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How to Lower Your Cholesterol?

Cholesterol Lowering Drugs and Cholesterol Lowering Diet

Whatever the reasons may be for your high blood cholesterol level - diet, heredity, or both - the treatment your doctor will prescribe first is a diet. If your blood cholesterol level has not decreased sufficiently after carefully following the diet for 6 months, your doctor may consider adding cholesterol-lowering medication to your dietary treatment. Remember, diet is a very essential step in the treatment of high blood cholesterol.

Cholesterol-lowering medications are more effective when combined with diet. Thus they are meant to supplement, not replace, a low-saturated fat, low-cholesterol diet.

Summary of Diet Guidelines for Lowering High Blood Cholesterol Levels

* Eat less high-fat food (especially those high in saturated fat)
* Replace part of the saturated fat in your diet with unsaturated fat
* Eat less high-cholesterol food
* Choose foods high in complex carbohydrates (starch and fiber)
* Reduce your weight, if you are overweight

Eat Less High-fat Food

Dietary Fat

There are two major types of dietary fat - saturated and unsaturated. Unsaturated fats are further classified as either polyunsaturated or monounsaturated fats. Together, saturated and unsaturated fats equal total fat. All foods containing fat contain a mixture of these fats.

Reduce Total Fat Intake

One of the goals in your blood cholesterol-lowering diet is to eat less total fat, because this is an effective way to eat less saturated fat. Because fat is the richest source of calories, this will also help reduce the number of calories you eat every day. If you are overweight, weight loss is another important step in lowering blood cholesterol levels (as discussed later in this brochure). If you are not overweight, be sure to replace the fat calories by eating more food high in complex carbohydrates.

Remember: When you decrease the amount of total fat you eat, you are likely to reduce the saturated fat and calories in your diet.

Saturated Fat

Saturated fat raises your blood cholesterol level more than anything else in your diet. The best way to reduce your blood cholesterol level is to reduce the amount of saturated fat you eat.

Animal Fats

Animal products as a group are a major source of saturated fat in the average American diet. Butter, cheese, whole milk, ice cream, and cream all contain high amounts of saturated fat. Saturated fat is also concentrated in the fat that surrounds meat and in the white streaks of fat in the muscle of meat (marbling). Poultry, fish, and shellfish also contain saturated fat, although generally less than meat.

Hydrogenated Fat - Known As Trans Fatty Acids or Trans-Fats

Trans fats are created during the food manufacturing process when cheap vegetable oils undergo a process called “hydrogenation” - they have hydrogen added to them to make them solid and less likely to become rancid. Unfortunately, trans fats are even worse for our heart than saturated fat, as they encourage atherosclerosis (narrowing of the arteries).

Vegetable Fats

A few vegetable fats - coconut oil, cocoa butter (found in chocolate), palm kernel oil, and palm oil - are high in saturated fat. These vegetable fats are found in many commercially baked goods, such as cookies and crackers, and in nondairy substitutes, such as whipped toppings, coffee creamers, cake mixes, and even frozen dinners. They also can be found in some snack foods like chips, candy bars, and buttered popcorn. Because these vegetable fats are not visible in these foods (unlike the fat in meats) it is important for you to read food labels. The label may tell you how much saturated fat a food contains, which will help you choose foods lowest in saturated fats.

Remember: Saturated fats are found primarily in animal products. But a few vegetable fats and many commercially processed foods also contain saturated fat. Read labels carefully. Choose foods wisely.

Substitute Unsaturated Fat for Saturated Fat

Unsaturated fat actually helps to lower cholesterol levels when it is substituted for saturated fat. Therefore, health professionals recommend that, when you do eat fats, unsaturated fats (polyunsaturated and monounsaturated fats) be substituted for part of the saturated fat whenever possible.

Polyunsaturated fats are found primarily in safflower, corn, soybean, cottonseed, sesame, and sunflower oils, which are common cooking oils. Polyunsaturated fats are also contained in most salad dressings. But be cautious. Commercially prepared salad dressings also may be high in saturated fats, and therefore careful inspection of labels is important. The word “hydrogenated” on a label means that some of the polyunsaturated fat has been converted to saturated fat.

Another type of polyunsaturated fat is found in the oils of fish and shellfish (often referred to as fish oils, or omega-3 fatty acids). This type of polyunsaturated fat is found in greatest amounts in such fatty fish as herring, salmon, and mackerel. There is little evidence that omega-3 fatty acids are useful for reducing LDL-cholesterol levels. However, fish is a good food choice for this diet play anyway because it is low in saturated fat. The use of fish oil supplements are not recommended for the treatment of high blood cholesterol because it is not known whether long-term ingestion of omega-3 fatty acids will lead to undesirable side effects.

Olive and canola oil (rapeseed oil) are examples of oils that are high in monounsaturated fats. Like other vegetable oils, these oils are used in cooking as well as in salads. Recently, research has shown that substituting monounsaturated fat, like substituting polyunsaturated fat, for saturated fat reduces blood cholesterol levels.

Remember: Unsaturated fats when substituted for saturated fats help lower blood cholesterol levels.

Eat Less High-Cholesterol Food

Dietary cholesterol is a waxy, fat-like substance found in foods that come from animals. Although it is not the same as saturated fat, dietary cholesterol also can raise your blood cholesterol level. Therefore, it is important to eat less food that is high in cholesterol. While cholesterol is needed for normal body function, your liver makes enough for your body’s needs so that you don’t need to eat any cholesterol at all.

