Monday, April 6, 2015

The Cause of Heart Disease? NOT Dietary Cholesterol, Goverment finally admits

For 40 years Americans have been eating fewer eggs, butter and red meat with saturated fat and cholesterol because US government policy makers told us not to.  We were told that dietary saturated fat and cholesterol were bad for our health and caused heart disease.  Manufactured foods such as margarine, egg substitutes, and low fat products laden with sugar or high fructose corn syrup to make them palatable were touted as the healthy way to go.
I have been advising my patients for most of my practice to stay away from the manufactured foods and eat whole foods, including eggs, red meat and butter.  And now, the US government finally agrees with me.
In February 2015 the 572-page Scientific Report of the 2015 Dietary Guidelines Advisory Committee was released.  Buried on page 91 it states, "...available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol....Cholesterol is not a nutrient of concern for overconsumption."
When the original recommendations were made in the 1960s and 1970s, the government policy relied on a kind of science called epidemiological or observational studies.  In these studies researchers follow large groups of people over many years.  However, these studies are limited in that they can only show an association between two things, and not that one causes the other.  Therefore a hypothesis can be formed from these studies, but it takes more rigorous studies to prove them.

There are still dietary guidelines in the current report that I don't agree with.  They continue to recommend reducing saturated fats, to the point of recommending that even lean meat be removed from the list of healthy foods, even though several recent meta-analyses have shown that there are no studies that prove that saturated fats cause heart disease.

And they continue to recommend limiting salt intake, even though in 2013 an authoritative study by the Institute of Medicine contradicted that recommendation.

While there may be a general correlation between high serum levels of cholesterol and heart disease, it is only oxidized cholesterol that leads to atherosclerotic plaque (hardening of the arteries).  High levels of non-oxidized serum cholesterol are actually protective and essential to life and all cells.  Studies of the elderly show that those with low cholesterol levels have higher death rates than those with high cholesterol levels.
We should be focusing on what oxidizes the cholesterol.  Inflammation in the arteries causes oxidation of cholesterol, platelet aggregation and atherosclerotic plaque formation.  Rather than focusing so much on the cholesterol levels, in our office we test Lp-PLA2 levels, a marker for inflammation and plaque in the arteries, and Cardiac C-reactive Protein, a marker for inflammation in the body.
What causes inflammation in the arteries?  The two most common causes are high blood glucose and insulin levels and high Homocysteine levels.  Anything else that causes inflammation in the body, such as autoimmune diseases, chronic infections, etc. can also increase inflammation in the arteries.
The increase of consumption of low fat, high simple carbohydrate diets high in sugar and processed grains has caused an explosion of pre-diabetes and diabetes.  The insulin levels rise to try and lower the blood glucose levels and try to drive glucose into the cells.  The cells start to become resistant to the high levels of insulin, and blood glucose levels rise. 
When blood glucose rises, it attaches to the proteins in a process called "glycosylation," which damages the protein and cells.  The amount of glycosylation in the body is measured by the Hemoglobin A1C.  If that level is elevated, is shows that damage is already being done in the body and in the arteries, even though it may not yet be considered full-blown diabetes.
When insulin levels rise, blood pressure rises, triglycerides and sometimes cholesterol increases, and it causes inflammation in the body and in the arteries.
Therefore, the recommendations by the government and the American Heart Association to cut down on dietary fat and cholesterol may have even worsened our health.  By cutting out meat and eggs, we have eaten more grains, pasta, sugar, high fructose corn syrup and polyunsaturated fats.  Over the past 50 years, Americans have cut saturated fat intake by 25% and increased carbohydrates by more than 30%.  However, well done studies are showing that a diet high in sugar, refined grains and polyunsaturated fats increases the risk of obesity, diabetes and heart disease much more than a diet high in natural fats and cholesterol.
Homocysteine is a non-protein amino acid, important in the synthesis of methionine and cysteine.  High Homocysteine levels can cause endothelial (cells that line the inner arteries) cell injury, causing inflammation and atherosclerotic plaques.
High levels of Homocysteine are caused by a reduction in three simple nutrients:  Folate, B-12 and B-6.  Today most of our processed foods contain these nutrients as additives.  Red meat and whole grains have higher levels of these vitamins.  However, around 40% of the population has a genetic defect which keeps the body from creating the activated form of these vitamins which are necessary to reduce Homocysteine.  This is a mutation of the MTHFR genes (See my blog from February to find out more about this mutation).  If you have a family history of heart disease, make sure you are tested for this mutation.
So what is my advice on reducing heart disease?
  • Check inflammatory markers Lp-PLA2 and Cardiac C-reactive protein
  • Check Homocysteine levels
  • Reduce oxidation of cholesterol with high levels of anti-oxidants such as those found in SpringTree SuperMulti Plus.
  • Balance insulin and blood glucose with a whole foods low carbohydrate diet.  Don't forget the natural fats--they balance blood sugar and give us energy in place of the carbs.  Also consider using SpringTree Glucose Balance
  • Reduce Homocysteine levels with the activated forms of B-12, folate and B-6, called methylcobalamine. 5-MTHF, and P-5-P, as found in SpringTree Methylation Factors.
  • Reduce inflammation with fish oil
  • Reduce inflammation with proteolytic enzymes and herbs such as turmeric, found in SpringTree's Pain and Inflammation supplement.
SpringTree Supplements can be found at
Until we meet again,
Dr. Judi

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