New Dietary Guidelines Reverse Flawed Recommendations on Cholesterol
By Dr. Mercola
For the past half century, cholesterol has been touted as a grave
health hazard, and dietary fat and cholesterol have been portrayed as
being among the “deadliest” foods you could possibly eat.
This may finally change, as limitations for cholesterol will likely be
removed from the 2015 edition of Dietary Guidelines for Americans. It’s
about time really, as 60 years’ worth of research has utterly failed to
demonstrate a correlation between high cholesterol and heart disease.
Not only does undamaged natural cholesterol not cause heart
disease, it is actually one of the most important molecules in your
body; indispensable for the building of cells and for producing stress
and sex hormones, as well as vitamin D.
Cholesterol is also important for brain health, and helps with the
formation of your memories. Low levels of HDL cholesterol have been
linked to memory loss and Alzheimer's disease, and may also increase your risk of depression, stroke, violent behavior, and even suicide.
New American Dietary Guidelines May Remove Limits on Cholesterol
A draft1 of the 2015 edition of Dietary Guidelines for Americans,2
created by the Dietary Guidelines Advisory Committee, now states that
“cholesterol is not considered a nutrient of concern for
overconsumption.”
And, according to a recent report in the Washington Post,3 an insider claims the new stance on cholesterol will remain in the final report. As noted by medical journalist Larry Husten:4
“The proposed change reflects a major shift in the scientific view of cholesterol that has taken place in recent years.
Although serum cholesterol is still considered an important risk
factor, cholesterol consumed in food is now thought to play a relatively
insignificant role in determining blood levels of cholesterol.”
However, if you process saturated fat or cholesterol and heat it by
frying, then you create very dangerous products that will clearly
increase your risk of cardiovascular disease. So this new information
does not give you free license to eat any type of cholesterol. Remember,
trans fats are worse than sugar for your health.
Guidelines on Fat and Cholesterol Should Never Have Been Made
Steve Nissen, chairman of cardiovascular medicine at the Cleveland Clinic, told USA Today:5 “It’s the right decision. We got the dietary guidelines wrong. They’ve been wrong for decades.” This message was echoed in Time Magazine, which recently reported that:
“[I]n the latest review6
of studies that investigated the link between dietary fat and causes of
death, researchers say the guidelines got it all wrong. In fact,
recommendations to reduce the amount of fat we eat every day should
never have been made.”
Low-fat diets saw a real upswing in 1977, but according to research published in the Open Heart journal,7 led by Zoe Harcombe, PhD, there was no scientific basis for the recommendations to cut fat from our diet in the first place.
What’s worse, the processed food industry replaced fat with large
amounts of sugar, While Dr. Harcombe shies away from making any
recommendation about how much dietary fat might be ideal, she suggests
that the take-home message here is to simply “eat real food.”
I have to say, it’s refreshing to finally see that message being repeated in the mainstream media. As reported by Time Magazine:8
“The less adulterated and processed your diet is, the more nutrients
and healthy fats, proteins and carbohydrates your body will get, and
the less you’ll have to worry about meeting specific guidelines or
advice that may or may not be based on a solid body of evidence.”
Processed Fructose Affects Your Body Like Alcohol
The low-fat craze led to an avalanche of new processed food products,
promising to benefit both your waistline and your heart. Alas, nothing
could have been further from the truth.
When fat was removed, sugar was added in, and this has led to a massive
increase in obesity, diabetes, heart disease, and non-alcoholic fatty
liver disease. As it turns out, your body metabolizes fructose in the same way it metabolizes ethanol, creating the same toxic effects.
Unlike glucose, which can be used by virtually every cell in your body, fructose can only be metabolized by your liver, because your liver is the only organ that has the transporter for it.
Since nearly all fructose gets shuttled to your liver, and, if you eat a
typical Western-style diet, you consume high amounts of it, fructose
ends up taxing and damaging your liver in the same way alcohol and other
toxins do.
In fact, when you compare the health outcomes of fructose versus alcohol
consumption, you see the diseases they cause are virtually identical:
Chronic Ethanol Consumption |
Chronic Fructose Consumption |
Hypertension |
Hypertension |
Cardiomyopathy |
Myocardial infarction |
Dyslipidemia |
Dyslipidemia |
Pancreatitis |
Pancreatitis |
Obesity |
Obesity |
Hepatic dysfunction (ASH) |
Hepatic dysfunction (NASH) |
Fetal alcohol syndrome |
Fetal insulin resistance |
Addiction |
Habituation, if not addiction |
Non-Alcoholic Liver Disease Has Become a Serious Public Health Concern
Dr. Robert Lustig, Professor of Pediatrics in the Division of
Endocrinology at the University of California, has been a pioneer in
decoding sugar metabolism and sounding the alarm on processed fructose in particular.
