At the end of this article you will find questions that may be fun to ask the next time you see him/her about cholesterol when they say your cholesterol is too high and he or she wants to put you on drugs.
What Is Cholesterol?
Cholesterol is not a fat, but rather a soft, waxy, "fat-like"
substance that circulates in the bloodstream. It is vital to life and is
found in all cell membranes. It is necessary for the production of bile
acids and steroid hormones and Vitamin D. Cholesterol is manufactured
by the liver, but is also present in all animal foods. It is abundant in
organ meats, shell fish, and egg yolks but is contained in smaller
amounts in all meats and poultry. Vegetable oils and shortenings contain
Cholesterol cannot dissolve in the blood, so your liver combines it
with special proteins called lipoproteins to “liquefy” it. The
lipoproteins used by the liver are either very low-density lipoproteins
(VLDL) or high-density lipoproteins (HDL). (VLDL cholesterol is
metabolized in the bloodstream to produce LDL, or low-density
Note: HDL is called the "good cholesterol" because HDL cholesterol
particles prevent atherosclerosis by extracting cholesterol from
arterial walls and disposing of them through the liver. LDL cholesterol
is called "bad" cholesterol, because elevated LDL cholesterol is
associated with an increased risk of coronary heart disease. Thus, high
levels of LDL cholesterol and low levels of HDL cholesterol (high
LDL/HDL ratios) are considered by most doctors to be risk factors for
atherosclerosis, while low levels of LDL cholesterol and high levels of
HDL cholesterol (low LDL/HDL ratios) are considered desirable.
It is important to note that the liver not only manufactures and
secretes LDL cholesterol into the blood, it also removes it. To remove
LDL cholesterol from the blood, the liver relies on special proteins
called LDL receptors that are normally present on the surface of liver
cells. LDL receptors snatch LDL cholesterol particles from the blood and
transport them inside the liver. A high number of
active LDL receptors on the liver surfaces are associated with the rapid
removal of LDL cholesterol from the blood and low blood LDL levels. A
deficiency of LDL receptors is associated with high LDL cholesterol
blood levels. But it is also crucial that the cholesterol which
has been stored in the liver by the LDL receptors be regularly "flushed"
to make room for “new” deposits, or the process comes to a standstill,
thus causing levels to soar in the bloodstream.
In point of fact, the liver is responsible for over 80% of your cholesterol level. Diet accounts for less than 20%
The Cholesterol Theory of Heart Disease
According to the cholesterol theory of heart disease (and despite all
that you may have heard, it is only a theory), LDL cholesterol in the
blood combines with other substances such as cellular waste products,
calcium, and fibrin (a clotting material in the blood) to form arterial
plaque, which attaches itself to the inner lining of the arteries. Over
time, cholesterol plaque causes thickening of the artery walls and
narrowing of the arteries, a process called atherosclerosis. Arteries
that supply blood and oxygen to the heart muscles are called coronary
arteries. When coronary arteries are narrowed by atherosclerosis, they
are incapable of supplying enough blood and oxygen to the heart muscle
during exertion. Lack of oxygen to the heart muscle (ischemia) causes
chest pain. Also formation of a blood clot in the artery can clause
complete blockage of the artery, leading to death of heart muscle (heart
attack). Atherosclerotic disease of coronary arteries (coronary heart
disease) is the most common cause of death in the United States,
accounting for about 750,000 deaths annually.
Causes of High Cholesterol
Again, according to the cholesterol theory of heart disease,
both heredity and diet have a significant influence on a patient's LDL,
HDL and total cholesterol levels. For example, familial
hypercholesterolemia is a common inherited disorder whose victims have a
diminished number or nonexistent LDL receptors on the surface of liver
cells. The resultant decreased activity of the LDL receptors limits the
liver's ability to remove LDL cholesterol from blood. Thus, affected
family members have abnormally high LDL cholesterol levels in the blood.
