Trying to prevent heart disease by lowering cholesterol is like trying to prevent obesity by cutting the lettuce out of your Big Mac.
Surprised? Read on.
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” (now the number 1 best-seller on Amazon in the category of heart disease).
We believe that a weird admixture of…
- 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:
- oxidative damage
These are things we can actually do something about using food, supplements and lifestyle changes, none of which have the costs—nor the considerable side effects—of drugs.
First, let’s start with some surprising facts.
- Cholesterol is a minor player in heart disease
- 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
- Lowering cholesterol has an extremely 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, but getting the information out there is difficult. (The two top cholesterol lowering medications, Lipitor and Zocor, together bring in roughly 34 billion dollars a year for their makers, who have a strong vested interest in keeping the cholesterol theory alive. And they’re hardly the only ones who do.)
But if you’re willing to consider breaking with conventional thinking for a minute, consider the following study, just one of the many we discuss in the book.
The Lyon Diet-Heart Study
In the 1990’s, French researchers decided to run an experiment- known as the Lyon Diet-Heart Study– to test the effect of different diets on heart disease.
They took two groups of men who had every risk factor for heart disease imaginable. 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)
- The other half were advised to eat a Mediterranean diet high in fish, omega-3’s, vegetables and monounsaturated fat like olive oil
The study was stopped midway because the reduction in heart attacks in the Mediterranean group was so pronounced—70%!!—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 70% reduction in deaths? You’d think they must have dropped like a rock, right?
Think again. Their cholesterol levels didn’t budge, and 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 that can be caused by anything from high blood pressure to toxins attract all sorts of metabolic riff-raff, from bacteria to oxidized (damaged) LDL particles; the immune system sends inflammatory cytokines to the area, and more oxidation and inflammation takes place eventually resulting in the growth of plaque and, ultimately, to an increased risk for heart disease. If there were no inflammation, the arteries would be clear.
The following is my seven 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. The stress hormones create inflammatory events that may explain why 40% of atherosclerotic patients have no other risk factors.
Pay attention to these seven 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. The fruit and vegetable kingdom is teeming with natural anti-inflammatories like quercetin (apples and onions) and curcumin (turmeric). Drink green tea and pomegranate juice. Balance your protein and fat with tons of vegetables. And eat dark chocolate—it’s cocoa flavanols help lower blood pressure and keep the cardiovascular system healthy.
- Reduce grains, starches, sugar and omega-6’s (vegetable oils). Every one of these has the power to increase inflammation—a lot!
- Manage Your Stress. Stress is an enormous risk factor for heart disease, and is inflammatory as well. Find a way to manage it. Anything from regular walks in the park to deep breathing exercises to warm baths can help.
- Exercise. It’s probably the best anti-aging (and heart protective) drug on the planet
- Drink only in moderation. And if you don’t process the word “moderation” very well, don’t drink at all.
- Don’t smoke. Probably the number one recommendation for heart disease prevention.
- Supplement with antioxidants, vitamin C, Coenzyme Q10, omega-3’s, curcumin, citrus bergamont. Antioxidants like vitamin C protect against oxidative damage (one of the promoters of heart disease) while omega-3’s are one of the most anti-inflammatory molecule on earth. Curcumin does just about everything—it’s an anti-inflammatory and antioxidant.
The Statin Scam
And one more thing—if your doctor wants to put you on a statin drug, push back. Ask for the newer (and far more important) cholesterol particle tests, which go well beyond old-fashioned measurements like “good” and “bad” cholesterol and actually tell you what type of LDL you have. (LDL-a is pretty harmless; LDL-b is not.) If you’re a woman, be aware that there’s no evidence that statin drugs save lives in women (or children!) Know that in a number of studies, statin users have a higher risk for diabetes. And that in older people, higher cholesterol is actually protective. (If your doctor doubts that, refer him to the Framingham Study!)
Statin drugs have many potential side effects, including muscle pain and weakness, memory loss, diminished libido and fatigue. Finally, know that the only population for which a modest—repeat, modest—benefit for statin drugs has been consistently shown is middle aged men with existing cardiovascular disease (previous heart attack). And many health professionals suspect that even this extremely modest benefit is probably due to the anti-inflammatory nature of statins, rather than their ability to lower cholesterol.
The Bottom Line
Lowering cholesterol and lowering the risk of heart disease are very far from the same thing.
The latter is important.
The former is almost irrelevant.