saturated fat and cholesterol (instead of vegetable oils), exercise, lose weight if you need to, and have a drink every now and then! Since this is the same advice I’d give you if you took a test that actually showed high levels of small LDL, I don’t see much value in doing the test.

However, if you need to see the test results to get motivated to make the changes I suggested above, by all means do the test. There are a few ways to go about it.

First, keep in mind that a regular cholesterol test at your doctor won’t tell you anything about your small LDL level. The standard tests measure your total cholesterol, LDL and HDL. But they don’t distinguish between the dangerous small LDL and benign or protective large LDL.

The fastest and cheapest, albeit most indirect, route is to test your blood sugar both before and then 60 minutes after a meal (this is called a “post-prandial” glucose test). The reason a post-prandial blood glucose test can be a rough indicator for small LDL is the same foods that trigger a rise in blood sugar also increase small LDL. Namely, carbohydrates.

Blood glucose monitors are readily available at places like Walgreens and cost about $10. You’ll also need lancets and test strips, which aren’t expensive either. If your post-prandial glucose is higher than 120 mg/dl, that may be suggestive of a higher than desired small LDL level. This test is not a perfect approximation of small LDL, but it’s the cheapest and and easiest way to get a sense of it.

If you want to get more specific, there are two tests I recommend for small LDL that use slightly different methodology:

  1. LDL-S3 GGE Test. Proteins from your blood are spread across a gel palette. As the molecules move from one end to the other, the gel becomes progressively denser. Large particles of LDL cholesterol can’t travel as far as the small, dense particles can, Dr. Ziajka says. After staining the gel, scientists determine the average size of your LDL cholesterol particles. Berkeley Heart Lab. About $15 with insurance.
  2. The VAP Test. Your sample is mixed into a solution designed to separate lipoproteins by density. Small, dense particles sink, and large, fluffy particles stay at the top. The liquid is stained and then analyzed to reveal 21 different lipoprotein subfractions, including dominant LDL size. The Vap Test. Direct cost is $40.

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coffinFor more than five decades we’ve been brainwashed to believe that saturated fat causes heart disease. It’s such a deeply ingrained belief that few people even question it. It’s just part of our culture now.

Almost every day one of my patients in the clinic tells me proudly that they have a “healthy” diet because they don’t eat butter, cheese or red meat or any other foods high in saturated fat (nevermind that red meat isn’t particularly high in saturated fat, but that’s a subject for another post). Or I might overhear someone at the grocery store saying how much they prefer whole fat yogurt to the low-fat version, but they eat the low-fat stuff anyways because they want to make the “healthy” choice.

What most people don’t realize is that it took many years to convince people that eating traditional, animal fats like butter and cheese is bad for you, while eating highly-processed, industrial vegetable oils like corn and soybean oil is good for you. This simply defied common sense for most people. But the relentless, widespread campaign to discredit saturated fat and promote industrial oils was eventually successful.

What if I told you that there’s absolutely no evidence to support the idea that saturated fat consumption causes heart disease? What if I told you that the 50+ years of cultural brainwashing we have all been subject to was based on small, poorly designed studies? And what if I told you that a review of large, well-designed studies published in reputable medical journals showed that there is absolutely no association between saturated fat and heart disease?

Well, that’s what I’m telling you. We’ve beed duped. Blindsided. Lied to. And we’ve suffered greatly as a result. Not only have we suffered from being encouraged to eat packaged and processed foods made with cheap, tasteless vegetable oils, but these very oils we were told would protect us from heart disease actually promote it! See my article How to Increase Your Risk of Heart Disease for more on that.

The recent review I’m talking about is a meta-analysis published this week in the American Journal of Clinical Nutrition. It pooled together data from 21 unique studies that included almost 350,000 people, about 11,000 of whom developed cardiovascular disease (CVD), tracked for an average of 14 years, and concluded that there is no relationship between the intake of saturated fat and the incidence of heart disease or stroke.

Let me put that in layman’s terms for you:

Eating saturated fat doesn’t cause heart disease.

There. That’s it. That’s really all you need to know. But if you’d like to read more about it, John Briffa and Chris Masterjohn have written articles about it here and here.

I wonder how long it will take for this information to trickle down into the mainstream culture? Unfortunately it’s not going to happen overnight. Paradigm shifts don’t work that way. But I’ve seen some positive signs, and I do believe the tide is turning. Let’s hope it doesn’t take another 50 years.

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statinsDr. John Briffa wrote a post worth reading on his blog today about the significant side effects of statin drugs, and the considerable effort pharmaceutical companies and the medical establishment spend trying to convince people that these drugs are safe.

Sadly, they’ve been largely successful. Some time ago a physician in the UK by the name of Dr. John Reckless (you can’t make this stuff up) suggested that statins are so safe that they should be put in the water supply!