In one of his papers,9 published in the Journal of the Academy of Nutrition and Dietetics in 2010, Dr. Lustig describes three similarities between fructose and its fermentation byproduct, ethanol (alcohol):
- Your liver's metabolism of fructose is similar to alcohol as they
both serve as substrates for converting dietary carbohydrate into fat,
which promotes insulin resistance, dyslipidemia (abnormal fat levels in
the bloodstream), and fatty liver
- Fructose undergoes the Maillard reaction with proteins, leading to
the formation of superoxide free radicals that can result in liver
inflammation similar to acetaldehyde, an intermediary metabolite of
ethanol
- By "stimulating the 'hedonic pathway' of the brain both directly and
indirectly," Dr. Lustig noted, "fructose creates habituation, and
possibly dependence; also paralleling ethanol"
As recently reported in Scientific American,10 non-alcoholic fatty liver disease11
(NAFLD) now affects an estimated 25 percent of Americans, including an
estimated 20 percent of children, who have never had a drop of alcohol.
Cases of NAFLD have even been reported in children as young as three
years old. This may sound like an impossibility. But did you know that
most infant formulas contain the sugar equivalent of a can of Coca-Cola?
Ditto for many baby foods,
which can contain as much sugar and harmful trans fats as chocolate
cookies or cheeseburgers. Babies are methodically “poisoned” with
exorbitant amounts of refined sugar and processed fructose from day one,
so it’s really no wonder that so many of our youngsters struggle with
weight issues and associated diseases. As explained in Scientific American:12
“NAFLD describes the accumulation of fat in hepatocytes, or liver
cells, in excessive amounts. These fats are typically triglycerides,
which the body naturally stores and creates from calories that it
doesn’t need right away. Normally these fats are burned off for energy,
but if the body is overwhelmed with calories and a lack of exercise,
then the triglycerides are simply never released. They instead
accumulate in the liver and cause NAFLD, which can lead to inflammation,
scarring, liver dysfunction and even liver cancer.”
Wrong Dietary Guidelines Has Led to Flawed Medical Interventions, Too
Since the cholesterol hypothesis is false, this also means that the
recommended therapies—low-fat, low-cholesterol diet, and cholesterol
lowering medications—are doing more harm than good. Statin treatment,
for example, is largely harmful, costly, and has transformed millions of
people into patients whose health is being adversely impacted by the
drug. As noted in the featured video, we now know a whole lot more about
HDL and LDL, commonly referred to as “good” and “bad” cholesterol
respectively, although that is also a bit of a fallacy.
Depending on the size of the particles, LDL may be either harmful or harmless, so LDL is not necessarily “bad” across the board. The issue of particle sizes
is discussed in greater detail in my 2013 interview with Chris Kresser,
L.Ac. If you’ve had your cholesterol levels checked, your doctor most
likely tested your total cholesterol, LDL cholesterol, HDL cholesterol,
and triglycerides. But we now know those are not accurate predictors for
cardiovascular disease risk.
A far more accurate predictor is your LDL particle number, the
test for which is called an NMR Lipoprofile. It’s easy to get and all
major labs offer it, including LabCorp and Quest. Most insurance
policies cover the test as well. Best of all, even if your doctor were
to refuse to order it, you can order it yourself via third-party
intermediaries like Direct Labs, or you can order the test online, and
get blood drawn locally. Also:
- Check your HDL to total cholesterol ratio. HDL
percentage is a potent heart disease risk factor. Just divide your HDL
level by your cholesterol. This ratio should ideally be above 24
percent.
- Boost your HDL cholesterol and lower your triglyceride levels.
High triglycerides are a very potent risk factor for heart disease. In
combination, high triglycerides and low HDL levels are an even bigger
risk; this ratio is far more important to your heart health than the
standard good vs. bad cholesterol ratio. In fact, one study found that
people with the highest ratio of triglycerides to HDL had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL.
You calculate your triglyceride/HDL cholesterol ratio by dividing your
triglyceride level by your HDL level. This ratio should ideally be below
2. So while you strive to keep your HDL cholesterol levels up, you'll
want to decrease your triglycerides. You’ll find strategies for
increasing your HDL level below. Triglycerides are easily decreased by
exercising and avoiding grains and sugars in your diet.
