Today is Independence Day for those who wish to be free of their fear of cholesterol, an important molecule for a healthy life. This Journal features a reading from Chris Kresser. As a licensed acupuncturist practicing in Berkeley, CA, Kresser is well known as a balanced, meticulously accurate, and well expressed commentator in his investigations and writings. You can read his personal bio here.
What follows is an accurate synopsis of his thinking about the cholesterol misinformation, or disinformation, or whatever the medical system propaganda is that causes many many people to be put on statin drugs. In the text below, he offers a good briefing on some cholesterol biochemistry.
I believe that statin drugs will be taken off of the market in the future. This class of pharmaceuticals is an overused, misused, and toxic way to deal with one’s cholesterol levels. There are excellent natural biochemical treatments for cholesterol management which do not create complications of drug therapies. Nor do the treatments and lifestyle practices I recommend engender an oblivious disregard in the patient and physician for the importance of cholesterol’s numerous functions in our overall health and vitality.
Here is Kresser’s accurate perspectives on cholesterol myths.
“Cardiovascular disease affects 80 million Americans, and accounts for 4 in 10 deaths. This year 1.3 million people will have a heart attack, and 40% of those will be fatal. Making real progress in preventing and treating heart disease could improve millions of lives each year.
The problem you face is that there’s so much conflicting information out there, and a lot of it is outdated, or simply wrong.”
Myth#1- Eating saturated fat and cholesterol raise cholesterol levels in the blood
“Most of us grew up being told that foods like red meat, eggs and bacon raise our cholesterol levels, and that high cholesterol clogs our arteries and gives us heart attacks. This idea is so deeply ingrained in our cultural psyche that few people even question it. But is this true?
Recent studies have conclusively shown that, for most people:
- Eating cholesterol-rich foods doesn’t raise cholesterol levels in the blood.
- Eating saturated fat does not increase cholesterol levels in the blood over the long-term (though it often does in the short-term).
Even the guy who came up with this hypothesis in the first place, Ancel Keys, doesn’t believe it anymore. He said:
“There’s no connection whatsoever between the cholesterol in food and cholesterol in the blood. And we’ve known that all along. Cholesterol in the diet doesn’t matter at all unless you happen to be a chicken or a rabbit.”
He mentions chickens and rabbits because the early experiments that led researchers to believe that dietary cholesterol raises cholesterol levels in the blood were done on chickens and rabbits.
It’s probably obvious to you that your body doesn’t work in the same way that a chicken or rabbit’s body does, but for some reason these results were extrapolated to humans.
The result of this misconception is that many people adopted a low-fat diet with the idea that it would protect them against heart disease. They switched their bacon & eggs for plain bagels and OJ. Unfortunately, studies show that replacing saturated fat and cholesterol with refined carbohydrates (the type most people eat) *increases* the risk of heart disease, by contributing to unfavorable metabolic changes.
In the next letter we’ll discuss another popular myth: that high cholesterol is the cause of heart disease.”
Myth #2 – High Cholesterol is the cause of heart disease
“If you asked 10 people on the street whether high cholesterol causes heart disease, my guess is 9.5 of them would say “yes”. Most people accept this without question, since it’s been pounded into their head in both subtle and not-so-subtle ways since the day they were born. We might call these folks the “cholesterol believers”.
But recently the cholesterol believers have been challenged by the “cholesterol skeptics”. They say that cholesterol has nothing to do with heart disease, and we shouldn’t even bother measuring it. So who’s right?
It turns out that they’re both right…and wrong.
Part of the problem is terminology. We don’t actually have a cholesterol level in our blood. Cholesterol is hydrophobic, which means it’s not water-soluble and must be transported through the blood (which is mostly water) attached to a protein – in this case, lipoproteins like LDL, HDL, etc. Lipoproteins carry cholesterol and other fats and nutrients in the blood and deliver them to cells and tissues around the body.
Let’s use an analogy to make this more clear. Imagine your bloodstream is a river. The lipoproteins that carry cholesterol through the blood (LDL, HDL, etc.) are like boats, and the cholesterol itself is like cargo in the boats.
A standard lipid panel measures the amount of cholesterol in low-density lipoproteins (LDL), high-density lipoproteins (HDL), and in all lipoproteins combined (total cholesterol). When the doctor tells you that you have “high cholesterol”, she’s saying that the amount of “cargo” (cholesterol) in your “boats” (lipoproteins) is too high. She’s usually referring to either your total cholesterol, LDL cholesterol, or both.
Here’s the thing: studies have shown that total and LDL cholesterol are only weakly correlated with heart disease risk. Some people with normal total and LDL are at high risk, and some people with high total and LDL cholesterol are at low risk. In other words, the amount of cargo (cholesterol) in the boats (lipoproteins) is not the driving factor in the development of heart disease.
In the next letter we’ll discuss what *does* cause heart disease (and how cholesterol fits in).”