That’s ridiculous, of course. Statins are dangerous drugs. What’s more, they don’t reduce the risk of total mortality (death from any cause) for 95% of the population. See my articles The Truth About Statin Drugs and More Statin Shenanigans for more on this.

If you’re wondering why you haven’t heard more about the danger of statin drugs, check out another great post Dr. Briffa wrote a couple of weeks ago called Adverse effects of drugs are “neglected, restricted, distorted or silenced”.

There’s big money in the drug business, folks. The total pharmaceutical industry is worth hundreds of billions, and drug companies make $25 billion on statin sales alone. Do you think they’re going to go out of their way to tell everyone about the side effects and risks of these drugs? They’re legally obligated to maximize profits for their shareholders, as are all corporations, and maximizing profits means selling as many pills as they can.

That’s just the way it works. Unfortunately, people like you and I and our families are the victims of this profit-driven health care system.

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caution signFor the last 50 years mainstream medical “authorities” have been hammering it into our heads that high cholesterol levels are dangerous and low cholesterol levels are desirable; that eating saturated fat is bad for us; and that a low-fat, high carbohydrate diet is healthy and helps people lose weight.

If you’re a new reader, you might be surprised to learn that there’s very little evidence to support these recommendations and plenty of evidence that contradicts them. Long ago I learned that if I wanted to live a long, healthy life it was in my best interest to ignore the dietary advice of the medical mainstream. And of course that’s why I started this blog – to share this information with all of you so you can make educated, and informed choices about your health.

Lately I’ve been encouraged by the number of studies being published that undermine the anti-fat, anti-cholesterol dogma we’ve been brainwashed with for so long. This is good news.

The bad news is that paradigm shifts do not happen overnight. It took half a century for researchers and doctors to convince people that eating toxic, highly processed, nasty-tasting vegetable oils was somehow better for them than eating traditional animal fats like butter and lard; that eating dry bagels, boneless-skinless chicken breast and salad with fat-free dressing was a path to good health; and that the best way to lose weight was to eat a highly unnatural diet high in processed, refined carbohydrates and low in fat.

So I don’t expect these ideas to disappear anytime soon, in spite of the solid evidence being published that contradicts them. It’s going to take time. But my sense is that it will take less time to convince people that eating traditional, nutrient-dense, whole foods that have been minimally processed is better for them than eating what the industrial food conglomerates have been selling us.

Here are the three studies.

The first is yet another study that associates low cholesterol with an increase in the risk of death (total mortality). It showed increased death rates in hospitalized patients with low cholesterol levels.

CONCLUSIONS: In our cohort, lower LDL-cholesterol at admission was associated with decreased 3-year survival in patients with NSTEMI.

This shouldn’t be a surprise. There’s already plenty of evidence suggesting low cholesterol increases the risk of death – as well as contributing to other conditions such as cancer and depression. For more on this see my previous article Cholesterol Doesn’t Cause Heart Disease.

The second study shows (once again) that cutting carbs is the best way to lose weight and fight obesity.

No surprise here either. Countless studies, trials and reviews have demonstrated that low-carb diets are superior for weight loss, managing diabetes and preventing many of the other modern diseases which plague us. How long will it take until doctors and the media get the message? For more on one such recent review, see Low-carb Diet Best for Weight Loss.

The last study I want to share with you was performed by a Swedish PhD student. It demonstrates that children who eat saturated fat and full-cream dairy products are healthier than those who do not.

Conclusions: BMI correlated strongly to fat mass and leptin was the best marker of overweight and fat mass in 8-year-olds. Food choice was similar to that at 4 years of age. An intake of fat fish once a week was associated with higher serum concentrations of n-3 fatty acids. Saturated fat and intake of full fat milk were inversely associated with BMI. Serum phospholipid fatty acids were associated with bone mineralisation. The results for metabolic markers may provide preliminary reference intervals in healthy children.

If you’re surprised by this, read my recent post Have Some Butter with Your Veggies as well as Whole Fat Milk: Benefits for Moms and Kids.

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butterYes, yes, I’m supposed to be on sabbatical but sometimes I just can’t resist. A Swedish study recently published in the International Journal of
Environmental Research and Public Health
found that eating fruits and vegetables didn’t lower the risk of coronary heart disease… unless said fruits and vegetables were consumed with high-fat dairy products!

Why would this be? The answer is simple biochemistry. Many of the vitamins and micronutrients in food are fat-soluble, which means they cannot be absorbed without the presence of adequate fat. That means that if you eat fruits or vegetables without fat, you’ll absorb only a fraction of the nutrients you would absorb if you ate them with fat.

Tara Parker-Pope, the health columnist for the Wall Street Journal, wrote an article about this some time back. She actually gives the ratios of nutrient absorption with and without accompanying fat.

