Important Facts About Cholesterol and Heart Disease by Dr. Mercola
Important Facts About Cholesterol and Heart Disease
June 29, 2016|34,991views
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By Dr. Mercola
Cholesterol is a wax-like fatty substance found in almost every cell
of your body. You need cholesterol to make hormones and vitamin D,
digest your foods, protect your nerves and for the production of cell
membranes.
Although it has been vilified, it is essential to your health. Your
liver manufactures most of the cholesterol you require from the
nutrients in your food.
Levels of cholesterol are not higher in fatty meats or lower in lean
meats. Like your body cells, the cells of all mammals contain
cholesterol. Fat cells contain as much cholesterol as other cells in the
meat. All meat averages about 25 milligrams of cholesterol per 1 ounce,
including beef, pork and poultry.1
Dietary (preformed cholesterol) absorption rates also vary between 20 and 60 percent in individuals.2 This may explain why eating cholesterol affects cholesterol levels differently in different people.
Cholesterol Ratios Are More Important Than Single Numbers
You may be following your cholesterol numbers
in terms of the "good" cholesterol (HDL) or the "bad" cholesterol
(LDL). But the best way to interpret your cholesterol numbers is to
understand your cholesterol ratio.
To say that all low-density lipoprotein (LDL) molecules are bad is an oversimplification of our understanding of cholesterol.
Through the use of new technology to test the size of lipoprotein
particles, scientists have identified which sizes are more closely
related to heart disease. The smaller sized LDL molecules hold the
highest risk for cardiovascular disease (CVD).
Small, dense LDL particles can squeeze between the cells of your
arterial lining, the so-called "gap junction" of the endothelium, where
they can get stuck and potentially oxidize, turn rancid and cause
inflammation and plaque formation. They also have a relationship to
other metabolic abnormalities.3
Large epidemiological studies have found people with predominantly small LDL particles are at increased risk for CVD.4,5
Even more interesting is the research demonstrating eating saturated
fats increases the size of your small LDL molecules to the larger size
and reduces your overall risk of CVD.6,7
The importance of measuring LDL cholesterol through common blood
testing has now decreased in value, to the point the American Heart
Association (AHA) no longer recommends using LDL cholesterol as a guide
in treating the risk for CVD or prescribing statin drugs.8
Instead, a better predictor is the ratio between your high-density
lipoproteins (HDL) and total cholesterol. HDL is an important factor in
the fight against heart disease. Your ratio between HDL and total
cholesterol (or HDL divided by your total cholesterol, multiplied by
100) should ideally be above 24 percent.
Triglycerides are another type of cholesterol formed in your body
with excess blood sugar from the metabolism of carbohydrates. They are a
significant risk factor in the development of heart disease. Your
triglyceride to HDL ratio (triglycerides divided by HDL, multiplied by
100) should ideally be below 2 percent.
Cholesterol Not a Trigger for Heart Disease
Total Video length: 05:40
In the two videos above, you'll discover some of the history behind
why science has clung to the belief that cholesterol is responsible for
heart disease, and why they have been wrong.
Recent research9 has again confirmed that high cholesterol is not
linked with heart disease in the elderly, prompting the researchers to
conclude that reducing cholesterol levels with statin drugs is "a waste
of time." Unfortunately, statins are not innocuous drugs, making their
use more than just a waste of time.
The research reviewed studies involving nearly 70,000 people to look
for a link between LDL cholesterol and premature death in those over 60.
Contrary to conventional wisdom, they found 92 percent of people with
high cholesterol levels actually lived longer than those who kept their
levels at or below "normal."
They concluded the results were "inconsistent with the cholesterol
hypothesis (i.e., that cholesterol, particularly LDL-C, is inherently
atherogenic)."10
They believe their analysis of the research provides a reason to
question the cholesterol hypothesis and a "rationale for reevaluation of
the guidelines recommending pharmacological reduction of LDL-C in the
elderly as a component of cardiovascular disease prevention strategies."11
While termed a "waste of time" by researchers, statins carry with
them a list of over 200 side effects and clinical challenges. Some of
these include:12,13
Before taking medications with such a significant side effect
profile, it's important to weigh the risks and benefits of the drug.
In this case, research shows that statins used for primary
prevention, or lowering the risk of a cardiovascular event (heart attack
or stroke) over 10 years, has a success rate of just 7 in 1,000 events
prevented. Put another way, in 99.3 percent of patients there's no
appreciable benefit.15,16
Ultimately, statins increase your risk of other dangerous health
conditions, while not delivering on the promise to reduce your risk of
heart disease or other cardiovascular events. More than a waste of time,
they are a danger to your health.
Heart Disease Risk Factors
If saturated fats and high cholesterol levels are not a cause for
rising heart disease rates, what is? The numbers of heart attacks and
strokes began to rise dramatically in the 1950s, after research was
published blaming heart disease on saturated fats.
