What if the long-held cholesterol-heart disease link is largely bro-science? This expert argues precisely that—and names the heart killers that should worry you instead. Trying to prevent heart disease by lowering cholesterol is like trying to prevent obesity by cutting out lettuce. Surprised? Read on.
Last year, cardiologist Stephen Sinatra, M.D., and I came together to write a book titled The Great Cholesterol Myth: Why Lowering Cholesterol Won’t Prevent Heart Disease–And The Statin-Free Plan That Will. We believe that a weird admixture of misinformation, scientifically questionable studies, corporate greed, and deceptive marketing has conspired to create one of the most indestructible and damaging myths in medical history: that cholesterol causes heart disease.
The real tragedy is that by putting all our attention on cholesterol, we’ve virtually ignored the real causes of heart disease: inflammation, oxidative damage, stress, and sugar. These are things we can actually do something about using food, supplements and lifestyle changes, none of which have the costs—or the side effects—of prescription drugs.
First, let’s start with some surprising facts:
– Cholesterol levels are a poor predictor of heart attacks.
– Half of heart attacks happen to people with normal cholesterol.
– Half the people with elevated cholesterol have healthy hearts.
It turns out that cholesterol is actually a minor player in heart disease, and that lowering cholesterol has a surprisingly limited benefit. I haven’t come to these conclusions lightly, and I wouldn’t expect you to take them at face value. The case against cholesterol as a cause of heart disease, or even as an important marker for it, has been crumbling steadily for decades.
Yet getting the information out there is difficult. The two top cholesterol-lowering medications, Lipitor and Zocor, together bring in roughly $34 billion each year for their makers, who have a vested interest in keeping the cholesterol theory alive. And they’re hardly the only ones who do.
The Lyon Diet-Heart Study
In the 1990s, French researchers decided to run an experiment to test the effect of different diets on heart disease.
The Lyon Diet-Heart Study took two groups of men who had every risk factor imaginable for heart disease. All of them had survived a heart attack. They had high cholesterol, they smoked, they didn’t exercise, and they had high levels of stress.
Half the men were advised to eat the American Heart Association “prudent” diet (low saturated fat and cholesterol), while the other half were advised to eat a Mediterranean diet high in fish, omega-3 fatty acids, vegetables, and monounsaturated fats such as olive oil.
The study was stopped midway because the reduction in heart attacks in the Mediterranean group was so pronounced—70 percent!—that researchers decided it was unethical to continue. So what do you think happened to the cholesterol levels in the men who ate the Mediterranean diet and had a 70 percent reduction in deaths? You’d think those levels must have dropped like a rock, right?
Think again. Their cholesterol levels didn’t budge; they were just as high when the study was stopped as they were when the study began. The men just stopped dying. Cholesterol had nothing to do with it.
So if cholesterol isn’t the cause of heart disease, what is?
The Real Cause of Heart Disease
Here’s the short answer: The primary cause of heart disease is inflammation. Small injuries to the vascular wall—which can be caused by anything from high blood pressure to toxins—cause oxidized (damaged) LDL particles take up residence in the area. The immune system responds by sending inflammatory cytokines to the “rescue,” eventually resulting in plaque and an increased risk for heart disease. If there were no inflammation, the arteries would be clear.
The following is my six-point program for reducing the risk of heart disease. Note that lowering cholesterol isn’t on it. Note also that managing stress is. Stress is a powerful contributor to heart disease. Stress hormones create inflammatory events that may explain why 40 percent of atherosclerotic patients have no other risk factors.
Pay attention to these six action items, and you just may find that you don’t need to worry quite so much about cholesterol after all:
– Eat an anti-inflammatory diet.
– Reduce intake of grains, starches, sugar and omega-6 fatty acids.
– Manage your stress.
– Don’t smoke.
– Supplement with antioxidants, vitamin C, Coenzyme Q10, omega-3 fatty acids.
The Case for Supplementation
Ask your typical mainstream doctor about nutritional supplements, and the first thing you’re likely to hear is this: “There’s no good research showing they work.” I’ve heard this refrain time and time again when I discuss nutritional medicine with my more conservative colleagues.
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