She reports on a study of the nutrient absorption from fat-free salsa with and without extra fat:

For the salsa study, 11 test subjects were first given a meal of fat-free salsa and some bread. Another day, the same meal was offered, but this time avocado was added to the salsa, boosting the fat content of the meal to about 37% of calories. In checking blood levels of the test subjects, researchers found that the men and women absorbed an average of 4.4 times as much lycopene and 2.6 times as much beta carotene when the avocado was added to the food.

And here’s a study with and without avocado:

The first salad included romaine lettuce, baby spinach, shredded carrots and a no-fat dressing, resulting in a fat content of about 2%. After avocado was added, the fat content jumped to 42%. When the salad was consumed with the avocado, the 11 test subjects absorbed seven times the lutein and nearly 18 times the beta carotene. Lutein is a carotenoid found in many green vegetables and is linked with improved eye and heart health.

Another study done a few years ago at Ohio State University showed that salad dressing with oil brings out the best in a salad when compared to no-fat, low-fat dressings.

When the seven test subjects consumed salads with no-fat dressing, the absorption of carotenoids was negligible. When a reduced-fat dressing was used, the added fat led to a higher absorption of alpha and beta carotene and lycopene. But there was substantially more absorption of the healthful compounds when full-fat dressing was used.

Consuming adequate amounts of fat with fruits and veggies is especially true in the case of children. Vitamins and micronutrients are crucial for proper physical and mental development. Without adequate fat in the diet, children are literally starved of these nutrients.

Parents will often be very worried if their toddler doesn’t like vegetables. But Dr. Tom Cowan, a practitioner of functional medicine in San Francisco, CA, counsels such parents not to be too concerned about vegetable intake in the first few years of a child’s life. It’s far more important to ensure that the child is getting adequate saturated fat. What’s more, most parents find that if they slather some butter on the veggies they’re serving, their kids actually like them!

So, next time you eat broccoli or feed it to your kids, remember to add a big pat of butter! And have some full-fat cream with those strawberries while you’re at it.

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devolutionResearch by an Iowa State University scientist due to be published this month in the journal Proceedings of the National Academy of Sciences indicates that cholesterol-lowering drugs (statins) may lessen brain function.

The results of the study show that drugs that inhibit the liver from making cholesterol may also keep the brain from making cholesterol, which is vital to efficient brain function.

“If you deprive cholesterol from the brain, then you directly affect the machinery that triggers the release of neurotransmitters,”, said Yeon-Kyun Shin, the lead researcher. “Neurotransmitters affect the data-processing and memory functions. In other words – how smart you are and how well you remember things.”

Cholesterol is abundant in the tissue of the brain and nervous system. Myelin, which covers nerve axons to help conduct the electrical impulses that make movement, sensation, thinking, learning, and remembering possible, is over one fifth cholesterol by weight. Even though the brain only makes up 2% of the body’s weight, it contains 25% of its cholesterol.

We now know that the formation of synapses, or connections between neurons, is directly dependent on the availability of cholesterol.

The formation of these synapses are what give us the ability to remember and learn. The benefits of sleep for memory formation and learning are in part a result of increased cholesterol synthesis during sleep.

“If you try to lower the cholesterol by taking medicine that is attacking the machinery of cholesterol synthesis in the liver, that medicine goes to the brain too. And then it reduces the synthesis of cholesterol which is necessary in the brain,” said Shin.

This study is yet another strike against statin drugs, which have numerous side effects and are not effective in reducing mortality for the vast majority of the population. Please see my recent article, The Truth About Statin Drugs, for more on why statins are probably not a good idea for you and your loved ones.

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inflammationA recent study published in the American Journal of Pathology adds to the already considerable body of evidence which suggests that inflammation is a primary cause of heart attacks and strokes.

In an article I wrote last year, Preventing Heart Disease Without Drugs, I reviewed the current scientific understanding of what causes heart disease. If you’ve been following this blog, you know that inflammation and oxidative damage – not saturated fat and cholesterol – are the primary causes of heart disease.

I wrote:

Inflammation is the body’s response to noxious substances. Those substances can be foreign, like bacteria, or found within our body, as in autoimmune diseases like rheumatoid arthritis. In the case of heart disease, inflammatory reactions within atherosclerotic plaques can induce clot formation.

When the lining of the artery is damaged, white blood cells flock to the site, resulting in inflammation. Inflammation not only further damages the artery walls, leaving them stiffer and more prone to plaque buildup, but it also makes any plaque that’s already there more fragile and more likely to burst.

Oxidative damage is a natural process of energy production and storage in the body. Oxidation produces free radicals, which are molecules missing an electron in their outer shell. Highly unstable and reactive, these molecules “attack” other molecules attempting to “steal” electrons from their outer shells in order to gain stability. Free radicals damage other cells and DNA, creating more free radicals in the process and a chain reaction of oxidative damage.