Dietary Cholesterol in Food

Cholesterol is found in eggs, dairy products, meat, poultry, fish, and shellfish. Egg yolks and organ meats (liver, kidney, sweetbread, brain) are particularly rich sources of cholesterol. High-fat dairy products, meat, and poultry all have similar amounts of cholesterol. Fish generally has less cholesterol, but shellfish varies in cholesterol content. Foods of plant origin, like fruits, vegetables, grains, cereals, nuts, and seeds, contain no cholesterol.

Since cholesterol is not a fat, you can find it in both high-fat and low-fat animal foods. In other words, even if a food is low in fat, it may be high in cholesterol. For instance, organ meats, like liver, are low in fat, but are high in cholesterol.

Because many foods such as dairy products and some meats are high in both saturated fat and cholesterol, it is important to limit the amount of these high-fat foods that you eat, choosing lean meats and low-fat dairy products whenever possible.

Remember: Organ meats and egg yolks are high in cholesterol. High-fat dairy products, meat, and poultry have similar amounts of cholesterol. Some fish has less. Foods of plant origin like fruits, vegetables, vegetable oils, grains, cereals, nuts, and seeds contain no cholesterol.

Substitute Low GI Carbohydrates for Saturated Fat

Breads, pasta, rice, cereals, dried peas and beans, fruits, and vegetables are good sources of complex carbohydrates (starch and fiber). Low-GI varieties are excellent substitutes for foods that are high in saturated fat and cholesterol. The type of fiber found in foods such as oat and barley bran, some fruits like apples and oranges, and in some dried beans may even help reduce blood cholesterol levels.

Contrary to popular belief, high-carbohydrate foods (like pasta, rice, potatoes) are lower in calories than foods high in fat. In addition, they are good sources of vitamins and minerals. What adds calories to these foods is the addition of butter, rich sauces, whole milk, or cream, which are high in fat, especially saturated fat. It is important not to add these to the high-carbohydrate foods you are substituting for foods high in fat.

Remember: Foods that are high in complex carbohydrates, if eaten plain, are low in saturated fat and cholesterol as well as being good sources of vitamins, minerals, and fiber.

Maintain a Desirable Weight

People who are overweight frequently have higher blood cholesterol levels than people of desirable weight.

You can reduce your weight by eating fewer calories and by increasing your physical activity on a regular basis. By reducing the amount of fat in your diet, you will be cutting down on the richest source of calories. Substituting foods that are high in complex carbohydrates for high-fat foods will also help you lose weight, because many high-carbohydrate foods contain little fat and thus fewer calories.

Fat Contains Twice the Calories of Carbs and Protein

Fat has more than twice the calories as the same amount of protein or carbohydrate. Protein and carbohydrate both have about 4 calories in each gram, but all fat-saturated, polyunsaturated or monounsaturated fat - has 9 calories in each gram. Thus, foods that are high in fat are high in calories. And all calories count. So, to maintain a desirable weight, it is important to eat no more calories than your body needs.

Remember: To achieve or maintain a desirable weight, your caloric intake must not exceed the number of calories your body burns.

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High cholesterol affects about 17% of Americans ages 20 and older, contributing to atherosclerotic heart disease, which is the single leading cause of death and disability in the developed world. This medical dictionary covers the terms used in the report, What to do about High Cholesterol, and includes details on how to lower and watch your cholesterol through tests and diets.

* antioxidant: A substance that inhibits oxidation.

* apolipoproteins: Proteins that combine with cholesterol and triglyceride to form lipoproteins.

* atherosclerosis: Development of cholesterol-rich plaque on the inner walls of arteries, which can eventually obstruct blood flow.

* atherosclerotic plaque: A cholesterol-rich deposit on an artery wall.

* biological variability: Fluctuations that occur naturally over time in the levels of a substance such as cholesterol in a person’s body.

* cholesterol: A fatlike substance that is produced by the liver and found in all food from animal sources; an essential component of body cells and a precursor of bile acids and certain hormones.

* chylomicron: A large, extremely low-density lipoprotein that transports triglyceride from the intestine to fat tissue in the body.

* combined hyperlipidemia: A condition in which LDL and triglyceride levels are very high.

* familial combined hyperlipidemia: An inherited disorder in which the liver overproduces VLDL, causing high levels of cholesterol or triglycerides, or both.

* familial hypercholesterolemia: An inherited disorder in which the liver cannot properly remove LDL particles from the blood, causing a very high cholesterol level.

* fasting lipid profile: A laboratory test to determine the relative levels of HDL, LDL, and total cholesterol in the blood. Also referred to as a lipoprotein analysis, full lipid profile, or cholesterol profile.

* fatty acids: The primary building blocks of lipids.

* foam cells: Lipid-laden cells, named for their foamy appearance under the microscope, which contribute to the formation of atherosclerotic plaque.

* high-density lipoprotein (HDL): A lipoprotein that protects the arteries by transporting cholesterol from body cells to the liver for elimination.

* hydrogenation: The addition of hydrogen to a compound, particularly to solidify unsaturated oils.

* lipids: Fats, oils, and waxes that serve as building blocks for cells or as energy sources for the body.