They also tend to develop atherosclerosis and heart attacks during
Diets that are high in saturated fats and cholesterol decrease the
LDL receptor activity in the liver, thereby raising the levels of LDL
cholesterol in the blood. Saturated fats are derived primarily from meat
and dairy products and according to most doctors can raise blood
cholesterol levels. Some vegetable oils made from coconut, palm, and
cocoa are also high in saturated fats and are on the medical "no-no"
list. On the other hand, most vegetable oils are high in unsaturated
fats. Unlike saturated fats, unsaturated fats do not raise blood
cholesterol (again according to the theory) and can sometimes lower
cholesterol. Olive and canola oil are high in monounsaturated fats,
which may have a protective effect against coronary heart disease.
Unfortunately, some vegetable oils are converted to saturated fats
during a process called "hydrogenation" which can be required for food
Note: The concept that you might have to flush cholesterol stored in
the liver to make room for new cholesterol coming from the bloodstream
did not make its way into the cholesterol theory of heart disease.
On May 15, 2001, the National Cholesterol Education Panel (NCEP)
issued major new clinical practice guidelines on the prevention and
treatment of high cholesterol levels in adults, lowering the target
optimum level for LDL to less than 100. This was the first major update
of the NCEP guidelines since 1993. The NCEP has predicted that the new
guidelines will increase the number of Americans requiring treatment for
elevated cholesterol levels (from 52 million to 65 million) and will nearly triple the number of Americans who will need to take cholesterol lowering drugs (from 13 million to 36 million).
But for many doctors, 36 million people under experimental drug
therapy are not enough. Many “experts” are now pushing to set target
limits for LDL to less than 80, which would mandate that tens of
millions more Americans be on moderate to high doses of statin drugs for
the rest of their lives – despite the fact that these drugs are known
to cause significant liver damage.
And, of course, there are the usual assortment of FDA approved double
blind studies to back these conclusions. In the past 10 years, clinical
trials have “conclusively” demonstrated that lowering LDL cholesterol
reduces heart attacks and saves lives. The benefits of lowering LDL
- Reducing the formation of new cholesterol plaques
- Eliminating existing plaques
- Preventing rupture of existing plaques
- Decreasing the risk of heart attacks
- Lowering the chance of strokes.
So what's my problem? Quite simply, that cholesterol doesn't cause
plaque to accumulate on arterial walls. If it did, why doesn't anyone
ever have clogged veins – only clogged arteries? Think about that for a
moment. If high levels of cholesterol promoted the formation of plaque
and its accumulation on arterial walls, then why doesn't it accumulate
on the walls of veins? And the answer is – because the problem is
centered in the walls of the arteries, not in the cholesterol
circulating in the bloodstream.
Challenging the Theory
To understand what I'm talking about, it's first necessary to
understand the beneficial role that arterial plaque plays in the human
body (yes, beneficial), because therein lies the key to understanding a
key role that cholesterol plays. So what is the role of plaque? It is
“repair cement” for arterial walls. That is to say, if there is any
damage to the arterial wall, your body will whip up some plaque from the
cholesterol, calcium, and fibrin in the bloodstream to repair the
damage before the arterial wall develops a leak and you bleed to death
internally. Cholesterol isn't part of the problem, it's part of the
solution – to a different problem.
With that in mind, let's now look at some of the basic assumptions of the cholesterol theory of heart disease.
- Does eating a high cholesterol diet automatically lead to heart
disease? Absolutely not. Look at the results seen on the Atkins Diet.
- Does eating a high saturated fat diet automatically lead to
heart disease? Again, absolutely not. Consider the traditional Eskimo
diet, probably the highest saturated fat diet in the world because of
all the whale and seal blubber consumed. And yet Eskimos on that diet
have virtually no heart disease – until they shift to a modern Western
diet. The same positive results are seen with the Atkins diet with its
high consumption of saturated fats. (Both diets, however, are associated
with different problems long term. Eskimos, on the traditional diet,
for example, have an extremely high rate of osteoporosis because their
diet promotes high acid levels in body tissue.)
- Does lowering cholesterol in the diet automatically reduce cholesterol levels in the bloodstream? Not necessarily.