Statins Are Based on a Flawed Premise
Part of the reason why cholesterol-lowering drugs like statins are ineffective for heart disease prevention (besides the fact that the drug causes heart disease as a side effect) is that drugs cannot address the real cause of heart disease, which is insulin and leptin resistance,
which in turn increase your LDL particle number via a number of
different mechanisms. While some genetic predisposition can play a role,
insulin and leptin resistance is primarily caused by a combination of
factors that are epidemic in our modern lifestyle:
- A diet high in processed and refined carbohydrates, sugars/fructose, refined flours, and industrial seed oils
- Insufficient everyday physical activity. Chronic sitting
is also an independent risk factor that causes biochemical changes that
predispose you to insulin and leptin resistance, even if you’re very
fit and exercise regularly
- Chronic sleep deprivation. Studies have shown that even one night of
disturbed sleep can decrease your insulin sensitivity the next day and
cause cravings and overeating
- Environmental toxins. Exposure to BPA, for example, can disrupt weight regulation
- Poor gut health. Studies indicate that imbalances in your gut flora
(the bacteria that live in our gut) can predispose you to obesity and
insulin and leptin resistance, and processed foods high in sugar effectively feed harmful bacteria, allowing them to take over
For Heart Health, Focus on Boosting Your HDL
A healthy diet is foundational for optimal health, and step number one
is to ignore the advice to eat a low-fat, low-cholesterol diet. Other
strategies that will help reduce your risk of heart disease include the
following:13
Replace processed foods (which are loaded with refined sugar and carbs,
processed fructose, and trans fat—all of which promote heart disease)
with whole, unprocessed or minimally processed foods, ideally organic
and/or locally grown. |
Avoid meats and other animal products such as dairy and eggs
sourced from animals raised in confined animal feeding operations
(CAFOs). Instead, opt for grass-fed, pastured varieties, raised
according to organic standards. |
Eliminate no-fat and low-fat foods, and increase consumption of
healthy fats. Half of the population suffers with insulin resistance and
would benefit from consuming 50-85 percent of their daily calories from
healthy saturated fats, such as avocados, butter made from raw
grass-fed organic milk, raw dairy, organic pastured egg yolks, coconuts
and coconut oil, unheated organic nut oils, raw nuts, and grass-fed
meats. No- or low-fat foods are usually processed foods that are high in
sugar, which raises your small, dense LDL particles.
Balancing your omega-3 to omega-6 ratio is also key for heart health, as
these fatty acids help build the cells in your arteries that make the
prostacyclin that keeps your blood flowing smoothly. Omega-3
deficiency can cause or contribute to very serious health problems,
both mental and physical, and may be a significant underlying factor of
up to 96,000 premature deaths each year. For more information about
omega-3s and the best sources of this fat, please review this previous article. |
You also need the appropriate ratios of calcium, magnesium, sodium, and potassium, and all of these are generally abundant in a whole food diet. To get more fresh vegetables into your diet, consider juicing. |
Optimize your vitamin D level. Some researchers, like Dr.
Stephanie Seneff, believe optimizing your vitamin D level through
regular sun exposure, opposed to taking an oral supplement, may be key
to optimizing your heart health.
If you do opt for a supplement, you also increase your need for vitamin
K2. Meanwhile, Dr. Robert Heaney recently highlighted research showing
that carnivorous animals actually get some of the vitamin D
they need from the meat they eat. For the longest time, meat was not
considered a good source of vitamin D, primarily because it was so
difficult to measure that we didn’t think it contained useful amounts.
He recommends getting approximately 5,000 to 6,000 IUs of vitamin D per
day from all sources – sun, supplements, and food – in order to reach and maintain a healthy blood level of 40-60 ng/ml. |
Optimize your gut health. Regularly eating fermented foods, such
as fermented vegetables, will help reseed your gut with beneficial
bacteria that may play an important role in preventing heart disease and
countless other health problems. |
Quit smoking and reduce your alcohol consumption. |
Exercise regularly. Exercise
is actually one of the safest, most effective ways to prevent and treat
heart disease. In 2013, researchers at Harvard and Stanford reviewed
305 randomized controlled trials, concluding there were "no
statistically detectable differences" between physical activity and
medications for heart disease. High-intensity interval training, which requires but a fraction of the time compared to conventional cardio, has been shown to be especially effective. |
Pay attention to your oral health. There's convincing evidence
linking the state of your teeth and gums to a variety of health issues,
including heart disease. In one 2010 study,14
those with the worst oral hygiene increased their risk of developing
heart disease by 70 percent, compared to those who brush their teeth
twice a day. |
Avoid statins, as the side effects of these drugs are numerous,
while the benefits are debatable. In my view, the only group of people
who may benefit from a cholesterol-lowering medication are those with
genetic familial hypercholesterolemia. This is a condition characterized
by abnormally high cholesterol, which tends to be resistant to lowering
with lifestyle strategies like diet and exercise. |
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