* lipoproteins: Protein-covered fat particles that enable cholesterol to move easily through the blood.

* low-density lipoprotein (LDL): A lipoprotein that transports cholesterol from the liver to the rest of the body, which can cause the buildup of plaque in the arteries.

* monounsaturated fats: Fatty acids; abundant in olive, peanut, sesame, and canola oils.

* oxidation: A process in which oxygen combines with a substance, altering its structure and changing or destroying its normal function.

* platelets: Minute, colorless disks in the blood that are instrumental in clotting.

* polyunsaturated fats: Fatty acids that are abundant in soybean, corn, cottonseed, safflower, and sunflower oils.

* saturated fats: Fatty acids that are abundant in red meat, lard, butter, cheese, and some vegetable oils, in which each molecule carries the maximum number of hydrogen atoms.

* trans fats: Fatty acids (such as those found in solid margarine) that have been reshaped by hydrogenation; also called trans fatty acids.

* triglyceride: The primary type of fat in the body and in the diet, formed from three fatty-acid molecules and one glycerol molecule.

* unsaturated fats: Fatty acids in which some of the hydrogen atoms in each molecule have been replaced by double bonds; includes monounsaturated and polyunsaturated fats.

* very-low-density lipoprotein (VLDL): A lipoprotein that transports triglyceride manufactured in the liver to fat tissue in the body; eventually becomes low-density lipoprotein (LDL) after the triglyceride has been removed.

In foods, cholesterol is found in eggs, dairy products, meat, and poultry. Egg yolks and organ meats (liver, kidney, sweetbread, and brain) are high in cholesterol. Fish generally contains less cholesterol than other meats, but some shellfish are high in cholesterol.

Foods of plant origin (vegetables, fruits, grains, cereals, nuts, and seeds) contain no cholesterol.

Fat content is not a good measure of cholesterol content. For example, liver and other organ meats are low in fat, but very high in cholesterol.

Therapeutic Lifestyle Changes (TLC) is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:

* The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7% of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power.
* Weight Management. Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
* Physical Activity. Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

Foods low in saturated fat include fat-free or 1percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

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A study appearing in this week’s New England Journal of Medicine confirms that a combination of gene variants previously associated with cholesterol levels does reflect patients’ cholesterol levels and can signify increased risk of heart attack, stroke or sudden cardiac death. Led by researchers from the Massachusetts General Hospital Cardiology Division, the study’s findings are a first step towards the ability to identify individuals who might benefit from earlier use of cholesterol-lowering medications and other measures to combat elevated risk.

“The prospect of personalized medicine has received much hype, but until recently, there has been little hard evidence to support the promise,” says Sekar Kathiresan, MD, MGH Director of Preventive Cardiology, the paper’s lead author. “We feel that our data provides two insights. First, we provide a foundation for the possibility that a panel of gene variants will eventually be useful in preventive cardiac care. Second, we show that the combination of multiple variants related to cholesterol importantly contribute to the genetic risk for heart attack.”

It is estimated that about half the variation in high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels is inherited, rather than being caused by lifestyle factors such as diet and exercise. While studies have associated several gene variants with cholesterol levels, exactly how those variants impact the risk of cardiovascular disease is unclear. The current study was designed to explore the influence of those variants on the risk of cardiovascular events — heart attack, stroke or sudden cardiac death — and whether measuring such variants could help predict risk better than simply measuring HDL and LDL levels.

Since the effects of individual gene variants appears slight, the research team looked at a combination of 9 single-nucleotide polymorphisms (SNPs) previously associated with cholesterol levels. They analyzed data from 5,414 Swedish adults who participated in a major prospective epidemiological study and correlated data — including standard measurements of HDL and LDL cholesterol and the presence of the 9 gene variants — with information on the participants’ subsequent medical histories available from a registry of information collected on all Swedish citizens. After the initial genotyping of participants not receiving lipid-lowering therapy, participants were assigned a genotype score ranging from 0 to 18, based on how many copies of the unfavorable SNPs they carried. Of the participants who had no cardiovascular events before enrolling in the study, 238 suffered a heart attack, stroke or cardiac death during the subsequent 10.6 years.

Higher genotype scores did reflect higher LDL (”bad”) cholesterol and lower HDL (”good”) cholesterol levels. Importantly, those with genotype scores of 11 or higher had a 63 percent greater risk of a cardiovascular event than did those with scores of 9 or lower. Although testing for the panel of 9 SNPs was not better than standard risk factors for predicting cardiac events in the overall population, among participants classified at intermediate risk by standard measures, adding the 9-SNP panel significantly improved the ability to distinguish truly elevated or reduced risk levels.

“A current clinical dilemma is how early to start patients on cholesterol-lowering medications like statins that can reduce the risk of heart attack. Our data suggest that those individuals classified as higher risk based on a genetic test may deserve more intense pharmacological and lifestyle treatments,” says Kathiresan. “But before we can move from our pilot data to information that can impact the care of patients with or at risk for cardiovascular disease, we need to discover all the risk-related variants — and there will probably be 50 to 100 — and then conduct clinical studies confirming that this information can reliably guide patient care.” Earlier this year Kathiresan, an instructor in Medicine at Harvard Medical School, and colleagues from the Broad Institute of Massachusetts Institute of Technology and Harvard University began this gene-discovery process and identified six new cholesterol-associated gene variants in a separate study published in Nature Genetics.