- Does lowering cholesterol in the bloodstream reduce the
formation of new plaques? In many cases it does, but not necessarily for
the reasons promoted. The primary reason may be that you've minimized
the ability of the body to effect repairs. You haven't got rid of the
problem – merely the ability of the problem to manifest one particular
set of symptoms.
- Do the statin drugs (Advicor, Lescol, Lipitor, Mevacor,
Pravachol and Zocor) reduce the incidence of heart attack and stroke?
Yes, but as we will discuss shortly, probably not because of their
ability to lower cholesterol, and not without significant side effects.
An Alternative Theory
I would like to propose now the “arterial damage” theory of heart
disease. Quite simply, it says that since your body produces arterial
plaque in response to arterial damage, excessive plaque build-up and the
concomitant hardening and narrowing of the arteries is the result of
excessive damage, scarring, and inflammation in the arterial walls. And
why only the arteries and not the veins? Because, as we shall see
shortly, arterial walls contain muscle tissue that is particularly
susceptible to damage. Veins contain much less muscle tissue and are
less likely to suffer damage.. So what causes damage or inflammation to
the arterial walls? Well, among other things.
- High homocysteine levels. Homocysteine is an amino acid produced
as a normal byproduct of the breakdown of methionine (from proteins),
which is an essential amino acid acquired mostly from eating meat.
Homocysteine generates superoxide and hydrogen peroxide, both of which
have been linked to damage of the endothelial lining of arterial
vessels. Studies have shown that too much homocysteine in the blood is
related to a higher risk of coronary heart disease, stroke and
peripheral vascular disease.
- Too much Omega-6 fatty acid in the diet. The body converts
linoleic acid, the primary fatty acid found in bottled vegetable oil, to
arachidonic acid. The Cox-2 enzyme then converts the arachidonic acid
to the hormone-like prostaglandin E2 (PGE2) and to the cytokines
interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor
alpha (TNFa), all of which promote inflammation in the body in general,
and in the arterial walls in particular.
- Eating high levels of meats and animal fat from grain fattened
animals saturates the body with large amounts arachidonic acid. As a
point of interest, the high levels of arachidonic acid found in most
meat are accumulated from the conversion of Omega-6 fatty acids present
in the grains used to fatten them. That means that only minimal levels
of arachidonic acid are found in range-fed beef. Iif you can find it,
range-fed beef is far healthier for you than the more common grain-fed
- High acid diets. Diets high in meat, sugar, grain, and starch
raise acid levels in body tissue – thereby making it hard for the body
to clear the lactic acid that builds up in muscle tissue from normal
muscle activity. This is a particular problem for arteries since the
arterial wall contains muscle tissue (again, veins do not) so that the
arteries can be contracted to even out blood pressure when changing
position (from lying down to suddenly standing up, for example). The
problem is that when the acid doesn't clear, it irritates, inflames, and
scars the muscle tissue in the arterial walls.
- High levels of circulating immune complexes in the blood.
Circulating immune complexes (CICs) are created when you eat complex
proteins (usually from wheat, corn, and dairy) that cannot be digested
thoroughly. They make their way into the bloodstream, where they are
treated as allergens by the body and combined with antibodies, thus
forming CICs. When the number of CICs climbs beyond the ability of the
body to eliminate them all, they are deposited in the body's soft
tissue, including the arterial walls, thereby triggering attacks by the
body's immune system, which results in inflammation.
- Inflammation in general. C-reactive protein (CRP) is an
inflammatory marker — a substance that the liver releases in response to
inflammation somewhere in the body. Studies indicate that men with high
levels of CRP have triple the risk of heart attack and double the risk of stroke
compared to men with lower CRP levels. In women, studies have shown
that elevated levels of CRP may increase the risk of a heart attack by as much as seven times.
The statin medicines (Advicor, Lescol, Lipitor, Mevacor, Pravachol and
Zocor) reduce levels of CRP. This may be more significant in accounting
for the ability of these drugs to statistically lower the incidence of
heart disease than the role these drugs play in lowering cholesterol
Solutions to Lower Cholesterol Levels
- Avoid trans fatty acids like the plague. Hydrogenated and
partially hydrogenated oils (the trans fatty acids) are the number one
killer in the modern diet.