One correlation, drawn in recent literature, is between the increased
amount of carbohydrates eaten when saturated fats are removed from the
diet, and the rise in CVD.17 An increase in carbohydrates will raise your triglyceride level, one risk factor for CVD.18
Besides cutting down on net carbs (total carbohydrates minus fiber),
another dietary factor that can help decrease your risk is to increase
your antioxidant intake. For example, resveratrol, found in grape skins,
has been shown to change your gut microbiome and protect against CVD.19
Other risk factors include a lack of exercise and smoking, both of which impact the oxygenation of your heart muscle and subsequent damage leading to heart disease.20,21 Chemicals in tobacco are associated with damage to your blood vessels and heart, and increase the risk of plaque formation.22
Your weight, and more specifically your waist circumference,
is another indicator or risk factor for heart disease. Although
interrelated, waist circumference is an independent predictor and useful
whether you are at your normal body mass index (BMI) or overweight.23 Abdominal fat in adults is associated with type 2 diabetes, high blood pressure and CVD.24
What Is a Silent Heart Attack?
CVD continues to be the leading cause of death in industrialized
nations, followed closely by cancer. Chronic lower respiratory diseases
are a distant third, at only 25 percent of the total number of deaths
from heart disease.25 (Officially, that is. Unofficially, medical errors and prescription drugs are actually the third leading killer in the U.S.)
High blood pressure is a leading cause of heart disease and often
called the silent killer, since unless you are tested for the condition
there are no clinical symptoms. There are also heart attacks that occur
silently, causing damage to your heart muscle and increasing your risk
of death with your next heart attack.26
To measure the incidence of silent heart attacks,
researchers studied almost 9,500 middle-aged adults, some for more than
13 years. During that time, researchers noted men had more silent
attacks, but these attacks killed more women.27
Silent heart attacks are usually discovered during physical
examination at a later time since people don't associate any symptoms
they may have with a heart attack. Women who have had a silent heart
attack are 58 percent more likely to die than women who have not had a
heart attack, but the mortality rate for men suffering a silent heart
attack is only 23 percent higher than men without a heart attack.28
The study found that nearly half of all heart attacks may be silent
and since people don't know they had a heart attack, they don't seek the
care needed to prevent another one. Researchers caution that once
discovered, those who have had a silent heart attack should be treated
as aggressively as those who had a traditional attack with symptoms.
What Can You Do?
There are several modifiable risk factors you can effectively change
to make a difference in your risk of suffering heart disease or a heart
attack. Reducing your risk factors require changes to your lifestyle,
such as the following:
Reduce your waist circumference to within normal limits
Abdominal
fat is different from being generally overweight. You can be within
normal limits for weight but still carry abdominal fat, increasing your
risk of metabolic stress and heart disease. Reducing belly fat requires
more than just reducing calories or increasing exercise. In my previous
articles titled "4 Ways to Shed Belly Fat" and "Cut Down on Carbs to Reduce Body Fat" I outline several strategies you can use.
Reduce or eliminate smoking
Smoking is a challenging addiction to break. However, it is also a significant risk factor for heart disease. Drugs used to stop smoking
have also been linked to an increased risk of suicide. Instead, make a
plan, work with a support group, include an exercise program and
understand you may stumble once in a while. However, just because you
smoke one or two, doesn't mean you have to go back to your old habit.
Reduce your net carbs to 20 to 30 percent of your total caloric intake
Net
carbs are equal to the number of grams of carbohydrates you've eaten
during the day minus the number of grams of fiber. If you generally eat
1,500 calories per day, you may want to limit your net carbs to between
300 and 450 calories each day.
Eat healthy saturated fats
Substitute healthy saturated fats
in your diet for the carbs you are losing. These may increase the size
of your LDL cholesterol and protect you against heart disease. They
include raw, organic nuts and seeds, avocadoes, pastured organic eggs,
grass-fed meat and virgin coconut oil.
Maintain your blood pressure within normal limits
High
blood pressure is a silent killer. Maintain yours with nutritional
strategies, controlling your fructose and carbohydrate intake, getting
outdoor exercise and considering several supplements I discuss in "Foundational Lifestyle Strategies to Maintain Healthy Blood Pressure."
Get at least 30 minutes of exercise each day
A
regular exercise routine is one way to improve your emotional, physical
and psychological health. It improves your sleep, reduces your risk of
heart disease and improves your resistance to infection. Peak Fitness
is an exercise program I developed to address the health needs of my
body without the damaging effects of hours of cardiovascular work.
Get up and move around during the day
Even
if you exercise an hour a day, six days a week, if you sit behind a
desk all day you eliminate the benefits to your heart and health. I
recommend standing up as much as possible. I've cut my sitting down to
about an hour a day, but aiming for a max of three hours of sitting a
day is a worthy goal. A stand-up desk is a great investment if you have
an office job.
Also make it a point to walk more. The idea is to
keep your body moving throughout the day. This can also help increase
your productivity and creativity, and may even be helpful if you're
struggling with back pain, like I did.
Improve your gut microbiome Keep your gut microbiome healthy
and flourishing to reduce your risk of heart disease and improve your
cholesterol ratio. Include fermented vegetables in your daily
nutritional plan, eat 50 grams of fiber for every 1,000 calories you
ingest and take antibiotics only when absolutely necessary.
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