Support for the NEJM study includes grants from the Doris Duke Charitable Foundation, the Fannie Rippel Foundation, the Donovan Family Foundation and the National Institutes of Health. Study co-authors are David Altshuler, MD, PhD, and Christopher Newton-Cheh, MD, MPH, MGH; Olle Melander, MD, PhD, Dragi Anevski, PhD, Charlotta Roos, MSc, Goran Berglund, MD, PhD, Bo Hedblad, MD, PhD, Leif Groop, MD, PhD, and Marju Orho-Melander, PhD, Lund University, Sweden; Candace Guiducci and Noel Burtt, Broad Institute; and Joel Hirschhorn, MD, PhD, Children’s Hospital Boston.

Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $500 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.

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A new gene locus has been discovered that may be associated with levels of low-density lipoprotein (LDL) cholesterol in the blood. This new finding may aid the development of new drugs to fight cardiovascular disease, according to an article published in the February 9 issue of The Lancet.

Higher LDL cholesterol concentrations have been linked to cardiovascular diseases, and in previous studies, a clinical benefit can be reaped by lowering concentrations of LDL cholesterol in the blood. This means that improving understanding of the biological mechanisms that control the metabolism and regulation of LDL cholesterol could provide valuable information for identification of new therapeutic directions.

Dr Manjinder Sandhu, Department of Public Health & Primary Care and MRC Epidemiology Unit, University of Cambridge, UK, and colleagues did performed an association of LDL cholesterol levels with genome-wide data from 11,685 participants in five separate studies.

The researchers found evidence that correlation existed between LDL-cholesterol levels and the chromosome region 1p13.3. Across all of the studies examined, this association maintained its magnitude and showed independent statistical association in each study. The authors conclude with optimism for the implications of this result: “These results potentially provide insight into the biological mechanisms that underlie the regulation of LDL cholesterol and might help in the discovery of novel therapeutic targets for cardiovascular disease.”

Dr Ronald Krauss, Children’s Hospital Oakland Research Institute, Oakland, CA, USA, contributed in an accompanying comment with more options for further investigation: “In addition to the identification of new treatment targets, the discovery of genetic polymorphisms that affect LDL and other markers of cardiovascular disease risk could provide a means to categorise specific phenotypes that might merit different treatments and to identify at-risk individuals.”

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High levels increase risk for early heart disease, other serious conditions.

High cholesterol levels are not just found in adults. Children may have high cholesterol, too, even without being overweight. Over years, cholesterol overload has similar hazards as in adults — clogged arteries and injury to the heart.

The Children’s Hospital of Philadelphia recommends that children, starting at age two years, should have a complete cholesterol profile checked after an overnight fasting if they have a family history of high cholesterol or of early heart disease, in line with similar recommendations from the American Academy of Pediatrics and the American Heart Association. Those who do not have a family history but have other risk factors for
early heart disease, such as being overweight, high blood pressure, diabetes, smoking, poor diet, and sedentary lifestyle should also be screened.

“Although the most common reasons for high cholesterol are poor diet, being overweight, and not getting enough exercise, some apparently healthy children inherit high cholesterol levels from their parents,” said Julie Brothers, M.D., medical director of the Lipid Heart Clinic at The Children’s Hospital of Philadelphia. “Overall, we’ve noticed an increase in children’s cholesterol levels the past several years and this is a disturbing trend.”

Children with a family history of high cholesterol or early heart disease, even if they have normal weight, should be routinely screened, as they may have a genetic predisposition for excess cholesterol levels — familial hypercholesterolemia (FH). These children have high levels of low-density lipoprotein (LDL), also called “bad cholesterol,” beginning at birth, which can lead to early thickening of the artery walls, premature cardiovascular disease and an increased risk of early heart attack.

Familial hypercholesterolemia is underestimated in the community and in pediatric primary care practices. Children with FH have no symptoms or signs of their condition and often do not fit the profile of someone who is at risk; they usually have a normal weight and a healthy lifestyle and diet. However, in addition to a family history of high cholesterol, they usually have a family history of early heart disease. Children with a parent, grandparent, sibling, aunt, or uncle with high cholesterol or who has suffered a cardiac event before the age of 55 should be routinely monitored.

Children who are overweight or obese should also have their cholesterol levels routinely screened by pediatric healthcare professionals, as this also places them at increased risk of developing early heart disease.

It is important to differentiate between obese children with high cholesterol and those with FH, which is not traditionally associated with obesity; however, with the obesity epidemic, many children with FH now also are overweight or obese.

“Cholesterol levels in children who are obese usually respond well to diet and lifestyle modifications, whereas children with FH often need medications in addition to diet and exercise,” added Dr. Brothers.

Modifications to diet and increased physical activity are the first-line treatments for children identified with raised cholesterol levels. Another option is putting a child on statin therapy, which is a lifetime commitment.

The Lipid Heart Clinic at The Children’s Hospital of Philadelphia evaluates and treats children and adolescents who have high levels of lipids (fats) in their blood. Elevated lipids put young people at risk for heart disease later in life.

The Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents.

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Healthy chocolate chip cookies contain ingredients proven to help reduce the risk of heart disease

RD Foods’ high fiber Right Direction Cookies are the healthy snacks for kids that parents can feel good about. Instead of a typical chocolate chip cookie that may contain large amounts of fat, parents can offer their children Right Direction Cookies as a delicious, healthy snack alternative. Each Right Direction Cookie contains psyllium soluble fiber and plant sterols proven to help reduce the risk of heart disease.