- Optimize the liver. Do a periodic liver flush that includes the
use of lipotropic herbs such as dandelion root to flush accumulated fats
and cholesterol from the liver and gallbladder.
- Lower homocysteine levels. While there is a considerable amount
we do not know about homocysteine, we do know how to use nutritional
supplements to reduce homocysteine levels. This is done through three
independent routes: (1) using folic acid with vitamin B-12, (2) using
trimethylglycine (TMG), and (3) through B-6. The first two work through a
process called methylation, and the B-6 through transsulfuration. Such a
combined approach can normalize homocysteine in 95% of the people
- Optimize Omega-6 to Omega-3 ratios by eliminating bottled
vegetable oils found in your supermarket, except for olive oil, and
supplementing with fish oil and flax seed oil, which are high in Omega-3
fatty acids. Much of the problem with inflammatory disorders actually
stems from a lopsided imbalance in dietary intake of the omega-6 and
omega-3 fatty acids and the resulting cascade in pro-inflammatory
activity. The ideal ratio is roughly 1 to 1; however, over the past 30
years, people from industrialized countries have replaced much of their
dietary saturated fat (on the mistaken advice of their doctors and the
media) with vegetable oil omega-6 fatty acids. Ratios of 20 to 1 and 30
to 1 are now not uncommon. From a biochemical standpoint, this sets the
stage for major arterial inflammation.
- A good antioxidant formula that contains OPCs, can help repair damage to arterial walls.
- Proteolytic Enzymes. This is one of the most important things you can do. The regular use of
proteolytic enzymes can help eliminate CICs from the body, reduce
overall inflammation, dissolve accumulated plaque, and repair arterial
scar tissue. Although the evidence is purely anecdotal at the moment, we
have seen extraordinary results using detox levels of this formula.
So, is there anything to worry about with high cholesterol levels? Yes, sort of.
- High cholesterol levels are indicative of other problems – sort
of like the canary in the coal mine. Among other things, they can be a
warning signal for:
- Liver problems
- Dietary imbalance
- High acid levels
- Chronic inflammation, which may be a factor in the onset of Alzheimer's and cancer in addition to heart disease
- High cholesterol levels and high levels of saturated fat in the
blood "thicken" the blood. If the arteries are wide open, this is not a
problem. But if the arterial walls have been narrowed or hardened, the
thickened blood significantly increase the odds of a heart attack or
stroke. Of course, there are a number of natural ways to thin the blood.
Gingko biloba is a blood thinner, as is garlic, as are Proteolytic
Enzymes (particularly nattokinase).
The trick, of course, is to take care of the problem, not the warning
signal. Artificially suppressing cholesterol levels with statin drugs
is a bit like feeling good about your car because you've disconnected
your warning lights. Not very bright.
And if you're desperate to lower cholesterol levels without
subjecting yourself to the side effects of the statin drugs, supplement
with niacin and policosanol. Policosanol is a natural supplement made
from sugar cane. It works by helping the liver control its production
and breakdown of cholesterol, as well as being a powerful antioxidant
that prevents LDL oxidation. Clinical studies show that policosanol is
as effective as prescription drugs in lowering cholesterol levels,
without their dangerous side effects. And, in addition, it reduces the
inflammatory response in the arterial wall.
Just for Fun - Questions for Your Doctor
Remember, the cholesterol theory of heart disease is only a theory – a
theory that is increasingly being discredited. For those of you who
enjoy tormenting your doctor, or if you just want to see them get
flustered and angry, be sure and ask them the following questions.
- If cholesterol is the main culprit in heart disease, why don't veins ever get narrowed and blocked?
- If high cholesterol foods are responsible for raising
cholesterol levels, then why do people on the high-cholesterol Atkins
Diet experience such a significant drop in cholesterol levels?
- Why do Eskimos who eat a traditional diet of almost pure
saturated fat (whale and seal blubber) have almost a zero incidence of
- If the liver is responsible for regulating up to 80% of my
cholesterol levels, why would I want to take statin drugs for lowering
cholesterol – considering that the number one known side effect of
statin drugs is liver damage?