Myth #3 – High Cholesterol is *NOT* the cause of heart disease
“Yes, you read that subject line correctly.
You might be thinking I’ve lost my mind. In the last email I argued that high cholesterol is not the cause of heart disease. In this email I’m going to argue that it is.
Again, the confusion is partly caused by sloppy terminology. When most people say “cholesterol”, what they’re really referring to is the amount of cholesterol contained in the lipoproteins (LDL, HDL, etc.) that carry cholesterol through the body. If you recall the analogy I used last time, the blood stream is a river, the lipoproteins are boats that carry the cholesterol, and the cholesterol is the cargo in the boats.
We now know that the amount of cholesterol (cargo) in the boats (LDL) is not a strong risk factor for heart disease. This is what I meant in the last email when I said that high cholesterol is not the cause of heart disease.
However, the number of LDL particles in the blood (boats in the river) definitely is a risk factor for heart disease. The more boats in the river, the higher the risk. This is what I mean when I say high cholesterol is the cause of heart disease.
As you can see, this stuff is complex and the subtleties are important. Crucial, in fact. That’s why both extremes of the debate come up short. They’re speaking in black & white when reality is much more grey.
The sad thing about this misunderstanding is that some people that need treatment aren’t getting it (i.e. those with normal LDL cholesterol, but a high number of LDL particles), and some people that don’t need treatment (i.e. those with high LDL cholesterol, but a normal number of LDL particles) are getting too much.
As you can see, a standard lipid panel that only measures the amount of cholesterol “cargo” in LDL and other lipoproteins may not be enough.
In the next letter I’ll debunk the myth that LDL cholesterol is ‘bad’ and HDL cholesterol is ‘good'”.
Myth #4 – LDL cholesterol is “bad” and HDL cholesterol is “good”
“By now most of you have probably heard that LDL is “bad” cholesterol and HDL is “good” cholesterol.
Ah, well. Another myth bites the dust.
The most accurate thing we could say is that there’s no such thing as “good” and “bad” cholesterol, but there is such a thing as cholesterol in the right and wrong place at the right and wrong time. And that’s much more important in determining the risk of heart disease.
Scientists got the idea that LDL is “bad” because they believed that it delivers cholesterol to the arterial wall, which initiates the process of heart disease, whereas HDL is “good” because it transports cholesterol back to the liver, where it is processed and eliminated from the body. This process of moving cholesterol back to the liver is called “reverse cholesterol transport” (RCT).
More recent studies have shown that this is not only overly simplistic, it’s simply not true.
It turns out that most RCT is performed by LDL, not HDL. In other words, it’s the so-called “bad cholesterol” that cleans up cholesterol from the circulation and helps remove it from the body.
And while it’s true that low HDL levels are associated with heart disease, raising HDL with drugs or other therapies like niacin has never been shown to reduce the risk of heart disease.
Stay tuned for the next myth, which is that statins extend lifespan in healthy people without heart disease.”
Myth #5 – Statin drugs save lives in healthy people without heart disease
“Statin drugs are wildly popular. Zocor (simvastatin) is the #2 most prescribed drug in the U.S., behind only vicodin (a pain reliever). Half of men between the ages of 65 – 74 and nearly 40% of women above 75 years of age take a statin. According to the latest census numbers, that means over 30 million Americans are taking statins – a number equal to the entire population of Florida and Illinois.
Some doctors have even suggested that statins are so safe and effective, we should add them to the water supply. (I’m not kidding.)
There’s no doubt that statins reduce heart attacks and extend lifespan in people that already have cardiovascular disease, although the effect is much less significant than most people assume, and not without side effects and risks.
However, the dramatic increase in statin use has come mostly from prescriptions for people with “high cholesterol” and other risk factors but no pre-existing heart disease. The problem with this is that research has shown that statins do not extend lifespan in this population.
For example, in a large meta-analysis of 11 randomized, controlled trials (the “gold standard” for drug research) published in the Archives of Internal Medicine, the researchers found that statins did not save lives in people at moderate and even high risk of heart disease that did not already have heart disease.
According to the data in this study, doctors would have to treat 1,000 people for 10 years with statins to delay 7 deaths. Put another way, even if you’re at high risk for heart disease, there’s only a 1 in 1,400 chance that statins will delay your death if you don’t already have heart disease.
If statins were harmless and free, these statistics wouldn’t matter. But they’re not. They have significant side effects and risks, and the cost can add up – especially with brand name statins.
Unfortunately, there are several other misconceptions about statins, and I cover these in more detail in the High Cholesterol Action Plan. For example, did you know that statins haven’t been shown to extend lifespan in women, even if they have heart disease?”
Here is another writing on his website which goes along with the information presented above.
Many thanks to Chris Kresser, L.Ac, for holding forth as a highly reliable source of the kind of meaningful human biochemistry, physiology, and pathophysiology which has never really been taught in a holistic manner in medical schools. Chris is not the only thinking healer out there, but he is certainly thought to be one of the finest by many.