Busy families on the go may not always have time to eat right. Right Direction Cookies can be part of a sensible diet high in soluble fiber, which absorbs cholesterol and fats. Each Right Direction Cookie contains only 1-2 grams of saturated fat, and high amounts of dietary fiber (5-6 grams per cookie). Research confirms the many benefits of psyllium soluble fiber, including its effectiveness in treating high blood pressure, irritable bowel syndrome, hemorrhoids, constipation, obesity, and coronary artery disease. By binding cholesterol in the intestine and removing it from the body, plant psyllium is highly beneficial in helping to reduce coronary artery disease risk.

“Our high fiber chocolate chip cookies are a healthy snack for children and give parents the peace of mind in knowing that their kids are happily getting difficult-to- find soluble fiber in a tasty snack. Right Direction chocolate chip and oatmeal raisin varieties contain psyllium soluble fiber and plant sterols, and have been proven to reduce the risk of heart disease,” states Wendy Miller, President of RD Foods.

Parents looking for healthy chocolate cookies to give their kids after school or anytime can feel good about Right Direction chocolate chip cookies. Right Direction Cookies also offer additional healthy benefits; with each cookie supplying 1.3 grams of plant sterols. By blocking cholesterol absorption, plant sterols play a significant role in reducing coronary disease risk. Part of a total wellness plan of sensible food choices, proper rest and regular exercise, Right Direction Cookies are the healthy snack foods kids will love.

About RD Foods
RD Foods’ mission is to help people lead healthier lives by providing healthful and appealing foods. The company’s debut product, Right Direction Cookies,™ offers an innovative way for consumers to manage cholesterol and add fiber to their diets. Based in New Jersey, RD Foods is a privately held company.

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In this month of love, with cards and shop windows adorned with heart-shaped items surrounding us, take a moment or two to appreciate your own heart.

Each day, it works tirelessly, without ceasing, steadily keeping lifeblood flowing through the veins and arteries of each and every human being. Quietly doing its job, the heart beats an average of 3.3 billion beats in a lifetime!

And how do we thank this hardworking muscle upon which our very lives depend? For many Americans, by feeding it cholesterol, saturated fats, refined sugars, and other harmful substances lacking the nutritive value a healthy heart needs to keep going, day in and day out, and with insufficient exercise and carrying weight that strains the body s hardest-working muscle.

Cardiovascular diseases, including stroke, are the No. 1 killers in the United States, according to information from the American Heart Association. Heart health   or the lack of it, for many of us   is one reason the president annually proclaims February as  American Heart Month,  at the request of Congress.

Coronary artery disease, or CAD, is the leading cause of death in every developed country,  according to doctors Michael F. Roizen and Mehmet C. Oz, authors of You   the Owner s Manual.  Every American, Asian, and European has a   50 percent chance that his or her quality of life will be damaged by arterial aging disease.

A healthy heart pumps oxygenated blood to itself and the rest of the body, while bringing blood through organs to have toxins removed and back to the lungs for more oxygen. A heart weakened by disease or pumping inefficiently due to clogged arteries means a diminished quality of life and can lead to sudden death.

For optimum health, say Roizen and Oz, your body needs  enough physical activity (exercise) to burn between 3,500 and 6,500 calories a week (or from 500 to about 950 a day).

The American Heart Association recommends,  Don t eat more calories than you know you can burn up every day.  For heart health, the association also suggests increasing the amount and intensity of physical activity to match the number of calories you take in.

Every body also needs about an hour each week of cardiovascular activity to elevate the heart rate to 80 percent or more of its age-adjusted maximum   calculated at 220 minus one s age   for an extended period of time. This can be in three 20-minute periods each week to obtain optimum health and for living younger, according to Roizen and Oz.

Exercise can be as simple as walking or as energetic as swimming or cycling. Another benefit of exercise is to maintain a healthy weight, as extra weight increases the risk of heart disease. A good guideline to follow is to keep a waist size of less than 40 inches for men or 35 inches for women.

Engaging in enough physical activity to be slightly out of breath, or enough to break a sweat during that time, is usually sufficient to maintain heart health and a healthy weight, provided a body is not overweight to begin with.

Keeping tabs on blood pressure and cholesterol levels also helps with heart health. A healthy pressure is 115/76, according to Roizen and Oz. Take steps if the pressure is too high and be guided by a doctor about the action to take.

Genetics and diet contribute to cholesterol levels. High HDL, or healthy cholesterol, can be caused by foods containing too much cholesterol, simple carbohydrates, and trans and saturated fats, or by genetics. High LDL, the unhealthy cholesterol, can run in families.

Avoiding most  white foods,  such as white bread, refined sugar, and white pasta, along with restricting saturated and trans fats to less than 20 grams daily, can lower LDL.

Among the things Roizen and Oz suggest for increasing healthy or HDL cholesterol are consuming healthy fats, such as a tablespoon of olive oil, 4 ounces of fish, or 12 walnuts daily; walking or another physical activity for 30 minutes a day; taking niacin; and having a drink of alcohol each night. A word of caution: Too much alcohol can cause aging of the immune system.

