Heart disease is the leading cause of death in the Western world, contributing to about 25% of deaths and leaving many other people affected, and their health compromised through heart attacks and strokes. For this reason alone it is a good idea to reduce our risk of a heart attack or stroke, but it is also costing governments (and ultimately us) billions of dollars in health costs and education, despite this heart disease and the associated risk factors like obesity and diabetes continue to rise.
For the last 30 years the message from the health authorities has been that we need to reduce our cholesterol levels, reduce our fat intake and cut out smoking …. this has all been done yet obesity, diabetes and heart disease rates have continued to steadily climb. Is it possible that we are being told the wrong message? Is it possible that fat intake has nothing to do with heart disease? Is it possible that high cholesterol is not the cause?
What is cholesterol and why do we need it?
Cholesterol is found in every cell in your body, it is there to help produce cell membranes, vitamin D, bile acids (which help you digest fats) and hormones like testosterone, estrogens and your adrenal hormones. Cholesterol helps to repair the damage to cells caused by inflammation, cholesterol is so important for the body that the liver produces most of the cholesterol your body needs.
These days many people are familiar with their cholesterol results and most people have heard of their so called “good cholesterol” which is HDL and they have heard of the “bad cholesterol” which is LDL and some may have heard of the “terribly bad cholesterol” which is VLDL but what does all this mean and is it that simple? The body is incapable of functioning without LDL cholesterol so how did it get such a bad reputation?
HDL is the lipoprotein that transports cholesterol from the bloodstream back to the liver for processing, which is then excreted through the bile and digestive system, which is why it has obtained a reputation for being the “good guy”
LDL delivers cholesterol to the cells in the body where it is used in cell membranes or to make the steroid hormones, the latest research into LDL shows that their are different types of this cholesterol transporter and some are larger and have little affect on oxidation and heart disease, while others are more prone to oxidative damage. It is true that LDL can oxidize in the bloodstream and irritate the blood vessels which is the start of atherosclerosis but many other things can oxidize too, including omega 3 fats and the amino acid methionine, which can oxidize and cause an elevation in Homocysteine, a major indicator for inflammation and heart disease. Yet you would not try and block methionine production as it has other essential functions, you would not reduce your omega 3 intake as this is also important, likewise you should not use statins to block LDL …. the answer is to reduce inflammation and oxidation in the body to reduce heart disease.
Apolipoprotein B is a protein in every LDL particle and is a more accurate way of measuring the harmful portion of LDL and is another strong predictor of heart disease along the with the HDL/ Triglyceride ratio. Whenever I am measuring a clients cholesterol levels I always test for this but at the moment many doctors in Australia are not, it is worthwhile asking for this next time you get your cholesterol done as there is good evidence that LDL particle number and not LDL levels are responsible for atherosclerosis.
Triglycerides are the form that fat takes as it travels to the body’s tissue through the bloodstream. High levels of triglycerides combined with low levels of HDL are more of an indicator of heart disease than LDL or total cholesterol. A high triglyceride level is not caused by a high fat diet but is caused by a high in processed carbohydrates like cereals, breads, pasta’s and sweet treats. High triglyceride levels often go hand in hand with other diet related conditions like diabetes.
Cholesterol levels and Food
The cholesterol that we eat comes mainly from animal proteins like eggs and meat, and especially the poor old cholesterol rich egg, these foods have had a bad reputation for causing high cholesterol for many years. The cholesterol we eat has little to do with the cholesterol in our bloodstream which is why those foods do not cause high cholesterol. The liver makes about 75% of our cholesterol and we usually eat about 25%, if we decide to try and limit cholesterol in our diet the liver will just produce more, likewise if we are eating lots of cholesterol rich foods the liver will just make less, cholesterol from food is actually poorly absorbed by the body so most cholesterol found in the blood is actually made by the liver.
With fat consumption in our diet going down over the past 30 years, millions of people around the western world taking medications to lower cholesterol levels yet heart disease and diabetes rates have steadily climbed over this time so what does cause heart disease?
What about Statins
Pharmaceutical companies have spent a lot of time and money “educating” doctors on the dangers of cholesterol levels, much of the research into statin medications and cholesterol has been funded by pharmaceutical companies, the research is obviously biased by the billions of dollars that they make from their top selling drug. Another reason why drug companies love cholesterol medications is that people are told they have to take them for the rest of their lives to reduce their risk of a heart attack, so the profits will keep coming in.
While statin medications have been shown to reduce cholesterol, they have not been shown to reduce heart disease in the average person who has “high” cholesterol levels but has never had a heart attack. In fact just as many people with normal cholesterol levels have heart attacks compared to people with high cholesterol. They do cause a slight reduction in heart attacks in people who have already had a heart attack, possibly due to the anti-inflammatory affect rather than the cholesterol lowering affect.
There are a number of side affects of statin medications including
- lowering Co-enzyme Q10 levels which is important for energy production, helps lower blood pressure and is an important nutrient for heart function.
- increase in liver problems, especially for people on a higher dose
- muscle toxicity, leading to fatigue, muscle aches and cramping
- may cause brain fog and memory issues which is the last thing you need as you get older
- increase in cancer risk
How to reduce cardiovascular risk
We have mentioned that high triglycerides and high LDL particle number as measured by apolipoprotein B are indicators of cardiovascular disease, so how do we reduce these! Nutrition and lifestyle changes can make a big difference, it is just not the typical reduce fat message that government health authorities around the world keep telling us (with an exception to Sweden who have just changed the health policy to recommend a high fat low processed carbohydrate diet)
- reduce processed carbohydrates like breads, cereals, biscuits and other high sugar foods and drinks
- reducing saturated animal fats and replacing with polyunsaturated vegetable oils has been shown in recent research to increase cardiovascular disease which is the opposite of what we have been told for years. The oils to look for must say cold pressed like olive oil, macadamia oil and coconut oil while the ones to avoid are the soybean oil, rice bran oil, canola oil and any other oil that does not say cold pressed.
- Increase consumption of salads and vegetables with the more variety and color the better.
- A quality fish oil supplement can also help to improve the omega 3 to omega 6 balance
- Regular physical exercise that combines both cardio and resistance training
- Get good quality sleep to help your body recover
- Stress reduction through meditation will also benefit your heart as well as your whole body.