Crestone and Beyond
I often say to people who seek some ultimate Holy Grail knowledge about healing that there is nothing more intelligent than a human body, and the Being which lives in it.
Unfortunately, Big Pharma and Big Medicine think that they can offer more intelligence than the healing design of Creation which is silently and constantly happening in our lives. A massive and expensive and intrusive industry has been established around this misconception. Big money and economic considerations are wrapped up in egoistic (arrogant) attempts to outsmart some disease process in the various “wars” on the various disease processes.
As an M.D. of 36 years of seasoned experience in dealing with many very difficult situations of patients’ health crises, I can comfortably say that I do not know of any licensed (or unlicensed) health practitioner who can think in their human minds more powerfully and nimbly and effectively than our own native healing wisdom. Health care providers of all sorts should learn how to work with this healing wisdom. This effort would naturally entail learning something about it. Such Hippocratic principles are not taught in medical schools.
Did I ever “outsmart” a disease and put it to an end without the intelligent cooperative assistance of the patient’s being and wisdom?
There are excellent and vital treatments which the medical industry offers. Almost everyone would acknowledge the necessity of good medical care in an emergency medical crisis. Examples abound. Interventions in emergency, and other urgent situations, comprise the best aspect of the current allopathic medical system treatments.
And also, there are many long term health problems which can only be managed with medical pharmacology and interventions in the lives of those who are predisposed and habituated to abdicate to medical treatments as being more intelligent than their own properly guided biochemical intelligence.
Suffice it to say that most Americans who partake of the medical system have not been introduced to, or held accountable to the power of natural biochemically intelligent healing practices. Moreover, the patient who partakes of the wrong guidance from a bad practitioner will suffer more from such misguidance.
I would also point out that there is an abundance of practitioners in the field of holistic or natural healing who really are no better than flim flam artists, just as is the case in the allopathic system of medical practice. Medical doctors are licensed to serve people in ways which often cause great harm. I consider this to be a form of corruption, even as much of it may actually be well intentioned.
One of my sons is a third generation physician, practicing as an Emergency Medicine physician. He often reminds me of the words, “garbage in…garbage out.” This statement applies to any field of human information, theory, and practice. In the context of this writing “garbage in…garbage out” most surely applies to garbage health information and garbage health practices (allopathic or holistic) which tend to garbage up peoples’ lives.
As inventor Thomas Edison once said, “The doctor of the future will give no medicine, but will interest her or his patients in the care of the human frame, in a proper diet, and in the cause and prevention of disease.”
I like the intent of this quotation, but I believe there is an important place for prescription medications.
A future time is shaping up when physicians in medical schools will be taught more in-depth and comprehensive biochemistry about the intelligence, the potential, and the efficacy of natural biochemical healing. These future doctors will also be taught more about how to get the current generations of patients off of their polypharmacy regimens; more than they are taught to put them on polypharmacy combinations.
My future commentary on the cholesterol subject will commence…henceforth…after I have assembled it. As long as you can remember that cholesterol is a molecule which is vital for a healthy life, that cholesterol has been wrongly demonized, that cholesterol “treatments” are highly lucrative, and that you do not want to have your cholesterol hammered into dangerously low levels with toxic drugs…as long as you can keep these points in mind, then your ongoing exploration of cholesterol biochemistry should be easy and rewarding.
These Journal entries will serve as a nice reference source for my clients who are being misguided with misinformation, statins, and other drugs. I attempt to educate people about their biochemistry intelligence and how it all fits together so nicely for them and it all acts on their behalf. Many clients are quite interested to learn about this information, and when it is presented in a manner which the client can grasp, then their own creativity and curiosity open up to assist their learning, growth, and healing.
The Greek origin and meaning of the word “doctor” is teacher.
Because we live in a culture which has not been conditioned with an educational system promoting independence, creativity, curiosity, and resultant self-accountability– I shall therefore have to concede that I am still practicing ways to reach and open peoples’ curiosity about their own native intelligence. The intelligence of all of Creation is inside of us, but as a culture we have commenced to try to out-think and out-smart our own native intelligence by allowing our various dismissive denial mechanisms to hold sway, and then we embrace the quick fix scenario attempts.
Such attempts to out-smart the disease leads us further astray. One only needs to think about rowing one’s boat gently down the stream, or going with the flow of Creation’s intelligence, which is infinitely abundant. Rowing down a stream is usually accompanied by a simultaneous curiosity as to how the stream may unfold. Such a natural childlike curiosity has health advantages, and should be part of the life of any child of any age.
You can refer to the previous Journal entry, “The Professor of Education,” where some points are registered about how our culture might benefit from an educational process wherein people actually experience learning.
Thank you for reading.
Signing off from Crestone and Beyond.