Diet plays a huge role in heart health. A diet rich in flavonoids, such as those found in nuts, teas, red wine, grapes, cranberries, onions, and tomatoes, along with conservative amounts of monounsaturated fats, like olive oil, and fatty fish like salmon and whitefish   both high in omega-3 fatty acids, provides energy and nutrients for a healthy heart.

Other aids for a healthy heart may include a low dose of aspirin, as prescribed by a doctor. A good multivitamin can also help, and getting enough potassium from your diet, such as from melons, bananas, or avocados, is beneficial.

Choose foods like vegetables, fruits, whole-grain products, and fat-free or low-fat dairy products most often,  the American Heart Association recommends. High in vitamins, minerals, and fiber, as well as calories, a variety of vegetables and fruits can help control weight and blood pressure. Whole-grain products contain fiber, which can help lower blood cholesterol and help you feel full, which in turn may help manage weight.

Generally, a healthy heart and cardiovascular system can be maintained with a plan including a healthy, low-fat diet, moderate exercise, and regular checks on blood pressure and cholesterol.

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While routine screening of children for high cholesterol isn’t necessary, you may want to consider it under certain circumstances.

Children should be screened if their parents, grandparents, aunts or uncles have high cholesterol or cardiovascular disease before age 55 for men and 65 for women.

Higher-than-normal blood cholesterol among children does not always predict high levels in adulthood. But for children from high-risk families, check with your doctor and work with a registered dietitian to bring cholesterol levels down.

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Cholesterol is not the major culprit in heart disease or any disease. If it becomes oxidized it can irritate/inflame tissues in which it is lodged in, such as the endothelium (lining of the arteries). This would be one of numerous causes of chronic inflammation that can injure the lining of arteries. However, many good fats are easily oxidized such as omega-3 fatty acids, but it does not mean that you should avoid it at all costs.

Common sense would indicate that we should avoid the oxidation (rancidity) of cholesterol and fatty acids and not get rid of important life-giving molecules. Using the same conventional medical thinking that is being used for cholesterol would lead one to believe that doctors should reduce the risk of Alzheimer’s disease by taking out everybody’s brain.

In fact, cholesterol is being transported to tissues as part of an inflammatory response that is there to repair damage.

The fixation on cholesterol as a major cause of heart disease defies the last 15 years of science and deflects from real causes such as the damage (via glycation) that sugars such as glucose and fructose inflict on tissues, including the lining of arteries, causing chronic inflammation and resultant plaque.

Insulin & Leptin Resistance

Hundreds of excellent scientific articles have linked insulin resistance and more recently leptin resistance to cardiovascular disease much more strongly than cholesterol, and they are in fact at least partially responsible for cholesterol abnormalities. For instance, insulin and leptin resistance result in “small dense” LDL particles and a greater number of particles.

This is much more important than the total cholesterol number. Because of particle size shift to small and dense, the total LDL cholesterol could still be low even though the number of particles and the density of the particles is greater. Small, dense LDL particles can squeeze between the cells lining the inside of the arteries, the “gap junction” of the endothelium, where they can get struck and potentially oxidize, turn rancid, and cause inflammation of the lining of the arteries and plaque formation.

Importantly, many solid scientific studies have shown a mechanistic, causal effect of elevated insulin and leptin on heart and vascular disease, whereas almost all studies with cholesterol misleadingly only show an association. Association does not imply cause. For instance, something else may be causing lipid abnormalities such as elevated cholesterol and triglycerides, and also causing heart disease.

This “something else” is improper insulin and leptin signaling. Similarly, sugar does not cause diabetes; sugar is just listening to orders. Improper insulin and leptin signaling is the cause of diabetes. Likewise, cholesterol does not cause heart disease, but improper metabolic signals including improper signals to cholesterol (causing it to oxidize) and perhaps to the liver that manufactures the cholesterol, will cause heart and vascular disease and hypertension.

Removing cholesterol will do nothing to improve the underlying problems, the real roots of chronic disease, which will always have to do with improper communication, and the generals of metabolic communication are insulin and leptin. They are really what must be treated to reverse heart disease, diabetes, osteoporosis, obesity, and to some extent aging itself.

Cholesterol; Wrongly Accused?

Before we can begin to talk about the real cause and effective treatment for heart and blood vessel disease, we must first look at what is known, or I should say what we think we know. The first thing that comes to mind when one hears about heart disease is almost always cholesterol. Cholesterol and heart disease has been almost synonymous for the last half-century. Cholesterol has been portrayed as the Darth Vader to our arteries and our heart.

The latest recommendation given by a so-called panel of “experts” recommends that a person’s cholesterol be as low as possible, in fact to a level so low they say it cannot be achieved by diet, exercise, or any known lifestyle modification. Therefore, they say cholesterol-lowering drugs; particularly the so-called “statins” need to be given to anyone at high risk of heart disease. Since heart disease is the number one killer in this country that would include most adults and even many children. The fact that this might add to the $26 billion in sales of statin drugs last year I’m sure played no role in their recommendations.

Or did it?

Expert Conflict of Interests

Major consumer groups think so. They found out that eight of the nine “experts” that made the recommendations were on the payroll of pharmaceutical companies that manufacture those drugs. Major scientific organizations have chastised medical journals for allowing the pharmaceutical industry to publish misleading results and half-truths. There is a major push under way to force the pharmaceutical industry (and others) to publish results of all of their studies, and not just the ones that appear positive. The studies that showed negative results would be forced to be published also.