Normally oxidation is kept in check, but when oxidative stress is high or the body’s level of antioxidants is low, oxidative damage occurs. Oxidative damage is strongly correlated to heart disease. Studies have shown that oxidated LDL cholesterol is 8x greater stronger a risk factor for heart disease than normal LDL.

The data from this study provide further support for the “oxidative response to inflammation” hypothesis described above. The researchers found that inflammation leads to a reduction of mature collagen in atherosclerotic plaques, leading to thinner caps that are more likely to rupture. This is important because other studies have shown that it is not atherosclerosis alone, but the rupture of the atherosclerotic plaques, that causes heart attacks and strokes.

It follows, then, that if we want to prevent heart disease we need to do everything we can to minimize inflammation and oxidative damage.

Top four causes of oxidative damage & inflammation

  1. Stress
  2. Smoking
  3. Poor nutrition
  4. Physical inactivity

By focusing on reducing or completely eliminating, when possible, the factors in our life that contribute to oxidative stress and inflammation, we can drastically lower our risk for heart disease.

For more in-depth information about each of these factors and how to minimize your risk of heart disease without drugs, please refer to Preventing Heart Disease Without Drugs.

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eggs

ATTN: Bay Area Healthy Skeptic readers!

I am once again offering my free public talk next week in Berkeley, CA which debunks the myth that cholesterol causes heart disease. We’ll also explore the true causes of heart disease as well as simple dietary and lifestyle changes you can make to protect yourself and your loved ones.

If you have family or friends that live in the area that might benefit from this information, please let them know about the talk.

Thursday, January 29th from 7:00 – 9:00 PM

Acupuncture & Integrated Medicine College, Berkeley (AIMC Berkeley)
2550 Shattuck Avenue (at Blake)

10-minute walk south on Shattuck from Downtown Berkeley BART

510.666.8248 ext. 106

www.aimc.edu

For over 50 years, the medical establishment has vigorously promoted the notion that high cholesterol is a primary risk factor for coronary heart disease, and that a diet high in saturated fat and cholesterol causes heart disease. These hypotheses are widely accepted as fact by physicians and the general public alike, despite the overwhelming body of evidence that suggests otherwise.

During this two-hour talk, we’ll review scientific studies demonstrating that:

  1. High cholesterol is not the primary of cause heart disease..
  2. Diets high in saturated fat and cholesterol don’t cause heart disease.
  3. Consumption of so-called “heart healthy” vegetable oils is linked to heart disease, cancer and many other conditions.
  4. Statin drugs don’t reduce the risk of death for most people, and have dangerous side effects and complications.

You’ll also learn the latest theories on what causes heart disease and a truly “heart healthy” approach to diet and lifestyle that is supported by both modern science and centuries of traditional wisdom.

The presentation draws on more than 150 peer-reviewed studies published in major journals and the work of an impressive list of physicians, scientists and researchers who question the connection between cholesterol and heart disease.

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pregnant womanBack in July I posted an article called Statins For Pregnant Women and Kids? criticizing a research study that actually recommended statins for pregnant women.

Well, it appears that even mainstream scientists are beginning to acknowledge the very real risks that statins present for pregnant mothers and fetuses.

Current clinical guidelines already recommend that women who are pregnant should stop taking statins but the advice is based on the knowledge that cholesterol is essential for normal fetal development.

But new research from The University of Manchester has shown that even water-soluble or ‘hydrophilic’ statins, such as pravastatin, can affect placental development leading to worse pregnancy outcomes.

According to Dr. Melissa Westwood, a Senior Lecturer in Endocrinology based at the Maternal and Fetal Health Research Centre at St. Mary’s Hospital, Manchester:

“Our study examined the effects that both lipophilic and hydrophilic statins had on a key biological system that is crucial for maintaining the normal function of the placenta, which acts as the nutrient-waste exchange barrier between mother and fetus.”

Fat-soluble statins like cerivastatin were already known to adversely affect the placenta, resulting in reducing growth. But the researchers also found that pravastatin – the water-soluble statin thought to be potentially compatible for use in pregnancy – had the same detrimental effect.

“These results clearly show that the effect of statins on the placenta is not dependent on their lipophilicity as had previously been suggested,” said Dr Westwood, whose findings are published in the Journal of Cellular and Molecular Medicine.

“While hydrophilic statins have not been reported to increase the incidence of fetal malformations, our research suggests that they will have a detrimental effect on placental growth, which is likely to result in poor pregnancy outcome.

“Healthcare professionals should continue to advise women to avoid the use of any type of statin once they plan to start a family or when a pregnancy is suspected or confirmed.

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