I’m going to tell you a secret– something that the smartest, most cutting edge health professionals know and have been talking about amongst themselves for a very long time. Get ready to be shocked. High cholesterol doesn’t cause heart disease.
Yes, you read that right, and before you dismiss it, consider this: More than half the people admitted to hospitals with heart disease have “normal” cholesterol while fully half the people with “elevated” cholesterol are healthy as a horse. Yet talk to people about keeping their hearts healthy and you’ll invariably hear someone say, “Yup, gotta do something about my cholesterol”.
Recently, cardiologist Stephen Sinatra and I came together to write a book—“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.
It’s not true. In fact, trying to prevent heart disease by lowering cholesterol is like trying to prevent obesity by cutting out lettuce. The famous Lyon Heart Study (http://www.ncbi.nlm.nih.gov/pubmed/7911176) found that certain dietary and lifestyle changes reduced deaths by 70 percent and reduced cardiovascular deaths by an even more impressive 76 percent, all without making as much as a dent in cholesterol levels.
The Nurses Health Study (http://www.nejm.org/doi/full/10.1056/NEJM200007063430103 ) found that 82 percent of coronary events could probably have been prevented were people to adhere to five lifestyle prescriptions, none of which had anything to do with lowering cholesterol
And that’s just the bare tip of an ever-growing iceberg of the research we review in “The Great Cholesterol Myth”. (http://www.amazon.com/The-Great-Cholesterol-Myth-Disease-/dp/1592335217/ref=sr_1_1?ie=UTF8&qid=1381453353&sr=8-1&keywords=the+great+cholesterol+myth )
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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. Things we can actually do something about using food, supplements and lifestyle changes, none of which have the costs—nor the side effects—of drugs.
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Cholesterol is the parent molecule for the sex hormones and vitamin D. (No wonder loss of libido is one of the most common side effects of cholesterol-lowering medication!) It’s also vitally important in the brain where it lives in a specialized region of the cell membrane called the lipid raft, making communication between cells easier.
Cholesterol is vitally necessary for memory and thinking (loss of memory is one of the most frightening “side effects” of cholesterol-lowering meds). The idea that there is a movement underfoot to put children and teenagers—whose brains have not finished developing—on a statin drug to lower one of the most important molecules for brain function, is an idea that should truly frighten the informed parent.
Want more? The Framingham Heart Study, which began in 1948 and is still going on, actually shows clearly that high cholesterol is protective in older adults—according to lead researcher Dr. William Castelli, (http://archinte.jamanetwork.com/article.aspx?articleid=616375 )those in the study who lived the longest tended to be those in the “highest cholesterol” category.
The real causes of heart disease
So if cholesterol isn’t the cause of heart disease, what is?
The short answer is this: The primary cause of heart disease is inflammation.
Here’s the very simple version of what happens. Small injuries to the vascular wall– injuries that can be caused by anything from high blood pressure to toxins—attract all kinds of biochemical riff-raff (including but not limited to oxidized (damaged) LDL-B particles), which then take up residence in the area.
The immune system responds by releasing inflammatory cytokines creating even more inflammation. More free radicals (oxidative damage) are formed, more inflammation accumulates, and eventually this results in plaque and an increased risk for heart disease.
If there was no inflammation or oxidative damage, the arteries would be clear. Cholesterol is a minor player and certainly not a causal factor.
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Note that I mentioned something called LDL-B particles. Perhaps you’re not familiar with those, but you should be soon. The old “good” and “bad” cholesterol tests are woefully out-of-date, a point we made on the Dr. Oz show. We now know that LDL cholesterol—the so-called “bad” cholesterol—comes in several flavors, and not all of them are bad at all.
LDL-A cholesterol is relatively harmless. LDL-B is not. Your doctor can easily determine which type of LDL you have with a simple test called a particle test. (Google it—it’s offered by several different companies, and insurance sometimes covers it.) The particle test will also tell you the number of particles you have, a number which trumps LDL as a predictor of heart disease ( http://www.lipidjournal.com/article/S1933-2874%2807%2900283-8/abstract any day of the week.
Any other cholesterol test is out-of-date and useless.
And here’s the good news: LDL particle size can be changed by diet. You’re not “stuck” with the bad kind (LDL-B); particle size, number and distribution can change dramatically in response to the right diet.
Hint: the “right diet” is not low-fat!
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Jonny Bowden, PhD, CNS, aka “The Rogue Nutritionist”™ is the best-selling author of 14 books on health, including the number one Amazon best-seller, “The Great Cholesterol Myth: Why Lowering Cholesterol Won’t Prevent Heart Disease and the Statin-Free Plan That Will”. ( http://www.amazon.com/The-Great-Cholesterol-Myth-Disease-/dp/1592335217/ref=sr_1_1?ie=UTF8&qid=1381453353&sr=8-1&keywords=the+great+cholesterol+myth)