It could be that lowering cholesterol might not be as healthy as we are being told. More and more studies are coming out showing just how unhealthy lowering cholesterol might be, particularly by the use of statin drugs. In particular, statin drugs have been shown to be harmful to muscles causing considerable damage. A common symptom of this damage is muscular aches and pains that many patients experience on cholesterol-lowering drugs, however most do not realize that these drugs are to blame.

Hmm…isn’t the heart a muscle?

Statin Drugs Actually Increase Heart Disease

Indeed, low cholesterol levels have been shown to worsen patients with congestive heart failure, a life-threatening condition where the heart becomes too weak to effectively pump blood. Statin drugs have been shown to also cause nerve damage and to greatly impair memory. One reason that statin drugs have these various serious side effects is that they work by inhibiting a vital enzyme that manufactures cholesterol in the liver. However, the same enzyme is used to manufacture coenzyme Q10, which is a biochemical needed to transfer energy from food to our cells to be used for the work of staying alive and healthy.

Statin drugs are known to inhibit our very important production of coenzyme Q10. Importantly, while many cardiologists insist that lowering cholesterol is correlated with a reduction in the risk of heart attacks; few can say that there is a reduction in the risk of mortality (death). That has been much harder to show. In other words it has never been conclusively shown that lowering cholesterol saves lives. In fact, several large studies have shown that lowering cholesterol into the range currently recommended is correlated with an increased risk of dying, especially of cancer.

No Such Thing as Good and Bad Cholesterol

Because the correlation of total cholesterol with heart disease is so weak, many years ago a stronger correlation was sought. It was found that there is so-called “good cholesterol” called HDL, and that the so-called “bad cholesterol” was LDL. HDL stands for high-density lipoprotein, and LDL stands for low-density lipoprotein. Notice please that LDL and HDL are lipoproteins — fats combined with proteins. There is only one cholesterol. There is no such thing as a good or a bad cholesterol. Cholesterol is just cholesterol. It combines with other fats and proteins to be carried through the bloodstream, since fat and our watery blood do not mix very well.

Fatty substances therefore must be shuttled to and from our tissues and cells using proteins. LDL and HDL are forms of proteins and are far from being just cholesterol. In fact we now know there are many types of these fat and protein particles. LDL particles come in many sizes and large LDL particles are not a problem. Only the so-called small dense LDL particles can potentially be a problem, because they can squeeze through the lining of the arteries and if they oxidize, otherwise known as turning rancid, they can cause damage and inflammation. Thus, you might say that there is “good LDL” and “bad LDL.” Also, some HDL particles are better than others. Knowing just your total cholesterol tells you very little. Even knowing your LDL and HDL levels do not tell you very much.

A mistake that is rarely made in the hard-core sciences such as physics seems to be frequently made in medicine. This is confusing correlation with cause. There may be a weak correlation of elevated cholesterol with heart attacks, however this does not mean it is the cholesterol that caused the heart attack. Certainly gray hair is correlated with getting older; however one could hardly say that the gray hair caused one to get old. Using hair dye to reduce the gray hair would not really make you any younger. Neither it appears would just lowering your cholesterol.

Perhaps something else is causing both the gray hair and aging. Even if elevated cholesterol were significant and heart disease (which I question) perhaps something else is causing the elevated cholesterol and also causing the heart disease.

Let’s look little more at cholesterol or, as Paul Harvey was fond of saying, “the rest of the story.” First and foremost, cholesterol is a vital component of every cell membrane on Earth. In other words, there is no life on Earth they can live without cholesterol. That will automatically tell you that, in of itself, it cannot be evil. In fact it is one of our best friends. We would not be here without it. No wonder lowering cholesterol too much increases one’s risk of dying. Cholesterol also is a precursor to all of the steroid hormones. You cannot make estrogen, testosterone, cortisone, and a host of other vital hormones without cholesterol.

Cholesterol Is The Hero, Not The Villain.

It was determined many years ago that the majority of cholesterol in your bloodstream comes from what your liver is manufacturing and distributing. The amount of cholesterol that one eats plays little role in determining your cholesterol levels. It is also known that HDL shuttles cholesterol away from tissues, and away from your arteries, back to your liver. That is why HDL is called the “good cholesterol;” because it is supposedly taking cholesterol away from your arteries. But let’s think about that.

* Why does your liver make sure that you have plenty of cholesterol?
* Why is HDL taking cholesterol back to your liver?
* Why not take it right to your kidneys, or your intestines to get rid of it?

It is taking it back to your liver so that your liver can recycle it; put it back into other particles to be taken to tissues and cells that need it. Your body is trying to make and conserve the cholesterol for the precise reason that it is so important, indeed vital, for health.

One function of cholesterol is to keep your cell membranes from falling apart. As such, you might consider cholesterol your cells “superglue.” It is a necessary ingredient in any sort of cellular repair. The coronary disease associated with heart attacks is now known to be caused from damage to the lining of those arteries. That damage causes inflammation. The coronary disease that causes heart attacks is now considered to be caused mostly from chronic inflammation.

What Is Inflammation?

Think of what happens if you were to cut your hand. Within a fraction of a second, chemicals are released by the damaged tissue to initiate the process known as inflammation. Inflammation will allow that little cut to heal, and indeed to keep you from dying. The cut blood vessels constrict to keep you from bleeding too much. Blood becomes “thicker” so that it can clot. Cells and chemicals from the immune system are alerted to come to the area to keep intruders such as viruses and bacteria from invading the cut. Other cells are told to multiply to repair the damage so that you can heal. When the repair is completed, you have lived to be careless another day, though you may have a small scar to show for your troubles.

We now know that similar events take place within the lining of our arteries. When damage occurs to the lining of our arteries (or even elsewhere) chemicals are released to initiate the process of inflammation. Arteries constrict, blood becomes more prone to clot, white blood cells are called to the area to gobble up damaged debris, and cells adjacent to those damaged are told to multiply. Ultimately, scars form, however inside our arteries we call it plaque. And the constriction of our arteries and the “thickening” of our blood further predisposes us to high blood pressure and heart attacks.

So Where Might Cholesterol Fit Into All Of This?

When damage is occurring and inflammation is being initiated, chemicals are being released so that that damage can be repaired. One could speculate that to replace damaged, old and worn-out cells the liver needs to be notified to either recycle or manufacture cholesterol since no cell, human or otherwise, can be made without it. In this case, cholesterol is being manufactured and distributed in your bloodstream to help you repair damaged tissue and in fact to keep you alive.

If excessive damage is occurring such that it is necessary to distribute extra cholesterol through the bloodstream, it would not seem very wise to merely lower the cholesterol and forget about why it is there in the first place. It would seem much smarter to reduce the extra need for the cholesterol — the excessive damage that is occurring, the reason for the chronic inflammation.

So Why Take Cholesterol-Lowering Drugs?

The pharmaceutical companies thought that you might think that. They went back to the drawing board. They did more “research” and found (coincidentally) that statin drugs had anti-inflammatory effects. Therefore we’re currently being told to stay on our cholesterol-lowering drugs because now they work by reducing inflammation and perhaps not even by reducing cholesterol, and in fact perhaps in spite of it. Aspirin reduces inflammation for a lot less money. So does vitamin E, and fish oil, and dietary changes without the dangers of drugs and having many other benefits instead.

What About Triglycerides?

Triglycerides are just medical terminology for fat. A person with high triglycerides has a lot of fat in the bloodstream. Triglycerides are generally measured when a person has fasted overnight. High fasting triglycerides are either from manufacturing too much, or using (burning) too little. In other words, what high triglycerides are telling you is that you are making too much fat and you are unable to burn it. This indeed is a major problem. The inability to burn fat underlies virtually all of the chronic diseases of aging, and in fact may contribute to the rate of aging itself.

As such, one might think that the control all fat burning and storage might be very important in heart disease, and the other diseases of aging such as diabetes, obesity, osteoporosis, and even cancer. Indeed, this appears to very much be the case. The two hormones that to a major extent control our ability to burn and store fat, insulin and leptin, appear to play a major role in all of the chronic diseases of aging. I would call them the most important hormones, indeed chemicals in the entire body. But that is a story for next time.

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Two and a half years ago, I had some health issues and went to a Dr. My cholesterol was near 400. This is not considered good. My first appointment I had to fill out a health history. 3 people read it back to me, 2 nurses and the Dr, and 3 people looked at the computer portion. I was completely honest with this history. Many people are not. I put that I smoked a pack of day. I smoked pot regularly. I drank nearly a quart a day of alcohol. I was 40 lbs overweight. These are not things I am proud of, but they were fact, and it was my health history. This is what my diagnosis and treatment were based on. If I wanted to get better, I thought honesty was important.

Not 1 person questioned these facts. The Dr did not recommend I change anything. He prescribed 3 medications. One of them was Lipitor. To begin taking it I had to have 2 blood liver tests. I went home and read the small print that came with it. I took them for 1 week and threw them away. From what I read, I did not fit any criteria to take it, and it would most likely harm me.

This week the cover of BusinessWeek is on Lipitor.  Go to Google. Type in Lipitor. Search the news. Congress is investigating it this week. By Pfizer’s own studies, Lipitor shows zero benefit for women and harm to 10-15%. Why is this the most prescribed drug in America???? Fear. And laziness. We don’t want to change the way we live, we want to take magic pills and make it all go away.

For myself, I chose not to go the pill route. I also had high blood pressure. It runs in my family. I studied the causes of it… extra weight, alcohol, smoking….  even with the pills, I was still committing suicide. I decided to change my habits. I lost 35 lbs, I started walking, I quit drinking alcohol and stopped drugs. Three months after that I stopped smoking. My blood pressure plummeted.  I wasn’t taking any meds and had not felt so good in all my life. Almost 2 years later, I could still lose 15 lbs, but I’m a lot like Oprah. I would just yo-yo. I have maintained this weight for over a year. I haven’t had any alcohol and 18 months since any cigarettes.

We are so conditioned to do everything a Dr tells us to.  I wish my Dr had to be to quit abusing myself. I think more Drs should try ti and quit writing so many prescriptions. But then we would have to take responsibility.

Get off this page, go to google or some search engine. Check out these medications. The results will astound you. Congress is investigating these drugs this week. What the Hell was the FDA doing years ago??? If we quit feeding these huge drug companies, maybe we could start getting true health care for more Americans.

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